Search Results (392)

Schaalia canis is a Gram-positive, facultatively anaerobic, rod-shaped bacterium originally isolated from the mucosa and skin of dogs. While it is a part of the normal canine oral flora, it has rarely been implicated in human disease, with only one prior case of cellulitis reported following a dog bite. Case Presentation: We present the case of a 57-year-old immunocompetent man who developed osteomyelitis of the left index finger following a delayed presentation after a dog bite. Despite initial conservative management with empirical oral antibiotics, the infection progressed, eventually requiring surgical debridement and the terminalisation of the finger at the proximal interphalangeal joint. Cultures from intraoperative bone specimens yielded the growth of Schaalia canis, with no other pathogenic organisms identified on the extended culture. Conclusions: This is the first documented case of Schaalia canis-associated osteomyelitis in a human and the first to necessitate a surgical intervention, expanding the known clinical spectrum of this organism. This case underscores the risks of delayed intervention in polymicrobial animal bite wounds and highlights the emerging role of Schaalia species as opportunistic zoonotic pathogens, particularly in the setting of deep, refractory infections. Full article

Background: Childhood cancer is considered one of the main causes of mortality and morbidity worldwide. There is strong evidence of the oral toxic effects of oncologic treatments, but their incidence is difficult to determine. The novel therapeutic strategies in Pediatric Oncology have led to increased survival in this population, resulting in an increased incidence of long-term effects, which diminish the patient’s quality of life. Methods: The search for articles started on 5 November 2024 and ended on 5 December 2024. Following the PRISMA Statement, a total of 1266 articles were obtained, from which 13 were selected for review. All articles were considered to be of high quality. The antineoplastic treatments used in them were chemotherapy, radiotherapy, surgery and immune therapy. Results: Most articles were cohorts and case controls. Only one case report was obtained. The results revealed that the most prevalent sequelae in the pediatric population after antineoplastic treatment were enamel alterations, microdontia, dental caries, periodontal disease, gingivitis, hyposalivation, alteration of the oral microbiome, alteration of mandibular bone density and malocclusion. The lesions are different depending on the therapy used. Conclusions: Oncologic treatments in children with cancer cause multiple oral sequelae such as microdontia, dental caries, enamel alterations, salivary gland alterations, mucositis and root resorption. It cannot be concluded which therapy has the most detrimental effect as each has a different mechanism of action in the oral cavity. Full article

Background: Type 2 diabetes (T2D) has been placed among the risk factors for fragility (osteoporotic) fractures, particularly in menopausal women amid modern clinical practice. Objective: We aimed to analyze the bone status in terms of mineral metabolism assays, blood bone turnover markers (BTM), and bone mineral density (DXA-BMD), respectively, to assess the 10-year fracture probability of major osteoporotic fractures (MOF) and hip fracture (HF) upon using conventional FRAX without/with femoral neck BMD (MOF-FN/HF-FN and MOF+FN/HF+FN) and the novel model (FRAXplus) with adjustments for T2D (MOF+T2D/HF+T2D) and lumbar spine BMD (MOF+LS/HF+LS). Methods: This retrospective, cross-sectional, pilot study, from January 2023 until January 2024, in menopausal women (aged: 50–80 years) with/without T2D (group DM/nonDM). Inclusion criteria (group DM): prior T2D under diet ± oral medication or novel T2D (OGTT diagnostic). Exclusion criteria: previous anti-osteoporotic medication, prediabetes, insulin therapy, non-T2D. Results: The cohort (N = 136; mean age: 61.36 ± 8.2y) included T2D (22.06%). Groups DM vs. non-DM were age- and years since menopause (YSM)-matched; they had a similar osteoporosis rate (16.67% vs. 23.58%) and fracture prevalence (6.66% vs. 9.43%). In T2D, body mass index (BMI) was higher (31.80 ± 5.31 vs. 26.54 ± 4.87 kg/m²; p < 0.001), while osteocalcin and CrossLaps were lower (18.09 ± 8.35 vs. 25.62 ± 12.78 ng/mL, p = 0.002; 0.39 ± 0.18 vs. 0.48 ± 0.22 ng/mL, p = 0.048), as well as 25-hydroxyvitamin D (16.96 ± 6.76 vs. 21.29 ± 9.84, p = 0.013). FN-BMD and TH-BMD were increased in T2D (p = 0.007, p = 0.002). MOF+LS/HF+LS were statistically significant lower than MOF-FN/HF-FN, respectively, MOF+FN/HF+FN (N = 136). In T2D: MOF+T2D was higher (p < 0.05) than MOF-FN, respectively, MOF+FN [median(IQR) of 3.7(2.5, 5.6) vs. 3.4(2.1, 5.8), respectively, 3.1(2.3, 4.39)], but MOF+LS was lower [2.75(1.9, 3.25)]. HF+T2D was higher (p < 0.05) than HF-FN, respectively, HF+FN [0.8(0.2, 2.4) vs. 0.5(0.2, 1.5), respectively, 0.35(0.13, 0.8)] but HF+LS was lower [0.2(0.1, 0.45)]. Conclusion: Type 2 diabetic menopausal women when compared to age- and YSM-match controls had a lower 25OHD and BTM (osteocalcin, CrossLaps), increased TH-BMD and FN-BMD (with loss of significance upon BMI adjustment). When applying novel FRAX model, LS-BMD adjustment showed lower MOF and HF as estimated by the conventional FRAX (in either subgroup or entire cohort) or as found by T2D adjustment using FRAXplus (in diabetic subgroup). To date, all four types of 10-year fracture probabilities displayed a strong correlation, but taking into consideration the presence of T2D, statistically significant higher risks than calculated by the traditional FRAX were found, hence, the current model might underestimate the condition-related fracture risk. Addressing the practical aspects of fracture risk assessment in diabetic menopausal women might improve the bone health and further offers a prompt tailored strategy to reduce the fracture risk, thus, reducing the overall disease burden. Full article

