Search Results (254)

Background: Local anesthesia is essential for most dental procedures, but its parenteral administration is often painful. Topical anesthetics are commonly used to minimize local anesthesia pain; however, commercial formulations fail to fully prevent the discomfort of local anesthetic injection. Methods: We developed and characterized a novel lidocaine and epinephrine co-loaded liquid crystalline precursor system (LCPS) for topical anesthesia. The formulation was structurally characterized using polarized light microscopy (PLM) and small-angle X-ray scattering (SAXS). Rheological behavior was assessed through continuous and oscillatory rheological analyses. Texture profile analysis, in vitro mucoadhesive force evaluation, in vitro drug release and permeation studies, and an in vivo toxicity assay using the chicken chorioallantoic membrane (CAM) model were also conducted. Results: PLM and SAXS confirmed the transition of the LCPS from a microemulsion to a lamellar liquid crystalline structure upon contact with artificial saliva. This transition enhanced formulation consistency by over 100 times and tripled mucoadhesion strength. The LCPS also provided controlled drug release, reducing permeation flow by 93% compared to the commercial formulation. Importantly, the CAM assay indicated that the LCPS exhibited similar toxicity to the commercial product. Conclusions: The developed LCPS demonstrated promising physicochemical and biological properties for topical anesthesia, including enhanced mucoadhesion, controlled drug delivery, and acceptable biocompatibility. These findings support its potential for in vivo application and future clinical use to reduce pain during dental anesthesia procedures. Full article

Background: The aim of this review is to summarize and evaluate the properties of antibacterial polysaccharides for application in dental implantology to identify knowledge gaps and provide new research ideas. Methods: The electronic databases PubMed, Medline, ProQuest, and Google Scholar were used to search for peer-reviewed scientific publications published between 2018 and 2025 that provide insights to answer research questions on the role of antibacterial polysaccharides in combating pathogens in dental implantology without triggering immune reactions and inflammation. Further research questions relate to the efficacy against various dental pathogens and the understanding of the antibacterial mechanism, which may enable the development of functionalized polysaccharides with long-term antibacterial activity. Results: Biomedical implants have revolutionized medicine but also increased the risk of infections. Implant infections are a major problem in implantology and lead to implant failure and replacement. An antibacterial coating could be an excellent strategy to extend the lifespan of implants and improve the quality of the patient’s life. Bacterial resistance to antibiotics poses significant challenges for researchers, forcing them to search for new ways to prevent bacterial infections in implantology. Antibacterial natural polymers have recently received considerable research attention due to their long-term antibacterial activity. Polysaccharides from marine sources, such as chitosan and alginate, or pectin, xanthan, etc., from various plants, appear to be promising biopolymers for such applications in implantology due to their antibacterial activity, biocompatibility, and osteogenic properties. The antibacterial activity of these natural biopolymers depends on their chemical and physical properties. Nanopolysaccharides exhibit higher antibacterial activity than conventional polysaccharides, but their toxicity to human cells must be considered. Their antibacterial activity is based on the disruption of bacterial DNA or RNA synthesis, increased cell wall permeability, membrane disruption, and cytoplasmic leakage. Conclusions: Polysaccharides are a class of natural polymers with a broad spectrum of biological activities. They exhibit antioxidant, immunomodulatory, anticoagulant, anticancer, anti-inflammatory, antibacterial, and antiviral activity. Furthermore, polysaccharides are non-cytotoxic and exhibit good biocompatibility with osteogenic cells. Bactericidal polysaccharides are attractive new antibacterial materials against implant infections and open up new perspectives in implantology. Full article

