Search Results (3,467)

The growing challenge of biofilm-associated infections in dentistry necessitates advanced solutions. This review highlights the potential of smart bioactive and antibacterial materials—bioactive glass ceramics (BGCs), silver nanoparticle (AgNP)-doped polymers, and pH-responsive chitosan coatings—in transforming restorative dentistry. BGCs reduce biofilms by >90% while promoting bone integration. AgNP-polymers effectively combat S. mutans and C. albicans but require controlled dosing (<0.3 wt% in PMMA) to avoid cytotoxicity. Chitosan coatings enable pH-triggered drug release, disrupting acidic biofilms. Emerging innovations like quaternary ammonium compounds, graphene oxide hybrids, and 4D-printed hydrogels offer on-demand antimicrobial and regenerative functions. However, clinical translation depends on addressing cytotoxicity, standardizing antibiofilm testing (≥3-log CFU/mL reduction), and ensuring long-term efficacy. These smart materials pave the way for self-defending restorations, merging infection control with tissue regeneration. Future advancements may integrate AI-driven design for multifunctional, immunomodulatory dental solutions. Full article

Objectives: Although 3D-printing has been identified as a promising technique for personalised medicine manufacturing, developing complex formulations that are suitable for the process can be challenging. This study evaluates the use of a mixture design for the targeted development of an optimised formulation designed for the 3D-printing of oral dosage forms containing the drug sertraline hydrochloride featuring immediate-release drug dissolution. Methods: The polymers Eudragit E PO, Kollidon 17 PF and hydroxypropyl cellulose were compared in simple screening experiments regarding their extrudability, printability and disintegration. A combination of Eudragit E PO and Kollidon 17 PF proved superior and therefore served as the basis for the mixture design. The resulting blends were processed via hot melt extrusion to produce filaments, which were then measured for bending stress using a 3-point-bending-test, and 3D-printed sample plates were used to determine the crystallinity index of sertraline hydrochloride using X-ray diffraction in a previously identified range with low interference from the other components. The formulation was optimised using statistically based models with the aim of minimising the bending stress to obtain flexible, process-robust filaments and simultaneously minimising the crystallinity index with the intention of improving the solubility of the drug by maximising its amorphous content. Results: The filaments made from the optimised formulation could be reliably printed, and the amorphous state of the active ingredient therein was confirmed. The oral dosage forms produced from these showed immediate release characteristics in an acidic medium. Conclusions: This study demonstrates the advantages of a mixture design for optimising complex formulations in a time- and resource-efficient way and could serve as a basis for other research groups to develop innovative, customisable drug delivery systems more effectively. Full article

The increased incidence of periodontitis, the resistance of periodontal pathogens to antibiotics, and the adverse effects of certain drugs used in general dentistry present a strong rationale for seeking safe and effective plant-based treatments for periodontitis. HPLC-DAD analysis of a commercial herbal tincture confirmed the presence of rosmarinic acid (1102.79 ± 21.56 µg/mL), luteolin-7-O-glucoside (358.06 ± 5.64 µg/mL), and isorhamnetin (24.17 ± 0.49 µg/mL), bioactive phytochemicals known for their antimicrobial and anti-inflammatoryproperties. The randomized prospective study analyzed Tinctura paradentoica^® as an adjunct to anti-infectious non-surgical periodontal therapy (NSPT) on clinical and microbiological parameters in patients with moderate periodontitis (Stage II, Grade A). All 60 recruited participants were randomly allocated to either the intervention group (NSPT + Tinctura paradentoica^®) or the control group (NSPT alone). The rate of prevalence of the following periodontopathogenic microorganisms (Treponema denticola, Tannerella forsythensis), assessed by polymerase chain reaction (PCR) analysis, was significantly lower in the intervention group (p < 0.001), but no statistically significant difference was found for Porphyromonas gingivalis. The herbal tincture, combined with NSPT, produces a short-term reduction in periodontal clinical parameters (Green–Vermilion plaque index, bleeding on probing index (BOP), and clinical attachment level (CAL), without clinical relevance, and the prevalence of the following bacteria species (Tannerella forsythensis, Treponema denticola). Full article