Objectives: The relationship between oral health and general health of geriatric in-hospital patients (GIH) who are poly-morbid and edentulous is currently unclear. This study determined the relationship between oral health and general health, and further implications and recommendations were derived. Methods: This retrospective cohort study included 81 GIH patients with impairment of oral state and masticatory function and need for immediate prosthetic treatment. The number of medical diagnoses, particularly main diagnoses of being hospitalized, comorbid diagnoses and the dental/oral state, were evaluated. Laboratory data of vitamin D3 and albumin concentrations were measured. Intraoral risk factors (IRF) affecting the masticatory function were intraoral inflammation, mucogingival impairment (MGI) and severe bone crest atrophy (SBCA). Masticatory function was evaluated by DMF*-T Index (number of destroyed/diseased, missing teeth and artificial fabrication), Eichner Index and Scores. The clinical relevance was surveyed by significance and effect size calculations. Results: In GIH, the number of medical diagnoses correlated significantly with the occurrence of IRFs. SBCA was the most affecting IRF, as measured by Eichner Index at baseline (p = 0.001). Single main diagnoses CNS and gastro-intestinal disease (GID) correlated with both deficiency of vitamin D3 levels (p = 0.011; p = 0.028) and hypoalbuminemia (p = 0.013; p = 0.023). Single comorbid diagnoses significantly correlated with both vitamin D3 deficiency and hypoalbuminemia (CVD (p = 0.031); DM (p = 0.042). Hypoalbuminemia was further found to be correlated with the sum of comorbid diagnoses (p = 0.033). Conclusions: GIH patients suffered from general and dental poly-morbidity. The prevalence of diseases was higher due to SBCA and impaired masticatory function. Deficiency of vitamin D3 and hypoalbuminemia were possible malnutrition markers. Full article

Periodontitis is a chronic, multifactorial inflammatory disease characterized by the progressive destruction of the periodontal supporting tissues, including alveolar bone, potentially resulting in tooth loss. Etiopathogenesis involves a dysbiotic shift in the subgingival microbiota where the presence of pathogenic species such as Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Treponema denticola has been documented. This disbalance is combined with an inadequate host immune response, often exacerbated by other systemic comorbidities including diabetes mellitus and cardiovascular diseases. Conventional therapy typically comprises mechanical debridement and adjunctive local or systemic antimicrobials, but emerging antibiotic resistance highlights a need for alternative adjuvant therapeutic strategies. The present descriptive analysis of microbiome and clinical trends study evaluated the adjuvant effects of a clinoptilolite-based zeolite material, namely PMA-zeolite, with professional prophylaxis on clinical and microbiological parameters in patients with chronic periodontitis over a 10-week period. Clinical assessment revealed significant reductions in bleeding on probing (BoP) and periodontal pocket depth (PD), indicating improved inflammatory status. Microbiome profiling demonstrated a marked decrease in key periodontal pathogens, suggesting that PMA-zeolite can help rebalance the oral microbiome. These findings suggest that the combined therapy exhibits promising anti-inflammatory and antimicrobial properties, indicating its role in promoting microbial homeostasis and reducing periodontal inflammation. However, further investigation through larger, controlled clinical trials is needed to validate the efficacy of the therapy. Full article

