Search Results (635)

Background: Periodontitis and psoriasis are chronic inflammatory diseases that share common risk factors and immune-mediated pathogenic pathways, suggesting a potential bidirectional relationship. Periodontal inflammation contributes to systemic inflammatory burden, which may influence the severity of immune-mediated diseases, such as psoriasis. Objective: The aim of this systematic review is to evaluate the effects of periodontal therapy on psoriasis severity in patients affected by both conditions. Methods: This review followed the PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251155439). Eligible studies included adults (≥18 years) with both psoriasis and periodontitis undergoing periodontal therapy compared with no periodontal treatment. The primary outcome was Psoriasis Area and Severity Index (PASI), while secondary outcomes included periodontal clinical parameters (PPD, CAL, FMBS). Results: A total of 228 records were identified; after screening and full-text evaluation, two randomized controlled trials, including a total of 166 patients, met the inclusion criteria. Both studies evaluated non-surgical periodontal therapy and reported significant reductions in PASI scores in treated patients compared with controls. Periodontal parameters (PPD, CAL, FMBS) also improved significantly following treatment in both studies. Conclusions: Evidence from the included trials indicates that non-surgical periodontal therapy may reduce psoriasis severity while simultaneously improving periodontal health in patients with both conditions. Periodontal treatment may serve as a beneficial adjunct to dermatological therapy. However, findings are limited by small sample sizes and short follow-up periods. Larger, long-term randomized controlled trials are needed to confirm these results. Full article

Background/Objectives: Dental caries and gingival inflammation share several biofilm-related determinants. This study evaluated the association between Community Periodontal Index (CPI) screening categories and permanent-dentition caries experience in a consecutively recruited clinical sample of children and adolescents from Southwest Romania. Methods: The multicenter cross-sectional study included 638 participants aged 6–19 years, analyzed as 6–12 years (n = 407) and 13–19 years (n = 231). Analyses included nonparametric comparisons, adjusted Poisson models, a formal CPI-by-age-stratum interaction, continuous-age sensitivity analyses, and generalized Poisson models allowing underdispersion. Results: Mean DMF-T was 4.71 ± 2.55 and 4.93 ± 2.58 in the younger and older strata, respectively. CPI correlated strongly with DMF-T (rho = 0.743 and 0.749; both p < 0.001). Adjusted expected DMF-T counts were higher for CPI 1 and CPI 2 than for CPI 0 in both strata. There was no statistical evidence that the CPI–DMF-T association differed by age stratum (global interaction p = 0.749) or continuous age (p = 0.552). Plaque Index adjustment markedly attenuated CPI estimates; the extent of residual CPI association was sensitive to count-model specification. Conclusions: Higher CPI categories were associated with greater cumulative caries experience in this clinical sample, but the findings do not establish temporality, causality, or predictive validity. Unequal numbers of erupted permanent teeth and CPI-eligible sextants may have contributed to the observed gradient because these quantities were not retained analytically. Full article

Background/Objectives: Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunct to non-surgical periodontal therapy, although its benefits remain debated. This study evaluated the clinical and microbiological effects of aPDT combined with ultrasonic scaling and root planing (US-SRP) compared with US-SRP alone in patients with periodontitis. Methods: In this randomized split-mouth clinical trial, 40 patients with stage II–III periodontitis were included. Two non-adjacent sites with probing pocket depth (PPD) ≥ 5 mm were assigned to either control (US-SRP) or test (aPDT + US-SRP) treatment. Clinical parameters, including PPD, bleeding on probing (BOP), plaque index (PI), gingival recession (REC), and clinical attachment level (CAL), were assessed at baseline and after 90 days. Subgingival plaque samples were analyzed by multiplex PCR for major periodontal pathogens. Results: No statistically significant differences were detected for microbiological outcomes at 90 days between groups. Significant greater variations were observed at T3 in the aPDT group for PPD (p = 0.04), BOP (p = 0.03) and PI (p = 0.005), whereas the control group showed a significant reduction only for PI (p = 0.01). Regarding comparisons of Δ(T0–T3) between the aPDT group and the control group, the paired t-test was significant for PPD, REC and CAL (p < 0.001), with a Cohen’s d_av < 0.5 for all three parameters (small effect sizes). In addition, the aPDT group showed a statistically significant reduction in BOP (p = 0.03 *) from T0 (92%) to T3 (50%). Exploratory analyses confirmed the same trend for BOP reduction in the aPDT group both in smokers and non-smokers. Conclusions: Despite the fact that adjunctive aPDT seems to offer predictable clinical outcomes in terms of PPD and BOP reductions, further larger and stratified studies are needed to verify if this treatment can provide superior benefits compared with conventional non-surgical periodontal therapy. Full article

