Search Results (3,199)

Periodontitis is a chronic inflammatory disease increasingly recognized as a manifestation of complex microbial dysbiosis extending beyond the oral cavity. Recent advances in spatial metagenomics provide unprecedented resolution to investigate microbial community structure, function, and localization within periodontal niches and along the oral–gut axis. This review aims to explore how spatially resolved metagenomic approaches refine our understanding of the ecological and functional shifts in bacterial populations associated with periodontitis and their systemic implications. By integrating spatial mapping with shotgun metagenomics, we highlight distinct microenvironmental signatures within periodontal pockets, characterized by anaerobic pathobionts, metabolic reprogramming, and localized inflammatory gradients. Furthermore, we examine evidence supporting bidirectional interactions between oral and gut microbiota, suggesting that oral-derived taxa may contribute to gut dysbiosis through translocation and ecological disruption. From a basic science perspective, spatial metagenomics reveals niche-specific microbial functions and interspecies interactions that are not captured by bulk sequencing. Clinically, these insights open avenues for precision diagnostics and targeted therapeutics, including microbiome modulation strategies tailored to spatial microbial organization. Overall, this work underscores the importance of spatial context in metagenomic analyses and advances the conceptual framework linking periodontal disease to systemic microbial dysbiosis. Full article

Background: Recent scientific evidence indicates that the oral–gut axis represents a critical interface in host–microbiota interactions, carrying profound implications for both periodontal and gastrointestinal diseases. This scoping review aims to evaluate the reciprocal influence between periodontitis and inflammatory bowel disease (IBD). Specifically, the underlying mechanisms of microbial translocation, immune interaction, and metabolite-mediated signaling linking the oral microbiota to gut microbial ecology are critically evaluated. Methods: Studies were selected from the PubMed, Web of Science, and Scopus databases up to May 2026. Eligible criteria included in vivo studies written in English and conducted within the last 10 years, whereas human studies involving participants under 18 years of age were excluded. The included studies analyze the effects of oral and gut dysbiosis on the opposing district. Through the database search, 2094 records were identified, and 34 articles were selected based on the eligibility criteria. Results: The included studies demonstrate the interconnection between the oral and gut microbiota. The included studies reveal that predominant oral taxa, specifically Porphyromonas gingivalis, Fusobacterium nucleatum, and Aggregatibacter actinomycetemcomitans, alter intestinal microbial composition. In particular, P. gingivalis colonizes the gut, exacerbating both oral and intestinal inflammation by stimulating pro-inflammatory cytokine expression via Th17 cell activation. Finally, salivary microbial composition appears to be associated with the presence and status of IBD. Conclusions: Understanding these interconnected microbial ecosystems provides valuable insights that may support the future development of integrated diagnostic and therapeutic strategies for patients suffering from periodontitis and IBD. Further large-scale studies with longer follow-up periods are required to standardize potential salivary markers and multidisciplinary therapeutic protocols for the management of periodontitis and IBD. Full article

