Search Results (2,080)

Tooth-bearing structures are commonly involved in the spread of various odontogenic lesions. Radicular and dentigerous cysts are among the most common odontogenic cysts, exhibiting significant variations in size and morphology within the jawbones. On the other hand, the influence of dental caries, periodontal diseases, and periapical lesions extends beyond tooth-bearing bone and also affects adjacent anatomical structures, especially the maxillary sinuses. In addition to untreated odontogenic lesions, treatment-related complications in the posterior maxilla may also disturb the sinus environment, particularly when oroantral communication is not recognized or adequately managed. The etiology of sinusitis is multifactorial; however, tooth-related infections are the primary cause of odontogenic sinusitis (ODS). Routine upper posterior tooth extraction may also become clinically significant when pre-existing sinus mucosal changes, close sinus floor proximity, or persistent oroantral communication are overlooked. When ODS is undiagnosed or overlooked on a classic computed tomography or a cone beam computed tomography (CBCT) scan, it is frequently inadequately managed by otolaryngological interventions alone; this leaves the underlying dental pathology unaddressed. Consequently, the utilization of CT/CBCT and close collaboration between dentists, oral surgeons, and otolaryngologists are essential for the successful management of these conditions. In advanced cases of ODS, isolated intranasal otolaryngological procedures are often insufficient. Comprehensive management relies on the elimination of all sources of odontogenic infection through endodontic therapy, dental extractions, and localized bone curettage. While the traditional Caldwell–Luc approach (CLA) is not commonly used nowadays, it remains an important surgical option in select cases, especially when infection spreads beyond tooth-bearing structures or soft tissue abscesses are present. This paper presents the radiological and clinical findings of two ODS cases with different etiologies and demonstrates how these findings influenced surgical planning. The aim is not to introduce the Caldwell–Luc approach as a novel technique but to illustrate its selective role when the direct treatment of the odontogenic source and oroantral defect is required. Full article

Background: Periodontitis and psoriasis are chronic inflammatory diseases that share common risk factors and immune-mediated pathogenic pathways, suggesting a potential bidirectional relationship. Periodontal inflammation contributes to systemic inflammatory burden, which may influence the severity of immune-mediated diseases, such as psoriasis. Objective: The aim of this systematic review is to evaluate the effects of periodontal therapy on psoriasis severity in patients affected by both conditions. Methods: This review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251155439). Eligible studies included adults (≥18 years) with both psoriasis and periodontitis undergoing periodontal therapy compared with no periodontal treatment. The primary outcome was Psoriasis Area and Severity Index (PASI), while secondary outcomes included periodontal clinical parameters (PPD, CAL, FMBS). Results: A total of 228 records were identified; after screening and full-text evaluation, two randomized controlled trials, including a total of 166 patients, met the inclusion criteria. Both studies evaluated non-surgical periodontal therapy and reported significant reductions in PASI scores in treated patients compared with controls. Periodontal parameters (PPD, CAL, FMBS) also improved significantly following treatment in both studies. Conclusions: Evidence from the included trials indicates that non-surgical periodontal therapy may reduce psoriasis severity while simultaneously improving periodontal health in patients with both conditions. Periodontal treatment may serve as a beneficial adjunct to dermatological therapy. However, findings are limited by small sample sizes and short follow-up periods. Larger, long-term randomized controlled trials are needed to confirm these results. Full article

