Dentistry Journal

Background: Systemic bone loss, particularly osteoporosis, and periodontal disease are highly prevalent chronic conditions that share common risk factors and biological pathways. Increasing evidence suggests a bidirectional relationship between these conditions; however, findings remain heterogeneous and evolving. Objective: This review aims to evaluate and update current evidence on the bidirectional association between systemic bone loss and periodontal disease, with emphasis on underlying mechanisms and clinical implications. Methods: A narrative review of the literature was conducted using major electronic databases, focusing on human studies evaluating the relationship between osteoporosis or systemic bone loss and periodontal disease. Relevant experimental, clinical, and epidemiological studies were included. Results: Most studies support an association between reduced bone mineral density and increased severity of periodontal disease, including greater alveolar bone loss and attachment loss. Conversely, periodontal inflammation may contribute to systemic bone remodeling through inflammatory mediators. However, variability in study design, diagnostic criteria, and confounding factors limits definitive conclusions. Conclusions: Current evidence supports a bidirectional association between systemic bone loss and periodontal disease. Greater interdisciplinary awareness is warranted, and future well-designed longitudinal studies are needed to clarify causality and inform preventive and therapeutic strategies.

Background and Objectives: Preheated composite resins have been proposed as an alternative to conventional luting agents due to their improved resistance, color stability, and adaptation. This review aims to critically evaluate the current literature on the use of preheated composites as luting agents exclusively on dentin and enamel, focusing on their mechanical behavior, optical properties, and biological effects, in order to determine whether they provide superior clinical outcomes compared with conventional resin cements. Materials and Methods: A comprehensive literature search from 2015 to 2025 was conducted in accordance with PRISMA-ScR guidelines. Eligible studies included in vitro investigations comparing the preheated composite with other luting agents performed on human, bovine, analog dentin or enamel substrates. Studies meeting these criteria were screened, evaluated, and synthesized. Results: Fifteen studies met the inclusion criteria: nine focused on the mechanical performance, and the remaining six studies examined additional properties such as color stability, pulpal temperature changes during preheating, film thickness characteristics, and the influence on marginal discrepancy. Conclusions: Preheated composite resins offer improved mechanical properties, marginal adaptation, and fracture resistance compared with conventional luting agents. However, their performance is highly technique-sensitive, and clinical outcomes depend on operator skill, restoration thickness, and material selection. Preheating generally does not compromise color stability, but it can elevate pulpal temperature, particularly when residual dentin is thin. Overall, preheated composites have potential clinical advantages, provided that careful handling and appropriate application are ensured.

Background: Congenital Insensitivity to Pain and Anhidrosis (CIPA) is a rare autosomal recessive disorder characterized by congenital analgesia, anhidrosis, and multisystem involvement affecting the musculoskeletal, cutaneous, oral, and para-oral structures. This case report describes the oral phenotype and multidisciplinary clinical management of a child with CIPA. Case Description: A 9-year-old boy presented with poor oral hygiene, multiple severely damaged teeth, masticatory difficulty, limited mouth opening, impaired bolus control, and para-oral traumatic injuries. Medical and orthopedic history indicated recurrent painless fractures, self-inflicted injuries, cutaneous scarring, and recurrent hyperpyrexia. Oral self-injury associated with CIPA was suspected and supported by the Nociception Assessment Test and Minor’s Iodine–Starch Test. Although the clinical findings were suggestive of CIPA, the diagnosis remained presumptive due to the absence of confirmatory molecular or histopathological testing. Management: A wearable wireless continuous temperature-monitoring device was prescribed to assist in tracking hyperpyrexia associated with CIPA (RHA-CIPA). A conservative, staged, multidisciplinary treatment was planned rather than full-mouth extraction, emphasizing prevention of dental sepsis and mitigation of future self-injury. Dental procedures were performed under local anesthesia to manage discomfort related to tactile hyperesthesia. To reduce nocturnal biting and oral trauma, a hard acrylic occlusal protector was fabricated using an intraoral scanner and a 3D-printed cast. The patient was followed for 12 months. Outcomes: At the 12-month follow-up, clinical improvement was observed, with particularly notable gains in cheek elasticity and soft tissue resilience. Conclusions: This case highlights the considerable challenges involved in the interdisciplinary management of children with CIPA, including oral self-injury prevention, limited mouth opening, and the necessity of close coordination with medical specialties. These findings are descriptive observations of a single case and do not establish efficacy or generalizability of any intervention.