Periodontitis is a chronic inflammatory disease caused by periodontopathic bacteria such as Porphyromonas gingivalis (P. gingivalis), which leads to alveolar bone destruction and systemic inflammation. Emerging evidence suggests that probiotics may mitigate periodontal pathology. To systematically evaluate the alleviative effects and mechanisms of different forms of probiotics, including live bacteria and postbiotics, on periodontitis, we first screened and identified Ligilactobacillus salivarius CCFM1332 (L. salivarius CCFM1332) through in vitro antibacterial and anti-biofilm activity assays. Subsequently, we investigated its therapeutic potential in a rat model of experimental periodontitis. The results demonstrated that both live L. salivarius CCFM1332 (PL) and its postbiotics (PP) significantly reduced the gingival index (GI) and probing depth (PD) in rats, while suppressing oral colonization of P. gingivalis. Serum pro-inflammatory cytokine levels were differentially modulated: the PL group exhibited reductions in interleukin-17A (IL-17A), interleukin-6 (IL-6), and interleukin-1β (IL-1β) by 39.31% (p < 0.01), 17.26% (p < 0.05), and 14.74% (p < 0.05), respectively, whereas the PP group showed decreases of 34.79% (p < 0.05), 29.85% (p < 0.01), and 19.74% (p < 0.05). Micro-computed tomography (Micro-CT) analysis demonstrated that compared to the periodontitis model group (PM), the PL group significantly reduced alveolar bone loss (ABL) by 30.1% (p < 0.05) and increased bone volume fraction (BV/TV) by 49.5% (p < 0.01). In contrast, while the PP group similarly decreased ABL by 32.7% (p < 0.05), it resulted in a 40.4% improvement in BV/TV (p > 0.05). Histological assessments via hematoxylin and eosin (H&E) and tartrate-resistant acid phosphatase (TRAP) staining confirmed that both the PL group and the PP group alleviated structural damage to alveolar bone-supporting tissues and reduced osteoclast-positive cell counts. This study suggests that live L. salivarius CCFM1332 and its postbiotics reduce alveolar bone resorption and attachment loss in rats through antibacterial and anti-inflammatory pathways, thereby alleviating periodontal inflammation in rats. 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/Objectives: Periodontitis is a chronic inflammation of the periodontium that induces damage in the periodontal ligaments and the surrounding alveolar bone. This study aimed to comparatively evaluate the clinical outcomes of two therapies used in the management of periodontal conditions, represented by scaling and root planing (SRP) alone and laser-assisted new attachment procedure (LANAP). Methods: Two quadrants of the oral cavity from each selected patient were randomly allocated to one of the treatment groups, SRP or LANAP. The periodontal status was documented in a periodontal chart at baseline, six weeks, and one year after treatment. SRP was performed in the first group of patients. The LANAP protocol was carried out on the patients belonging to the second group. Results: The outcomes of the study highlighted that LANAP leads to a reduction in periodontal disease signs (pocket depth, bleeding on probing, and gingival recession), contributing to the formation of new attachment tissues. LANAP shows more stability in maintaining the improvements achieved during six weeks, while SRP shows a slight deterioration in several parameters, particularly attachment loss, between six weeks and one year. The collected data at six-week and one-year follow-ups show improvements in periodontal health, thus improving oral health. Conclusions: Both minimally invasive periodontal procedures were effective, with LANAP demonstrating greater efficiency in patients with chronic periodontal disease, a greater reduction in pocket depth, and improved clinical outcomes compared to SRP alone. Full article

Periodontitis (PD), is a chronic inflammatory disease of the periodontal system, which includes gingiva, periodontal ligament, alveolar bone, and tooth cement. It is becoming increasingly prevalent globally, and its implications for oral health are profound. The Nrf2 signaling pathway is crucial in managing the relationship between inflammation and oxidative stress, making it vital for understanding this disease. Nrf2 interacts with key redox-sensitive inflammatory pathways, playing a vital role in the development of periodontitis. Acknowledging these dynamics underscores the importance of proactively addressing the complex aspects of periodontal disease. This review emphasizes its intricate interactions with redox-sensitive transcription factors vital for sustaining the self-perpetuating inflammatory processes underlying the disease. Additionally, it explores promising therapeutic strategies aimed at Nrf2 activation and encourages more effective management of PD. Full article