Background: Large periapical cyst-like lesions pose challenges for nonsurgical management. This study evaluated the clinical and radiological outcomes of conventional endodontic therapy alone versus endodontic therapy with decompression in treating such lesions. Methods: Ten patients with CBCT-confirmed periapical lesions >5 mm were randomly assigned to two groups. Group 1 received standard root canal treatment with calcium hydroxide; Group 2 received the same protocol plus decompression. Lesion dimensions were measured in three planes using CBCT at baseline, 12 months, and 24 months. Results: Both groups showed significant lesion size reduction over time. At 12 months, Group 2 had a significantly greater mean reduction (8.49 ± 5.09 mm) compared to Group 1 (4.36 ± 1.46 mm) (p = 0.008). At 24 months, both groups had comparable outcomes (Group 1: 1.12 ± 0.98 mm; Group 2: 2.41 ± 5.15 mm; p = 0.356), with most lesions nearly or fully resolved. Histopathology confirmed radicular cysts in decompressed cases. Conclusions: Conservative endodontic therapy is effective for large periapical lesions. Adjunctive decompression accelerates early healing, particularly in extensive cases, potentially reducing the need for surgical intervention. CBCT is valuable for monitoring healing. Full article

Background/Objectives: Artificial Intelligence (AI) is improving dentistry through increased accuracy in diagnostics, planning, and workflow automation. AI tools, including machine learning (ML) and deep learning (DL), are being adopted in oral medicine to improve patient care, efficiency, and lessen clinicians’ workloads. AI in dentistry, despite its use, faces an issue of acceptance, with its obstacles including ethical, legal, and technological ones. In this article, a review of current AI use in oral medicine, new technology development, and integration barriers is discussed. Methods: A narrative review of peer-reviewed articles in databases such as PubMed, Scopus, Web of Science, and Google Scholar was conducted. Peer-reviewed articles over the last decade, such as AI application in diagnostic imaging, predictive analysis, real-time documentation, and workflows automation, were examined. Besides, improvements in AI models and critical impediments such as ethical concerns and integration barriers were addressed in the review. Results: AI has exhibited strong performance in radiographic diagnostics, with high accuracy in reading cone-beam computed tomography (CBCT) scan, intraoral photographs, and radiographs. AI-facilitated predictive analysis has enhanced personalized care planning and disease avoidance, and AI-facilitated automation of workflows has maximized administrative workflows and patient record management. U-Net-based segmentation models exhibit sensitivities and specificities of approximately 93.0% and 88.0%, respectively, in identifying periapical lesions on 2D CBCT slices. TensorFlow-based workflow modules, integrated into vendor platforms such as Planmeca Romexis, can reduce the processing time of patient records by a minimum of 30 percent in standard practice. The privacy-preserving federated learning architecture has attained cross-site model consistency exceeding 90% accuracy, enabling collaborative training among diverse dentistry clinics. Explainable AI (XAI) and federated learning have enhanced AI transparency and security with technological advancement, but barriers include concerns regarding data privacy, AI bias, gaps in AI regulating, and training clinicians. Conclusions: AI is revolutionizing dentistry with enhanced diagnostic accuracy, predictive planning, and efficient administration automation. With technology developing AI software even smarter, ethics and legislation have to follow in order to allow responsible AI integration. To make AI in dental care work at its best, future research will have to prioritize AI interpretability, developing uniform protocols, and collaboration between specialties in order to allow AI’s full potential in dentistry. Full article

Background: This paper provides the first national analysis of antimicrobial use (AMU) of oral and parenteral dosages in Bangladesh, as well as biannual trends for the years from 2019 to 2023. It also analyzes the effect of the COVID-19 pandemic on AMU. Methods: AMU was analyzed in accordance with the WHO Anatomical Therapeutic Chemical classification and defined daily doses per 1000 inhabitants per day methodology. Data on antimicrobial medicine dispatched from manufacturers’ central warehouse was collected and categorized based on the WHO’s Access, Watch, and Reserve (AWaRe) classification. Findings: This AMU surveillance demonstrates an increase in the use of antimicrobial medicines from 2021 to 2022, and in 2023, it decreased, with our national AMU surveillance data indicating that cefixime and azithromycin were the most consumed antibiotics during this period. Most antibiotics used in Bangladesh are broad-spectrum ‘Watch’-category antibiotics. Among oral antibiotics, 50 to 67% are from the ‘Watch’-category. When considering only parenteral antibiotics, 70 to 91 % fall under the ‘Watch’-category. Third-generation cephalosporin consumption has been found to be higher than second- and first-generation cephalosporins. The oral antimicrobials are more commonly used than parenteral ones. AMU notably increased during the COVID-19 pandemic, especially in the case of systemic antibacterial use. Conclusions: To achieve the global target of 70% use of Access category antibiotics by 2030, the use of Watch-group antibiotics, like cefixime, azithromycin, ciprofloxacin, levofloxacin, and ceftibuten, needs to be reduced through investing in and strengthening stewardship programs and eliminating self-medication in Bangladesh. The findings of this study provide useful information to policymakers to tackle AMR in Bangladesh. Full article

