Search Results (318)

Background/Objectives: Periodontitis is a chronic infectious inflammatory disorder that affects the supporting structures of the teeth. The gingival epithelium plays a crucial role as a physical and immunological barrier, producing pro-inflammatory cytokines in response to microbial pathogens. Modulation of gingival epithelial function has been proposed as a therapeutic strategy to prevent the progression of periodontal disease. Houttuynia cordata, a perennial herb traditionally used in Asian medicine, is recognized for its anti-inflammatory properties, with documented benefits in the cardiovascular, respiratory, and gastrointestinal systems. However, its potential therapeutic role in oral pathologies, such as periodontitis, remains underexplored. This study aimed to investigate the anti-inflammatory effects of H. cordata extract on interleukin (IL)-1β-stimulated primary gingival keratinocytes (PGKs) subjected to IL-1β-induced inflammatory stress, simulating the conditions encountered during orthodontic treatment. Methods: Inflammation was induced in PGKs using IL-1β, and the impact of H. cordata extract pretreatment was assessed using quantitative real-time reverse transcription polymerase chain reaction, enzyme-linked immunosorbent assay, and immunoblotting. Results: H. cordata extract significantly downregulated the mRNA and protein expression levels of tumor necrosis factor-alpha, IL-8, and intercellular adhesion molecule-1 in IL-1β-stimulated PGKs without inducing cytotoxicity. Conclusions: These findings suggest that H. cordata holds promise as a preventive agent against periodontitis by attenuating inflammatory responses in gingival epithelial tissues. We believe that our findings will inform the development of prophylactic interventions to reduce periodontitis risk in patients undergoing orthodontic 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

Osteoclasts, which are derived from myeloid precursors, are essential for physiologic bone remodeling but also mediate pathological bone loss in inflammatory diseases such as periodontitis and rheumatoid arthritis. Lysine-specific demethylase (LSD1/KDM1A) is a histone demethylase that modulates the chromatin landscape via demethylation of H3K4me1/2 and H3K9me1/2, thereby regulating the expression of genes essential for deciding cell fate. We previously demonstrated that myeloid-specific deletion of LSD1 (LSD1LysM-Cre) disrupts osteoclast differentiation, leading to enhanced BV/TV under physiological conditions. In this study, we show that LSD1LysM-Cre female mice are similarly resistant to inflammatory bone loss in both ligature-induced periodontitis and K/BxN serum-transfer arthritis models. Bulk RNA-seq of mandibular-derived preosteoclasts from LSD1LysM-Cre mice with ligature-induced periodontitis revealed the upregulation of genes involved in inflammation, lipid metabolism, and immune response. Notably, LSD1 deletion blocked osteoclastogenesis even under TGF-β and TNF co-stimulation, which is an alternative RANKL-independent differentiation pathway. Upregulation of Nlrp3, Hif1α, and Acod1 in LSD1LysM-Cre preosteoclasts suggests that LSD1 is essential for repressing inflammatory and metabolic programs that otherwise hinder osteoclast commitment. These findings establish LSD1 as a critical epigenetic gatekeeper integrating inflammatory and metabolic signals to regulate osteoclast differentiation and bone resorption. Therapeutic inhibition of LSD1 may selectively mitigate inflammatory bone loss while preserving physiological bone remodeling. Full article

Dens invaginatus is a developmental dental anomaly characterized by the infolding of the enamel organ into the dental papilla during early odontogenesis. This process leads to a broad spectrum of anatomical variations, ranging from minor enamel-lined pits confined to the crown to deep invaginations extending through the root, occasionally communicating with periodontal or periapical tissues. The internal complexity of affected teeth presents diagnostic and therapeutic challenges, particularly in severe forms that mimic root canal systems or are associated with pulpal or periapical pathology. Maxillary lateral incisors are most frequently affected, likely due to their unique developmental timeline and morphological susceptibility. Although various classification systems have been proposed, Oehlers’ classification remains the most clinically relevant due to its simplicity and correlation with treatment complexity. Recent advances in diagnostic imaging, especially cone beam computed tomography (CBCT), have revolutionized the identification and classification of these anomalies. CBCT-based adaptations of Oehlers’ classification allow for the precise assessment of invagination extent and pulpal involvement, facilitating improved treatment planning. Contemporary therapeutic strategies now include calcium-silicate-based cement sealing materials, endodontic microsurgery for inaccessible anatomy, and regenerative endodontic procedures for immature teeth with necrotic pulps. Emerging developments in artificial intelligence, genetic research, and tissue engineering promise to further refine diagnostic capabilities and treatment options. Early detection remains critical to prevent complications such as pulpal necrosis or apical disease. A multidisciplinary, image-guided, and patient-centered approach is essential for optimizing clinical outcomes in cases of dens invaginatus. Full article

