Search Results (86)

Background: The oral microbiome differs in obese patients compared to normal-weight subjects. Microbiologic shifts very often appear after surgical interventions such as bariatric surgery (BS) and in immunocompromised patients. However, the oral microbiome composition and load in subjects after bariatric surgery are unclear. Aim: The aim of this review is to summarize the current state of the art related to the oral microbiome shift induced by bariatric surgery and to discuss its implications on oral cavity health. Methods: Electronic databases: PubMed/Medline, Web of Science, and Cochrane Library were searched for articles published up to March 30, 2025, describing prospective studies focused on changes in the oral microbiota of patients who underwent bariatric surgery. Results: Eight studies measuring the oral microbiome with different approaches—16S ribosomal RNA (16S rRNA) sequencing, polymerase chain reaction (PCR), culture, and matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI TOF MS)—were included in this review. The following bariatric techniques were used: sleeve gastrectomy, Roux-en-Y gastric bypass, Omega loop gastric bypass, and laparoscopic gastric plication. The follow-up period ranged from 3 to 12 months. The results of microbiologic studies were unequivocal. There was an increment in Streptococcus mutans reported, high levels of Candida species, and increased rates of some periodontitis-associated bacteria (Porphyromonas gingivalis) in the post-bariatric surgery period, though some studies suggested a shift towards non-pathogenic composition of the oral microbiome in prospective observations. Conclusions: The local oral microbial homeostasis becomes strongly impacted by the bariatric surgical treatment itself as well as its consequences in the further post-operative period. Therefore, obese patients undergoing BS require very careful dental observation. Full article

Background/Objectives: Among the paranasal sinuses, the maxillary antrum holds unique clinical relevance due to its proximity to the alveolar process of the maxilla, which houses the teeth. This study aimed to evaluate the position of the root apices of the maxillary canines and posterior teeth relative to the maxillary sinus floor in Romanian subjects. Methods: Data for the study were retrospectively obtained from cone-beam computed tomography (CBCT) scans. The evaluation considered the pattern of proximity to the sinus floor for each tooth type, comparisons of the sinus relationships of teeth within the same dental hemiarch, as well as those of homologous teeth, and variation in root-to-sinus distance in relation to sex and age. Nonparametric tests were used for statistical analysis, and multiple comparisons were performed using Bonferroni post hoc correction. Results: The study included 70 individuals aged 20 to 60 years. The distance to the sinus floor decreased progressively from the first premolar to the second molar, with median values of 3.68 mm (first premolar), 1.45 mm (second premolar), 0.50 mm (first molar), and 0.34 mm (second molar) (p < 0.01). Stronger correlations were observed between adjacent teeth than between non-adjacent ones. The distances to the sinus floor were greater on the right side compared to the left; however, these differences were not statistically significant (p > 0.05 for all teeth). Concordance between left and right dental hemiarches regarding the closest tooth to the sinus floor was found in 70% of cases (n = 49), most frequently involving the second molars (n = 38; 54.3%). On average, the distance from the sinus floor was smaller in males compared to females, with statistically significant differences observed only for the second molar. Increased age was associated with a greater distance to the sinus floor. Conclusions: Of all the teeth investigated, the second molar showed the highest combined prevalence of penetrating and tangential relationships with the maxillary sinus. At the dental hemiarch level, the second molar was most frequently the closest tooth to the sinus floor, and in the majority of cases, at least one posterior tooth was located within 0.3 mm. Accurate preoperative assessment of tooth position relative to the sinus floor is essential when performing non-surgical or surgical root canal therapy and extractions of maxillary molars and premolars. CBCT provides essential three-dimensional imaging that improves diagnostic precision and supports safer treatment planning for procedures involving the posterior maxilla. Full article