Background: This study aimed to assess cone-beam computed tomography (CBCT) knowledge, adherence to justification criteria, field-of-view (FOV) selection practices, and awareness of radiation protection guidelines among dental practitioners in the Asir region. In Saudi Arabia, the Saudi Food and Drug Authority (SFDA) and the Nuclear and Radiological Regulatory Commission are the regulatory bodies responsible for radiation protection and the safe use of dental imaging; limited awareness of their roles may undermine regulatory compliance and patient safety. Accordingly, the specific objectives of this study were: (i) to assess knowledge of CBCT justification criteria and radiation-dose magnitudes; (ii) to evaluate adherence to the requirement for a prior 2D radiograph; (iii) to examine FOV selection across standardized clinical vignettes; (iv) to explore factors associated with knowledge scores; and (v) to identify perceived barriers to appropriate CBCT prescribing. Methods: A cross-sectional descriptive-analytical survey targeted 73 dental practitioners in Abha, Saudi Arabia. A validated 30-item questionnaire was distributed via Google Forms using snowball convenience sampling. The effective target population comprised dental practitioners and interns working in Abha during the study period. Because recruitment used open snowball distribution without a fixed sampling frame, a formal response rate could not be calculated. Results: The mean knowledge score was 5.47/10 (standard deviation: 1.86). Item-level correct rates were 82.2% for caries detection, 80.8% for the requirement for a prior 2D radiograph, and 58.9% for paediatric CBCT justification. FOV selection across four clinical vignettes ranged from 27.4% to 68.5% correct, with the lower-left-molar implant vignette showing the lowest rate (27.4%) and the six-unit anterior implant bridge vignette also poorly answered (37.0%), reflecting a frequent tendency to select an inappropriately large FOV. Guideline awareness was low: 65.8% were completely unaware of the Safety and Efficacy of a New and Emerging Dental X-ray Modality Computed Tomography (SEDENTEX CT) 2012 guidelines, while 54.8% did not know that the American Dental Association publishes specific radiation guidelines. In an exploratory multivariable model, no factor was a statistically significant predictor of the knowledge score; formal CBCT training showed a small, non-significant association (B = 0.585; 95% confidence interval [−0.27, 1.44]; p = 0.175). Conclusions: In this preliminary survey, CBCT knowledge among dental practitioners in Abha was moderate but suboptimal, with almost half of respondents scoring below the satisfactory threshold and with significant gaps in FOV optimisation and guideline awareness. Given the small, non-probability sample, these findings should be regarded as preliminary and hypothesis-generating. Full article

Background/Objectives: The aim of this systematic review was to analyze the impact of dietary modifications on unsaturated fatty acids (UFAs) intake on the course of three oral autoimmune conditions: oral lichen planus (OLP), recurrent aphthous stomatitis (RAS), and pemphigus. These acids serve a structural function as key components of cell membrane phospholipids, influencing their fluidity and membrane receptor activity. The proper ratio of these acids in the diet may be crucial for maintaining normal functioning of the human immune system. Methods: The following bases were searched with no time restrictions: PUMS Library, Embase/Elsevier, PubMed/MEDLINE, Scopus, and Web of Science. Of the 247 results identified in pre-screening, 6 studies that met all search criteria were included in the final systematic review. The risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for randomized trials and the Newcastle–Ottawa Scale for non-randomized studies. Results: The outcome measures included: proportions of LA-derived oxylipins (9-HODE, 13-HODE), ulcer size (mm), monthly number of ulcers, average pain (VAS), duration of episodes, and quality of life (OHIP-14), healing time, and fatty acid analysis of total plasma phospholipid fraction, Pemphigus Disease Area Index (PDAI) for disease severity (mild ≤ 15, severe > 15); AHEI-2010 score (9–90 points) for diet quality. In all studies, improvements in clinical parameters and subjective complaints were observed after implementing a dietary intervention. Conclusions: Dietary modification may be a valuable component of adjunctive therapy. Nutritional optimization offers a genuine opportunity to reduce reliance on conventional pharmaceuticals, thereby limiting the risk of systemic adverse effects associated with long-term pharmacotherapy. Full article

Background/Objectives: Immediate implant placement in the esthetic zone is increasingly preferred due to its advantages for patient comfort and reduced treatment time. However, maintaining peri-implant soft tissue volume and preserving or reconstructing the interdental papilla remain significant clinical challenges. This report aims to describe a clinical protocol designed to enhance peri-implant soft tissue stability and promote papilla regeneration following immediate implant placement. Methods: This article presents a clinical case managed through a combined mucogingival and prosthetic approach. The protocol included digital planning for implant positioning, immediate implant placement, and a connective tissue graft to support peri-implant soft tissues. Particular attention was given to the design and progressive modification of the provisional restoration. Targeted additions of composite material were applied in the under-proximal areas of the provisional crown to create controlled pressure at the base of the papilla, aiming to stimulate soft tissue adaptation and growth. Results: The progressive “bumping” technique applied to the provisional crown promoted the gradual growth of the interdental papilla and complete closure of the interproximal spaces. Clinical and radiographic follow-up showed stable peri-implant soft tissues, adequate tissue volume, and highly satisfactory esthetic outcomes. Conclusions: This report represents an initial proof of concept that highlights the importance of integrating precise surgical techniques, customized prosthetic contouring, and digital workflows to achieve predictable soft tissue management in immediate implant placement. This combined approach may contribute to improved papilla formation and enhanced esthetic outcomes. Further prospective studies are needed to confirm the reproducibility and clinical advantages of this protocol. Full article