Background: Periodontitis is associated with elevated circulating C-reactive protein (CRP), but the extent to which CRP changes after nonsurgical periodontal therapy remains uncertain. This systematic review and meta-analysis examined within-participant changes in serum CRP and considered controlled evidence separately. Methods: PubMed/MEDLINE, the Cochrane Library, and SciELO were searched through August 2025. For uncontrolled pre-post studies reporting periodontitis-specific paired data, mean CRP reductions in mg/L were pooled using a random-effects model with restricted maximum likelihood and Hartung-Knapp confidence intervals. When the standard deviation (SD) of change was unavailable, it was calculated assuming a pre-post correlation of 0.50; correlations of 0.25 and 0.75 were examined in sensitivity analyses. Controlled trials were not pooled with uncontrolled studies. The protocol was retrospectively registered in the Open Science Framework before the quantitative analyses. Results: Five studies were included in the systematic review. Three uncontrolled studies comprising 119 participants contributed to the primary meta-analysis. The pooled within-participant reduction in CRP was 1.11 mg/L (95% CI: 0.21 to 2.01), with considerable heterogeneity (I² = 80.8%). The result was stable across the assumed correlations. In the only trial comparing periodontal treatment with a control condition for which an effect could be calculated, the difference in mean changes was 2.95 mg/L (95% CI: −0.50 to 6.40) and was not statistically significant. Conclusions: CRP decreased after nonsurgical periodontal therapy in uncontrolled pre-post studies, but this finding does not establish a controlled treatment effect. Controlled evidence was limited and imprecise, and the clinical relevance of the biomarker change remains uncertain. Full article

Background/Objectives: Surgical periodontal therapy is frequently performed when residual periodontal pockets persist after scaling and root planing (SRP). This study compared the clinical outcomes of SRP alone and SRP followed by surgical periodontal therapy in patients with stage III/IV periodontitis. Methods: A retrospective comparative study was conducted in 180 adults with stage III/IV periodontitis. Ninety patients received SRP alone, while ninety underwent SRP followed by surgical periodontal therapy when clinically indicated. Probing depth (PD), clinical attachment level/loss (CAL), and bleeding on probing (BOP) were recorded at baseline and at a 12-week reevaluation. Results: PD reduction was significantly greater in the SRP followed by surgical therapy group than in the SRP-alone group (p < 0.001). BOP also showed a significantly greater reduction following surgical therapy (p < 0.001). CAL improved in both groups; however, the between-group difference was not statistically significant (p = 0.104). Conclusions: Both treatment approaches improved periodontal clinical parameters. However, SRP followed by surgical periodontal therapy resulted in greater reductions in probing depth and bleeding on probing, while CAL improvement was similar between groups. Full article

Background/Objectives: Chronic hyperglycemia drives gingival fibroblast dysfunction, disrupting extracellular matrix homeostasis and the migratory capacity required for wound healing, which contributes to increased periodontal susceptibility in diabetes. Ferulic acid (FA), a dietary phenolic compound with antioxidant and anti-inflammatory properties, has demonstrated wound-healing activity in various tissues; however, its effects on human gingival fibroblasts (HGFs) under hyperglycemic conditions remain unclear. This study investigated the effects of FA on HGF viability, wound closure, and the secreted concentrations of matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinase-1 (TIMP-1), and interleukin-6 (IL-6) under normoglycemic and hyperglycemic conditions. Methods: Cultured HGFs (HGF-1 cell line) were pre-conditioned for 72 h under normal glucose (5.5 mM) or high glucose (25 mM), with an iso-osmolar mannitol control to distinguish glucose-specific effects from osmotic changes. Viability was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and wound closure by scratch assay following FA treatment, while MMP-1, TIMP-1, and IL-6 concentrations in conditioned medium were quantified by enzyme-linked immunosorbent assay (ELISA). Results: FA was non-cytotoxic at all tested concentrations, whereas 50 µM transiently increased viability. FA significantly enhanced wound closure under both conditions, independent of osmotic effects. High glucose increased IL-6 concentration in the conditioned medium (significant at 48 h) and MMP-1 levels. FA partially attenuated MMP-1 levels at specific time points, modestly reduced IL-6 levels, and markedly increased TIMP-1 concentration under both glucose conditions. Conclusions: FA enhanced wound closure in scratch assay and shifted the secreted MMP-1/TIMP-1 concentration ratio toward a more favorable, matrix-protective profile at the protein level, without cytotoxicity, supporting further investigation of its potential role in periodontal tissue repair under high glucose conditions. Full article