Plasma technology is an emerging method for implant surface decontamination and modification. This in vitro study evaluates the effects of plasma treatment on fibroblast and osteoblast adhesion, proliferation, and differentiation on titanium surfaces. Plasma was applied to machined and rough titanium discs, followed by surface characterization using scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and hydrophilicity testing. SEM imaging, cell viability assays, and immunohistologic staining were used to assess cell behaviour in response to treatment, while RNA sequencing evaluated gene expression related to differentiation. Although no significant architecture changes were observed with plasma treatment, XPS revealed a significant reduction in carbon content (p < 0.001), indicating decreased hydrocarbon contamination. Plasma treatment significantly increased surface hydrophilicity in both machined and rough surfaces (p < 0.0001). SEM and IHC imaging showed greater early-stage cell attachment for both fibroblasts and osteoblasts, though differences diminished after 12 h. RNA sequencing revealed time-dependent gene expression in both cell types, with Apln and Crabp2 significantly upregulated at 6 h in the plasma-treated fibroblast group. In conclusion, plasma treatment reduces hydrocarbon buildup, enhances hydrophilicity, promotes early cell attachment, and upregulates genes linked to angiogenesis and proliferation. Further studies are needed to determine its clinical significance in managing peri-implant disease. Full article

Background/Objectives: Frailty syndrome favors the deterioration of health; therefore, identifying associated factors is essential for establishing preventive measures. Oral candidiasis is a factor that may be related to the onset of frailty. Our objective was to evaluate the association between frailty and oral candidiasis in institutionalized participants. Methods: We conducted a cross-sectional study involving 589 institutionalized individuals aged 65 years or older. A diagnosis of candidiasis was established clinically and with a microbiological study (potassium hydroxide (KOH) test and culture for candidiasis). Assessments of salivary flow and the use of dental prostheses were also performed. Frailty was classified according to Fried’s phenotype criteria. Results: Frailty and prefrailty were found in 28.9% and 66.7% of the participants, respectively. Oral candidiasis was diagnosed in 39.05% of cases and was more frequent among individuals with dental prostheses (49.13%) and hyposalivation (47.54%). Conclusions: Our findings suggest that frailty in institutionalized older adults is associated with the presence of subprosthetic stomatitis associated with candidiasis and hyposalivation, indicating the need for integrated oral health strategies in geriatric care. Full article

Vervain (Verbena officinalis L., Verbenaceae family) is a perennial plant which grows widely in Europe. It is rich in iridoids, phenolic acids, phenylpropanoid glycosides, flavonoids and terpenoids. Verbena has traditionally been used in folk medicine to calm the nervous system, but there is a lack of scientific data about it. The aim of this study was to explore and characterise the chemical profile and neurotropic effects of V. officinalis dry extracts and their amino acid-based preparations. We determined a total of eight main phenolic compounds and 17 amino acids in the V. officinalis dry extracts. To evaluate the neurotropic effects of the verbena extracts, the following behavioural pharmacology tests were used: Open Field Test, Elevated Plus Maze, Black-and-White Box Test and Tail Suspension Test. The dry aqueous–ethanolic extract (extractant 70% ethanol) demonstrated strong anxiolytic and antidepressant effects, while its dry modified extracts with valine and arginine consistently exhibited pronounced sedative activity across all studies. For example, the Tail Suspension Test demonstrated that the total immobility time in animals receiving the dry aqueous–ethanolic extract was the lowest, being 1.22-fold (p < 0.05) lower than in control animals and 2.25-fold (p < 0.05) lower than in the animals treated with the reference drug preparation (“Sedaphyton”). A novel aqueous-based gel formulation feasible for semi-solid extrusion (SSE) 3D printing was designed. This printing gel enables the fabrication of new oral dosage forms for V. officinalis dry extracts. The effects of pharmaceutical preparations on the human central nervous system require clinical studies. Full article

