Dentistry Journal最新文献

Background: Periodontitis is associated with systemic inflammation; however, the relationship between disease severity and systemic inflammatory biomarkers remains unclear. This study aimed to evaluate the association between periodontitis stage and grade with systemic levels of C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) and assess changes following standardized non-surgical periodontal therapy. Methods: Patient records from the University Dentistry Clinical Center of Kosovo were reviewed. Periodontitis was classified using the 2018 staging and grading system. Periodontal parameters (probing pocket depth, clinical attachment loss, bleeding on probing, plaque index, and gingival index) were assessed at six sites per tooth (excluding third molars). Serum levels of IL-1β, IL-6, TNF-α, and high-sensitivity CRP were measured before and after therapy using high-sensitivity ELISA. Blood samples were centrifuged, and serum was stored at -20 °C. All patients underwent standardized non-surgical periodontal therapy, including full-mouth scaling and root planning, without systemic antibiotics. Data were analyzed using SPSS v22.0. Results: Among the patients, 28.0% had Stage I-II, 40.0% Stage III, and 32.0% Stage IV periodontitis; 29.3% were Grade A, 45.3% Grade B, and 25.3% Grade C. At baseline, all systemic inflammatory biomarkers (CRP, IL-1β, IL-6, and TNF-α) were significantly higher in periodontitis patients compared with the control group, indicating an increased systemic inflammatory burden before therapy. After therapy, significant reductions in CRP, IL-1β, IL-6, and TNF-α were observed across all stages and grades (all p < 0.01), indicating a decrease in systemic inflammatory burden. Conclusions: Non-surgical periodontal therapy significantly lowers systemic inflammatory biomarkers regardless of periodontitis severity, supporting their role as indicators of disease activity and treatment response.

Background/Objectives: The present study aimed to investigate how the changes in the inclination of the upper and lower incisor regions during the alignment phase of orthodontic treatment (OT) without premolar extraction influence the height and thickness of the gingiva around these incisors. Methods: This prospective clinical study included 62 patients undergoing OT without premolar extraction. Cone beam computed tomography and intraoral 3D scans were taken before and after the alignment phase, and superimposed using specialized software. The changes in the inclination of each tooth, alveolar bone height (ABH), clinical crown height (CCH), and gingival thickness on the level of the cement-enamel junction (CEJ) and 1 mm below it were determined on both tooth sides. Results: The alignment phase of OT was accompanied by an increase in CCH on the buccal side of both upper and lower incisors. In contrast, on the palatal/lingual sides, either a decrease or an increase in CCH was observed, depending on the direction and amount of the changes in the inclination. Furthermore, in many cases, a decrease in the gingival thickness was observed, which was especially pronounced on the palatal side of the upper incisors after proclination. The changes in the CCH and gingival thickness on the palatal/lingual sides exhibited a weak to moderate correlation with the changes in the inclination. In addition, a very weak to weak correlation between the changes in gingival parameters and ABH was observed. Conclusions: Our data suggest that there is some soft tissue remodeling during the alignment phase of OT, and the changes in soft tissue parameters exhibit some dependency on the changes in inclination. Potential changes in the soft tissue should be considered in planning orthodontic treatment.

Background: Pediatric syrups are frequently prescribed but may pose a risk to dental enamel due to their acidity and viscosity. Aim: To evaluate the erosive potential of commonly prescribed pediatric syrups on enamel from primary and permanent human teeth under ex vivo conditions. Design: Enamel-dentin blocks from sound primary and permanent teeth were assigned to nine groups (eight syrups and one control). Samples were immersed in their respective solutions four times daily for a 6-day exposure period. Mineral loss (ΔF) was assessed via Quantitative Light-Induced Fluorescence (QLF), surface roughness via profilometry, and morphological changes via scanning electron microscopy (SEM). Syrup pH and viscosity were also measured. Results: Significant ΔF changes were found only for dextromethorphan on primary enamel (p = 0.0054). No significant enamel loss was observed by profilometry. Surface roughness increased significantly with glycerin, distilled water, and azithromycin. Syrups showed a wide pH range (3.92-8.44) and varied viscosity, with ibuprofen and glycerin being the most viscous. Conclusions: Most pediatric syrups did not cause significant enamel demineralization or loss under short-term ex vivo exposure. However, increased surface roughness suggests that specific formulations may affect enamel texture, underscoring the need for preventive care in frequent users.