Background: The behavior of soft tissues following recession type 1 (RT1) and/or non-carious cervical lesions (NCCLs) treated with class V restorations is not well understood. These conditions cause both functional and esthetic issues. Recent studies show that increased cervical thickness can influence gingival tissue response. This suggests that restoration design has a key impact. This study aims to evaluate the effect of tooth shape modification on gingival tissue response and periodontal health with 3D analysis. Methods: Seven patients with buccal gingival recession and NCCL were selected, resulting in 50 treated teeth. Patients underwent class V buccal restorations using the BOVR technique. Three-dimensional evaluation through scanned dental impressions was performed at baseline and at T1 to monitor tissue profile changes in the buccal zenith sagittal plane. The average observation period was 4 months. Following the assessment, linear measurements were calculated according to standard planes. These measurements aimed to monitor transverse and axial tissue modifications. Probing depth, plaque index, and bleeding index were also recorded. Results: Increased tooth thickness led to tissue alteration. Greater composite thickness was significantly associated with an increase in tissue thickness (p ≤ 0.001) and gingival creeping (p ≤ 0.001) at the free gingival margin. Periodontal health remained unaffected, and 50% of the teeth required no additional surgical treatment due to satisfactory outcomes. Conclusions: Class V restorations that increase cervical thickness may promote soft tissue volume gain over a 4-month period without compromising periodontal health. A 4-month observation period is recommended before considering the surgical correction. Full article

Background/Objectives: Orthodontic camouflage is a treatment strategy designed to address mild to moderate skeletal discrepancies through dental compensation when growth modification or orthognathic surgery (OGS) is unsuitable or declined by the patient. This report highlights the treatment of a child with a skeletal Class II pattern, Class II division 1 malocclusion, a 10.8 mm overjet, traumatic overbite, and unilateral temporomandibular joint (TMJ) ankylosis on the left side. Methods: The treatment plan focused on correcting the proclination of the maxillary incisors and improving the facial profile. A non-extraction camouflage approach using pre-adjusted edgewise appliances was implemented following a gap arthroplasty procedure on the left TMJ. Results: The patient achieved a satisfactory treatment outcome, with an ideal static and functional occlusion and significant improvement in facial esthetics. The approach effectively managed the severe mandibular retrognathia and TMJ ankylosis without OGS, thereby minimizing the risk of progressive condylar resorption. Conclusions: This case underscores the importance of personalized treatment plans tailored to each patient’s dental, skeletal, and individual needs. It demonstrates that non-surgical camouflage treatments can be a viable alternative for addressing severe mandibular retrognathia with TMJ ankylosis, achieving favorable esthetic and functional outcomes. Full article

Background: Topical application within peri-implant pockets ensures high drug concentrations at the infection site while minimizing systemic exposure. However, the comparative effectiveness of non-surgical causal therapy alone versus its combination with doxycycline remains unclear. This retrospective observational clinical study aimed to evaluate the impact of adjunctive doxycycline on peri-implant parameters, considering smoking, systemic conditions, and implant–prosthetic rehabilitation (single implant, implant-supported bridge, or full-arch). Methods: Patients were retrospectively assigned to a control group (CG), receiving non-surgical causal therapy alone, or a test group (TG), which is also treated with topical doxycycline. Peri-implant parameters, including Peri-implant Probing Depht (PPD), Bleeding on Probing (BoP), Plaque Index (PI), and suppuration, were assessed at baseline (T0) and follow-up (T1). Multivariate logistic regression and stratified subgroup analyses were conducted to adjust for confounders such as smoking, systemic conditions, and implant–prosthetic rehabilitation types. Results: Two hundred nine patients were included in the study, of whom 97 were in the CG and 112 were in the TG. At T1, the TG exhibited a statistically significant reduction in PPD, BoP, PI, and suppuration compared to the CG (p < 0.05). Conclusions: The adjunctive use of topical doxycycline significantly enhances clinical outcomes in non-surgical peri-implantitis treatment. Further longitudinal studies are needed to confirm these findings and assess long-term stability. Full article