Background/Objectives: The impact of nutritional interventions on Sjögren disease (SD) remains uncertain, and no standardized guidelines currently exist for managing its sicca symptoms. This systematic review evaluated the effects of dietary interventions on the symptoms of dry mouth and dry eyes in individuals with SD. Methods: Electronic searches were performed in four databases, supplemented by manual searches and searches of the gray literature. Both human and animal studies were included. The methodological quality of the selected studies was appraised, and the data were analyzed descriptively. Results: A total of nineteen studies (ten in humans and nine in animal models) were included. The treatments evaluated were dietary supplements, vitamins, medicinal herbs, and specially modified diets. The primary outcomes assessed included unstimulated and stimulated whole salivary flow rates, salivary-gland inflammation, and ocular dryness (Schirmer test). In animal models of SD, interventions such as caloric restriction, gluten-free diets, low-fat diets, and supplements (e.g., resveratrol, triptolide, and Lycium barbarum polysaccharide) were associated with increased salivary flow and reduced glandular inflammation. Conversely, diets rich in saturated fats were associated with reduced salivary flow and increased lymphocytic infiltration in salivary glands. Human studies yielded mixed results, with some reporting improvements in salivation following interventions with vitamins, herbal supplements, gluten-free diets, liquid diets, and whole-food, plant-based diets. Conclusions: Although dietary management may alleviate sicca symptoms and improve nutritional status in SD, the current evidence is insufficient to support specific recommendations for the management of oral symptoms. Full article

The aim of this study was to evaluate whether combined administration of olive leaf extract (OLE) with standard antifungal therapy—nystatin (NYS) or miconazole (MIC) could be a more efficient alternative in reducing the number of Candida colonies, the presence of oral signs and symptoms and changes in salivary IL-17A level compared to standard therapy alone. The study included 59 subjects with a positive microbiological Candida colony number greater than 600 CFU/mL and at least one oral sign or symptom present. Subjects were randomly divided into four groups depending on applied therapy: OLE + NYS group (n = 15), OLE + MIC group (n = 15), NYS group (n = 14), MIC group (n = 15). Therapy duration and clinical monitoring were standardized across all groups. There was no significant difference between the tested groups in Candida spp. colony number or salivary IL-17A levels. In the OLE + NYS group, a significant increase in salivation rate was observed, while a significant decrease in tongue burning was reported in the OLE + MIC group. A significant reduction in burning of the oral mucosa and tongue was observed in the MIC group. No significant differences were found in other clinical signs or symptoms among treatment groups. OLE, as an adjunct to standard antifungal therapy, did not significantly reduce Candida spp. colony number or salivary IL-17A levels. However, in combination with NYS it increased salivation rate, while in combination with miconazole, it significantly decreased tongue burning. Both symptoms are common clinical findings in oral Candida-related disease and suggest that OLE may have supportive potential in the clinical management of these conditions. Further research is needed to explore its potential therapeutic benefits on oral health. Full article

Background/Objectives: Diabetes mellitus (DM) is an increasingly prevalent endocrine disorder affecting humans and companion animals. Type 1 DM (T1DM) and type 2 DM (T2DM) are well characterized in humans, and canine DM most often resembles T1DM, marked by insulin dependence and β-cell destruction. Conversely, feline DM shares key features with human T2DM, including insulin resistance, obesity-related inflammation, and islet amyloidosis. This review provides a comprehensive comparative analysis of antidiabetic therapies in humans, dogs, and cats, focusing on three core areas: disease pathophysiology, pharmacological and delivery strategies, and translational implications. In human medicine, a wide array of insulin analogs, oral hypoglycemic agents, and incretin-based therapies, including glucagon-like peptide-1 receptor agonists (liraglutide) and sodium-glucose cotransporter-2 inhibitors (empagliflozin), are available. Veterinary treatments remain limited to species-adapted insulin formulations and off-label use of human drugs. Interspecies differences in gastrointestinal physiology, drug metabolism, and behavioral compliance influence therapeutic efficacy and pharmacokinetics. Recent innovations, such as microneedle patches for insulin delivery and continuous glucose monitoring systems, show promise in humans and animals. Companion animals with naturally occurring diabetes serve as valuable models for preclinical testing of novel delivery platforms and long-acting formulations under real-world settings. While these technologies show potential, challenges remain in regulatory approval and behavioral adaptation in animals. Conclusions: Future research should prioritize pharmacokinetic bridging studies, veterinary-specific formulation trials, and device validation in animal models. By highlighting shared and species-specific characteristics of DM pathogenesis and treatment, this review advocates a One Health approach toward optimized antidiabetic therapies that benefit human and veterinary medicine. Full article