Background/Objectives: This study aimed to comprehensively evaluate the interaction between periodontal disease, sleep quality, and quality of life and to investigate the effects of the presence and severity of periodontal disease on individuals’ sleep patterns and oral health-related quality of life. Materials and Methods: A total of 195 individuals were included in the study. Participants’ sociodemographic data and dental habits were recorded. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), while the impact of oral health on quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Results: A significant difference was observed in OHIP-14 scores among the groups (p < 0.001), with median values of 6, 13, and 22 in the healthy, gingivitis, and periodontitis groups, respectively. OHIP-14 scores also increased significantly with the stage and grade of periodontitis (p < 0.001). PSQI scores differed significantly among the groups (p < 0.001), with median values of 4, 8, and 10 in the healthy, gingivitis, and periodontitis groups, respectively. However, no significant differences were observed in total PSQI scores across the stages or grades of periodontitis. In addition, a strong positive correlation was found between total PSQI and OHIP-14 scores (r = 0.63, p < 0.001). Multiple linear regression analysis confirmed that periodontal status remained independently associated with both PSQI and OHIP-14 scores after adjusting for age, sex, education level, and smoking status, with periodontitis showing the strongest association in both models (PSQI: B = 5.03; OHIP-14: B = 15.80, both p < 0.001). Conclusions: A significant relationship was identified between periodontal disease, sleep quality, and oral health-related quality of life. Furthermore, the strong positive correlation between sleep quality and oral health-related quality of life suggests that deterioration in sleep quality may be associated with poorer oral health-related quality of life. These findings indicate that periodontal health is not limited to oral tissues but is also closely associated with an individual’s overall well-being. Full article

Background/Objectives: Gingival recession frequently affects the anterior mandibular region. Anatomical features, such as thin buccal bone, narrow keratinized gingiva, and root proximity, increase susceptibility to periodontal disease. Recession can progress over time and may be exacerbated by orthodontic treatment. However, it remains uncertain whether the severity of crowding before treatment contributes to recession after orthodontic therapy The present study aimed to determine whether a relationship exists between the degree of mandibular anterior crowding before orthodontic treatment and the development or progression of gingival recession after treatment completion. Methods: This retrospective study was conducted on 269 participants with pre- and post-treatment records. The Little’s irregularity index was used to assess the degree of crowding. Clinical photographs of the six mandibular anterior teeth (1614 sites) were digitally calibrated permit millimeter-based assessment of gingival recession and keratinized tissue (KT) width. Oral hygiene (OH) was also evaluated at both time points. Results: Post-treatment recession was detected in 76 teeth. (4.7% of sites) among 48 participants (17.8%). Pretreatment crowding severity was not significantly associated with the occurrence of recession after treatment. Pretreatment mucogingival deformities were independently associated with post-treatment gingival recession. Mandibular central incisors demonstrated the highest prevalence of post-treatment gingival recession. Conclusions: Pretreatment mandibular anterior did not appear to predict gingival recession at treatment completion. Periodontal characteristics may play a more important role in recession development, supporting careful periodontal evaluation before and throughout orthodontic care. Full article

