Special Issue "Pathogenesis of Periodontal Disease"

A special issue of Dentistry Journal (ISSN 2304-6767). This special issue belongs to the section "Oral Hygiene, Periodontology and Peri-implant Diseases".

Deadline for manuscript submissions: closed (30 May 2020).

Special Issue Editors

Prof. Dr. Gaetano Isola
Website
Guest Editor
Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
Interests: periodontitis; oral surgery; oral pathology; oral health-systemic health; bone biology
Special Issues and Collections in MDPI journals
Dr. Domenico Dalessandri
Website
Guest Editor
Università degli Studi di Brescia, Brescia, Italy

Special Issue Information

Dear Colleagues,

Periodontitis and Peri-Implant diseases are a plaque-induced inflammatory condition that affects the periodontium; it is caused by the adherence to tooth surfaces of pathogenic bacterial species organized in complex communities that form biofilms.

Periodontitis can be defined as a chronic inflammatory disease initiated by dental plaque biofilm and perpetuated by a deregulated immune response usually accompanied by an irreversible destruction of the supporting tissues surrounding the tooth, including the alveolar bone that may results in a tooth loss.

The aim of this Special Issue is to update the current knowledge of aetiology of periodontitis based on the most recent scientific evidence. Special emphasis is given to the implications for chronic and aggressive periodontitis.

We especially welcome intervention and review studies with impact on immunomediators active in the periodontal disease and interventional studies aiming at improving the knowledge about the effectiveness of salivary and gingival crevicular fluid diagnostics involved in the diagnosis of periodontitis or in a personalized medicine approach. Review studies including those that use conceptual frameworks for periodontitis pathways on any of the aforementioned topics will also be welcomed.

Dr. Gaetano Isola
Dr. Domenico Dalessandri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Periodontitis
  • Biofilm
  • Salivary diagnostics
  • Personalized periodontal medicine
  • Periodontal immune response

Published Papers (13 papers)