Background: Periodontitis is a chronic inflammatory disease influenced by host aging, yet the specific effects of aging on disease susceptibility remain unclear. Objective: This study aimed to evaluate whether aging increases susceptibility to Porphyromonas gingivalis (P. gingivalis)-induced periodontitis in a murine model. We formulated the null hypothesis that age does not affect susceptibility to periodontal bone loss. Methods: Young (8 weeks) and aged (78 weeks) male C57BL/6 mice were randomly assigned into four groups: young control, young infected, old control, and old infected (n = 8 per group, except for old control, where n = 7). Experimental periodontitis was induced by oral application of P. gingivalis suspended in 5% carboxymethylcellulose (CMC), administered every other day, for a total of three applications. Alveolar bone loss was assessed 39 days after the last inoculation using histomorphometric measurement of buccal distance from the cemento-enamel junction to the alveolar bone crest (CEJ–ABC distance) and micro-computed tomography (μCT) at mesial and distal interdental sites. Bonferroni’s correction was applied to the Mann–Whitney U Test to determine statistical significance. A p-value of less than 0.05 was considered statistically significant. Results: Morphometric analysis showed significantly greater buccal bone loss in infected mice versus controls in both age groups (young: 0.193 mm vs. 0.100 mm, p < 0.01; old: 0.262 mm vs. 0.181 mm, p < 0.01). μCT analysis revealed that interdental bone loss was significant only in aged infected mice (mesial: 0.155 mm vs. 0.120 mm, p < 0.05; distal: 0.185 mm vs. 0.100 mm, p < 0.01), and not significant in young infected mice. Conclusions: Aging significantly exacerbates P. gingivalis-induced alveolar bone loss, particularly in interdental regions. These results allowed us to reject the null hypothesis. This study validates a clinically relevant murine model for analyzing age-related periodontitis and provides a foundation for investigating underlying molecular mechanisms and potential therapeutic interventions. Full article

Proanthocyanidins (PACs), also called condensed tannins, are oligomers or polymers composed of flavan-3-ols. This review aimed to explore the potential role of PACs in ameliorating oral health problems, with a particular focus on their effects within the intestine—especially the colon, where most orally ingested PACs are believed to accumulate. Previous studies suggest that PACs can be beneficial in periodontal disease as well as in the osseointegration of dental implants in patients with osteoporosis. Periodontal disease is worsened by lipopolysaccharides (LPS) that enter the bloodstream due to disrupted tight junctions of intestinal epithelial cells, along with inflammatory cytokines released by activated macrophages. A similar mechanism is thought to affect osseointegration: LPS-induced inflammatory cytokines originating in the intestine can enter the bloodstream, contributing to bone loss and impaired integration of dental implants. PACs absorbed by intestinal epithelial cells can function as prooxidants, triggering the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, which strengthens the gut barrier. This enhanced barrier reduces the levels of LPS and inflammatory cytokines in the blood, leading to the alleviation of periodontal inflammation and increased alveolar bone density, thereby promoting better osseointegration of dental implants. Full article

Gene therapy has emerged as a promising therapeutic approach across various oral diseases. This review examines current applications and future prospects of gene therapy in dentistry, focusing on five key areas: oral cancer, cancer-related pain, xerostomia (dry mouth), dental caries, and periodontal disease. Recent advances in viral and non-viral vectors have enabled more efficient gene delivery systems, with particular success in cancer pain management through µ-opioid receptor gene transfer and xerostomia treatment using aquaporin-1 gene therapy. For periodontal applications, gene therapy strategies include both immunomodulation and tissue regeneration approaches using growth factors like platelet-derived growth factor and bone morphogenetic proteins. While significant progress has been made, particularly in treating radiation-induced xerostomia and oral cancer pain, challenges remain in vector optimization and delivery methods. Clinical trials, predominantly in Phase I, indicate both the potential and current limitations of gene therapy in oral healthcare. This review synthesizes current evidence and outlines future directions for gene therapy applications in oral medicine and dentistry. Full article