Background: Oral squamous cell carcinoma (OSCC) has increasingly been associated with oral microbiota and chronic periodontal inflammation. While major periodontal pathogens have been extensively studied, the role of Capnocytophaga gingivalis (C. gingivalis) in oral carcinogenesis remains unclear. This study investigated the prevalence and quantified the presence of C. gingivalis in benign oral lesions, oral potentially malignant disorders (OPMDs), and OSCCs, as well as its association with carcinogenesis-related gene expression. Methods: Ninety patients with periodontitis were included: 30 with benign lesions, 30 with OPMDs, and 30 with OSCCs. C. gingivalis quantification was performed using qPCR, while relative expression of VEGF, Cyclin D1, PIK3CA, DUSP16, mTOR, and MAPK14 was analyzed by RT-qPCR. Results: C. gingivalis was detected in 2 benign lesions, 11 OPMDs, and 18 OSCC samples (p < 0.001). Overall bacterial burden was significantly higher in OPMD and OSCC groups compared to benign lesions (p = 0.001). Expression of PIK3CA and MAPK14 was significantly increased in the OPMD and OSCC groups. In OSCC samples, C. gingivalis abundance positively correlated with VEGF and Cyclin D1 expression. Conclusions: C. gingivalis showed progressively increased prevalence and abundance across examined lesions and was associated with altered expression of genes involved in carcinogenesis, supporting its potential role in OSCC progression. Full article

Repeated exposure to subinhibitory concentrations of antiseptics may lead to reduced susceptibility or resistance and potentially promote cross-resistance to antibiotics. However, the underlying molecular mechanisms remain incompletely understood. This study investigated whether antiseptic-adapted Escherichia coli strains exhibit altered protein expression profiles compared with wild-type (WT) E. coli. Protein expression was analysed in E. coli strains previously adapted over ten passages to subinhibitory concentrations of chlorhexidine (CHX), cetylpyridinium chloride (CPC), and benzalkonium chloride (BAC). WT bacteria were exposed to sub-minimum inhibitory concentrations (sub-MICs) of antiseptics for 3 h to induce stress. Untreated WT and heat-shocked WT E. coli (42 °C, 2 h) served as controls. Protein expression profiles were assessed using SDS-PAGE and Western blotting targeting stress-associated proteins. SDS-PAGE demonstrated altered protein expression patterns in antiseptic-adapted strains, including differences in band intensities and additional protein bands. Western blot analysis showed increased DnaK and GroEL expression with reduced LexA levels in heat-shocked WT bacteria, whereas RecA remained largely unchanged. Antiseptic-adapted strains exhibited increased DnaK, GroEL, and OmpF expression together with reduced LexA and RecA expression. These findings indicate that adaptation to antiseptics involves complex mechanisms among multiple proteins rather than a single adaptive mechanism. Full article

Background/Objectives: The management of severe anterior dental trauma in growing patients remains a clinical challenge. This case report describes the treatment of a 10-year-old boy presenting with traumatic loss of maxillary anterior teeth following a road traffic accident, including avulsion of two permanent incisors and a primary canine, associated with luxation and intrusion of the contralateral central incisor. Methods: A multidisciplinary approach involving paediatric dentistry, orthodontics, oral surgery, and restorative dentistry was implemented. Treatment aimed to preserve the traumatised incisor and restore the anterior maxillary region through a biological approach combining mandibular first premolar autotransplantation and orthodontic space management. Results: The transplanted first mandibular premolar demonstrated favourable healing, with continued root development and a satisfactory crown-to-root ratio. After orthodontic treatment, the tooth was restored with a composite veneer, achieving good aesthetic and functional outcomes, maintained at the 5-year follow-up. Conclusions: This case highlights that autotransplantation combined with orthodontic space management may represent a viable treatment option in carefully selected growing patients, allowing preservation of alveolar bone, function, and aesthetics. Appropriate surgical, orthodontic, and restorative planning was crucial to the treatment’s success. Full article