Background: The role of collagen membrane fixation during guided bone regeneration (GBR) remains debatable, particularly in post-extraction sockets with buccal defects and concomitant immediate implant placement. This study evaluated whether or not fixation with titanium pins improved regenerative outcomes. Methods: Six adult Beagle dogs received bilateral extractions of the fourth mandibular premolars. An implant was immediately placed in both the distal alveoli, and standardized buccal bone defects (5 mm height, 3–2 mm width) were prepared. All defects were filled with a slowly resorbing equine xenograft and covered by a resorbable pericardium membrane. At the test sites, the membrane was apically fixed with pins, while no fixation was applied to the control sites. After 3 months of healing, histomorphometric analyses were performed. Results: The vertical bone gain of the buccal crest was 3.2 mm in the test sites (pin group) and 2.9 mm in the control sites (no-pin) (p > 0.754). No significant difference was found in terms of bone-to-implant contact (BIC). However, residual graft particles were located significantly more coronally in the pin group compared to the no-pin group (p = 0.021). Morphometric analyses revealed similar new bone formation within the groups, but with higher amounts of residual xenograft and soft tissue in the pin group. Conclusions: Membrane fixation did not significantly enhance vertical bone gain, and although the slightly higher regeneration in the pin group (3.2 mm vs. 2.9 mm) may hold clinical relevance in esthetically sensitive areas and osseointegration, it appeared to limit apical migration of the grafting material. Full article

Peri-implantitis is an inflammatory disease-causing bone loss around dental implants, often requiring reconstructive surgical therapies to reduce probing depth and regenerate bone. However, such surgeries are frequently complicated by postoperative issues. This retrospective case series aimed to identify the main postoperative complications following the reconstructive treatment of peri-implant bone defects in peri-implantitis patients. Data from 14 patients with 21 affected implants were analyzed, including demographics, oral hygiene, surgical techniques, and complications such as wound dehiscence, membrane exposure, and infections. Wound dehiscence was measured using Image J^® software version 1.54. Descriptive and bivariate analyses were performed. The results showed that 11 implants (52.4%; 95% confidence interval (95%CI): 29% to 76%) in nine patients (57.1%; 95%CI = 27% to 87%) developed soft tissue dehiscence after one week, with membrane exposure observed in 4 implants. Dehiscence was significantly associated with mandibular implant location (p = 0.003), poor interproximal hygiene (p = 0.008), and membrane exposure (p = 0.034). No postoperative infections were recorded. In conclusion, more than half of peri-implantitis patients undergoing reconstructive surgery experience wound dehiscence, particularly in cases involving mandible, poor hygiene, and membrane exposure. This complication might compromise bone regeneration and reduce the treatment success rate. These results should be interpreted cautiously due to study design limitations (retrospective design, lack of a control group, and small sample size). Full article

Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development of customized scaffolds tailored to patient needs, potentially overcoming the limitations of conventional methods. Materials and Methods: A scoping review was conducted according to the PRISMA guidelines. Electronic searches were performed in MEDLINE (PubMed), the Cochrane Library, Scopus, and Web of Science up to January 2025 to identify studies on digital technologies applied to bone augmentation. Eligible studies encompassed randomized controlled trials, cohort studies, case series, and case reports, all published in English. Data regarding digital workflows, software, materials, printing techniques, and sterilization methods were extracted from 23 studies published between 2015 and 2024. Results: The review highlights a diverse range of digital workflows, beginning with CBCT-based DICOM to STL conversion using software such as Mimics and Btk-3D^®. Customized titanium meshes and other meshes like Poly Ether-Ether Ketone (PEEK) meshes were produced via techniques including direct metal laser sintering (DMLS), selective laser melting (SLM), and five-axis milling. Although titanium remained the predominant material, studies reported variations in mesh design, thickness, and sterilization protocols. The findings underscore that digital customization enhances surgical precision and efficiency in BR, with several studies demonstrating improved bone gain and reduced operative time compared to conventional approaches. Conclusions: This scoping review confirms that 3D techniques represent a promising advancement in BR. Customized digital workflows provide superior accuracy and support for BR procedures, yet variability in protocols and limited high-quality trials underscore the need for further clinical research to standardize techniques and validate long-term outcomes. Full article