Inflammatory bowel diseases (IBDs), such as ulcerative colitis, and Crohn’s disease are chronic idiopathic inflammatory diseases of the gastrointestinal system involving interaction between genetic and environmental factors mediating the occurrence of oxidative stress and inflammation. There is no permanent cure for IBD except long-term treatment or surgery (resection of the intestine), and the available agents in the long term appear unsatisfactory and elicit numerous adverse effects. To keep the disease in remission, prevent relapses and minimize adverse effects of currently used medicines, novel dietary compounds of natural origin convincingly appear to be one of the important therapeutic strategies for the pharmacological targeting of oxidative stress and inflammation. Therefore, it is imperative to investigate plant-derived dietary agents to overcome the debilitating conditions of IBD. In the present study, the effect of α-Bisabolol (BSB), a dietary bioactive monoterpene commonly found in many edible plants as well as important components of traditional medicines, was investigated in acetic acid (AA)-induced colitis model in rats. BSB was orally administered to Wistar male rats at a dose of 50 mg/kg/day either for 3 days before or 30 min after induction of IBD for 7 days through intrarectal administration of AA. The changes in body weight, macroscopic and microscopic analysis of the colon and calprotectin levels in the colon of rats from different experimental groups were observed on day 0, 2, 4, and 7. The levels of myeloperoxidase (MPO), a marker of neutrophil activation, reduced glutathione (GSH) and malondialdehyde (MDA), a marker of lipid peroxidation, and the levels of pro-inflammatory cytokines were measured. AA caused a significant reduction in body weight and induced macroscopic and microscopic ulcers, along with a significant decline of endogenous antioxidants (superoxide dismutase (SOD), catalase, and GSH), with a concomitant increase in MDA level and MPO activity. BSB significantly improved the AA-induced reduction in body weight, colonic mucosal histology, inhibited MDA formation, and restored antioxidant levels along with a reduction in MPO activity. AA also induced the release of pro-inflammatory cytokines such as interleukin-1 (IL-1), interleukin-23 (IL-23) and tumor necrosis factor-α (TNF-α). Furthermore, AA also increased levels of calprotectin, a protein released by neutrophils under inflammatory conditions of the gastrointestinal tract. BSB treatment significantly reduced the release of calprotectin and pro-inflammatory cytokines. The findings of the present study demonstrate that BSB has the potential to improve disease activity and rescue colonic tissues from damage by inhibiting oxidative stress, lipid peroxidation and inflammation. The findings are suggestive of the benefits of BSB in IBD treatment and substantiate its usefulness in colitis management, along with its gastroprotective effects in gastric ulcer. Full article

The oral microbiota, long recognized for their role in local pathologies, are increasingly implicated in systemic disorders, particularly cardiovascular disease (CVD). This review focuses on emerging evidence linking oral dysbiosis to neuroglial activation and autonomic dysfunction as key mediators of cardiovascular pathology. Pathogen-associated molecular patterns, as well as gingipains and leukotoxin A from Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola, Aggregatibacter actinomycetemcomitans, etc., disrupt the blood–brain barrier, activate glial cells in autonomic centers, and amplify pro-inflammatory signaling. This glia driven sympathetic overactivity fosters hypertension, endothelial injury, and atherosclerosis. Crucially, sex hormones modulate these neuroimmune interactions, with estrogen and testosterone shaping microbial composition, glial reactivity, and cardiovascular outcomes in distinct ways. Female-specific factors such as early menarche, pregnancy, adverse pregnancy outcomes, and menopause exert profound influences on oral microbial ecology, systemic inflammation, and long-term CVD risk. By mapping this oral–brain–heart axis, this review highlights the dual role of oral microbial virulence factors and glial dynamics as mechanistic bridges linking periodontal disease to neurogenic cardiovascular regulation. Integrating salivary microbiome profiling with glial biomarkers [e.g., GFAP (Glial Fibrillary Acidic Protein) and sTREM2 (soluble Triggering Receptor Expressed on Myeloid cells 2)] offers promising avenues for sex-specific precision medicine. This framework not only reframes oral dysbiosis as a modifiable cardiovascular risk factor, but also charts a translational path toward gender tailored diagnostics and therapeutics to reduce the global CVD burden. Full article