Canine periodontitis is one of the most prevalent chronic diseases for dogs over two years of age. Periodontal pockets may serve as a reservoir for opportunistic bacteria including Pasteurella stomatis, Neisseria animaloris, and Streptococcus canis; however, data on their antimicrobial susceptibility and potential One Health relevance remain limited. This pilot study investigated culturable bacterial isolates recovered from periodontal pockets of dogs with different stages of periodontal disease. Subgingival samples were collected under general anesthesia after periodontal probing and dental radiographic assessment during routine comprehensive oral health assessment and treatment (COHAT) procedures. Bacterial isolates were cultured, identified using MALDI-TOF MS, and tested for minimum inhibitory concentrations (MIC) against amoxicillin (AML), doxycycline (DX), trimethoprim–sulfamethoxazole (SXT), gentamicin (CN), chloramphenicol (C), and ciprofloxacin (CIP). In total, 122 isolates from 101 dogs were analyzed, including Pasteurella stomatis (n = 54), Neisseria animaloris (n = 33), and Streptococcus canis (n = 35). MIC distributions varied between bacterial species and antimicrobial agents, while interpretation was limited by the lack of species-specific veterinary medicine breakpoints for some isolates. These preliminary findings highlight the need for larger standardized studies to support antimicrobial resistance surveillance in canine oral microbiota. Full article

Background/Objectives: Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunct to non-surgical periodontal therapy, although its benefits remain debated. This study evaluated the clinical and microbiological effects of aPDT combined with ultrasonic scaling and root planing (US-SRP) compared with US-SRP alone in patients with periodontitis. Methods: In this randomized split-mouth clinical trial, 40 patients with stage II–III periodontitis were included. Two non-adjacent sites with probing pocket depth (PPD) ≥ 5 mm were assigned to either control (US-SRP) or test (aPDT + US-SRP) treatment. Clinical parameters, including PPD, bleeding on probing (BOP), plaque index (PI), gingival recession (REC), and clinical attachment level (CAL), were assessed at baseline and after 90 days. Subgingival plaque samples were analyzed by multiplex PCR for major periodontal pathogens. Results: No statistically significant differences were detected for microbiological outcomes at 90 days between groups. Significant greater variations were observed at T3 in the aPDT group for PPD (p = 0.04), BOP (p = 0.03) and PI (p = 0.005), whereas the control group showed a significant reduction only for PI (p = 0.01). Regarding comparisons of Δ(T0–T3) between the aPDT group and the control group, the paired t-test was significant for PPD, REC and CAL (p < 0.001), with a Cohen’s d_av < 0.5 for all three parameters (small effect sizes). In addition, the aPDT group showed a statistically significant reduction in BOP (p = 0.03 *) from T0 (92%) to T3 (50%). Exploratory analyses confirmed the same trend for BOP reduction in the aPDT group both in smokers and non-smokers. Conclusions: Despite the fact that adjunctive aPDT seems to offer predictable clinical outcomes in terms of PPD and BOP reductions, further larger and stratified studies are needed to verify if this treatment can provide superior benefits compared with conventional non-surgical periodontal therapy. Full article

Background/Objectives: Gingival recession frequently affects the anterior mandibular region. Anatomical features, such as thin buccal bone, narrow keratinized gingiva, and root proximity, increase susceptibility to periodontal disease. Recession can progress over time and may be exacerbated by orthodontic treatment. However, it remains uncertain whether the severity of crowding before treatment contributes to recession after orthodontic therapy The present study aimed to determine whether a relationship exists between the degree of mandibular anterior crowding before orthodontic treatment and the development or progression of gingival recession after treatment completion. Methods: This retrospective study was conducted on 269 participants with pre- and post-treatment records. The Little’s irregularity index was used to assess the degree of crowding. Clinical photographs of the six mandibular anterior teeth (1614 sites) were digitally calibrated permit millimeter-based assessment of gingival recession and keratinized tissue (KT) width. Oral hygiene (OH) was also evaluated at both time points. Results: Post-treatment recession was detected in 76 teeth. (4.7% of sites) among 48 participants (17.8%). Pretreatment crowding severity was not significantly associated with the occurrence of recession after treatment. Pretreatment mucogingival deformities were independently associated with post-treatment gingival recession. Mandibular central incisors demonstrated the highest prevalence of post-treatment gingival recession. Conclusions: Pretreatment mandibular anterior did not appear to predict gingival recession at treatment completion. Periodontal characteristics may play a more important role in recession development, supporting careful periodontal evaluation before and throughout orthodontic care. Full article

