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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry and Oral Health".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 8546

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Prof. Dr. Radu Iliescu

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Department of Pharmacology, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
Interests: physiology; pharmacology; baroreflex; blood pressure; hypertension; heart rate; cardiovascular
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Dr. Ionut Luchian

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Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
Interests: periodontal diseases; periodontology; clinical studies; experimental studies
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Dr. Mihaela Moscalu

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Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
Interests: physiology; biomarker; predictive modeling; risk classification methods; biostatistics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The involvement of biomarkers in predictive modeling and their inclusion in the risk assessment of clinical events has seen significant development in recent years. These aspects are essential for personalized medicine, allowing for tailored approaches to disease prevention, diagnosis, treatment and monitoring. Biomarkers are key to an early and accurate diagnosis, as well as risk assessment and prognosis, providing measurable indicators of individual characteristics and guiding personalized treatment strategies.

This Special Issue aims to collect papers that highlight the use of biomarkers in preventive, diagnostic, therapeutic and prognostic medicine. We also focus our attention on the involvement of biomarkers in public health and their current use in clinical practice.

Currently, there are only a limited number of predictors available, but the development and addition of predictive markers could have a significant impact. Interest in biomarkers has increased, and new methodologies have been developed to evaluate their utility. Biomarker discovery and validation are of particular interest for the advancement of personalized medicine. Analytical techniques are available to quantify the added value of biomarkers, highlighting both their strengths and limitations. While some biomarkers may be relevant to both clinical medicine and dentistry, dentistry has its own unique set of biomarkers that are relevant to oral health, diagnosis and management of dental conditions. In the future, preventive and predictive biomarkers will play a key role in healthcare.

Original articles, reviews, systematic reviews, meta-analyses and case reports are welcomed.

Prof. Dr. Radu Iliescu
Dr. Ionut Luchian
Dr. Mihaela Moscalu
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 submissions that pass pre-check are 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. Medicina 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 2200 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

physiology
biomarker
predictive modeling
risk classification methods
salivary diagnosis
cytokines
systemic diseases
genetics
microbiology
pharmacology
biostatistics

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Related Special Issue

Advances in Interdisciplinary Research in Medicine and Dentistry in Medicina (17 articles)

Published Papers (7 papers)

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14 pages, 1296 KiB

Open AccessArticle

Association Between Impacted Mandibular Third Molars and Temporomandibular Dysfunction: An Analysis Based on the Modified Helkimo Index

by Dorin Ioan Cocoș, Alexandru Vlasa, Sorana Maria Bucur, Mariana Păcurar and Kamel Earar

Medicina 2025, 61(5), 850; https://doi.org/10.3390/medicina61050850 - 5 May 2025

Viewed by 306

Abstract

Background and Objectives: To evaluate the impact of impacted mandibular third molars on temporomandibular joint dysfunction using the Modified Helkimo Index, analyzing symptom severity across age groups. Materials and Methods: A cohort of 140 patients (70 with impacted molars, 70 without) was assessed using the Modified Helkimo Index. Patients were categorized by age (<25, 26–30, 31–35, >36 years), and statistical comparisons between Icdⁱ (with impacted molars) and Icd^a (without impacted molars) were performed. Key parameters included mandibular movement limitation, joint noises, and pain scores. Data were analyzed using descriptive statistics and statistical tests, with significance set at p < 0.05. Results: TMJ dysfunction was significantly more prevalent in patients under 25 years (Icdⁱ = 13.5, Icd^a = 11.0; p = 0.045), with a progressive decrease in severity in older groups (>36 years: Icdⁱ = 3.5, Icd^a = 4.5; p = 0.072). Women exhibited a higher prevalence across all age categories (female-to-male ratio: <25 years = 2.7, >36 years = 3.0). The most frequent symptoms were mandibular movement restriction (42.5%), joint noises (38.2%), and pain (35.7%). Conclusions: Impacted third molars may significantly exacerbate TMJ dysfunctions, particularly in younger individuals and females, with a strong association between impacted molars and increased Modified Helkimo Index scores. Early extraction might mitigate symptoms, emphasizing the need for proactive clinical management. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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14 pages, 2270 KiB

Open AccessArticle

Immunohistochemical Expression of Differentiated Embryonic Chondrocyte 1 and Cluster of Differentiation 44 in Oral Potentially Malignant Disorders

by Bianca-Andreea Onofrei, Delia Gabriela Ciobanu Apostol, Mădălina-Gabriela Tanasă, Elena-Raluca Baciu, Cristina Popa, Ana Maria Sciuca, Mihaela Paula Toader and Victor-Vlad Costan