Non-tuberculous mycobacteria (NTM) are saprophytes of both soil and water that may cause infection with a high risk of dissemination, mainly in immunocompromised patients. Most NTM infections occur in the lungs, while uncommon localizations are the skin, soft tissues, musculoskeletal apparatus, and lymphatic system. The possible relationship between NTM infections and dental procedures is still unclear. The authors reported a rare manifestation of NTM infection occurring in a 6-year-old girl who developed sub-mandibular swelling related to a necrotic tooth, thus mimicking an abscess of odontogenic origin. Fine-needle aspiration biopsy of the sub-mandibular swelling and the following microbiologic investigation showed infection sustained by the Mycobacterium fortuitum complex. After the medical and surgical treatment, the patient completely recovered after 8 months. A review of the relevant literature was carried out to deepen the clinical and microbiological aspects of such a rare occurrence. 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

The purpose of this study was to evaluate in vitro whether the type of tooth preservation before treatment with the Tooth Transformer^® (TT) device affects the osteoinductive characteristics of the extracted tooth. Forty extracted teeth from healthy non-smoking patients were selected. All teeth were cleaned of caries, tartar, and filling material and then roughly sectioned and divided into four experimental groups according to storage type: room-temperature (RT) tooth samples, frozen tooth samples, RIPA tooth samples, and fresh tooth samples. Each sample was minced, demineralized, and disinfected using the TT device. The Enzyme-Linked ImmunoSorbent Assay (ELISA) test revealed the presence of bone morphogenetic protein-2 (BMP-2) and collagen type-I (COL-I) in all of the samples, demonstrating that the fresh teeth retained the most significant amount of osteoinductive protein. In contrast, the tooth samples stored at room temperature (RT) showed the most important loss of BMP-2 and COL-I. A Western Blot analysis demonstrated the presence of the Mineralization Protein LIM-1 (LMP-1) and Transforming Growth Factor-β (TGF-β) in all of the dental samples analyzed. The fresh and frozen dental samples showed significantly higher levels of LMP-1 than those in the other samples. In contrast, the levels of TGF-β were similar in all of the dental samples examined, regardless of the type of storage. These experimental results suggest that an extracted tooth should be treated with the TT device as soon as possible to maximize its osteoinductive potential in surgical bone preservation and regeneration procedures. Full article

Background: Periodontitis is a prevalent inflammatory condition that destroys periodontal tissues. Scaling and root planing (SRP) is the gold standard for non-surgical treatment; however, its efficacy may be limited in cases with complex dental issues. This umbrella review aims to evaluate the effectiveness of hyaluronic acid (HA) as an adjunct to scaling and root planing (SRP) in enhancing clinical outcomes for periodontitis management. Methods: A comprehensive review of five systematic reviews, including meta-analyses where available, was conducted to synthesize evidence on the adjunctive use of HA with SRP. The studies were evaluated using the AMSTAR-2 quality assessment tool to determine methodological rigor. Data on clinical parameters such as probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), and plaque index (PI) were extracted and analyzed. Results: The findings indicate that HA supplementation leads to moderate improvements in PD, CAL, BOP, GI, and PI compared to SRP alone. Notable reductions in PD and gains in CAL were observed, with some meta-analyses showing statistically significant benefits. However, the heterogeneity in HA concentrations (0.2–1.4%), application methods, treatment frequencies, and follow-up durations (1 week to 12 months) limits definitive conclusions. Additionally, HA did not significantly affect the reduction in P. gingivalis prevalence. Conclusions: The use of HA in conjunction with SRP shows promise in enhancing the efficacy of non-surgical periodontal therapy. However, the heterogeneity in the quality and methodologies of the studies indicates the necessity for high-quality, standardized randomized controlled trials to establish clear clinical guidelines for the application of HA in the treatment of periodontitis. Full article