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Research

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Open AccessArticle
Short-Term Impact of Non-Surgical and Surgical Periodontal Therapy on Oral Health-Related Quality of Life in a Greek Population—A Prospective Cohort Study
Dent. J. 2020, 8(2), 54; https://doi.org/10.3390/dj8020054 - 25 May 2020
Abstract
While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments [...] Read more.
While periodontitis deteriorates patients’ quality of life, non-surgical periodontal treatment seems to offer an improvement. The purpose of the present study was to evaluate the impact of non-surgical and surgical periodontal treatment on the oral health-related quality of life (OHRQoL) utilizing patient-centered assessments and surrogate clinical measurements in Greek adults. Eighty-three individuals with chronic periodontitis were enrolled in the study. Assessment of OHRQoL with the use of the Oral Health Impact Profile (OHIP-14) questionnaire in conjunction with clinical measurements of pocket probing depth (PPD), plaque index (PI) and bleeding on probing (BOP) were performed at baseline (t0), after non-surgical therapy (t1) and after periodontal surgery (t2). A statistically significant reduction of OHIP-14 score was recorded at t1 and t2 examination compared to baseline (p < 0.001) and a statistically significant improvement in all clinical parameter at all time points was recorded (p < 0.05). No correlation between the clinical parameters and the total score of OHIP-14 was recorded at any time point. Non-surgical periodontal treatment seemed to improve OHRQoL in terms of OHIP-14 scores, whilst supplementary surgical periodontal therapy did not offer any additional benefit. No correlation was found between patients’ perception of quality of life expressed by OHIP-14 score and the surrogate clinical parameters. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
A Comparative Assessment of Pain Caused by the Placement of Banded Orthodontic Appliances with and without Low-Level Laser Therapy: A Randomized Controlled Prospective Study
Dent. J. 2020, 8(1), 24; https://doi.org/10.3390/dj8010024 - 04 Mar 2020
Cited by 2
Abstract
Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were [...] Read more.
Patients still refuse or discontinue orthodontic treatment due to related pain and discomfort. In this study, we investigate if low-level laser therapy (LLLT) can reduce pain caused by orthodontic bands. Sixty subjects who needed bands placed on the upper permanent first molars were assigned randomly to the LLLT group, placebo, and control groups. Inclusion criteria were: age range 10–14 years, fully erupted upper first molars in healthy condition, presence of tight mesial proximal contact. Exclusion criteria were: systemic or metabolic diseases, chronic pain or neurological or psychiatric disorders, use of pharmacological agents interfering with pain perception, previous orthodontic treatment or the simultaneous presence of other devices in the patient’s mouth. The assessment of pain was performed by using a numeric rating scale (NRS) considering different time intervals, i.e., immediately after bands placement, 6 h, 24 h, and from day 2 to day 5. Differences in the maximum pain and in pain experienced at each time-point, among the three groups, was assessed by using the Kruskal–Wallis H. The final sample included 56 patients, 29 males, and 27 females, with a mean age of 12.03 ± 1.3 years. Patients were randomly allocated into three groups (tested, control, and placebo group) with each group consisting respectively of 19, 20, and 17 individuals. Subjects in the LLLT experienced less pain at each time interval as well as the maximum pain score being lower in the LLLT compared to control and placebo groups. These findings were all statistically significant (p < 0.05). LLLT can alleviate the intensity of pain after the placement of orthodontic bands. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessFeature PaperArticle
Anti-Bacterial and Anti-Inflammatory Effects of Toothpaste with Swiss Medicinal Herbs towards Patients Suffering from Gingivitis and Initial Stage of Periodontitis: From Clinical Efficacy to Mechanisms
Dent. J. 2020, 8(1), 10; https://doi.org/10.3390/dj8010010 - 15 Jan 2020
Abstract
Objective: To distinguish clinical effects and mechanisms of sodium monofluorophosphate plus xylitol and herbal extracts of Swiss medicinal plants (Chamomilla recutita, Arnica montana, Echinacea purpurea, and Salvia officinalis). Materials and Methods: A 2-month-long comparative clinical study of toothpaste [...] Read more.
Objective: To distinguish clinical effects and mechanisms of sodium monofluorophosphate plus xylitol and herbal extracts of Swiss medicinal plants (Chamomilla recutita, Arnica montana, Echinacea purpurea, and Salvia officinalis). Materials and Methods: A 2-month-long comparative clinical study of toothpaste containing 1450 ppm sodium monofluorophosphate and xylitol (control, 15 patients) and toothpaste additionally containing extracts of the medicinal herbs (experiment, 35 patients) was performed on patients with gingivitis and the initial stage of periodontitis. Clinical indices of gingivitis/periodontitis were quantified by Loe & Silness’s, CPITN, OHI-S, and PMA indexes. The pro-inflammatory and anti-inflammatory interleukins, nitrites/nitrates, total antioxidant activity, and bacterial pattern characteristic for gingivitis and periodontitis were quantified in the gingival crevicular fluid and plaque. In the in vitro tests, direct anti-bacterial effects, inhibition of catalase induction in Staphylococcus aureus, in response to oxidative burst of phagocytes, and intracellular bacterial killing were determined for the toothpastes, individual plant extracts, and their mixture. Results: Experimental toothpaste was more efficient clinically and in the diminishing of bacterial load specific for gingivitis/periodontitis. Although the control toothpaste exerted a direct moderate anti-bacterial effect, herbal extracts provided anti-inflammatory, anti-oxidant, direct, and indirect anti-bacterial actions through inhibition of bacterial defence against phagocytes. Conclusions: Chemical and plant-derived anti-bacterials to treat gingivitis and periodontitis at the initial stage should be used in combination amid their different mechanisms of action. Plant-derived actives for oral care could substitute toxic chemicals due to multiple modes of positive effects. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
The Capacity of Periodontal Gel to Occupy the Spaces Inside the Periodontal Pockets Using Computational Fluid Dynamic
Dent. J. 2020, 8(1), 1; https://doi.org/10.3390/dj8010001 - 24 Dec 2019
Abstract
The aim of the current work is to demonstrate the capacity of a new periodontal gel to occupy the spaces inside the periodontal pockets through Computational Fluid Dynamic (CFD). The test gel consists of two resorbable medical grade polymers (PEO, Poly Ethylen Oxide [...] Read more.