Background/Objectives: The aim of this study was to identify and assess the independent risk factors and potential predictors for endo-periodontal lesions (EPLs) in endodontically treated teeth with periapical pathology. Methods: The study group included 90 patients (35 men, 55 women; mean age 47.96 ± 13.495 years) with 126 endodontically treated teeth. Following clinical examinations and radiologic evaluation, 50 patients were diagnosed with endo-periodontal lesions (EPLs) in 64 molars (test group); the control group included 62 endodontically treated teeth without EPLs diagnosed in 40 patients. The independent variables were assessed as risk factors for EPLs. The relationship between patients’ demographic and clinical features and endo-periodontal status was assessed using Chi-squared tests for categorical variables and Student’s t- or Mann–Whitney tests for continuous variables, depending on data distribution. The potential risk factors were characterized by calculating Odds Ratios (ORs) with 95% confidence intervals. The variables included in the multivariate logistic regression model were selected based on their clinical relevance and statistical significance in the univariate analysis. To evaluate the combined effect of the identified risk factors, a binary logistic regression model was constructed using the Enter method. Results: Out of the 126 endodontically treated molars with periapical pathology, 64 teeth (50.8%) were diagnosed with endo-periodontal lesions (EPLs). Patients aged ≥60 years were significantly more represented in the EPL group (32.8%) compared to the control group (12.9%) (p = 0.024). Probing pocket depth ≥ 4 mm was present in 85.9% of teeth with EPLs versus only 30.6% in teeth without EPLs (p < 0.001). Probing pocket depth (PPD) ≥ 4 mm was the strongest predictor (OR = 13.830) and remained significant after adjustment in multivariate analysis (OR = 6.585). PPD ≥ 3.625 mm showed a strong association in univariate analysis (OR = 12.587) and preserved significance in the multivariate model (OR = 6.163). Conclusions: This study highlights age ≥ 60 years and PPD ≥ 4 mm as the most significant independent risk factors for EPLs, emphasizing the need for early periodontal assessment in endodontically treated teeth with periapical pathology. While PPD greater than 3.625 mm is a strong indicator of the presence of EPLs, other factors such as MBL (marginal bone loss) and occlusal considerations appear to have indirect roles in EPL development in endodontically treated teeth with periapical lesions. Full article

Background\Objectives: Chronic kidney disease (CKD) is defined as a clinical syndrome secondary to a permanent change in kidney function or structure, making it irreversible. Most patients at the onset of the disease are asymptomatic or present nonspecific symptoms, including signs and symptoms at the oral level. These manifestations, such as hyposalivation, increased calculus index, enamel defects, or changes in saliva composition, contribute to the diagnosis of this pathology and can also significantly affect the patient’s quality of life. The aim is to systematically assess the presence and relevance of oral manifestations in patients with CKD, and to identify correlations between these symptoms and clinical parameters such as glomerular filtration rate or concomitant conditions of the patient. Materials and Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was carried out in the PubMed, Scopus, Scielo, and The Cochrane Library databases on 7 April 2025, using terms related to “chronic kidney disease” and “oral manifestations”. Inclusion criteria referred to observational studies published in the last ten years that reported oral symptoms in patients with CKD. The quality of cohort and case-control studies was assessed using the Newcastle–Ottawa Scale (NOS), while for cross-sectional studies, the Joanna Briggs Institute (JBI) critical appraisal checklist was used. Results: A total of 27 studies met the inclusion criteria, primarily cross-sectional in design. The most frequently reported oral manifestations included hyposalivation, increased calculus and plaque indices, enamel defects, periodontal disease, and oral candidiasis. Significant associations were identified between the duration of dialysis and severity of periodontal disease, as well as between CKD stage and taste dysfunction. Findings varied by age group and CKD stage, with children showing distinct salivary profiles and adults presenting more pronounced periodontal and mucosal conditions. Conclusions: This review highlights a clear relationship between CKD and various oral health disturbances, although more studies are needed to better understand oral–systemic interactions in CKD. What is necessary is the establishment of multidisciplinary care approaches. Full article