Medicina 2025, 61(2), 251; https://doi.org/10.3390/medicina61020251 - 1 Feb 2025

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Abstract

Background and Objectives: Oral cancer remains a critical global health concern, with oral squamous cell carcinoma (OSCC) being the most prevalent form. Oral potentially malignant disorders (OPMDs), such as oral leukoplakia (OLK), oral lichen planus (OLP), and actinic cheilitis (AC), often precede OSCC. Identifying reliable biomarkers is vital for assessing malignant transformation risk. The present study aimed to evaluate the immunohistochemical expression of differentiated embryonic chondrocyte 1 (DEC1), a marker of dysplasia severity, and cluster of differentiation 44 (CD44), which is associated with cancer progression, in OPMD and OSCC tissues. Materials and Methods: A retrospective analysis was conducted on 145 biopsy specimens from January 2015 to January 2023, comprising normal mucosa (NM), OLK, OLP, AC, and OSCC. DEC1 and CD44 expression levels were assessed using immunohistochemical staining. Positivity scores were determined based on staining intensity and extent, with statistical analyses performed using SPSS software (SPSS Inc., Chicago, IL, USA, version 29.0 for Windows). Results: It was found that CD44 expression significantly increased across OPMD and OSCC compared to NM (p < 0.001). Conversely, DEC1 expression was consistent across lesion types and dysplasia levels. CD44 expression was the highest in AC and OSCC, underscoring its potential role as a progression marker. Conclusions: The results indicate that CD44 is a more sensitive marker for assessing dysplastic severity and malignant transformation, while DEC1 may serve as a complementary marker for early-stage evaluation. Further research involving larger cohorts is needed to confirm these findings. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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17 pages, 1121 KiB

Open AccessArticle

Deep Neck Infections: The Effectiveness of Therapeutic Management and Bacteriological Profile

by Geanina Bandol, Mihail Dan Cobzeanu, Mihaela Moscalu, Octavian Dragos Palade, Liliana Moisii, Florentina Severin, Emilia Patrascanu, Florin Mocanu, Andrei Ionut Roman and Bogdan Mihail Cobzeanu

Medicina 2025, 61(1), 129; https://doi.org/10.3390/medicina61010129 - 15 Jan 2025

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Abstract

Background and Objectives: Deep neck infections (DNIs) are severe diagnoses that can cause serious complications. However, there are insufficient data to predict the evolution of this pathology. This study aims to review the microbiology of DNIs and to identify the factors that influence prolonged hospitalization. Materials and Methods: The present retrospective cohort observational analytical study analyzed 138 patients with DNIs who were diagnosed and received surgical treatment over a 8-year period. Results: Reduced lymphocyte percentages and increased neutrophil-to-lymphocyte ratios (NLRs) were significantly associated with complications (p < 0.001 and p = 0.0041, respectively). Laryngotracheal infections were significantly associated with complications (25.53%) (p = 0.0004). Diabetes mellitus (DM) and immunocompromised status were strongly associated with complications (p < 0.001 and p = 0.0056, respectively), establishing these conditions as significant risk factors. Patients with complications experienced substantially longer hospitalizations, with a mean duration of 24.9 days compared to 8.32 days in patients without complications (p < 0.001). Complications were observed in 47 patients (34.06%). The most common complications were airway obstruction, which occurred in 26 patients (18.84%), and mediastinitis, which was noted in 31 patients (22.46%). Patients requiring tracheotomy due to airway obstruction had 6.51 times higher odds of long-term hospitalization compared to those without airway obstruction (OR = 6.51; p < 0.001). Mediastinitis was associated with a 4.81-fold increase in the odds of prolonged hospitalization (OR = 4.81; p < 0.001). Monomicrobial infections were observed in 35.5% of cases, with no significant difference between the short-term (<2 weeks, 37.33%) and long-term (≥2 weeks, 33.33%) hospitalization groups (p = 0.8472). Conversely, polymicrobial infections were significantly associated with prolonged hospitalization, occurring in 20.63% of the long-term cases compared to 6.66% of the short-term cases (p < 0.001). The most common aerobic bacteria observed were Staphylococcus aureus (14.28%), Streptococcus constellatus (12.69%) and Streptococcus viridans (7.93%) during long-term hospitalization. Comparative analysis of the Kaplan–Meier survival curves based on the presence of infection revealed a significantly lower survival in cases with a positive culture. Conclusions: Deep neck infection has a complex pathology, whose therapeutic management remains a challenge in order to reduce the length of hospitalization and mortality. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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15 pages, 988 KiB