Background/Objectives: This study aimed to investigate the effects of oral Bacillus subtilis (BS) on alveolar bone loss, intestinal morphology, and gut microbiota in a mouse model of ligature-induced periodontitis. Methods: A total of 24 male C57BL/6J mice (6 weeks old) were allocated to control, periodontitis (P), BS, and BS+P groups. Periodontitis was induced by bilateral ligation of maxillary second molars, and BS was orally administered for 18 consecutive days. Gut microbiota composition was analyzed by 16S rDNA sequencing, alveolar bone loss and gut morphology were evaluated using ImageJ version 1.54g, and ELISA-detectable serum vitamin D metabolite concentrations were measured using an enzyme-linked immunosorbent assay. Results: Compared with the P group, the BS+P group showed reduced bone loss. Serum vitamin D metabolite concentrations, small-intestine villus height, and villus height-to-crypt depth ratios were higher in the BS+P group. In gut microbiota, alpha diversity differed significantly among groups based on the Shannon index. Bray–Curtis-based beta diversity differed significantly among groups. Conclusions: Oral supplementation of BS attenuated the progression of ligature-induced periodontitis in a mouse model, and changes in gut microbiota may be associated with this effect. Full article

Background/Objectives: Periodontitis is a chronic inflammatory disease in which host response and oxidative stress contribute to periodontal tissue destruction. Apelin isoforms may be involved in inflammatory regulation, tissue remodeling, and oxidative balance. This study evaluated changes in gingival crevicular fluid (GCF) apelin-13, apelin-36, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) following non-surgical periodontal therapy (NSPT) in systemically healthy individuals with stage I–II or stage III–IV periodontitis. Methods: A total of 61 systemically healthy individuals with periodontitis were included and divided into two groups: stage I–II periodontitis (n = 31) and stage III–IV periodontitis (n = 30). Clinical periodontal parameters and GCF samples were obtained at baseline and at 1, 3, and 6 months after NSPT. Apelin-13 and apelin-36 levels were measured by enzyme-linked immunosorbent assay, while TAS and TOS levels were determined using commercial assay kits. OSI was calculated as the percentage ratio of TOS to TAS. The study was retrospectively registered at ClinicalTrials.gov (NCT06850987). Results: Baseline apelin-13 levels were significantly higher in stage III–IV periodontitis and decreased in both groups after NSPT, whereas apelin-36 increased over time and was higher in stage I–II periodontitis at baseline. Apelin-13 was positively associated with clinical periodontal parameters, while apelin-36 showed negative associations. TAS remained higher in stage I–II periodontitis, whereas OSI was consistently higher in stage III–IV periodontitis. Conclusions: These findings suggest that the combined assessment of GCF apelin isoforms and oxidative stress markers may provide useful biomarker information for distinguishing periodontitis severity and monitoring biochemical responses to NSPT. Full article

Background/Objectives: To evaluate the clinical and microbiological effects of adjunctive gaseous ozone therapy combined with full-mouth ultrasonic debridement and scaling and root planing (FMUD–SRP) in patients with generalized periodontitis. Materials and Methods: Thirty-nine patients with stage II–IV generalized periodontitis were enrolled in a randomized split-mouth clinical trial. Quadrants were assigned to receive FMUD–SRP alone or FMUD–SRP plus adjunctive gaseous ozone therapy. Ozone (2100 ppm, 80% oxygen) was applied subgingivally immediately after instrumentation during three treatment sessions. Clinical parameters were recorded at baseline, 45, and 90 days. Subgingival plaque samples were analyzed using qualitative polymerase chain reaction to detect six periodontal pathogens. Results: Both treatments resulted in significant clinical improvements over time (p < 0.05). At 90 days, ozone-treated sites showed greater probing pocket depth reduction (−1.6 ± 0.8 mm vs. −1.2 ± 0.8 mm; p = 0.02) and clinical attachment level gain (−1.1 ± 1.0 mm vs. −0.6 ± 1.0 mm; p = 0.03) compared with control sites. No significant intergroup differences were observed for bleeding on probing, plaque index, or gingival recession. A significantly greater reduction in the detection frequency of periodontal pathogens was observed in the ozone group, including complete suppression of Treponema denticola and marked reductions in other anaerobic species. Conclusions: Adjunctive gaseous ozone therapy enhances the clinical outcomes of non-surgical periodontal treatment and exerts a selective antimicrobial effect against anaerobic periodontal pathogens. Full article