This study aimed to develop and validate a dual murine model integrating a high-fat diet (HFD) and a single streptozotocin (STZ) dose to induce diabetes mellitus (DM), alongside periodontitis (Perio) induced by ligature placement and oral inoculation with Porphyromonas gingivalis (P. gingivalis). The goal was to mimic human pathological conditions, creating a physiologically relevant environment to study the interplay between DM and Perio. A total of 128 six-week-old male C57BL/6J mice were randomly divided into four groups: Control, DM, Perio, and DM-P. DM was induced by HFD and STZ injection, and Perio by ligature placement and P. gingivalis infection. Evaluations occurred at baseline and days 7, 14, and 21. Alveolar bone loss was assessed by micro-computed tomography, and inflammation was examined histologically. DM mice showed elevated glucose levels and insulin resistance. Perio and DM-P groups experienced significant bone loss compared with Control and DM groups. The morphometric analysis revealed abundant inflammatory cells and reduced collagen fibers in Perio and DM-P groups, especially at day 7. This dual murine model successfully replicated the key features of DM and Perio, maintaining overall health of the animals, and good tolerability by those subjects to the stress of both interventional procedures. Full article

The aim of this study was to explore diabetes mellitus type 2 as a risk factor in the prevalence of chronic apical periodontitis (CAP) in untreated and endodontically treated teeth. The second objective was to describe the correlation between the presence of periapical lesions and blood glucose/glycated hemoglobin levels among diabetic (DM) and non-diabetic patients with endodontically treated or untreated teeth with CAP. Materials and methods: This cross-sectional study was conducted on 90 patients (55 with DM, 35 without DM), admitted to the Oral and Maxillofacial Surgery Department of “St. Spiridon” Hospital in Iași, Romania. Endodontic and perapical status was evaluated using the Periapical Index (PAI) based on clinical and radiological evaluations with blood glucose levels and HbA1c analysis. Statistical analysis included data, correlations and regression analysis, and group comparisons using appropriate parametric or non-parametric tests. DM subjects had a higher mean value of untreated teeth with CAP (2.53 vs. 2.00) compared to the control group (p = 0.010) and a lower mean number of endodontically treated teeth without CAP (1.53 vs. 2.74) compared to the control group (p < 0.001). Diabetic patients also had a higher mean number of root-filled teeth with CAP (3.33 vs. 1.94; p < 0.001). Conclusions: There was a clear association between diabetes and oral pathology, with diabetic patients having fewer teeth, more untreated teeth, and a higher prevalence of periapical lesions. Elevated blood glucose and HbA1c levels indicated that poor metabolic control negatively impacts periapical healing and overall endodontic health. Full article

Background: Nanomaterial-based biosensors represent a transformative advancement in oral health diagnostics and therapeutics, offering superior sensitivity and selectivity for early disease detection compared to conventional methods. Their applications span prosthetic dentistry, where they enable the precise monitoring of dental implants, and theranostics for conditions such as dental caries, oral cancers, and periodontal diseases. These innovations promise to enhance proactive oral healthcare by integrating detection, treatment, and preventive strategies. Objectives: This review comprehensively examines the role of nanomaterial-based biosensors in dental theranostics, with a focus on prosthetic applications. It emphasizes their utility in dental implant surveillance, the early identification of prosthesis-related complications, and their broader implications for personalized treatment paradigms. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science for studies published between 2010 and early 2025. Keywords included combinations of “nanomaterials”, “biosensors”, “dentistry”, “oral health”, “diagnostics”, “therapeutics”, and “theranostics”. Articles were selected based on their relevance to nanomaterial applications in dental biosensors and their clinical translation. Results: The review identified diverse classes of nanomaterials—such as metallic nanoparticles, carbon-based structures, and quantum dots—whose unique physicochemical properties enhance biosensor performance. Key advancements include the ultra-sensitive detection of biomarkers in saliva and gingival crevicular fluid, the real-time monitoring of peri-implant inflammatory markers, and cost-effective diagnostic platforms. These systems demonstrate exceptional precision in detecting early-stage pathologies while improving operational efficiency in clinical settings. Conclusions: Nanomaterial-based biosensors hold significant promise for revolutionizing dental care through real-time implant monitoring and early complication detection. Despite challenges related to biocompatibility, scalable manufacturing, and rigorous clinical validation, these technologies may redefine oral healthcare by extending prosthetic device longevity, enabling personalized interventions, and reducing long-term treatment costs. Future research must address translational barriers to fully harness their potential in improving diagnostic accuracy and therapeutic outcomes. Full article

