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Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation...
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Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions

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

Deadline for manuscript submissions: 31 July 2025 | Viewed by 5265

Special Issue Editors

Prof. Dr. Marina Consuelo Vitale

E-Mail Website
Guest Editor
Unit of Orthodontics and Pediatric Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 2, Piazzale Golgi, 27100 Pavia, Italy
Interests: laser; oral surgery; photobiomodulation; oral psychophysiology
Special Issues, Collections and Topics in MDPI journals
Dr. Alexandru Vlasa

E-Mail Website
Guest Editor Assistant
Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540139 Târgu-Mureș, Romania
Interests: periodontics; periodontal disease; gingivitis; non-surgical treatment

Special Issue Information

Dear Colleagues,

Periodontal disorders encompass a range of conditions affecting the tooth and surrounding tissues and are a multifaceted aspect of overall health that involves various physiological and psychological processes. This Special Issue seeks to elucidate the intricate interplay between the protective mechanisms and periodontal disorders.

Recent research suggests a bidirectional relationship, a disrupted pattern and exacerbation of symptoms between the immune responses and periodontal structures. Understanding the relationship between these has important clinical implications. Healthcare providers should consider assessing immune patterns in individuals with periodontitis symptoms, and vice versa. Comprehensive treatment strategies may yield more effective outcomes. Collaborative efforts between researchers, clinicians, and healthcare professionals are essential to advance our understanding of this intricate interplay and enhance patient care.

Original research articles and reviews are welcome. We look forward to receiving your contributions.

Prof. Dr. Marina Consuelo Vitale
Guest Editor

Dr. Alexandru Vlasa
Guest Editor Assistant

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

  • periodontal disease
  • gingivitis
  • immune response
  • oxidative stress

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Published Papers (5 papers)