The aim of the current work is to demonstrate the capacity of a new periodontal gel to occupy the spaces inside the periodontal pockets through Computational Fluid Dynamic (CFD). The test gel consists of two resorbable medical grade polymers (PEO, Poly Ethylen Oxide and HPMC, Hydroxy Propyl Metyl Cellulose), Type I Collagen, SAP (Vitamin C), and PBS (Saline Solution), while the control gel is 14% doxyclin controlled release gel, which is used for treating periodontal pockets with probing ≥5 mm after scaling and root plaining. The study examined the fluid dynamic analysis (Computational Fluid Dynamic—CFD) of two different gels, used in dentistry to treat periodontitis, in relation to both the geometry of the periodontal pocket and the function of two different types of needles that are used to distribute the preparation. The periodontal pocket was determined by reading DICOM images taken from the patient’s CAT scan. The results show that the H42® gel comes out uniformly compared to the other gel. Moreover, it is possible to observe how the rheological properties of the gel allow the fluid to spread evenly within the periodontal pocket in relation to the geometry of the needle. In particular, H42® gel exits in a constant way both from the first and the second exit. In fact, it was observed that by changing the geometry of the needle or the type of periodontal gel, the distribution of the gel inside the pocket was no longer homogeneous. Thus, having the correct rheological properties and correct needle geometries both speeds up the gel and optimizes the pressure distribution. Currently, the literature is still lacking, therefore further studies will be needed to confirm these results. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
Evaluation of a Digital Protocol for Pre-Surgical Orthopedic Treatment of Cleft Lip and Palate in Newborn Patients: A Pilot Study
Dent. J. 2019, 7(4), 111; https://doi.org/10.3390/dj7040111 - 09 Dec 2019
Abstract
The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients [...] Read more.
The aim of this study was to evaluate the accuracy, invasiveness and impact on clinical results of a digital oral impression protocol in the pre-surgical orthopedic treatment (PSOT) of newborn cleft lip and palate (CLP) patients undergoing primary alveolar surgical repair. Six patients were divided, according to impression technique used, into a digital (intraoral scanner (IOS)) and a non-digital (tray and putty (T&P)) group. Parents considered IOS impressions to be less invasive, compared to T&P impressions. The clinician that took all the impressions considered the IOS to be less stressful compared to the T&P method. In two T&P patients, the impression was repeated because some important anatomical details were missing, in one case due to patient regurgitation during the first attempt. No impression was repeated, and any adverse event was reported in the IOS group. There were no significant differences between these two protocols in pre-surgical alveolar gap reduction and surgical challenge. The study results indicate that this digital protocol can accelerate the production process of the passive molding plate with an instantaneous transmission of the digital impression to the dental lab, maintaining the same accuracy level and clinical outcomes of classical techniques and reducing the invasiveness of impression taking, avoiding any risk of impression material ingestion or inhalation. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
An Insight into Acute Pericoronitis and the Need for an Evidence-Based Standard of Care
Dent. J. 2019, 7(3), 88; https://doi.org/10.3390/dj7030088 - 02 Sep 2019
Cited by 3
Abstract
Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis [...] Read more.
Background: Pericoronitis is inflammation of the operculum associated with a partially erupted third molar. It is a highly prevalent infection of the oral cavity and presents as a painful sensation of the soft tissue encompassing the crown of the involved tooth. Though pericoronitis is common, there is no evidence-based standard-of-care for treatment of emergency patients with acute pericoronitis. Study Design: In this study, anonymous clinicians were asked to participate in an online survey with questions formulated to identify professional clinical background, emergency treatment preferred for acute pericoronitis, number of associated complications, frequency of third molar extraction, and patient satisfaction. Results and Conclusion: A statistical analysis of the collected data regarding the variance among different treatment plans and associated complications revealed little consensus in the treatment of pericoronitis. The lack of consistency of the responses focusing on the preferred treatment for emergency patients with acute pericoronitis reinforces the need for developing a standard-of-care to train future dental professionals based on well-designed randomized controlled clinical trials and meta-analyses. Practical Implications: The ultimate goal is developing a treatment option with the fewest complications to provide the best health care for patients with pericoronitis. This issue is seen not only as an acute infection but also has the potential to impact overall health. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
Protective Effect of UP446 on Ligature-Induced Periodontitis in Beagle Dogs
Dent. J. 2019, 7(2), 33; https://doi.org/10.3390/dj7020033 - 28 Mar 2019
Cited by 3
Abstract
Periodontal disease is an inflammatory disease of the gum caused by a formation of a plaque that triggers immune responses and inflammation leading to the destruction of tissues surrounding and supporting the teeth. Chronic usage of synthetic chemicals and antibiotics is limited by [...] Read more.
Periodontal disease is an inflammatory disease of the gum caused by a formation of a plaque that triggers immune responses and inflammation leading to the destruction of tissues surrounding and supporting the teeth. Chronic usage of synthetic chemicals and antibiotics is limited by undesired adverse events to the host. A botanical composition (UP446), which consists primarily of bioflavonoids such as baicalin from roots of Scutellaria baicalensis and catechins from heartwoods of Acacia catechu, was evaluated for its effect on ligature-induced periodontal disease in beagle dogs. Disease model was induced in 20 male and female dogs. After a 12-week induction of periodontitis, animals were assigned to a placebo, positive control (doxycycline), and two treatment groups consisting of five animals each. The placebo group was only administrated to normal dog chow (25 g/kg/day). In the doxycycline treatment group, animals were fed a normal diet (25 g/kg/day) and doxycycline (5 mg/kg) was orally administrated every day. Treatment of UP446 was done by feeding the regular diet formulated with 0.1% and 0.2% of UP446 by weight. Clinical indices such as plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing pocket depth (PPD), and bleeding on probing (BoP) were measured every two weeks for 12 weeks. UP446 administered to beagle dogs for 12 weeks at 0.1% and 0.2% resulted in statistically significant reductions in gingivitis, pocket depth, loss of attachment, and gum bleeding. UP446 could potentially be used alone or as an adjunct with other oral hygiene preparations for periodontal disease in both human and companion animals. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
An Analysis of Dentigerous Cysts Developed around a Mandibular Third Molar by Panoramic Radiographs