Objectives: Periodontitis is a chronic inflammatory disease that could influence the pathophysiology of cardiovascular diseases through immunoinflammatory and epigenetic mechanisms. MicroRNAs (miRNAs) could be key mediators in this interaction, regulating gene expression and the synthesis of inflammatory molecules. The objective of this systematic review was to evaluate the relationship between periodontitis and cardiovascular diseases by analyzing the expression of miRNAs involved in both pathologies. Methods: A systematic search was performed in the PubMed, Scopus, Embase, and Web of Science databases following the PRISMA guidelines. A total of 320 studies were identified, of which seven were included after applying eligibility criteria. Data on study design, sample characteristics, periodontal and cardiovascular diagnostic methodology, and the analyzed miRNAs were extracted. Results: The included studies were observational case-control studies in humans (n = 5) and experimental studies in animal models (n = 3). The miRNAs selected by the studies to link both pathologies were miR-155, miR-155-5p, miR-146a, miR-143, miR-145, and miR-23b. Most studies observed the overexpression of these miRNAs in patients with periodontitis and cardiovascular disease, with miR-146a being the most frequently associated. Conclusions: The findings suggest that certain miRNAs, particularly miR-146a, may play a key role in the connection between periodontitis and cardiovascular disease. Its overexpression in patients with both pathologies reinforces the hypothesis of its involvement in the inflammatory processes associated with both conditions. It would be interesting to conduct studies to validate their clinical applicability as biomarkers of susceptibility to cardiovascular disease. Full article

While periodontitis is increasingly linked to systemic disorders through the oral–gut axis, the molecular mediators driving gut microbiota dysbiosis and barrier disruption remain elusive. Hepatocyte growth factor (HGF), a novel regulator of inflammatory bone loss in periodontitis, may serve as a critical communicator between oral infection and distal intestinal pathology. This study investigates how HGF overexpression modulates the gut microbial ecosystem and intestinal barrier integrity in a transgenic periodontitis model. In this study, we combined 16S rRNA sequencing of fecal microbiota with comprehensive gut barrier assessments, including systemic markers (D-lactate, LPS, and DAO ELISA), structural integrity (villous morphology), and molecular analysis (ZO-1, occludin, and NOD2 immunohistochemistry), using HGF-overexpressing transgenic (HGF-Tg) mice with periodontitis. The results demonstrated that HGF increased gut permeability in the context of periodontitis, as evidenced by elevated serum levels of D-lactate and LPS compared to wild type (WT) mice. In addition, gut villous morphology disorder was observed in HGF-Tg mice with periodontitis. HGF also diminished the protein level of occludin and upregulated NOD2 expression in mice with periodontitis. Moreover, HGF-Tg mice with periodontitis exhibited significant dysbiosis of gut microbiota, with reduced levels of probiotics (e.g., Faecalibaculum). Notably, HGF also increased the enrichment of the periodontitis-associated pathogens (e.g., Desulfovibrio and Streptococcus) in the gut. Microbial functions, particularly metabolic pathways, were significantly altered by HGF when periodontitis occurred. Some microorganisms like g_Desulfovibrio may play a role in gut barrier disorder in HGF-Tg mice with periodontitis. Overall, our findings position HGF as a novel orchestrator of oral–gut crosstalk, where its overexpression reshapes gut microbial ecology toward a “leaky gut” phenotype to compromise intestinal barrier integrity, further deepening our understanding of the oral–gut axis. Full article