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Research

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10 pages, 572 KiB  
Article
The Impact of Orthodontic Adhesives on the Subgingival Microbiota During Early Fixed Appliance Therapy: A Pilot Study
by Krisztina Martha, Esztella-Éva Kis, Izabella Éva Mureșan and Andrei Constantin Ioanovici
Medicina 2025, 61(5), 858; https://doi.org/10.3390/medicina61050858 - 7 May 2025
Abstract
Background and Objectives: The most common method for treating malocclusions today is fixed orthodontic therapy, during which brackets and tubes are bonded to the surface of the teeth, which makes oral hygiene difficult to maintain. Increased plaque retention, gingival bleeding, and gingivitis [...] Read more.
Background and Objectives: The most common method for treating malocclusions today is fixed orthodontic therapy, during which brackets and tubes are bonded to the surface of the teeth, which makes oral hygiene difficult to maintain. Increased plaque retention, gingival bleeding, and gingivitis can be diagnosed in the early phases of treatment. The periodontal response to plaque accumulation can be explained by quantitative and qualitative changes in the subgingival microbiota. The aim of our research was to investigate the changes in the subgingival microbiota that occurred within 6–8 weeks after bonding when two different orthodontic adhesives were used. Materials and Methods: Thirty patients were followed; molar tubes were bonded with a composite (C) in fifteen cases, and in the other fifteen cases, they were bonded with glass ionomer cementum (GIC). A microbiological sample was taken from the gingival sulcus of the maxillary first molars at the time of appliance placement (T1) and 6–8 weeks (T2) after bonding. Bacterial DNA detection was performed using the micro-IDent®plus11 (Hain Lifescience GmbH, Germany) PCR (polymerase chain reaction) method. The statistical analysis included McNemar’s test to analyze the paired binary data and Fisher’s Exact Test to compare the prevalence of each of the 11 bacteria at T1 and, ultimately, T2 between the two studied groups. The Bonferroni correction was also applied. Results: When analyzing GIC vs. C at T1 and T2, none of the studied pathogens showed significant differences. Conclusions: Given the lack of statistical significance, these trends do not confirm a definitive impact of the procedure on bacterial presence. The increased presence of periodontal pathogens might suggest that bonding does not reduce the bacterial loading of subgingival microbiota. Less protective effects of the GIC intervention against Tannerella forsythia and Eubacterium nodatum bacteria were detected. Full article
(This article belongs to the Special Issue Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions)
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14 pages, 1312 KiB  
Article
The Role of Oxidative Stress-Related Gene Polymorphisms (SOD2, GPX1) in Severe Early Childhood Caries (S-ECC)
by Timea Dakó, Ana-Petra Lazăr, Luminița Lazăr, Alexandra-Mihaela Stoica, Adriana-Stela Crișan, Monica Monea and Cristina-Ioana Bica
Medicina 2025, 61(3), 432; https://doi.org/10.3390/medicina61030432 - 28 Feb 2025
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Abstract
Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local [...] Read more.
Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local antioxidants plays an important role in determining susceptibility to caries. This study aimed to demonstrate that the host’s redox imbalance, modified by genetic polymorphisms, may influence the onset and severity of S-ECC. Materials and Methods: A total of 110 patients were included in the study (59 diagnosed with S-ECC and 51 healthy controls). Upon initial appraisal, the DMFT (decayed-missing-filled teeth) index was determined, and epithelial cells were collected using oral swabs for genomic DNA extraction. Genotyping of SOD2 (rs4880) and GPX1 (rs1050450) was performed using TaqMan SNP genotyping assays and real-time polymerase chain reaction (PCR). Results: According to the results of the present study, there was a significant difference between the frequency of the reference genotype and variants for rs4880 (p = 0.0303). Subjects carrying the AG and GG variant genotype of rs4880 were significantly associated with a high DMFT value (p = 0.0005). However, no significant difference was found between the genotypes for rs1050450, nor was there an association with the severity of S-ECC. Conclusions: The AG and GG variant genotypes of the SOD2 polymorphism (rs4880) increase the severity of caries in preschoolers and predispose patients to develop carious lesions, especially when associated with certain feeding practices and infrequent toothbrushing. This observation emphasizes that host sensitivity to caries is a crucial factor in the onset and development of carious lesions in primary dentition, despite the main contributing factors to this pathology. The rs1050450 polymorphism was not associated with the severity of S-ECC. Full article
(This article belongs to the Special Issue Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions)
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13 pages, 2766 KiB  
Article
Retrospective Study on Orthodontic Gingival Recession Correction Using Clear Aligners
by Sorana Maria Bucur, Eugen Bud, Mioara Decusară and Cristian-Doru Olteanu
Medicina 2024, 60(12), 2024; https://doi.org/10.3390/medicina60122024 - 8 Dec 2024
Viewed by 1577
Abstract
Background and Objectives: Our study aims to evaluate the effectiveness of ClearCorrect® clear aligners (The Straumann Group) in improving gingival recession, which developed following prior fixed orthodontic treatment. The specific objectives were to assess changes in recession severity in patients with [...] Read more.
Background and Objectives: Our study aims to evaluate the effectiveness of ClearCorrect® clear aligners (The Straumann Group) in improving gingival recession, which developed following prior fixed orthodontic treatment. The specific objectives were to assess changes in recession severity in patients with orthodontic gingival recessions following aligner therapy and to determine whether the initial severity of recession influenced improvement rates across three categories—mild (RT1), moderate (RT2), and severe (RT3)—as defined by the Cairo classification. Materials and Methods: Fifty-six patients with gingival recession from previous orthodontic treatment received aligner therapy for seven to twelve months, focusing on 146 recession sites, primarily in the lower anterior region. Recession severity was classified and tracked as RT1, RT2, and RT3. Statistical analyses, including a Chi-square test, assessed improvement rates across these categories. Results: Among severe recessions (RT3), 52% showed no improvement, while 48% exhibited some improvement, with 16% improving to RT1. In the moderate group (RT2), 63% improved to RT1, and 16% resolved. The mild group (RT1) showed a 58% reduction in recession depth. Chi-square testing confirmed a statistically significant difference in improvement rates across the three groups (p = 1.44 × 10−7). Conclusions: Clear aligners may contribute to gingival recession improvement, particularly in mild and moderate cases (RT1 and RT2), though severe cases (RT3) show a more limited response. Full article
(This article belongs to the Special Issue Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions)
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11 pages, 647 KiB  
Article
Assessing the Effectiveness of A-PRF+ for Treating Periodontal Defects: A Prospective Interventional Pilot Study Involving Smokers
by Ada Stefanescu, Dorin Ioan Cocoș, Gabi Topor, Fabian Cezar Lupu, Doriana Forna-Agop and Kamel Earar
Medicina 2024, 60(11), 1897; https://doi.org/10.3390/medicina60111897 - 19 Nov 2024
Viewed by 1131
Abstract
Background and Objectives: This study aimed to evaluate the effects of advanced platelet-rich fibrin (A-PRF+) tissue regeneration therapy on clinical periodontal parameters in non-smokers and smoker patients. The anticipated biological mechanisms of A-PRF+ include stimulating angiogenesis, thereby promoting the formation of new blood [...] Read more.
Background and Objectives: This study aimed to evaluate the effects of advanced platelet-rich fibrin (A-PRF+) tissue regeneration therapy on clinical periodontal parameters in non-smokers and smoker patients. The anticipated biological mechanisms of A-PRF+ include stimulating angiogenesis, thereby promoting the formation of new blood vessels, which is essential for tissue healing. Additionally, A-PRF+ harnesses the regenerative properties of platelet-rich fibrin, contributing to the repair and regeneration of periodontal tissues. Materials and Methods: The study was conducted on 55 patients, divided into two groups: non-smoker patients (n = 29) and smoker patients (n = 26). A single operator conducted the surgical procedure. Following the administration of local anesthesia with articaine 4% with adrenaline 1:100,000 precise intracrevicular incisions were made, extending towards the adjacent teeth, until the interproximal spaces, with meticulous attention to conserving the interdental gingival tissue to the greatest extent possible. Extended, full-thickness vestibular and oral flaps were carefully lifted, and all granulation tissue was meticulously removed from the defect without altering the bone contour. After debridement of the defects, A-PRF+ was applied. BOP (bleeding on probing), PI (plaque index), CAL (clinical attachment loss), and probing depth (PD) were determined at baseline and six months post-surgery. Results: Significant reductions were observed in PD and CAL after six months. In the non-smokers group, PD decreased from 7.0 ± 1.0 mm to 3.1 ± 0.1 mm (p < 0.001), while in the smokers group, PD decreased from 6.9 ± 1.1 mm to 3.9 ± 0.3 mm (p < 0.001). CAL decreased in the non-smokers group from 5.8 ± 0.7 mm to 2.6 ± 0.2 mm and from 5.7 ± 0.9 mm to 3.2 ± 0.2 mm (p < 0.001) in smokers. Notably, the reductions in CAL and PD were statistically more significant in the non-smokers group. Conclusions: Even though the clinical periodontal improvements were considerable in smoker patients, they did not reach the level observed in non-smoker patients. Full article
(This article belongs to the Special Issue Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions)
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Review