The development of bioactive surgical sutures capable of delivering therapeutic agents directly at the wound site has gained increasing attention in biomedical research. Functionalized sutures may provide localized antimicrobial or anti-inflammatory activity, potentially reducing postoperative complications and promoting tissue healing. In this study, absorbable surgical sutures were impregnated with carvacrol, a natural phenolic compound with well-known antimicrobial properties, using supercritical carbon dioxide (scCO₂) technology. The impregnation process was carried out at 35 °C and 10 MPa for 120 min, allowing for the incorporation of carvacrol into the polymeric matrix of the sutures. The in vitro release behavior of the impregnated sutures was evaluated in phosphate-buffered saline (PBS, pH 7.4) at 37 °C over an 8-day period. The concentration of released compounds was determined by UV–Vis spectrophotometry using previously established calibration curves. An analysis of the experimental release data demonstrated that both carvacrol and benzydamine hydrochloride (HCl) (Tantum Verde^®) exhibited a sustained release profile throughout the incubation period. Carvacrol release increased progressively from 2.02 ± 0.15 ppm on day 1 to 7.45 ± 0.15 ppm on day 7, followed by a slight stabilization on day 8 (7.25 ± 0.31 ppm). Similarly, benzydamine HCl (Tantum Verde^®) release increased from 1.83 ± 0.11 ppm on day 1 to 3.29 ± 0.13 ppm on day 8. Release kinetics were analyzed using the Korsmeyer–Peppas model, indicating that the release mechanism was predominantly diffusion-controlled during the initial stage of the experiment. The results demonstrate that supercritical CO₂ impregnation is an effective solvent-free technique for incorporating bioactive compounds into absorbable sutures, enabling controlled release under physiological conditions. Full article

Background: Porphyromonas gingivalis is the principal bacterial species implicated in the pathogenesis of periodontitis. Despite its central role, direct detection of periodontopathic bacteria is not routinely performed in dental clinics. Although test kits using monoclonal antibodies against P. gingivalis have been reported, no practical chairside method has yet been established. Objectives: In this study, we developed an immunochromatography system that enables rapid and quantitative detection of P. gingivalis within 10 min. Methods: We evaluated the performance of the developed immunochromatography system and its dedicated measurement reader. Results: The kit demonstrated a minimum detection limit of 2.6 × 10⁴ CFU/mL and maintained detection capability across fimbrial types I and II. The dedicated reader showed strong correlations with a reference reader (R² = 0.9921) and visual color chart evaluation (R² = 0.9347). High intra- and inter-device precision was observed, with coefficients of variation less than 0.6%. Although the presence of 2% whole blood interfered with visual interpretation, other oral substances, including toothpastes and mouthwashes, did not significantly affect the assay performance. Conclusions: Collectively, these findings indicate that the developed system may serve as a rapid and reliable chairside tool for quantitative detection of P. gingivalis, with potential utility in the diagnosis and management of periodontitis and related systemic conditions. Full article