Aim: Class II Division I malocclusion poses significant challenges in orthodontics. The combination of a Herbst appliance and miniscrew anchorage emerged as a practical solution to improve skeletal and dental outcomes. This study employed finite element analysis to evaluate the biomechanical effects of a miniscrew-supported Herbst appliance on mandibular advancement and dentition movement. Methods: High-definition CBCT scans captured the maxilla and mandible’s detailed dental anatomy. The scans were stored in DICOM format for seamless integration with Mimics software (Mimics Innovation Suite research version 21.0, Materialise NV, Leuven, Belgium) for 3D reconstruction and model refinement. The appliance, designed with a maxillary fixed palatal arch and mandibular acrylic splint connected by telescoping rods, incorporated titanium TADs and elastic chains. STL models were optimized in Geomagic x Design for finite element analysis in Abaqus, assigning validated mechanical properties for materials. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Tetrahedral C3D4 elements were used for meshing, ensuring a balance between computational efficiency and detailed anatomical representation. Tetrahedral meshing and realistic boundary conditions simulated biomechanical interactions. Dynamic simulations in CATIA evaluated mandibular movement. FEA analyzed displacement across dentoalveolar structures along the X, Y, and Z axes to assess treatment efficacy and biomechanical stability. Results: The Z displacement analysis revealed that the incisal edges of the lower central, lateral, and canines shifted lingually by 0.41, 0.4, and 0.47 mm, respectively. Additionally, the apices of the lower central, lateral, and canines displaced backwards by 0.05 mm, 0.05 mm, and 0.07 mm, respectively. Conclusions: The appliance facilitated mandibular advancement, bodily retracted the lower incisors, well-controlled the upper ones, and mesial-tipped the upper posterior teeth. In contrast with traditional functional appliances, it caused the lower anterior teeth to move backwards, while skeletal anchorage overcame some shortcomings of nonsurgical treatments. This method might be a good treatment option for growing skeletal Class II patients. Full article

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings. Full article

Background: One of the parameters of maximum interest regarding the quality of the intraoral hard tissues is represented by the bone density, with direct clinical implications. The evaluation of this extremely important clinical parameter can be achieved by several imaging methods, of which the most known in dentistry is represented by the cone beam computed tomography (CBCT). Objectives: The purpose of the study is to obtain a quantitative analysis of bone mineral density changes in patients who underwent treatments of photobiomodulation (PBM), as complementary to a surgical approach in oral surgery and implantology. Methods: The study included the retrospective analysis of maxillary cone beam computed tomography of 28 patients without pathology or medication known to affect bone metabolism or its qualitative and quantitative properties. All patients from the study group followed the same laser PBM treatment protocol after placing dental implants; the PBM protocol implied the intraoral use of a gallium aluminum arsenide laser (GaAlAs) of 808 nm, 450 mW, in pulsed mode, administering an energy of 6 J in 3 points corresponding to each inserted dental implant—mesial, distal, and apical—totaling 18 J/implant. Treatment sessions were performed immediately postoperatively and at a subsequent distance of 48 h for 2 weeks (a total of eight sessions). For every patient, bone density was analyzed before and after PBM treatment, in the same areas of interest, within the same anatomical landmarks. A comparison was also made between the results obtained for the anterior maxilla and the posterior maxilla. All the measurements made were analyzed statistically, the results being presented in the dedicated section. Results: Based on the data analysis, the comparison between the lasered and non-lasered groups reveals that patients who underwent PBM showed a statistically significant improvement in bone mineral density, with the mean increasing from 530.91 HU before treatment to 842.55 HU after treatment (t-test: p < 0.001). In contrast, the non-lasered group showed no significant improvement, with a slight decrease in bone mineral density, as the mean dropped from 495.19 HU before treatment to 462.16 HU after treatment (t-test: p = 0.47). Conclusions: The study demonstrated results with statistical significance regarding the mineral bone density improvement of patients who underwent laser PBM treatment. This positive effect of laser therapy has been shown, both at the level of the vestibular cortical bone and at level of the trabecular bone, independent of the patient’s sex, for the anterior maxilla and at the lateral areas also. Full article

