Dentistry Journal

Research

16 pages, 4765 KiB

Open AccessArticle

In Vitro Evaluation of the Antibacterial Properties and Cellular Response of Liquid-Leukocyte Platelet-Rich Fibrin Products on Barrier Membranes: A Pilot Study

by Nichol Chun Wai Tsang, Aneesha Acharya and Georgios Pelekos

Dent. J. 2025, 13(6), 228; https://doi.org/10.3390/dj13060228 - 22 May 2025

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Abstract

Background: Barrier membranes (BMs) have been used in dental surgical procedures for decades, but their exposure can increase the risk of infections and compromise healing from regenerative procedures. Liquid-leukocyte platelet-rich fibrin (LPRF) products have shown antimicrobial effects and enhance wound healing. This in [...] Read more.

Background: Barrier membranes (BMs) have been used in dental surgical procedures for decades, but their exposure can increase the risk of infections and compromise healing from regenerative procedures. Liquid-leukocyte platelet-rich fibrin (LPRF) products have shown antimicrobial effects and enhance wound healing. This in vitro study aimed to evaluate the antimicrobial effects and cellular responses of LPRF products as adjunctive treatments for barrier membranes, hypothesizing that the two liquid LPRF products could improve antibacterial activity against selected oral pathogen species and augment human gingival fibroblast cellular proliferation on BM. Methods: LPRF exudate (LPRF-EX) and liquid fibrinogen (PLyf), human LPRF products, were prepared with recommended centrifugation protocols and used to treat resorbable (Bio-gide^®) and non-resorbable (Cyto-plast™) BMs. Human gingival fibroblasts (HGFs) were cultured on the treated and untreated BMs. Scanning electron microscopy (SEM) was applied to observe cell adhesion, and CCK-8 assays were used to study cell proliferation. Oral P. gingivalis and A. naeslundii were incubated with the BMs. Bacterial adhesion was visualized using SEM, and colony-forming unit (CFU) counts were obtained. Results: SEM images showed markedly greater fibrin network formation after 7 days on resorbable BM (Bio-gide^®) treated with PLyF, but with no notable differences in other resorbable BM or non-resorbable BM groups with both treatments. CCK-8 assays showed non-significant effects on HGF proliferation at 3 and 5 days. SEM showed A. naeslundii growth inhibition in the LPRF-EX- and PLyf-treated BMs, and the greatest reduction in CFU counts of both P. gingivalis and A. naeslundii was noted with treated Cytoplast™. Conclusions: Within the limitations of this preliminary study, it can be concluded that the LPRF-EX and PLyf treatment of BM induced an antimicrobial effect. Their effects on cellular response were unclear due to the lack of significant findings on SEM analysis. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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11 pages, 1663 KiB

Open AccessArticle

Ultra-Low Frequency TENS as an Adjunctive Therapy for Pain Management in Non-Surgical Periodontal Treatment: A Pilot Study

by Eleonora Ortu, Sara Di Nicolantonio, Roberta Di Felice, Antonella Barone, Davide Pietropaoli and Annalisa Monaco

Dent. J. 2025, 13(4), 161; https://doi.org/10.3390/dj13040161 - 9 Apr 2025

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Abstract

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, [...] Read more.

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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11 pages, 463 KiB

Open AccessArticle

Additive Manufacturing Titanium Dental Implants Placed in Sinuses Grafted with 70HA:30-TCP: A One-Year Retrospective Study for Evaluation of Survival Rate

by Ilton José Mafra, Dimorvan Bordin, Rafael S. Siroma, Vittorio Moraschini, Leonardo P. Faverani, João Gabriel Souza, Carlos Fernando Mourão and Jamil Awad Shibli

Dent. J. 2024, 12(6), 181; https://doi.org/10.3390/dj12060181 - 13 Jun 2024

Cited by 1 | Viewed by 1636

Abstract

The present short-term retrospective study evaluated the implant survival rate and peri-implant bone loss around additive-manufactured titanium implants placed in sinuses grafted with Plenum Osshp (Plenum Bioengenharia, Jundia, SP, Brazil) (70HA:30β-TCP) material. A total of 39 implants were inserted after 23 sinus floor [...] Read more.

The present short-term retrospective study evaluated the implant survival rate and peri-implant bone loss around additive-manufactured titanium implants placed in sinuses grafted with Plenum Osshp (Plenum Bioengenharia, Jundia, SP, Brazil) (70HA:30β-TCP) material. A total of 39 implants were inserted after 23 sinus floor elevation procedures in 16 consecutive patients. Prosthetic rehabilitation included fixed partial prostheses (three units), single crowns (eleven units), and fixed full arches (three units). Clinical and radiographic parameters of implant-supported restorations were evaluated after at least one year of occlusal loading. The implant–crown success criteria included the absence of pain, suppuration, and clinical mobility, an average distance between the implant shoulder and the first visible bone contact (DIB) < 1.0 mm from the initial surgery, and the absence of prosthetic complications at the implant–abutment interface. The overall cumulative implant survival rate was 97.43%. No prosthetic complications at the implant–abutment interface were reported. After one year, the mean DIB was 0.23 mm ± 0.14. Within the limits of this retrospective study, it can be concluded that 70 HA:30 β-TCP allowed stable and reliable bone support to maintain healthy conditions around titanium dental implants produced by additive manufacturing. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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Review