Background: Primary stability of dental implants depends on bone quality, bone quantity, and implant design. In cases of large defects, such as periapical lesions, the selection of an appropriate alveolar ridge preservation (ARP) material is crucial for bone regeneration and preparation for implant placement. Objective: The aim of this study was to evaluate clinical and histological outcomes of a novel ARP material hydroxyapatite and sugar cross-linked collagen (HSCC) combined with a knife-edge thread implant (KTI) design. Methods: Thirty patients were divided into two groups: a control group treated with KTI after spontaneous alveolar ridge healing, and an experimental group that underwent ARP using HSCC, and six months later, KTIs were placed in newly formed bone. Clinical parameters including insertion torque value (ITV), resonance frequency analysis (RFA), implant stability quotient (ISQ), and horizontal bone dimension were evaluated. Histological analysis was also performed. Results: No significant differences were observed between groups in ITV, ISQ, or horizontal bone dimension (p > 0.05). However, histological analysis demonstrated a significantly higher number of active osteoblasts in the ARP group compared to the control (p < 0.001), whereas collagen deposition was significantly greater in the control group (p < 0.001). Conclusions: ARP using HSCC, combined with KTI, provides favorable conditions for primary stability and successful graft integration, supporting reliable implant placement in sites with bone defects.

Background: The use of prosthetic caps in screw-retained implant restorations aims to enhance passivity and protect abutment threads; however, these components may increase prosthetic volume and impair esthetics. Advances in high-strength zirconia have raised the question of whether such caps remain necessary. Methods: A retrospective clinical analysis was conducted on 20 partial screw-retained zirconia restorations comparing cases fabricated with and without a prosthetic cap. All restorations were followed for 3-5 years. Clinical outcomes included screw stability, marginal adaptation, esthetics (VAS), hygiene access, and biological response. A supplementary mechanical verification was performed on four standardized zirconia crowns fabricated through digital and conventional impression workflows to qualitatively assess their behavior under 30 N·cm torque and compressive loading above 1200 MPa. Results: Throughout follow-up, no mechanical or biological complications were recorded in either group. One restoration with a cap required screw re-tightening, while none failed in the cap-free group. Radiographic analysis showed smaller mean marginal gaps in cap-free restorations (0.183 mm) compared to those with caps (0.289 mm; p < 0.01). Esthetic satisfaction scores were higher in the cap-free group (VAS = 9.3 ± 0.1 vs. 8.2 ± 0.1; p < 0.001). Mechanical verification confirmed that all zirconia crowns tolerated torque and compressive loads without visible fracture or deformation. Conclusions: Within the study limitations, cap-free screw-retained zirconia restorations exhibited excellent 5-year clinical stability, improved esthetics, and better hygiene access compared with capped designs. The small-scale mechanical verification supported the clinical findings, indicating that cap omission does not compromise mechanical performance when accurate fit and digital workflow precision are ensured.