Background: Aquaporins (AQPs) are integral membrane proteins that facilitate water transport across biological membranes. While their role is well-characterized in various tissues, their function in the oral cavity remains poorly understood. Saliva is an easily accessible, non-invasive biofluid that contains stable extracellular RNA and can reflect both systemic and local physiological or pathological processes, making it a promising source for RNA analyses. This study investigates AQP mRNA levels in human saliva. Methods: Saliva samples were collected from patients of a dental practice and analyzed using quantitative PCR to detect AQP levels. An in silico analysis of AQPs in cells of the oral cavity were performed. Baseline data of the patients were recorded. Results: Our findings demonstrate the presence of multiple AQP subtypes in human saliva. AQP5 was the most abundant, followed by AQP9 and AQP1. The levels of several AQPs showed intercorrelation, whereas AQP3 appeared to be independently regulated and did not correlate with the other AQPs. Conclusions: This study demonstrates that differential AQP mRNA levels can be detected in human saliva. These findings suggest that salivary AQP mRNA may serve as surrogate markers for altered AQP levels in cells of the oral cavity. In the future, such patterns of AQP levels could potentially be used to identify or monitor pathological conditions affecting the oral mucosa or salivary glands. Further studies are required to validate this approach and to understand its diagnostic relevance. Full article

Background: Vertical ridge augmentations (VRAs), including guided bone regeneration (GBR) techniques, have been utilized in the reconstruction of deficient alveolar ridges for quite some time. GBR-based VRA procedures are technique-sensitive, operator-dependent, and often lead to complications detected during or after the treatment. The main objective of this systematic review was to include randomized and non-randomized human studies that investigated the regenerative outcome differences, as well as the incidence rates of healing and surgical complications of titanium meshes and/or titanium-reinforced membranes with and without collagen membranes utilized in GBR-based VRA. Methods: This systematic review has been prepared and organized according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines and is registered at PROSPERO (Registration ID: CRD420251002615). Medline via PubMed, Scopus, Web of Science, Embase, and the Cochrane Library were searched for eligible studies up to 5 June 2025. Randomized and non-randomized human clinical studies, except for case reports, focused on applying titanium meshes or titanium-reinforced membranes with or without collagen membranes in GBR-based VRA, were eligible. Results: A total of 119 patients from three human randomized clinical trials (RCTs) and one case series reported across nine articles were included. The addition of collagen membranes causes no significant differences in vertical bone gain or surgical/healing complication rates. Conclusions: The addition of collagen membranes on top of titanium meshes and titanium-reinforced membranes might not be necessary in GBR-based VRA. Further human RCTs are required to reach a reliable conclusion. Full article

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred. Full article

Background: The combination of polynucleotides and hyaluronic acid with bovine bone grafts in maxillary sinus lift procedures appears to be a promising strategy to enhance bone regeneration. This study aimed to analyze implant osseointegration, bone repair and sinus mucosa integrity using Bio-Oss^® and Hyaluronic Acid-Polynucleotide Gel (Regenfast^®) in maxillary sinus augmentation in rabbits. Methods: Sinus floor elevation was performed in 12 rabbits, with one implant placed per sinus simultaneously. In the control group, sinuses were grafted with deproteinized bovine bone mineral (Bio-Oss^®) alone; in the test group, Bio-Oss^® was combined with Regenfast^®. Two histological slides were obtained per sinus after 2 weeks (six animals) and 10 weeks (six animals): one from the grafted area alone (non-implant sites), and one from the implant site. Primary outcome variables included the percentage of newly formed bone, the extent of implant osseointegration, and the number of sinus mucosa perforations caused by contact with graft granules. Results: After 10 weeks of healing, the test group showed a significantly higher percentage of new bone formation (37.2 ± 6.7%) compared to the control group (26.8 ± 10.0%; p = 0.031); osseointegration extended to the implant apex in both groups; fewer sinus mucosa perforations were observed in the test group (n = 5) than in the control group (n = 14). Conclusions: The addition of Regenfast^® to Bio-Oss^® granules promoted enhanced bone regeneration within the elevated sinus area and was associated with a lower incidence of sinus membrane perforations compared to the use of Bio-Oss^® alone. Full article