Background: The recent rise in worldwide e-cigarette use has sparked concerns about its effects on oral health, especially regarding the increased risk of periodontal disease. Measuring pro-inflammatory cytokines in crevicular fluid can help detect early subclinical inflammation before symptoms appear. Aim: To quantify the levels of inflammatory biomarkers (IL-1β, IL-6, TNF-α, and MCP-1) in the gingival crevicular fluid of vaping and non-vaping patients. Methods: An observational, cross-sectional study was conducted with vaper and non-vaper patients. Participants were selected through convenience sampling based on specific inclusion and exclusion criteria. The study collected demographic and clinical data and measured cytokines such as IL-1β, IL-6, TNF-α, and MCP-1 in crevicular fluid using flow cytometry. Data analysis was conducted in SPSS^®, including descriptive statistics, Shapiro–Wilk normality tests, and correlation analyses (Spearman rank). The Ethics Committee approved the study (Act No. 6-2025). Results: Sixteen vapers and sixteen non-vapers participated, paired by age. Vapers showed higher levels of all markers, especially TNF-α (1451.55 pg/mL, SD = 428.5, p = 0.036) and IL-6 (55.01 pg/mL, SD = 46.48, p = 0.050), compared to non-vapers. No significant differences were found in IL-1β and MCP-1. Conclusions: Vaping is associated with increased pro-inflammatory cytokines, notably TNF-α and IL-6, and clinical signs of periodontal inflammation, specifically a higher plaque index (p = 0.027); bleeding on probing showed only a non-significant upward trend (p = 0.19). These findings suggest vaping may enhance periodontal–inflammatory responses and should be considered in the assessment of periodontitis progression. Full article

In postmortem Alzheimer’s disease (AD) brains, Porphyromonas gingivalis (Pg), a major periodontal pathogen, and Candida albicans, one of the most common fungal pathogens, have been detected. Although it is important to better understand the effects of their co-infection in the brain for elucidating the pathogenesis of AD, little is known about the neuropathological significance of such co-infection. In the present study, we aimed to elucidate the effects of co-exposure to virulence factors derived from Pg and C. albicans on microglial inflammatory responses. We demonstrated, for the first time, that both candidalysin dissolved in dimethyl sulfoxide (CLd) and water (CLw) significantly suppressed Pg lipopolysaccharide (LPS)-induced interleukin-1β (IL-1β) production by 35–60% and nuclear factor-κB (NF-κB) activation by 20–40%. It should be noted that contaminating Pg outer membrane lipoproteins in Pg LPS were mainly responsible for IL-1β production. To examine the possible hydrophobic interactions between lipoproteins contaminating the Pg LPS preparation and CL, we used 8-anilino-1-naphthalenesulfonic acid sodium salt (ANS-Na), which can be excited to emit fluorescence by binding of hydrophobic molecules. The mean fluorescence intensity of ANS-Na was significantly reduced by approximately 26% following co-treatment with CLw and Pg LPS compared with CLw alone. Furthermore, we generated a mutant form of CL with reduced hydrophobicity (GRAVY index: 1.106 vs. 0.874) while preserving its predicted structural properties. This mutant CLd no longer inhibited Pg LPS-induced IL-1β production. Taken together, these findings indicate that hydrophobic interactions between lipoproteins contaminating the Pg LPS preparation and CL mediate the inhibitory effect of CL on Pg LPS-induced inflammatory responses. The present findings suggest that interactions between polymicrobial virulence factors in the brain may modulate microglia-mediated inflammatory responses during AD progression. Full article