Dent. J. 2019, 7(1), 13; https://doi.org/10.3390/dj7010013 - 04 Feb 2019
Cited by 5
Abstract
Dentigerous cysts are one of the most prevalent types of odontogenic cysts and are associated with the crown of an unerupted tooth, especially of the mandibular third molar. In this study, the characteristics of a dentigerous cyst developed around a mandibular third molar [...] Read more.
Dentigerous cysts are one of the most prevalent types of odontogenic cysts and are associated with the crown of an unerupted tooth, especially of the mandibular third molar. In this study, the characteristics of a dentigerous cyst developed around a mandibular third molar on panoramic radiographs were investigated. The panoramic images of 257 consecutive dentigerous cyst cases associated with a mandibular third molar were analyzed. The mean age of the patients was 45.9 ± 13.3 years. The size of the cyst did not significantly correlate to the age of the patient. The unilocular type (89.1%) and the crown side type (68.5%) were significant. The associated mandibular third molars had a high frequency of class III (64.6%) and position B (48.3%) in Pell and Gregory classification and of horizontal position (36.3%) in angulation. Dentigerous cysts were thought to originate and grow commonly around deeply impacted third molars. The associated third molar with dentigerous cyst tends to have a mesial inclination. Dentigerous cysts do not appear to develop gradually after the crown formation has finished, but arise at various periods randomly. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
Adjunctive Effects of a Sub-Antimicrobial Dose of Doxycycline on Clinical Parameters and Potential Biomarkers of Periodontal Tissue Catabolism
Dent. J. 2019, 7(1), 9; https://doi.org/10.3390/dj7010009 - 20 Jan 2019
Cited by 3
Abstract
Objectives: The aim of the present randomized, double-blind, placebo-controlled, parallel-arm study was to examine the effectiveness of a sub-antimicrobial dose of doxycycline (SDD) in combination with nonsurgical periodontal therapy, compared to nonsurgical periodontal therapy alone, on potential gingival crevicular fluid (GCF) biomarkers of [...] Read more.
Objectives: The aim of the present randomized, double-blind, placebo-controlled, parallel-arm study was to examine the effectiveness of a sub-antimicrobial dose of doxycycline (SDD) in combination with nonsurgical periodontal therapy, compared to nonsurgical periodontal therapy alone, on potential gingival crevicular fluid (GCF) biomarkers of periodontal tissue catabolism related to the clinical outcomes over a 12-month period. Materials and Methods: GCF was collected and clinical parameters were recorded from 30 periodontitis patients randomized either to an SDD or placebo group. The SDD group received SDD (20 mg) b.i.d for 3 months plus scaling and root planing (SRP), while the placebo group was given placebo capsules b.i.d for 3 months plus SRP. The patients were evaluated every 3 months during the 12-month study period. At each visit, clinical parameters and GCF sampling were repeated. Matrix metalloproteinase (MMP)-8, MMP-9, MMP-13, myeloperoxidase (MPO), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase-5 (TRAP-5) were determined by IFMA and ELISA. Results: Significant improvements were observed in all clinical parameters in both groups over 12 months (p < 0.0125) while the SDD group showed significantly better reduction in gingival index (GI) and pocket depth and a gain in clinical attachment compared to the placebo group (p < 0.05). GCF MMP-8 and OPG levels significantly reduced in the SDD group compared to baseline (p < 0.05). GCF MMP-9 significantly decreased in both groups compared to baseline (p < 0.05). GCF MPO significantly decreased at 3 and 9 months in the SDD group, while it significantly decreased at 6 months in the placebo group (p < 0.05). TRAP and MMP-13 could be detected in none of the samples. Conclusions: The present results indicate that three months of adjunctive usage of SDD to nonsurgical periodontal therapy compared to nonsurgical periodontal therapy alone in periodontitis patients results in further improvement of clinical periodontal parameters and GCF markers of periodontal tissue breakdown over a 12-month period. Beneficial effects of adjunctive SDD therapy is likely to be related to the reduced levels of two major periodontitis-associated MMPs, MMP-8 and -9, and their potential oxidative activator MPO. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessArticle
Substantial Differences in the Subgingival Microbiome Measured by 16S Metagenomics According to Periodontitis Status in Older Women
Dent. J. 2018, 6(4), 58; https://doi.org/10.3390/dj6040058 - 19 Oct 2018
Cited by 5
Abstract
Aging invokes physiological changes, such as immunosenescence and inflammation, that could increase host susceptibility to oral microbiome shifts that enable periodontitis progression in later life. At present, there is a dearth of studies specifically evaluating the oral microbiome and periodontitis in older adults. [...] Read more.
Aging invokes physiological changes, such as immunosenescence and inflammation, that could increase host susceptibility to oral microbiome shifts that enable periodontitis progression in later life. At present, there is a dearth of studies specifically evaluating the oral microbiome and periodontitis in older adults. We used high-throughput untargeted sequencing methods and functional metagenomic analyses to assess and compare the subgingival biofilm of postmenopausal women (mean age 71 years) according to periodontitis status. Subgingival plaque samples were obtained from 15 postmenopausal women with no periodontitis, and from 15 women with severe periodontitis, determined by probing measures. The 16S rRNA gene (V1–V3 region) was sequenced on the 454 FLX platform. The PICRUSt technique was used to provide information on what the potential functional characteristics of microbiota might be in healthy, compared with diseased, periodontium. The subgingival microbiome associated with periodontitis showed clear differences to that associated with health. Of the 464 species identified, 22.8% had elevated abundance in disease, while only 6.3% had elevated abundance in health. Among the 12 most prevalent organisms in periodontitis, one-half have previously been recognized as periodontal pathogens by other investigators. The subgingival microbiome in periodontitis contained genes that could code for specific activities, including microbial mobility, synthesis of endotoxin, and proteolytic degradation. The healthy microbiome included genes that could code for sustaining microbial life, including encoding for transporters, glycolysis, gluconeogenesis, the Krebs cycle, and protein kinases. In the present study on postmenopausal women, aged 60 and older, the subgingival microbiome differed in composition and potential function between those with and without periodontitis. Studies of functional gene expression, such as transcriptomics, are needed to definitively identify the molecules carrying out functions associated with pathogenic subgingival complexes. This, in turn, could lead to identification of targets for enhanced management of periodontitis and, possibly, other diseases, in later life. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Review