Background: Oral health problems are common among elite athletes, yet the evidence remains fragmented and inconsistent. Objectives: To estimate the prevalence and severity of oral conditions in elite athletes through a systematic review and meta-analysis. Methods: Studies published in English, Spanish, or Portuguese, with observational design, available in PubMed, Embase, CINAHL, Web of Science, Scopus, Dentistry & Oral Science Source, and LILACS databases until 5 January 2025, were included. A narrative synthesis was used to describe the studies, and a meta-analysis of prevalences was performed using a random-effects model. Study quality assessment was performed using the Joanna Briggs Institute Critical Appraisal tools. Results: A total of 10 articles were included in the systematic review and meta-analysis. The overall combined prevalence of caries was found to be 44.4% (95%CI: 33.9-55.1%), the prevalence of dental erosion was 36.5% (95%CI: 22.6-51.7%), the prevalence of gingivitis was 41.4% (95%CI: 14.7-71%), the prevalence of pericoronitis was 18.7% (95%CI: 2.3-45.4%), the prevalence of periodontitis was 10.8% (95%CI: 2.7-23.3%) and the prevalence of orofacial trauma was 15.6% (95%CI: 5.3-29.7%). High heterogeneity was observed across studies. Most studies presented limitations related to participant recruitment and sample size adequacy. Conclusions: Dental caries, gingivitis, and dental erosion are highly prevalent among elite athletes, underscoring the importance of integrating oral health assessments into sports medicine care. High heterogeneity across studies limits the precision of prevalence estimates, emphasizing the need for standardized methodologies in future research.

Background: Periodontitis is a chronic inflammatory disease mostly associated with Porphyromonas gingivalis infection and characterized by progressive destruction of the supporting structures of the tooth, including the gingiva, periodontal ligament and alveolar bone. However, the impact of other members of the periodontal microbiome on stage of the severity of the periodontitis remains largely uncharacterized. Methods: This exploratory study employs whole-genome shotgun (WGS) metagenomics to characterize the periodontal microbiome in patients suffering from mild and severe periodontitis, aiming to identify microbial signatures linked to disease severity via analysis of taxonomic composition, predicted metabolic pathways and metagenome-assembled genomes (MAGs). After initial selection, 28 adult patients with a computer tomography (CT)-confirmed diagnosis of mild and severe stage of periodontitis from 2 clinics were included in the research project. Results: Taxonomic analysis confirms the presence of various commensal and pathogenic bacteria detectable at the species level, especially belonging to so-called "red, orange and green periodontal complexes"-P. gingivalis, T. forsythia, C. rectus, and Capnocytophaga spp. that may contribute to disease heterogeneity. The conducted investigation suggests that non-microbial factors such as cardiovascular diseases and antibiotic usage in the last 6 months prior to the hospital admission could explain variance of disease progression and impact on severity. Analysis of microbial functional composition revealed metabolic traits showing positive correlations with severe stage of periodontitis. Robust network analysis suggested interactions between pathogenic bacteria of the red complex and other members of the periodontal microbiome. Conclusions: These findings underscore the multifactorial nature of periodontitis pathogenesis, highlighting the need for integrated approaches combining microbial, host, and environmental data to unravel drivers of disease progression. The study provides a foundation for future large-scale investigations into personalized diagnostic or therapeutic strategies.

Background/Objectives: Clear aligners (CAs) are a popular alternative to classical fixed appliances (FAs) for orthodontic treatment. This systematic review aimed to compare the external apical root resorption (EARR) in patients undergoing orthodontic therapy with either FAs or removable CAs. Methods: An electronic search was conducted to identify comparative studies. Risk of bias was assessed using the Cochrane RoB 2.0 tool for randomized controlled trials (RCTs) and the ROBINS-I tool for non-RCTs. EARR at the following incisors was considered: maxillary central (MxC), maxillary lateral (MxL), mandibular central (MdC), and mandibular lateral (MdL). A random-effects meta-analysis was performed, and mean differences were estimated. Results: Ten studies (one RCT, two prospective, and seven retrospective studies) were included. Four had a low risk of bias, four had a moderate risk, and two had a serious concern. In total, 286 patients (1476 incisors) and 289 patients (1487 incisors) in the CA and FA groups were considered, respectively. The mean follow-up was 22.7 ± 9.9 (standard deviation) in the CA group and 22.5 ± 8.2 months in the FA group. The meta-analysis found that CAs caused significantly less EARR than FAs for all tooth types except for MdL. On a patient basis, the mean difference (MD) in favour of CAs ranged from -0.64 mm (95% CI (confidence interval): -0.90, -0.38 mm) for MxC to -0.26 mm (95% CI: -0.43, -0.09 mm) in MdC. Heterogeneity across studies was generally high, except for MdC cases. Conclusions: EARR at incisor teeth is generally lower using CAs compared to FAs. Further evidence-based studies are needed to confirm these results and understand the clinical relevance of such a difference.