Periodontitis, a chronic inflammatory disease affecting approximately 40% of U.S. adults aged 30 years and older, is characterized by dysbiosis of the dental plaque microbiome. However, although scaling and root planing (SRP) is the cornerstone of periodontal treatment, its effects on the taxonomic composition and functional potential of the dental plaque microbiome remain incompletely understood. In this study, we used whole-metagenome shotgun sequencing to characterize taxonomic composition and functional potential in dental plaque microbiomes collected from 39 patients with Stage II or III generalized periodontitis before and 3–4 months after SRP. Consistent with clinical improvement, periodontal therapy significantly reduced probing depth, clinical attachment level, bleeding on probing, and plaque index. Whole-metagenome shotgun sequencing identified 3.18 million non-redundant genes and 12,353 microbial species across 78 samples, revealing increased gene and species richness after treatment, along with a significant restructuring of the microbial community. Established periodontal pathogens, including Porphyromonas gingivalis, as well as the emerging pathogens Escherichia coli and Burkholderia multivorans, decreased following treatment. Tannerella forsythia also showed a marked reduction after treatment, although this decrease was not significant after false discovery rate (FDR) correction. In contrast, health-associated early colonizers, including multiple Actinomyces species and Streptococcus cristatus, increased. Functional annotation using the Carbohydrate-Active Enzymes (CAZy) database identified significant treatment-associated differences in carbohydrate-active enzymes, including multiple glycosyltransferases, indicating remodeling of the predicted functional potential of the dental plaque microbiome. These findings demonstrate that successful SRP promotes coordinated taxonomic and predicted functional remodeling of the dental plaque microbiome and highlight the value of shotgun metagenomic sequencing for characterizing both taxonomic and functional recovery following periodontal therapy. Full article

Background/Objectives: The increasing prevalence of electronic nicotine delivery systems (ENDS) has prompted questions regarding their effects on periodontal health. While the detrimental impacts of cigarette smoking are well-established, the periodontal implications of ENDS use remain poorly understood. This narrative review aimed to evaluate current evidence comparing periodontal parameters, inflammatory markers, and oral microbiome composition among ENDS users, cigarette smokers, and non-smokers. Methods: A structured literature search was conducted in PubMed (January 2009–May 2026) following a PICO question: “What is the impact of ENDS, compared to cigarette smoking and non-smoking, on periodontal health?” Clinical studies reporting on periodontal health parameters (plaque index, bleeding on probing, probing depth, and clinical attachment loss), inflammatory markers (e.g., IL-1β, IL-6, TNF-α), and microbial composition were included. Due to methodological heterogeneity across studies, meta-analysis was not feasible, necessitating narrative synthesis. Results: Across studies, clinical periodontal findings in ENDS users were heterogeneous and did not consistently resemble those of either cigarette smokers or non-smokers. In contrast, ENDS use was consistently associated with alterations in inflammatory profiles and oral microbiome composition, characterized by selective changes in specific inflammatory cytokines rather than uniform inflammatory upregulation, as well as shifts towards microbial communities linked to periodontal inflammation. Notably, these biological alterations were not uniformly reflected in traditional clinical periodontal indices. Conclusions: ENDS use is associated with heterogeneous clinical findings and inflammatory and microbial alterations that suggest ENDS is a distinct exposure rather than a predictable intermediate between smoking and non-use. This review, to our knowledge, is the first to integrate clinical, inflammatory, and microbiome outcomes and highlights the limitations of relying solely on clinical parameters to assess the impact of ENDS on periodontal health. It also underscores the need for well-designed longitudinal studies to clarify the periodontal implications of ENDS use. Full article