Background/Objectives: Estrogen is a key female hormone; however, its role in periodontitis remains poorly understood. This study investigated the effects of 17β-estradiol (E2) on experimental periodontitis using an ovariectomy (OVX) model with E2 administration. Methods: Female mice aged 8–10 weeks underwent OVX, followed by induction of ligature-induced periodontitis, and subsequent quantification of alveolar bone resorption. Additional groups received an aromatase inhibitor or E2 supplementation after OVX, with subsequent induction of periodontitis and evaluation of bone resorption. Histological analysis assessed multinucleated giant cells and tartrate-resistant acid phosphatase-positive osteoclasts on the bone surface. Gingival tissue was analyzed for gene expression related to osteoclastogenesis. The effect of E2 on osteoclast differentiation from bone marrow cells was also examined. Results: OVX significantly reduced serum E2 levels and decreased alveolar bone resorption. Aromatase inhibitor administration similarly reduced bone loss. Histological evaluation revealed a reduced number of resorbing osteoclasts in OVX mice, whereas E2 supplementation increased osteoclast numbers. No significant changes in inflammatory cytokine or receptor activator of nuclear factor-kappa B ligand (RANKL) expression were observed. E2 promoted osteoclast differentiation in vitro, and treatment with E2 prior to RANKL stimulation further increased the number of osteoclasts. This effect was suppressed by an estrogen receptor antagonist. Moreover, E2 enhanced the expression of osteoclast differentiation–associated genes in the presence of RANKL, an effect abolished by tamoxifen. Conclusions: E2 increased alveolar bone resorption in experimental periodontitis, likely by promoting osteoclast differentiation, independent of inflammatory cytokine or RANKL gene expression. Full article

Accurate assessment of radiographic bone loss (RBL) is essential for periodontal diagnosis and staging; however, manual measurement from dental radiographs is labor-intensive, time-consuming and subject to inter- and intra-examiner variability. Existing AI-based methods primarily formulate bone loss assessment as classification, landmark prediction, or direct segmentation of thin anatomical structures, limiting measurement interpretability and robustness. This study proposes clinically interpretable two-phase framework for automated and clinically interpretable RBL estimation from periapical radiographs. The framework explicitly separates anatomical structure recognition from geometric measurement, improving transparency and reducing error propagation. In the first phase, deep learning models segment key anatomical structures, including the crown, root, third root and alveolar bone. In the second phase, a deterministic geometric algorithm extracts clinically relevant landmarks, including the cemento–enamel junction (CEJ), bone crest, and root apex, and computes root length, CEJ–bone crest distance, and radiographic bone loss following established periodontal measurement principles. The framework was evaluated on a curated dataset of annotated radiographs. DS-TransUNet achieved the best segmentation performance. Quantitative evaluation yielded mean absolute errors of 0.81 mm for CEJ–bone crest distance, 0.71 mm for root length, and 5.89% for RBL estimation. Bland–Altman analysis demonstrated minimal systematic bias (−1.03%) and good agreement with expert measurements across different disease severities, supporting the framework’s potential as an objective and clinically applicable tool for periodontal bone loss assessment. Full article

Background/Objectives: Periodontitis is a highly prevalent inflammatory disease and a major cause of tooth loss worldwide. Accurate diagnosis requires integration of clinical and radiographic findings, but interpretation of panoramic radiographs is subject to variability. Artificial intelligence (AI) has emerged as a promising adjunct for radiographic assessment. This systematic review evaluated the diagnostic performance of AI-based models for detecting periodontitis using panoramic radiographic images. Methods: A systematic search of PubMed, Scopus, and Web of Science identified studies published between 1 January 2015 and 1 March 2026. Eligible studies assessed AI models for periodontitis detection on panoramic radiographs and used either clinically confirmed periodontal diagnosis or expert radiographic annotation as the reference standard. Data extraction and quality assessment were performed independently by two reviewers using the QUADAS-2 tool. Owing to heterogeneity in AI architectures, datasets, and outcome measures, a narrative synthesis was conducted. Results: Nine studies met the inclusion criteria, comprising more than 20,000 radiographs. AI models included convolutional neural networks (CNNs), segmentation-based systems, and hybrid architectures. Sensitivity ranged from 0.795 to 1.00, specificity from 0.784 to 0.99, and AUC values from 0.843 to 0.967. Studies using clinical periodontal diagnosis as the reference standard generally reported lower performance than those relying solely on expert annotation. Only four studies performed external validation, and dataset sizes varied widely. One study combining panoramic and periapical radiographs showed moderate diagnostic performance. Conclusions: AI-based diagnostic models demonstrate promising performance for detecting periodontitis on panoramic radiographs, with several studies reporting high sensitivity and AUC values. However, heterogeneity in reference standards, limited external validation, and inconsistent dataset quality restrict generalizability. AI should be considered an adjunct to, rather than a replacement for, comprehensive clinical periodontal examination. Standardized datasets and robust external validation are needed to support clinical implementation. Full article