Background/Objective: To outline strategies for the safe clinical use of orthodontic temporary anchorage devices (TADs) by analyzing papers that examine associated risks, complications, and approaches for their prevention and resolution. Methods: The research protocol used PubMed, Medline, and Scopus up to May 2024, focusing on controlled and randomized clinical trials aligned with the review objective. Fourteen studies were included; bias risk was assessed, key data extracted, and a descriptive analysis performed. Study quality and evidence strength were also evaluated. Results: TADs optimize anchorage control without relying on patient compliance. However, they carry risks and complications. TAD contact with the periodontal ligament or root without pulp involvement requires removal for spontaneous healing. If pulp is involved, the TAD should be removed and endodontic therapy performed. If anatomical structures are violated, TAD should be removed. If transient, spontaneous recovery occurs, but sometimes pharmacological treatment may be needed. A 2 mm gap between the TAD and surrounding structures can prevent damage. In the maxillary sinus, a less than 2 mm perforation of the Schneiderian membrane recovers spontaneously; wider perforations require TAD removal. Good oral hygiene and TAD abutments prevent soft tissue inflammation, which resolves with 0.2% chlorhexidine for 14 days. Unwanted forces can cause TAD fractures, requiring removal. Minor TAD mobility due to loss of primary stability can be maintained; significant instability requires repositioning. Conclusions: The use of TADs requires meticulous planning, radiological guidance, and monitoring to minimize risks and manage complications. With proper care, TADs improve orthodontic outcomes and patient satisfaction.

Background: Maxillary sinus floor augmentation is widely used to enable implant placement in the atrophic posterior maxilla, yet comparative data for porcine-derived xenografts remain limited. Objective: To evaluate long-term bone regeneration and implant outcomes following sinus augmentation using a collagenated porcine xenograft. Methods: This paper reports a retrospective case series of three partially edentulous patients (aged 46-56 years) who underwent lateral sinus augmentation with a small-particle collagenated porcine xenograft (THE Graft™, Purgo Biologics, Gyeonggi-do, Republic of Korea) and staged implant placement. In one case, a controlled perforation of the Schneiderian membrane was performed to access and remove a sinus mucocele, followed by repair using a resorbable collagen membrane. Core biopsies were harvested at implant placement for histology (hematoxylin-eosin, Masson-Goldner) and tartrate-resistant acid phosphatase (TRAP) staining. Clinical outcomes included surgical events, vertical bone gain, marginal bone levels, and implant survival at long-term follow-up. Results: Healing was uneventful in all cases. Mean vertical bone gain was 12.0 mm (baseline 1.33 mm to 13.33 mm final). At a mean 46.8-month follow-up (range 38.3-52.2 months), 100% of implants were functional without failure; marginal bone loss remained < 1 mm during the first year and was stable thereafter. Histology at 3.7, 4.7, and 7.5 months showed vascularized new trabecular bone intimately contacting residual xenograft particles (new bone 20-30%, residual biomaterial 30-40%, connective tissue 30-50%). TRAP-positive multinucleated giant cells at 7.5 months indicated ongoing biomaterial degradation without severe inflammatory reactions. Conclusions: Within the limits of a small case series, collagenated porcine xenograft supported predictable bone regeneration and stable long-term implant function after sinus floor elevation, with favorable histologic integration and gradual resorption.