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16 pages, 238 KiB

Open AccessReview

The Decision Between Tooth Retention or Replacement with Implants: A Continuing Dilemma

by Eleni Bentour, Eirini Papamanoli and Ioannis K. Karoussis

Dent. J. 2025, 13(3), 99; https://doi.org/10.3390/dj13030099 - 26 Feb 2025

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Abstract

The global adoption of dental implants has significantly reshaped modern dental practices, with the market projected to reach USD 16 billion by 2029. However, despite high success rates, dental implants can still be prone to complications, particularly when underlying causes of tooth loss, [...] Read more.

The global adoption of dental implants has significantly reshaped modern dental practices, with the market projected to reach USD 16 billion by 2029. However, despite high success rates, dental implants can still be prone to complications, particularly when underlying causes of tooth loss, such as periodontal disease and bone loss, are not addressed. This paper explores the biological and mechanical considerations in the decision-making process between preserving a tooth through periodontal therapy or opting for extraction and implant placement. It also highlights the importance of a holistic approach that includes assessing the patient’s oral health, periodontal status, and the biomechanical factors influencing tooth retention. Periodontal therapy has been proven to be highly effective, with both non-surgical and surgical therapies showing long-term efficacy in preserving natural teeth, especially in the presence of furcation involvement. Studies show that proper periodontal management, including regular maintenance therapy after the active therapy, significantly enhances tooth survival, even in cases of severe periodontitis. In contrast, dental implants, while effective, are not free of complications, mainly inflammatory peri-implant diseases, but also mechanical complications, which can compromise long-term outcomes. The paper reviews clinical studies on implant survival, demonstrating that periodontal therapy can sometimes offer a more cost-effective and biologically sound alternative to implant therapy, especially for teeth with severe attachment loss or furcation involvement. In conclusion, treatment decisions should be based on a comprehensive evaluation of clinical, biological, and patient-specific factors. By integrating regenerative therapies even in more compromised teeth and addressing the root causes of tooth loss, implant rehabilitation can be postponed for many years and offer a cost-effective and successful long-term treatment plan. This approach underscores the importance of individualized care in the evolving landscape of restorative dentistry and implantology. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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Other

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14 pages, 893 KiB

Open AccessSystematic Review

Clinical Performance of Subperiosteal Implants in the Full-Arch Rehabilitation of Severely Resorbed Edentulous Jaws: A Systematic Review and Metanalysis

by Luis Sánchez-Labrador, Santiago Bazal-Bonelli, Fabián Pérez-González, Tomás Beca-Campoy, Carlos Manuel Cobo-Vázquez, Jorge Cortés-Bretón Brinkmann and José María Martínez-González

Dent. J. 2025, 13(6), 240; https://doi.org/10.3390/dj13060240 - 28 May 2025

Abstract

Background/Objectives: Subperiosteal implants (SPIs) were first used in the 1940s, but due to their complications and the rise of dental implants, they were discontinued. Thanks to new technologies and new materials, nowadays they are being used again and studied as a treatment for [...] Read more.

Background/Objectives: Subperiosteal implants (SPIs) were first used in the 1940s, but due to their complications and the rise of dental implants, they were discontinued. Thanks to new technologies and new materials, nowadays they are being used again and studied as a treatment for severe bone defects. This review analyzes the clinical results—survival rates and complications—of SPIs used to support full arch rehabilitations of severely resorbed maxillae and mandibles, comparing the outcomes resulting from implant placement conducted in one or two surgical interventions. Methods: An automated search was conducted in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library), as well as a manual search for relevant clinical articles published before 28 February 2025. The review included human studies with at least four patients, in which SPIs were placed to restore full-arch edentulous maxillae and mandibles. Quality of evidence was evaluated using the Newcastle–Ottawa Quality Assessment Scale and the Joanna Briggs Institute Critical Appraisal tool. Results: A total of 14 studies met the inclusion criteria and were included for analysis, including 958 patients and 973 SPIs. The survival rate was 100% when one surgical intervention was performed and 85% when two interventions were performed after 4–38 months and 3–22 years follow-up, respectively. Conclusions: SPIs would appear to offer a good alternative for patients with severe bone atrophies, especially SPIs fabricated using digital techniques in a single step, presenting promising survival rates and a low complication rate, although more randomized clinical trials with long-term follow-up are needed. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

16 pages, 2136 KiB

Open AccessSystematic Review

Periodontal Pathogens Correlate with Rheumatoid Arthritis Disease Parameters: A Systematic Review Based on Clinical Studies

by Luki Astuti, Sri Lelyati Chaidar Masulili, Indrayadi Gunardi, Benso Sulijaya and Yuniarti Soeroso

Dent. J. 2025, 13(5), 214; https://doi.org/10.3390/dj13050214 - 15 May 2025

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Abstract

Background: Numerous studies have found higher levels of autoantibodies including anti citrullinated protein antibodies (ACPAs), anti-cyclic citrullinated peptides (aCCP), or rheumatoid factor (RF) against periodontal microorganisms in rheumatoid arthritis (RA). Objective: To evaluate the correlation between periodontal bacteria and RA disease parameters. [...] Read more.