Open AccessArticle

Salivary Cortisol and Total Antioxidant Capacity (TAC) as Biomarkers of Stress in Dental Medicine Students—A Pilot Study

by Otilia Bolos, Vanessa Bolchis, Ramona Dumitrescu, Vlad Tiberiu Alexa, Berivan Laura Rebeca Buzatu, Anca Marcu, Catalin Marian, Paula Diana Ciordas, Daniela Jumanca, Atena Galuscan and Octavia Balean

Medicina 2024, 60(12), 1972; https://doi.org/10.3390/medicina60121972 - 30 Nov 2024

Cited by 1 | Viewed by 1014

Abstract

Background and Objectives: Stress is a significant issue among dental students, with both psychological and physiological impacts affecting their academic performance. This cross-sectional study aimed to explore the relationship between academic stress and salivary biochemical markers, specifically cortisol and total antioxidant capacity (TAC), in third- and fifth-year dental students during the 2022/2023 academic year. Materials and Methods: This study included 44 participants from the Faculty of Dental Medicine at Victor Babes University, Romania. Saliva samples were collected during a low-stress period and prior to exams (high-stress period). Results: Cortisol and TAC levels were measured using ELISA and TAC assays, respectively, decreasing from an average of 3.69 (SD ± 1.49) before stress to 2.86 (SD ± 2.28) during high-stress periods (p < 0.05), while salivary cortisol levels showed a non-significant change from 23.69 (SD ± 35.6) ng/mL to 20.44 (SD ± 23.07) ng/mL; additionally, female participants exhibited a mean STAI score of 91.65 (SD ± 5.13) compared to 91.09 (SD ± 9.41) for males, indicating greater stress responses among females. Conclusions: The State-Trait Anxiety Inventory (STAI) scores confirmed elevated anxiety levels during exams. The findings suggest that academic stress negatively impacts TAC while triggering a moderate increase in salivary cortisol, underlining the need for stress management interventions in dental education. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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16 pages, 1371 KiB

Open AccessFeature PaperArticle

Impact of Infrabony Defects Treatment on Periodontal Markers and Glycated Hemoglobin Using Platelet-Rich Fibrin, Guided Tissue Regeneration, and Access-Flap Surgery

by Ada Stefanescu, Irina-Georgeta Sufaru, Cristian Martu, Diana-Maria Anton, Gabriel Rotundu and Kamel Earar

Medicina 2024, 60(11), 1769; https://doi.org/10.3390/medicina60111769 - 29 Oct 2024

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Abstract

Background and Objectives: This study evaluated the outcomes of single open-flap debridement, open-flap debridement (OFD) plus resorbable membrane placement, and OFD with resorbable membrane placement plus platelet-rich fibrin (PRF) in terms of periodontal clinical parameters and glycated hemoglobin (HbA1c) levels in 24 adult patients with stage 3 grade C periodontitis and type II diabetes mellitus. Materials and Methods: The primary outcome measure for this study was the clinical attachment level (CAL); secondary outcomes included additional periodontal parameters, such as the plaque index (PI), bleeding on probing (BOP), probing depth (PD), as well as glycated hemoglobin (HbA1c) levels to evaluate the systemic impact of the treatments on glycemic control. The parameters were assessed before and at three and six months post-surgery. In Group A, the flap was sutured closed; in Group B, an absorbable collagen membrane was placed over the defect; and in Group C, PRF was utilized in the defect, with two additional PRF membranes used to cover the defect. The wound healing index (WHI) was recorded at 7 and 14 days after the surgery. Results: The initial findings indicated no significant differences in the periodontal parameters among the three groups. However, improvements in the PD and CAL were most notable in Group C, followed by Group B, with Group A showing the slightest improvement. At six months, there was a highly significant difference in the CAL (p < 0.001). Group C (4.92 ± 0.35) and Group B (4.99 ± 0.31) demonstrated the most significant improvements in the CAL compared to Group A (5.89 ± 0.57). At seven days post-surgery, Group C demonstrated significant healing, with 85% of the sites showing complete healing. By the 14-day mark, all sites in Group C indicated complete healing. Although the HbA1c values did not exhibit statistically significant differences among the groups at baseline, at the 6-month evaluation, all groups showed significantly lower values than baseline. However, the comparison between groups revealed significantly improved values for Group C. Conclusions: The study’s results suggest that PRF is an exceptional material for infrabony defects treatment and notably improves HbA1c levels. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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10 pages, 294 KiB