Background/Objectives: The objective of this study is to evaluate the diagnostic performance of a combined screening approach using self-reported periodontal information and radiographic periodontal bone loss (R-PBL) in identifying individuals with periodontitis. Methods: An exploratory cross-sectional study was conducted including adult participants with available panoramic radiographs and responses to a validated self-reported periodontal screening questionnaire. R-PBL was assessed on interproximal sites and classified according to established thresholds. Self-reported information followed a validated strategy based on the Center for Diseases Control tool. The performance of individual and combined indicators was analyzed against the 2018 case definition for periodontitis, calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: A total of 150 participants were included, equally divided between periodontitis cases and controls, with a mean age of 46.5 years. The R-PBL model demonstrated the best predictive performance for both periodontitis (AUC: 0.833) and severe periodontitis (AUC: 0.796), with the highest precision and net benefit across thresholds. The Either model showed similar performance, particularly in sensitivity, while SR and Both models underperformed. Decision curve analysis confirmed the superior clinical utility of ‘R-PBL’ and ‘Either’ models in guiding decision-making. Conclusions: Combining self-reported information with radiographic bone loss showed adequate screening performance for periodontitis. This dual approach may provide a feasible strategy for identifying high-risk individuals in settings where full clinical examination is not possible. Full article

Background: Eighty-five percent of peri-implant malignancies are oral squamous cell carcinomas (OSCCs), and most of them are misdiagnosed as peri-implantitis because of their clinical and radiological presentation; few studies have focused on addressing and solving the diagnostic issues related to peri-implant OSCCs. Objectives: The study aimed to describe the clinicopathological features of peri-implant OSCCs and to report the staging issues related to the diagnosis of these lesions. Methods: This retrospective cohort study included patients who received a diagnosis of and treatment for peri-implant OSCCs at the Unit of Dentistry of the “Aldo Moro” University of Bari (Italy) from 2018 to 2024. By using descriptive statistics, the authors highlighted the diagnostic issues related to the clinical presentation, radiological features, and histology of peri-implant OSCCs. Results: A total of 13 women and 8 men with a mean age of 70.6 ± 11.7 years met the inclusion criteria; the medical history of the participants showed potentially malignant disorders (OPMDs) in 52.4% of patients, whereas 14.3% had already developed an OSCC. The patients showed 24 peri-implant OSCCs; the clinical presentation was leuko-erythroplakia-like (41.7%) or erythroplakia-like (58.3%), thus simulating peri-implantitis; in addition, 52.0% of dental implants involved had a probing pocket depth ≥ 10 mm, further mimicking peri-implantitis. Panoramic radiograms and cone beam computed tomography were of little use in studying bundle bone–implant interfaces; in particular, the tomography showed circumferential bone resorption only in peri-implantitis-like OSCCs. In total, 91.6% of histological examinations of OSCCs showed peri-implantitis-like inflammation; early-stage lesions (pTNM I-II) accounted for 33.3%, whereas late-stage lesions (pTNM III-IV) accounted for 66.7%; lymph nodal metastases occurred in 25.0% and 62.5%, respectively. The mean follow-up was 3.4 ± 1.0 years; all patients with OPMDs had poorly differentiated tumors and thus showed a worse prognosis than those without OPMDs (mean disease-free survival of 15.5 ± 7.7 months and 44.7 ± 12.1 months, respectively). Conclusions: The results of the study showed that peri-implant OSCCs occurred most frequently in patients with OPMDs or previous OSCC; in addition, peri-implant OSCCs required demolition rather than conservative excision, and the prognosis of patients strictly depended on the grade of the cancer. In the authors’ experience, the clinical–radiological presentation simulating peri-implantitis was the feature that concurred most in complicating the diagnosis of those tumors. Full article

Periodontitis is a highly prevalent, irreversible inflammatory disease characterized by the destruction of tooth-supporting tissues, eventually leading to tooth loss. Conventional treatment involves the mechanical removal of the subgingival biofilm, which is a major cause of gingival inflammation. However, the inaccessibility of deep-seated polymicrobial biofilms limits its effectiveness. Despite the adjunct use of systemic antimicrobials, their low site-specific bioavailability and systemic side effects remain concerns. Local drug administration offers a targeted alternative. However, the dynamic oral environment, which is characterized by continuous salivary and gingival crevicular fluid flow, poses challenges in maintaining therapeutic drug levels. Drug delivery systems (DDSs) provide technical solutions to overcome these limitations. With advancements in materials science and nanotechnology, diverse local DDS (LDDS) formulations tailored for periodontal applications have been developed. While traditionally focused on infection control, the application of LDDSs has expanded beyond antimicrobial therapy. Increasing attention has been paid to LDDS-based regenerative strategies, which aim to overcome the limitations of conventional regenerative therapies. This review aims to provide a comprehensive overview of the current and emerging DDS strategies in periodontal therapy, focusing on their applications in infection management and bone regeneration and discussing their limitations and prospects for clinical translation. Full article