Background/Objectives: Provisional restorations are essential for maintaining oral function, esthetics, periodontal health, and patient comfort during prosthodontic treatment. This study evaluated current clinical practices, material preferences, fabrication techniques, and digital technology adoption among Romanian dental practitioners. Methods: A cross-sectional survey was conducted between January and March 2025. The questionnaire was sent directly to a predefined closed list of 150 licensed dental practitioners, of whom 95 submitted complete responses (response rate: 63.3%). The questionnaire assessed professional characteristics, materials and fabrication techniques used for provisional restorations, attitudes toward digital technologies, educational sources, and clinical complications. Data were analyzed using descriptive statistics, association tests, and exploratory multivariable logistic regression. Results: Composite resin (77.9%) and acrylic resin (65.3%) were the most frequently reported materials. Direct fabrication was used by 51.6% of respondents, while 42.1% used indirect techniques. An affirmative response to the general item concerning current digital technology use was provided by 47.4% of participants. Faster and more efficient fabrication and superior intraoral adaptation were the principal perceived advantages of 3D-printed restorations, whereas high equipment and material costs represented the main perceived disadvantage. The exploratory multivariable analysis identified no statistically significant independent associations with digital technology utilization. Debonding (44.2%) and fracture (42.1%) were the most frequently reported complications. Conclusions: Among the surveyed practitioners, conventional materials and fabrication techniques remained widely used, while digital workflows showed incomplete integration. Larger, representative studies using clearly defined technology-specific outcomes are needed to evaluate the determinants and clinical implications of digital adoption in provisional prosthodontics. Full article

Background/Objectives: To evaluate the clinical and microbiological effects of adjunctive gaseous ozone therapy combined with full-mouth ultrasonic debridement and scaling and root planing (FMUD–SRP) in patients with generalized periodontitis. Materials and Methods: Thirty-nine patients with stage II–IV generalized periodontitis were enrolled in a randomized split-mouth clinical trial. Quadrants were assigned to receive FMUD–SRP alone or FMUD–SRP plus adjunctive gaseous ozone therapy. Ozone (2100 ppm, 80% oxygen) was applied subgingivally immediately after instrumentation during three treatment sessions. Clinical parameters were recorded at baseline, 45, and 90 days. Subgingival plaque samples were analyzed using qualitative polymerase chain reaction to detect six periodontal pathogens. Results: Both treatments resulted in significant clinical improvements over time (p < 0.05). At 90 days, ozone-treated sites showed greater probing pocket depth reduction (−1.6 ± 0.8 mm vs. −1.2 ± 0.8 mm; p = 0.02) and clinical attachment level gain (−1.1 ± 1.0 mm vs. −0.6 ± 1.0 mm; p = 0.03) compared with control sites. No significant intergroup differences were observed for bleeding on probing, plaque index, or gingival recession. A significantly greater reduction in the detection frequency of periodontal pathogens was observed in the ozone group, including complete suppression of Treponema denticola and marked reductions in other anaerobic species. Conclusions: Adjunctive gaseous ozone therapy enhances the clinical outcomes of non-surgical periodontal treatment and exerts a selective antimicrobial effect against anaerobic periodontal pathogens. Full article