Open AccessArticle

The Influence of Dental Status and Blood Parameters Characterizing Endogenous Intoxication on the Timing of Childbirth

by Maria Hakobyan, Gayane Manrikyan, Marina Markaryan, Izabella Vardanyan and Mikayel Manrikyan

Medicina 2024, 60(7), 1176; https://doi.org/10.3390/medicina60071176 - 19 Jul 2024

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Abstract

Background and Objectives: Epidemiological and microbiological–immunological studies have led to the conclusion that periodontal disease may be a risk factor for preterm birth. The aim of this study was to investigate and identify the relationship of some hematological cellular biomarkers characterizing the chronic oral focus of infection with pregnancy outcomes and their impact on those outcomes. Materials and Methods: Clinical and laboratory tests were conducted on 100 pregnant women, grouped by full-term or preterm births, with the assessment of the following markers: DMF, CPI and PIRI, PHP, microbiological examination of periodontal pockets and amniotic fluid, WBS count, WBCSI, LGI, and NMR. A statistical analysis was carried out with SPSS Statistics version 19.0. Results: Women with preterm labor had higher-grade caries (CSL > 0.3), while women with full-term childbirth had moderate caries (CSL < 0.3). A satisfactory level of oral hygiene efficiency was found in 50% (group 1) and 38.1% (group 2) of the expectant mothers. The periodontal status by the PIRI showed tissue lesions in 20.7% (group 1) and 92.9% (group 2) of the women. The WBCSI was 2.27 ± 0.82 and 2.15 ± 0.68, the NMR was 9.29 ± 5.119 and 11.62 ± 7.78, and the LGI was 3.54 ± 1.1 and 3.73 ± 0.81 in groups 1 and 2, respectively. Comparative analysis of bacterial contamination of the amniotic fluid revealed the predominance of Fusobacterium nucleatum (64.3%), Tannerella forsythia (57.1%), Prevotella intermedia (50%), Porphyromonas gingivalis (57.1%), Staphylococcus aureus (45.2%), and Candida albicans (50%) in women with premature birth. Conclusions: In women with preterm birth, the values of the indices characterizing a chronic oral focus of infection evoke more significant correlations with the timing of delivery, which indicates the significant role of an oral focus of infection. The presence of microbial invasion of amniotic fluid may indicate the role of periodontopathogenic bacteria in pregnant women diagnosed with a risk of preterm birth. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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14 pages, 1173 KiB

Open AccessSystematic Review

Long-Term Effects of Sinus Floor Elevation with and Without Bone Graft: A Systematic Analysis of Randomized Clinical Trials

by Andrei Paul Tent, Ioan Andrei Țig, Simion Bran, Andra Zlotu, Alexandru Mester and Florin Onisor

Medicina 2025, 61(1), 104; https://doi.org/10.3390/medicina61010104 - 13 Jan 2025

Viewed by 1593

Abstract

Background and Objective: The aim of this systematic review was to assess clinical trials on the efficiency of sinus lift techniques with and without bone grafting in the atrophic posterior maxilla. Materials and Methods: This article was written under the PRISMA and the Cochrane Handbook for Systematic Reviews of Interventions guidelines. PubMed, Scopus, and Web of Science databases were electronically searched until December 2023. The risk of bias was assessed according to Cochrane Risk of Bias tool guidelines. Statistical analysis was performed for implant survival rate (ISR), marginal bone loss (MBL), and endo-sinus bone gain (ESBG). Results: At the end of the electronic search, 5 clinical trials were considered eligible. Statistical analysis was achieved for osteotome sinus floor elevation. The ISR at 3 years had a risk ratio (RR) of 0.98 [0.90, 1.07] (CI 95%), p = 0.7, and at 5 years, RR 1.02 [0.93, 1.11] (CI 95%), p = 0.68. The MBL, at 3 years, indicated a weighted mean difference (WMD) of 0.01 [−0.15, 0.16] (CI 95%), p = 0.93, and at 5 years, WMD of −0.08 [−0.53, 0.37] (CI 95%), p = 0.73. ESBG at 3 years had a WMD of −0.44 [−1.05, 0.17] (CI 95%), p = 0.16, and at 5 years, WMD of −0.61 [−1.63, 0.41] (CI 95%), p = 0.24. Conclusions: The available evidence underlines that the osteotome sinus floor elevation technique without bone graft may be used. Full article

(This article belongs to the Special Issue Advances in Clinical Medicine and Dentistry)

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