Background/Objectives: Periodontitis and diabetes mellitus share a well-established bidirectional relationship, where hyperglycemia exacerbates periodontal inflammation, and periodontal disease further impairs glycemic control. Within the diabetic periodontal microenvironment, an imbalance between pro-inflammatory (M1) and anti-inflammatory (M2) macrophages promotes chronic inflammation, oxidative stress, delayed healing, and alveolar bone resorption. Resveratrol (RSV), a polyphenol with antioxidant, anti-inflammatory, and pro-osteogenic properties, holds potential to restore macrophage balance. However, its clinical application is limited by poor bioavailability and instability. This study aimed to develop and evaluate a novel RSV delivery system to overcome these limitations and promote periodontal tissue regeneration under diabetic conditions. Methods: A drug delivery system comprising RSV-loaded solid lipid nanoparticles embedded within a cross-linked hyaluronic acid hydrogel (RSV@CLgel) was formulated. The system was tested under hyperglycemic and inflammatory conditions for its effects on macrophage polarization, cytokine expression, oxidative stress, mitochondrial function, and osteoblast differentiation. Results: RSV@CLgel effectively suppressed pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) while upregulating anti-inflammatory markers (IL-10, TGF-β). It significantly reduced oxidative stress by decreasing ROS and lipid peroxidation levels and improved mitochondrial function and antioxidant enzyme activity. Furthermore, RSV@CLgel enhanced osteoblast differentiation, as evidenced by increased ALP activity, calcium nodule formation, and upregulation of osteogenic genes (COL-I, RUNX2, OCN, OPN). It also inhibited RANKL-induced osteoclastogenesis, contributing to alveolar bone preservation. Conclusions: The RSV@CLgel delivery system presents a promising multifunctional strategy for the management of diabetic periodontitis. By modulating immune responses, reducing oxidative stress, and promoting periodontal tissue regeneration, RSV@CLgel addresses key pathological aspects of diabetes-associated periodontal disease. Full article

Background/Objectives: Odontogenic sinusitis (ODS) is a distinct subtype of chronic rhinosinusitis that arises from dental pathology, with unique etiologies and treatment strategies. This study aimed to evaluate the clinical features, radiological findings, and surgical outcomes of ODS patients treated with endoscopic sinus surgery (ESS). Methods: This retrospective study included 139 patients diagnosed with ODS who underwent ESS. Demographic characteristics, clinical symptoms, radiological findings, and treatment outcomes were analyzed. Outcomes were assessed using pre- and postoperative LundKennedy (L-K) scores, with additional evaluation of the impact of concurrent dental treatment. Results: The most common etiology was periodontal disease (60.4%), followed by dental implants (20.1%) and dental extractions (19.4%). Radiological findings revealed sinus involvement beyond the maxillary sinus in 78.4% of patients, with common abnormalities including periapical abscesses (60.4%), oroantral fistulas (19.4%), and implant-related complications (20.1%). Patients who received concurrent dental treatment with ESS demonstrated significantly better outcomes, with success rates of 96.4% compared to 73.9% for those without dental treatment (p = 0.003). Conclusions: ODS is frequently underdiagnosed due to overlapping symptoms with chronic rhinosinusitis of other origins. Radiological imaging is crucial for identifying dental pathologies contributing to ODS. Combining ESS with dental treatment significantly improves outcomes and is recommended as the optimal management strategy for ODS. Full article

Background: Periodontal disease is a multifactorial infectious pathology that affects dental supporting tissues, impacting the health and quality of life of patients. Assessing chewing efficiency before and after periodontal therapy is crucial to better understand its impact on the quality of life of periodontal patients. Thus, the aim of this case series study was to determine whether basic periodontal therapy improves masticatory ability and efficiency in patients with mild to moderate periodontitis. Methods: A prospective, longitudinal, case series study was carried out in 42 periodontal patients treated at the University Odontology Clinic. Masticatory efficiency before and after basic periodontal treatment was assessed using both objective (HueCheck Gum test) and subjective (Quality of Masticatory Function Questionnaire: QMFQ) methods. Results: Significant improvements (p = 0.0001) were observed in periodontal variables such as hygiene index (HI), probing depth (PD), and clinical attachment level (CAL), as well as in the initial and final QMFQ total score (p = 0.045). In addition, significant differences were found in post-treatment QMFQ scores related to parafunctional habits (p = 0.046) and facial patterns, especially in meat consumption (p = 0.042) fruit and vegetable consumption (p = 0.007, p = 0.044). The initial mean HueCheck Gum test values were 0.59 ± 0.09 and the final values were 0.61 ± 0.11. These differences were not statistically significant. Conclusions: Basic periodontal treatment does not objectively improve the masticatory efficiency of patients with mild–moderate periodontitis, evaluated by means of the test of mixing two chewing gums, but it does offer subjective improvements. Full article