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12 pages, 327 KiB  
Review
Challenges and Perspectives Regarding the Determination of Gingival Crevicular Fluid Biomarkers During Orthodontic Treatment: A Narrative Review
by Anamaria Bud, Luminița Lazăr, Maria-Alexandra Mârțu, Timea Dakó, Mircea Suciu, Andreea Vlasiu and Ana-Petra Lazăr
Medicina 2024, 60(12), 2004; https://doi.org/10.3390/medicina60122004 - 4 Dec 2024
Viewed by 1219
Abstract
Background: Changes in the positions of teeth occur during orthodontic treatment due to the application of forces that cause restructuring of the periodontal tissue. In the last decade, substantial research has been conducted to detect different biomarkers in the gingival crevicular fluid (GCF) [...] Read more.
Background: Changes in the positions of teeth occur during orthodontic treatment due to the application of forces that cause restructuring of the periodontal tissue. In the last decade, substantial research has been conducted to detect different biomarkers in the gingival crevicular fluid (GCF) to obtain a better assessment of the periodontal status. Aim: The purpose of this review is to describe how the levels of certain biomarkers from the gingival fluid change during tissue remodeling throughout orthodontic treatment. Materials and methods: To carry out the purpose of this research, electronic databases were searched using specific keywords, leading to 387 articles, out of which 19 were used in writing this narrative review. A sampling period of the last 10 years was used in selecting the articles. Results: The results highlight that the origin of the gingival crevicular fluid is at the gingival blood vessels’ plexus. GCF has a complex composition with differences depending on the periodontal status and the tissue restructuring which takes place in the periodontium. The levels of inflammatory mediators, enzymes, and metabolic products of tissue remodeling in GCF change during orthodontic treatment. Being aware of their specific role, they can provide valuable information about bone remodeling during orthodontic tooth movement. Conclusions: By determining the biomarkers in GCF, as an investigative method, clinicians could easily monitor the orthodontic tooth movement, and, subsequently, the treatment period could be shortened and the adverse effects associated with it could be avoided. Full article
(This article belongs to the Special Issue Oral Physiology: Protective Mechanisms, Immune Responses and Pathways of Inflammation in Periodontal Conditions)
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