Background: Resorbable biopolymers are increasingly explored for use in regenerative procedures within dental surgery. Their ability to degrade naturally, minimize surgical reinterventions, and potentially reduce immunogenicity makes them appealing in guided bone and tissue regeneration applications. However, despite these advantages, uncertainties persist regarding their comparative effectiveness and associated risks. For example, polyethylene glycol (PEG)-based membranes have shown comparable outcomes to porcine-derived collagen membranes in bone regeneration procedures, yet studies have reported a higher incidence of soft tissue healing complications associated with PEG-based materials. Similarly, while polycaprolactone (PCL) and dextrin-based hydrogels have demonstrated promising clinical handling and bone fill capabilities, their long-term performance and consistency across different anatomical sites remain under investigation. These findings highlight the need for further well-powered clinical trials to establish standardized guidelines for their safe and effective use. Methods: A systematic review protocol was registered with the PROSPERO database and developed in alignment with PRISMA guidelines. Database searches were conducted in PubMed, Medline, Scopus, and Cochrane from June to December 2024. Only randomized controlled trials (RCTs) focusing on synthetic resorbable biopolymers in bone augmentation procedures were considered. Bias was evaluated using the Cochrane Risk of Bias tool. Results: Eleven RCTs were included, totaling 188 patients. The findings suggest that materials such as polylactic acid (PLA), polycaprolactone (PCL), and polyethylene glycol (PEG) contributed effectively to new bone formation. PEG-based membranes were found to perform on par with or occasionally better than traditional collagen membranes derived from porcine sources. Additionally, the application of 3D-printable polymers demonstrated promise in site-specific healing. Conclusions: Resorbable biopolymers are effective and safe for GBR procedures, with clinical outcomes comparable to traditional materials. Advances in 3D-printing technology and bioactive coatings may further enhance their regenerative potential. However, the incidence of soft tissue healing complications suggests the need for further long-term studies to optimize material properties and clinical application. Full article

Background and Clinical Significance: To describe the effectiveness of alveolar ridge preservation under the radiological and histological analysis of a customized resorbable scaffold three-dimensionally printed with polycaprolactone (PCL) reinforced with a coating of a copolymer of polycaprolactone-block-polyethylene glycol (PCL–PEG) by electrospray. Case Presentation: A 62-year-old male with vertical root fractures of teeth #14 and #15. From the cone beam CT (CBCT) image, the scaffold root replicas were designed with the shape of the roots and printed with PCL coated with PCL–PEG by electrospray. The scaffold was inserted into the alveolar bone and maintained with a tension-free flap closure. After six months, a CBCT of the surgical site and histological analysis of a bone sample at the dental implant installation site were performed. After 6 months, the wound in tooth #14 was closed, clinically proving no adverse reaction or complications. The histological analysis of the bone sample showed new bone formation with lamellar structure, Haversian canal structure, and osteocyte spaces. However, the scaffold in tooth #15 was exposed and not osseointegrated, and it was covered with membranous tissue. Histologically, the sample showed tissue compatible with lax connective tissue with mixed inflammatory infiltrate. In tooth #14, the dental implant presented an insertion torque >35 Ncm and was rehabilitated three months after its installation. Conclusions: Three-dimensional printed PCL scaffolds showed the ability to regenerate vital and functional bone with osseointegration capability for maxillary bone regeneration and oral rehabilitation based on dental implants. A case of inadequate scaffold osseointegration accompanied by lax connective tissue formation is shown. Full article