Introduction: Tooth autotransplantation is a well-established dental surgical procedure. However, third molar autotransplantation to bony free flaps is rarely performed. We present a case of two impacted wisdom teeth that were transplanted to a DCIA free flap using 3D printing technologies. Case report: A 10-year-old girl was diagnosed with ossifying fibroma. She underwent a segmental mandibular resection with nerve preservation and reconstruction using a DCIA free flap. Six years later, due to edentulism, wisdom tooth autotransplantation was performed with digital planning, thermoplastic vacuum-formed guides, and 3D-printed replicas. Postoperatively, splint fixation was required for 12 weeks due to mobility, and a minor wound complication resolved spontaneously. At the one-year follow-up, the transplanted teeth integrated successfully without resorption or ankylosis. Orthodontic treatment was initiated to optimize alignment. Conclusions: This case of an impacted third molar autotransplantation to a DCIA free flap in an adolescent patient after a non-malignant mandibular tumor resection and reconstruction demonstrates promising results. The application of 3D printing technology significantly enhances the feasibility of dental transplantation in challenging cases, particularly for suboptimal donor teeth such as impacted wisdom teeth, by enabling precise surgical planning and optimized recipient site preparation while also reducing damage to the grafted teeth during transplantation. Further research is needed to assess the role of tooth autotransplantation in bony free flaps. Full article

Background and Objectives: Nowadays, dental anxiety is one of the most common problems among the masses globally, causing individuals to avoid seeking dental treatment, which in turn leads to deterioration of quality of life related to oral health. Despite the technological advances in dentistry such that less pain is felt and high comfort performance is maintained, dental anxiety is still seen in individuals. Non-surgical periodontal therapy can be the cause of tension, anxiety, and stress. The aim of this study is to evaluate the possible relationships between pain perception and dental anxiety in individuals who underwent supragingival scaling. Materials and Methods: In our study, 226 individuals (114 female and 112 male) who were referred to the Dicle University Faculty of Dentistry, Department of Periodontology and who underwent supragingival scaling treatment were included. Participants were asked to complete the Modified Dental Anxiety Scale (M-DAS) and the Visual Analog Scale (VAS) to determine anxiety and pain levels and questionnaires containing information on gender, age, education level, previous dental visits, and complications. Results: The M-DAS score for females was significantly higher compared to males (p < 0.05). However, there was no statistically significant difference between genders regarding VAS scores. No statistically significant difference existed between M-DAS and VAS scores and education levels. There was a statistically significant relationship between M-DAS and VAS scores in females (p < 0.05). Conclusions: M-DAS and VAS scores in male patients did not show any statistically significant difference. Female patients exhibited higher levels of dental anxiety, and VAS scores were increased in females; M-DAS scores were also increased. Full article

Introduction: Dental anomalies present a significant challenge to clinicians due to their impact on both dental function and esthetics. The correction of these anomalies plays a critical role in improving the quality of life of our patients, highlighting the importance of this restorative work. Objective: The purpose of this systematic review is to assess the techniques used to restore various dental anomalies, and their subsequent esthetic impact on the overall dentition. Methods: Inclusion criteria consisted of restorative rehabilitations of the permanent dentition in non-syndromic patients with dental anomalies of morphology, structure, size, and number in the maxillary incisors. Exclusion criteria included surgical rehabilitation techniques, endodontic treatments, and anomalies of the primary dentition. The medical literature was systematically searched (Pubmed, PMC, Embase, Cochrane Central Register of Controlled Clinical trials, Scopus and Google Scholar) to identify all relevant articles reporting data regarding the chosen anomalies. ROBINS–I was used to assess the risk of bias tool, and the results were tabulate due to data heterogeneity. Results: Of the 1821 analyzed articles, 46 articles met the inclusion criteria, and were chosen to go through the final review procedure. Of the selected articles, 3 investigated amelogenesis imperfecta and dentinogenesis imperfecta, 1 analyzed conoid teeth, 1 considered hypodontia (other than MLIA), 3 concerned microdontia (excluding peg laterals and conoid teeth), 10 evaluated peg-shaped laterals, 2 investigated talon cusps and geminated teeth, 15 were regarding maxillary lateral incisor agenesis, and 11 papers were related to the perception of anomalies. Conclusions: Pre-visualization using Digital Smile Design, a treatment plan encompassing minimally invasive restorations, and using a multidisciplinary approach among practitioners helps the anomalous patient achieve the best possible esthetic result. Full article