This narrative review aimed to summarize the contemporary evidence regarding the integration of periodontal and prosthodontic treatment. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar, including studies published between January 1990 and May 2026. Relevant studies, systematic reviews, meta-analyses, consensus reports, and clinical guidelines published in English were analyzed. Current evidence highlights the importance of comprehensive periodontal assessment before prosthodontic treatment, including evaluation of probing depth, attachment loss, furcation involvement, tooth mobility, periodontal phenotype, and oral hygiene status. Appropriate periodontal preparation and supportive periodontal care contribute significantly to the long-term success of both tooth-supported and implant-supported restorations. Successful oral rehabilitation requires close interdisciplinary collaboration between periodontology and prosthodontics. Periodontal stability, patient compliance, and long-term maintenance remain key factors for predictable treatment outcomes. Full article

Background: Periodontitis is a chronic inflammatory disease characterized by a dysbiotic oral microbiome that leads to progressive periodontal tissue destruction. Current treatment primarily relies on scaling and root planing (SRP); however, this approach does not always completely eliminate pathogenic microorganisms or adequately modulate the host inflammatory response. Cold atmospheric plasma (CAP) generates reactive oxygen and nitrogen species (RONS) with potential antimicrobial, antibiofilm, and immunomodulatory properties, making it a promising adjunctive therapeutic modality for the management of periodontitis. Literature Search Strategy: A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Embase to identify relevant studies published between January 2000 and June 2025. The search included in vitro, in vivo, and clinical studies evaluating the antimicrobial, immunomodulatory, and regenerative effects of CAP in periodontitis and related periodontal models. Reference lists of relevant articles were also manually screened to identify additional eligible studies. Objectives: This review aims to provide a comprehensive overview of the antimicrobial and immunomodulatory effects of CAP on periodontitis and to evaluate its potential as an adjunctive treatment modality. Furthermore, the review examines the regenerative potential and underlying mechanisms of CAP, while also addressing its clinical safety and biocompatibility. Key Findings: Preclinical evidence indicates that CAP reduces bacterial viability, disrupts biofilm architecture, and modulates host immune responses through RONS-mediated signaling pathways. In animal models of periodontitis, CAP has been shown to enhance markers of periodontal tissue repair, reduce the expression of pro-inflammatory cytokines, increase LC3-associated phagocytosis in macrophages, and accelerate wound healing. Clinical studies evaluating CAP as an adjunct to SRP have reported improvements in clinical attachment level (CAL) and reductions in the recolonization of periodontal pathogens. Nevertheless, substantial heterogeneity in CAP treatment parameters and a lack of long-term safety and efficacy data limit direct comparisons across studies and highlight the need for further well-designed clinical investigations. Conclusions: CAP appears to be a potentially useful adjunct to SRP in the management of periodontitis. Current preclinical evidence demonstrates significant antimicrobial, immunomodulatory, and regenerative effects; however, clinical evidence remains limited. Further high-quality clinical trials are required to validate these findings, establish standardized treatment protocols, optimize therapeutic parameters, and facilitate the development of regulatory frameworks for clinical implementation. Full article

Objectives: The aim of this study was to evaluate the influence of systemic lutein (LT) supplementation on the progression of experimental periodontitis (EP) and its impact on mechanical periodontal therapy (SRP) in rats. Methods: A total of 120 male Wistar rats were used, and EP was induced by placing a ligature around the left mandibular first molar. The animals were allocated into four groups: NT (no treatment)/VEH (vehicle), NT/LT, SRP/VEH and SRP/LT. Supplementation was administered daily by oral gavage (0.7 mL/kg of vehicle or 250 mg/kg of LT). Animals were euthanized at 7, 15 and 30 days, and the hemimandibles were collected for histomorphometric analysis of the percentage of bone in the furcation region (PBF), histopathological assessment and immunohistochemical detection of inflammatory mediators (tumor necrosis factor-alpha, interleukin-1β and interleukin-10) and bone markers (tartrate-resistant acid phosphatase and osteocalcin). Results: Systemic LT supplementation, particularly when associated with scaling and root planning (SRP/LT), reduced the intensity and extent of the inflammatory infiltrate, partially decreased immunolabelling for IL-1β and TNF-α, and promoted greater organization of the connective tissue. Higher PBF values and fewer TRAP-positive cells were observed in LT-treated groups. Conclusions: Systemic LT supplementation reduced inflammation and alveolar bone resorption and enhanced the effects of mechanical periodontal therapy. Full article