Background: Numerous studies have found higher levels of autoantibodies including anti citrullinated protein antibodies (ACPAs), anti-cyclic citrullinated peptides (aCCP), or rheumatoid factor (RF) against periodontal microorganisms in rheumatoid arthritis (RA). Objective: To evaluate the correlation between periodontal bacteria and RA disease parameters. Methods: We utilized PubMed, Scopus, ScienceDirect, and manual search databases up until March 2024 using PRISMA 2020 guidelines. The data were obtained from microbiological assays by RT-PCR/qPCR, sequencing, and serological testing of disease parameters (ACPA, aCCP, and RF) utilizing ELISA method. Results: A total of 1514 documents were discovered based on the inclusion criteria. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Prevotella_9 were associated with elevated levels of ACPA/aCCP and RF in RA with periodontitis. A positive correlation was found between Peptococcus simiae, Aminipila butyrica, Leptotrichia spp., Leptotrichia wadei, and Neisseria bacilliformis with ACPA, and Treponema sp. canine oral taxon 087 with RF. Conclusions: This study found that several oral microorganisms correlate with elevated ACPA/aCCP and RF in RA with periodontitis. Future studies of the oral microbiome and the molecular mechanisms are anticipated to discover new therapies and diagnostic methods for periodontitis and RA. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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17 pages, 3643 KiB

Open AccessSystematic Review

Bony Defect Regeneration in Periodontitis: A Systematic Review of the Literature Regarding the Use of Enamel Matrix Derivative Proteins

by Eugen Bud, Silvia-Izabella Pop, Anamaria Bud, Benjamin Robert Steele and Alexandru Vlasa

Dent. J. 2025, 13(3), 92; https://doi.org/10.3390/dj13030092 - 20 Feb 2025

Viewed by 1372

Abstract

Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was [...] Read more.

Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was to observe and analyze recent information from the literature on the effect of enamel matrix derivative proteins on the bony defects caused by periodontitis. Methods: Through using two major online databases and search engines, the literature was manually searched for papers published until May 2024. To find relevant studies, this research utilized a combination of target keywords, and the reference lists of manuscripts that were chosen for inclusion in this study were checked and analyzed in tabular form, enabling the collection and comparison of data. Results: According to the results, the average value of the probing depth gained was 4 mm for the EMD™ alone and 4.25 mm for the EMD combined with surgical techniques such as open-flap techniques, platelet derivatives, and growth factors. In regard to clinical attachment level (CAL) gaining, average values of 3.6 mm in EMD™ alone and 3.86 mm with EMD™ combined with other techniques were observed. Conclusions: It can be concluded that the healing propensity depends on the morphological structure of the bone defect represented by the wall stage, and there is a certain coherence and correlation between the values of probing depth (PD) and clinical attachment level (CAL), whether for the use of EMD alone or its use in combination with other materials. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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11 pages, 5594 KiB

Open AccessCase Report

Using the Modified Apical Access Technique to Treat Peri-Implant Mucosa Defects: Description of the Technique and Three-Dimensional Quantitative Measurement of Buccal Augmented Tissue

by Norberto Quispe-López, Tiago Marques, Yasmina Guadilla, Javier Flores-Fraile, Pablo Garrido-Martínez and Javier Montero

Dent. J. 2024, 12(7), 194; https://doi.org/10.3390/dj12070194 - 24 Jun 2024

Viewed by 1571

Abstract

The importance of augmenting the peri-implant soft- and hard-tissue architecture is now widely accepted. However, while most contemporary research supports this premise, clinicians are encountering peri-implant soft tissue defects with increasing frequency, which they are therefore required to reconstruct. These complications can result [...] Read more.

The importance of augmenting the peri-implant soft- and hard-tissue architecture is now widely accepted. However, while most contemporary research supports this premise, clinicians are encountering peri-implant soft tissue defects with increasing frequency, which they are therefore required to reconstruct. These complications can result from the difficulty of establishing an appropriate diagnosis and treatment plan or from suboptimal clinical situations (implant malposition, insufficient vestibular alveolar bone thickness or inadequate mucosal thickness). In this context, it is the peri-implant soft-tissue phenotype that most influences esthetic and health-related results in the short and long term. This article describes two clinical cases in which a modification of the apical access technique is presented that may be useful in clinical scenarios requiring large gains in mucosal thickness. Use of the modified bilaminar apical access with de-epithelialized free gingival graft technique showed promising results, with a significant increase in mucosal thickness and satisfactory outcomes in esthetics and peri-implant health. Full article

(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)

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