Foods rich in polyphenols are known to promote oral health by modifying the enamel pellicle. In doing so, they reduce bacterial adhesion, biofilm maturation, and erosion. The goal of this study was to screen local herbal drugs available in Central Europe for their potential suitability as part of a diet promoting oral health by targeting the initial stages of biofilm formation. To achieve this, an in situ study was conducted to evaluate the effects of the four polyphenol-rich herbal extracts of blackcurrant leaves, oak bark, horse chestnut leaves, and sweet chestnut leaves on early bacterial adhesion and biofilm formation on tooth enamel over an 8 h period. This research aimed to identify natural remedies that could support oral hygiene by targeting the initial stages of biofilm formation. Study Design and Experimental Procedures: Aqueous extracts were prepared by ultrasonic extraction. Eight human subjects wore bovine enamel slabs intraorally for 8 h. After 1 min of pellicle formation, the subjects rinsed with 8 mL of the extracts for 10 min, followed by intraoral exposure without food. An 8 h-exposure without rinse served as the negative control; 0.2% chlorhexidine gluconate (CHX) served as the positive control. After 8 h, bacterial adhesion and biofilm matrix formation on the enamel slabs were quantified ex vivo using DAPI/Concanavalin A staining and fluorescence microscopy. The LIVE/DEAD™ BacLight™ assay was used to assess bacterial viability. Statistical analysis was performed by the Mann–Whitney U test and Kruskal–Wallis test (p < 0.05), as well as the Bonferroni–Holm correction (p < 0.01). Results and Conclusions: The screened herbal drugs did not demonstrate a statistically significant impact on the number of adherent bacteria, suggesting that their mode of action may not directly interfere with bacterial adhesion mechanisms. However, all four extracts exhibited consistent trends toward reduced glucan formation and decreased bacterial viability. The observed inhibition of glucan formation indicates that these drugs may potentially target the enzymatic pathways responsible for polysaccharide synthesis. By disrupting glucan production, the structural integrity of the biofilm matrix might be compromised, which indirectly affects bacterial survival within the biofilm environment. Full article

Background: Crown lengthening procedures are widely used in restorative and periodontal therapy to expose sufficient tooth structure for functional and esthetic rehabilitation. Traditionally performed using an open-flap approach, these procedures have evolved with the introduction of minimally invasive flapless techniques. This narrative review aims to summarize the biological foundations, clinical outcomes, and contemporary approaches associated with crown lengthening procedures, with particular emphasis on flapless and flap techniques, healing processes, technological advancements, and clinical decision-making considerations. Methods: A narrative literature review was conducted using electronic databases, including PubMed, Scopus, and Web of Science, to identify relevant publications on crown lengthening procedures. The search focused on studies addressing flapless and flap techniques, biological principles, healing dynamics, clinical outcomes, postoperative considerations, and contemporary approaches such as laser-assisted and digitally guided procedures. Titles and abstracts were screened for relevance, followed by full-text assessment of eligible articles. The study selection process was documented using a simplified PRISMA-style flow diagram to enhance transparency. Results: The reviewed literature suggests that flapless crown lengthening may be associated with reduced surgical time, less postoperative discomfort, faster healing, and preservation of soft tissue architecture in appropriately selected cases. However, its applicability appears to be influenced by anatomical factors, including bone morphology and the need for adequate visualization during osseous recontouring. Conventional flap techniques continue to be widely used and may offer improved surgical access and visibility, particularly in more complex situations requiring extensive bone modification. Although these procedures have been associated with longer healing periods and greater postoperative morbidity, the heterogeneity of the available evidence and the narrative nature of this review limit definitive comparisons between the two approaches. Conclusions: In conclusion, both flapless and flap crown lengthening procedures demonstrate high clinical efficacy when appropriately indicated. The choice of technique should be guided by case-specific factors, clinician expertise, and patient expectations. Further randomized controlled trials are recommended to strengthen the evidence base and establish standardized clinical guidelines. Full article