Background/Objectives: Self-injurious behavior (SIB) is one of the most disabling manifestations of Lesch–Nyhan disease (LND), frequently involving the oral cavity and severely affecting patients’ quality of life and caregiver burden. Evidence regarding the impact of dental interventions on patient- and caregiver-reported outcomes remains limited. This study investigated the characteristics of SIB in patients with LND and explored the perceived effectiveness, tolerability, and psychosocial impact of intraoral devices and dental extractions. Methods: A questionnaire-based observational study was conducted among patients with LND. A purpose-built 32-item questionnaire, developed by dentists with expertise in Special Care Dentistry at Mauriziano Umberto I Hospital (Turin, Italy), was administered to patients attending the Pediatric Dentistry and Orthodontics Unit at IRCCS Istituto Giannina Gaslini (Genoa, Italy). The questionnaire assessed demographic and clinical characteristics, SIB features, dental management strategies, treatment-related complications, and patient- and caregiver-reported outcomes. Results: Twenty-four questionnaires were analyzed. SIB was reported in 21 patients (87.5%). Fingers (80%) and lips (70%) were the most frequently affected sites, with multiple anatomical sites involved in 80% of patients. Intraoral devices were used in 14 patients (66.7%), whereas dental extractions were performed in 4 (19%). Among patients treated with intraoral devices, 78.6% reported increased reassurance and protection. Device-related complications occurred in three patients and were mainly periodontal. All patients and caregivers reported relief following dental extraction, although SIB persisted in 50% of cases. Conclusions: SIB is highly prevalent among individuals with LND and commonly affects multiple anatomical sites. Intraoral devices are the most frequently adopted treatment strategy and are generally well tolerated, whereas dental extractions were associated with substantial perceived relief but do not necessarily eliminate SIB. Patient- and caregiver-reported outcomes should be considered when evaluating treatment effectiveness. Full article

Periodontitis, a chronic inflammatory disease driven by plaque biofilm, is a leading cause of tooth loss in adults worldwide. Effective treatment requires not only infection and inflammation control but, more critically, functional regeneration of the periodontal ligament, cementum, and alveolar bone. Periodontal regeneration, however, is a highly ordered, multi-stage biological cascade involving temporally coordinated phases of blood clot formation, inflammatory regulation, tissue formation, and remodeling. Conventional single-drug or mixed-delivery strategies cannot distinguish the distinct demands of each healing phase and fail to replicate this natural rhythm. Sequential controlled-release systems address this gap by delivering multiple bioactive agents (antimicrobials, immunomodulators, and growth factors) in a programmed order tailored to the healing cascade, enabling precise modulation of the periodontal microenvironment and orderly tissue regeneration. This review systematically summarizes advances in these systems, classifying material platforms into four categories: (1) diffusion-barrier and degradation-kinetics systems, including multilayer films, core–shell fibers, porous microspheres, and microneedle arrays; (2) stimuli-responsive systems triggered by pH, matrix metalloproteinases, reactive oxygen species, or exogenous physical stimuli; (3) cell and extracellular vesicle-based systems exploiting the inflammatory tropism of M2 macrophage-derived exosomes for targeted immune reprogramming; and (4) asymmetric structural designs achieving spatiotemporal coordination of physical and biochemical signals through hierarchical architectures. These systems follow an anti-infection/anti-inflammation first, osteogenesis later therapeutic logic, circumventing temporal antagonism among bioactive factors. However, significant challenges hinder clinical translation, including individualized prediction of release kinetics, long-term biocompatibility of carrier materials, material retention under dynamic oral conditions, translational limitations of animal models, and precise regulation of complex factor networks. Future progress will likely depend on multi-responsive and logic-gated systems, deeper integration of biotechnology and immunomodulation, personalized precision medicine, AI-driven material design, and robust clinical translational research. Full article