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Open AccessReview
Case Reports in Pediatric Dentistry Journals: A Systematic Review about Their Effect on Impact Factor and Future Investigations
Dent. J. 2019, 7(4), 103; https://doi.org/10.3390/dj7040103 - 24 Oct 2019
Cited by 8
Abstract
Background: The effects of publishing case reports on journal impact factor and their impact on future research in pediatric dentistry has not been clearly evaluated yet. Aim. To assess the relevance and role of case reports in pediatric dentistry. Methods: A systematic review [...] Read more.
Background: The effects of publishing case reports on journal impact factor and their impact on future research in pediatric dentistry has not been clearly evaluated yet. Aim. To assess the relevance and role of case reports in pediatric dentistry. Methods: A systematic review (PROSPERO registration number: CRD42018108621) of all case reports published between 2011 and 2012 in the three major pediatric dentistry journals was performed manually. Data regarding citations of each report were acquired from the Institute for Scientific Information database available online. The authors analyzed information regarding citations (number, percentage, and mean) received by each case report and considered their relation with the 2013 journal impact factor. Results: Case reports accounted for almost sixteen per cent of all articles published between 2011 and 2012. The citation rate of case reports was generally low and the highest mean citation was 0.5. This review revealed that 6 (9.52%) case reports had at least 5 citations and that the majority of the citing articles were also case reports (27.78%) or narrative reviews (25%). Conclusions: The publication of case reports affected the journal impact factor in a negative way, this influence is closely related to the percentage of the published case reports. Case reports about innovative topics, describing rare diseases, syndromes, and pathologies were more frequently cited. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Other