Background: To reconstruct and maintain hard tissues over time, it is necessary to follow effective protocols and use appropriate materials. The selection of the graft material and its properties can also affect the final outcomes. For this purpose, numerous graft materials have been suggested. Among the valuable alternatives to these biomaterials, interest in using teeth as graft material has grown in recent years. Aim: The aim of the study was to investigate the histomorphometric outcomes of using tooth-derived materials when used as a bone substitute. Methods: We evaluated the histological results of autologous demineralized tooth graft material prepared using a Tooth Transformer device. A total of 187 histological samples from 186 subjects (52% male and 48% female, with an average age of 56.30 ± 12.97 years) were analyzed. The analysis focused on the total bone volume (BV%), residual tooth material (residual graft, TT%), and vital bone (VB%). The differences between the presence and absence of the resorbable membrane were also analyzed. Results: The amount of VB was 36.28 ± 19.09%, the residual graft TT was 9.6 ± 10.76%, and 46.96 ± 13.85% was the total bone volume (BV). The presence of membrane increased the amount of BV% and reduced the time to produce bone. Conclusions: The procedure using demineralized autologous tooth-derived biomaterial may be a predictable method for producing new vital bone capable of supporting dental implant rehabilitation and the use of membrane allow better results. Full article

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

Oral infections, caused by bacterial, fungal, and viral pathogens, are a significant source of dental morbidity and can lead to systemic complications, especially in immunocompromised individuals. Complex microbial interactions and host immune responses drive common conditions such as dental caries, periodontal disease, oral candidiasis, and herpetic lesions. Conventional antimicrobial therapies face limitations due to resistance and adverse effects, prompting interest in alternative treatments. Cannabidiol (CBD), a non-psychoactive compound derived from Cannabis sativa, has emerged as a promising candidate due to its antimicrobial, anti-inflammatory, and immunomodulatory properties. CBD targets various molecular pathways, including cannabinoid receptors, TRP channels, adenosine receptors, and PPARs, contributing to its multifaceted therapeutic effects. It has demonstrated efficacy against oral pathogens such as Streptococcus mutans, Enterococcus faecalis, and Candida albicans, disrupting biofilms and bacterial membranes. Additionally, CBD modulates inflammatory responses by reducing cytokine production and oxidative stress, particularly relevant in chronic conditions like periodontal disease. Emerging evidence also suggests synergistic effects with conventional antimicrobials and benefits in tissue regeneration. This review highlights the therapeutic potential of CBD in managing oral infections, offering a novel approach to overcoming current treatment limitations and guiding future research into safer and more effective oral health interventions. Full article

Background/Objectives: The satisfaction of patients following maxillary full-arch rehabilitation is crucial in assessing treatment effectiveness. This one-year study evaluated patients’ satisfaction, quality of life, and aesthetic perception after receiving the Maxilla-for-All^®/All-On-X treatments, which combine standard, pterygoid, trans-sinus, and zygomatic implants to support a fixed prosthesis and offer a graftless solution that reduces morbidity and treatment time. Methods: A prospective cohort study using convenience sampling of subjects treated for severe maxillary atrophies was conducted on patients receiving immediate implant-supported full-arch fixed prostheses. The Oral Health Impact Profile (OHIP-14) and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ-23) were administered preoperatively and one year post-treatment. Patients were grouped based on the presence or absence of complications (surgical, technical, and mechanical) and Wilcoxon tests were used for comparison (significance level = 0.05). Results: A total of 56 patients (29 female, 27 male) participated, with no implant or prosthesis failures. Eleven patients reported unilateral sinus membrane perforation, and seven had technical or mechanical complications. Preoperatively, 69% of patients rated their oral condition as unfavorable according to the OHIP-14; this dropped significantly to 21.8% post-treatment (p-value < 0.0001). After one year, the average PIDAQ-23 score improved significantly from 44.7 ± 16.6 to 6.8 ± 5.3 (p-value < 0.0001). No significant differences were observed between patients with or without complications (p-values ranging from 0.5270 to 0.8920). Conclusions: Full-arch rehabilitation using Maxilla-for-All^®/All-On-X treatments significantly improved both aesthetic perception and chewing function in patients with severe maxillary atrophies. They reported a substantial reduction in oral health-related discomfort, as shown by a significant decrease in OHIP-14 scores one year post-treatment. Clinical or technical complications did not significantly impact patients’ quality-of-life outcomes or satisfaction, supporting the reliability of this treatment protocol. Full article