Background and Objectives: Periodontal diseases are highly prevalent worldwide and have been associated with impaired oral health-related quality of life (OHRQoL). However, the strength and direction of this association remain inconsistent, particularly when sociodemographic and behavioural factors are considered. The aim of this study was to evaluate the independent association between periodontal status and OHRQoL in Bulgarian adults attending a university dental clinic, while accounting for sociodemographic factors and sleep quality, which was included as a clinically relevant behavioural determinant of oral health-related quality of life. Materials and Methods: This cross-sectional study included 504 adult participants (≥18 years) who underwent comprehensive periodontal examination and completed validated questionnaires. OHRQoL was assessed using the culturally adapted Bulgarian version of the Oral Health Impact Profile (OHIP-14), and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Due to the skewed distribution of OHIP-14 scores, the outcome was dichotomized at the sample median. Multivariable logistic regression analysis was performed to assess independent associations, adjusting for age, sex, education, financial status, place of residence, and sleep quality. Results: Periodontal status, sex, and sleep quality were independently associated with impaired OHRQoL. Females demonstrated lower odds of impaired OHRQoL compared to males (OR = 0.636; 95% CI: 0.428–0.924; p = 0.025). Poor sleep quality was associated with increased odds of impaired OHRQoL (OR = 1.554; 95% CI: 1.041–2.321; p = 0.031). Periodontitis was significantly associated with impaired OHRQoL (OR = 3.526; 95% CI: 2.073–5.998; p < 0.001), reflecting a complex relationship between clinical periodontal status and subjective health perception. Conclusions: OHRQoL is influenced by a multifactorial framework integrating periodontal status, behavioural factors, and sociodemographic characteristics. These findings highlight the importance of incorporating patient-reported outcomes into periodontal assessment and support a biopsychosocial approach to oral health research. Full article

Objectives: This prospective observational study aimed to compare the efficacy of a novel bioceramic intracanal medicament (Bio-C Temp) with a conventional calcium hydroxide-based medicament (UltraCal XS) in reducing postoperative spontaneous pain and percussion sensitivity in patients with symptomatic irreversible pulpitis (SIP) with apical periodontitis (AP). Methods: Thirty-seven systemically healthy patients diagnosed with SIP with AP were included. The selected teeth were vital, single-rooted, single-canal maxillary or mandibular teeth presenting with prolonged moderate to severe pain in response to cold testing (Visual Analog Scale [VAS] ≥ 50 mm), moderate to severe percussion pain (VAS ≥ 50 mm), and a periapical index (PAI) score ≤ 2. Patients were randomly allocated to receive either Bio-C Temp (n = 19) or UltraCal XS (n = 18) as the intracanal medicament. Postoperative pain, percussion sensitivity, and analgesic consumption were recorded at 6, 12, and 24 h, and 3, 5, and 7 days. Data were analyzed using R statistical software (version 4.5.0). Statistical significance was set at p < 0.05. Results: Both groups demonstrated a significant reduction in postoperative pain and percussion sensitivity compared with preoperative levels (p < 0.05). By the end of the 7th day, the UltraCal XS group showed significantly lower spontaneous pain (p < 0.001) and percussion sensitivity (p < 0.001) than the Bio-C Temp group. Complete spontaneous pain relief was reported in 65% of the UltraCal XS group and 31% of the Bio-C Temp. However, no patient in either group achieved complete resolution of percussion sensitivity. Conclusions: UltraCal XS provided superior short-term postoperative pain relief and greater reduction in percussion sensitivity compared with the bioseramic medicament. Neither medicament fully resolved percussion sensitivity within 7 days. Full article

Background/Objectives: Polycystic ovary syndrome (PCOS) is a prevalent endocrine condition in women. The impacts on oral and dental health have not been explicitly articulated. This study aimed to ascertain the association between serum asprosin levels, DMFT, and periodontitis in women with polycystic ovary syndrome (PCOS). Methods: The study included 100 participants: 60 women with PCOS and 40 healthy individuals. Clinical attachment loss (CAL), probing pocket depth (PPD), plaque index (PI), and gingival bleeding index (GBI) were documented. An enzyme-linked immunosorbent assay (ELISA) was used to measure serum asprosin and HOMA-IR concentrations. Results: An individual diagnosed with DMFT and periodontitis in women with PCOS had a markedly elevated concentration of asprosin (5.67 ± 3.55 ng/mL) compared to the control group (3.23 ± 2.25 ng/mL; p < 0.0001). The correlation between serum asprosin levels and clinical periodontal markers was found to be significantly positive. Conclusions: This case-control study suggests that elevated serum asprosin levels in women with polycystic ovary syndrome (PCOS) may be associated with poor periodontal sensitivity to proinflammatory stimuli. Full article