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Open AccessCase Report
A Full Diagnostic Process for the Orthodontic Treatment Strategy: A Documented Case Report
Dent. J. 2020, 8(2), 41; https://doi.org/10.3390/dj8020041 - 06 May 2020
Abstract
The need for extractions in orthodontic treatment has always been a controversial topic. However, to date there is not a specific clinical guideline that can help the clinicians deciding to plan an extractive or a non-extractive orthodontic treatment. In this respect, clinicians must [...] Read more.
The need for extractions in orthodontic treatment has always been a controversial topic. However, to date there is not a specific clinical guideline that can help the clinicians deciding to plan an extractive or a non-extractive orthodontic treatment. In this respect, clinicians must deal with patients’ occlusal, functional, periodontal and aesthetics characteristics before planning an orthodontic treatment including extraction. Considering the absence of specific guidelines, the choice to extract teeth or not is complicated, particularly in borderline cases. In this case report, we present a borderline case of a patient with the skeletal Class III pattern and significant crowding in both arches that could be treated with or without extraction, illustrating the diagnostic and decision-making processes that were conducted for the orthodontic treatment strategy. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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Open AccessCase Report
Unusual Imaging Features of Dentigerous Cyst: A Case Report
Dent. J. 2019, 7(3), 76; https://doi.org/10.3390/dj7030076 - 01 Aug 2019
Cited by 1
Abstract
Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an [...] Read more.
Dentigerous cysts (DC) are cystic lesions radiographically represented by a well-defined unilocular radiolucent area involving an impacted tooth crown. We present an unusual radiographic feature of dentigerous cyst related to the impacted mandibular right second molar, in a 16-year-old patient, which suggested an ameloblastoma or odontogenic keratocyst (OKC) because of its multilocular appearance seen on the panoramic radiography. A multi-slice computed tomography (MSCT), however, revealed a unilocular lesion without septations, with an attenuation coefficient from 3.9 to 22.9 HU suggesting a cystic lesion. Due to its extension, a marsupialization was performed together with the histopathological analysis of the fragment removed which suggested a dentigerous cyst. Nine months later, the lesion was reduced in size and then totally excised. The impacted mandibular right second molar was also extracted. Histopathological examination confirmed the diagnosis of a dentigerous cyst. One year later, the panoramic radiography showed a complete mandible bone healing. Large dentigerous cysts can sometimes suggest other more aggressive pathologies. Precise diagnosis is important to avoid mistakes since DC, OKC and ameloblastoma require different treatments. Histological examination is, therefore, essential to establish a definitive diagnosis. In our case, MSCT and the tissue attenuation coefficient analysis contributed to guide the diagnosis and management of the dentigerous cyst. Full article
(This article belongs to the Special Issue Pathogenesis of Periodontal Disease)
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