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Purpose of Review Zeolite is an aluminosilicate compound having a wide spectrum of applications in medicine and dentistry. Several articles were published combining zeolites with various other elements for different applications in dentistry. This review aims to provide a detailed review on the origin of zeolites, their physical and chemical properties and possible applications as dental materials. Recent Findings Zeolite-based hybrid films can be used for detection of oral cancers. Silver zeolite can be added in restorative materials and dental liners. In cases of root canal irrigation, chlorhexidine zeolite is used owing to its antibacterial properties. For dental implants, a zeolite coating can improve the osseointegration. Summary Due to its microporous structure, application-driven zeolitic frameworks can be prepared by sieving in various cations and antibacterial compounds. This review helps improve our understanding regarding the uses of zeolites as a material in different aspects of dentistry along with possible further improvements as a dental material.

The purpose of this paper is to gain an understanding of existing knowledge and attain familiarity on mucormycosis for early diagnosis and treatment. It highlights the systematic factors, signs and symptoms, diagnostic tests and treatment procedure for mucormycosis from dentistry point of view. PubMed/ Medline, Scopus, Web of Science were the search engine used. Study selection encompassed systematic reviews, critical reviews and case reports related to mucormycosis in COVID-19 patients and only mucormycosis. 19 articles were selected between Years 2001 to 2021. Analysis was done based on patient's comorbidity, site of mucormycosis infection, use of steroids and its effect on people with COVID -19 infection.Rhino-orbito-cerebral mucormycosis is the most common of all systemic manifestations of mucormycosis. Diabetes mellitus and long-term corticosteroid therapy are the leading risk factors with pre-existing diabetes mellitus accounting for almost 80% cases. Elements that facilitate the growth of mucor in COVID-19 patients are the presence of low oxygen levels, high blood glucose levels, acidic media, high levels of iron, immunosuppression, and episodes of prolonged hospitalization. Mucormycosis is heterogenic in nature. Its management requires an individualized plan that considers the immunity status of the host, stage of the infection, systemic disease, early diagnosis and susceptibility to anti-fungal agents. Supervised use of corticosteroids and betadine gargle prevent the occurance of mucormycosis.The paper sheds some light on the warning signs and diagnostic tests that can help in early identification of infection by a dentist. This enables the timely implementation of therapy resulting in good prognosis of the treatment.

Purpose of Review A large number of smartphone applications bring with it cluttering and distorted information. Hence, the aim of this review was to critically evaluate conservative dentistry and endodontics apps among mobile phone apps. Furthermore, the objective was to assess the quality of apps using the Mobile App Rating Scale (MARS). Mobile applications were explored on the Apple App Store (AAS) and Google Play Store (GPS), using search terms and content analysis done using the MARS rating scale which is divided into three categories: app overall quality, app subjective quality, and app specific quality. Statistical analysis used Pearson’s correlations analyzed correlations between app scores and downloads/ratings and ANOVA, to analyze any differences between app focus and mean scores. Recent Findings Overall MARS scores ranged from 2 to 4.68 with a mean (SD) of 3.40 (0.79). The highest mean score in engagement (4.8/5) and highest esthetic mean score (4.6/5) were noted with an app named “Denticalc.” The highest functionality score (4.88/5) and information domain (4.7/5) belonged to the “AAE Endocase” app. A positive correlation was seen among average user rating score with app subjective mean score and overall mean scores. Summary To improve the overall quality of apps, developers must take into account both engaging and necessary features with high-quality, evidence-based information. Graphical Abstract

Purpose of Review In the field of periodontology, numerous studies have been conducted to observe the effects of sex hormones on the periodontal tissues and the oral mucosa. The balance in the circulating hormonal levels in the female body ensures proper homeostasis of the periodontium. Therefore, this literature review focuses on the more recent concepts related to changes in the endogenous and exogenous female hormones on the periodontal health in the lifetime of a woman. Recent Findings Previous studies have reported severe gingival inflammation in women using oral contraceptives. But present day oral contraceptives have decreased dosages in contrast to the older formulations and therefore only mildly affect the periodontium with the majority reporting lack of gingival inflammation. Periodontal treatment strategies for each stage in a woman’s life is also described in this review, and research pertaining to periodontal therapy during pregnancy has shown conflicting results in terms of reducing the risk of adverse pregnancy outcomes. Summary The changes seen in the periodontium seen in each milestone of a woman’s life correlates to the fluctuating levels in the female sex hormones. Maintaining oral health during the peak of hormone release such as pregnancy helps alleviate the symptoms of periodontal disease as well as reduce the risk of adverse pregnancy outcomes, although studies report conflicting results.

Purpose of Review To establish a link or causation between periodontitis and Alzheimer’s disease requires studies that first establish an association or correlation between these two diseases, followed by in vitro, animal model, and human studies to identify possible underlying biological mechanisms, and finally assessing the benefits of periodontal therapy in general and targeted therapies against the microbiota and inflammatory responses in periodontitis. This review presents an update on the current correlation and biological mechanisms that link these two diseases, with special emphasis on the keystone periodontal pathogen Porphyromonas gingivalis and its key family of gingipain enzymes. Recent Findings Recent evidence for slowing the progression of Alzheimer’s disease through periodontal therapy in general, as well as focused therapies directed against Porphyromonas gingivalis and its gingipains, are presented. Summary These intervention studies, together with the recent association and biological mechanism studies, strengthen the evidence for a direct link or causation between these two diseases. In addition, these recent studies support the special role of the dental practitioner in the management of patients with cognitive decline.

Purpose of Review This review aims to discuss burning mouth disorder (BMD) and its management and offers a guide to general dental practitioners to manage periodontal health in patients with BMD. Recent Findings Dental practitioners are well trained in diagnosing and treating periodontal disease; however, when periodontal disease coexists with BMD, diagnosis and management of these conditions become more complex. Personalised treatment for individual patients is prudent for long-term treatment compliance and effectiveness. Summary BMD is a chronic pain disorder characterised by the absence of visible mucosal lesions. It is often associated with the symptoms of burning, altered taste, and dry mouth with no obvious medical or dental cause. Diagnosis and treatment of BMD are complex and are influenced by multiple factors, which may complicate the diagnosis and treatment of especially painful periodontal disease.

Purpose of Review Despite advanced technologies to avoid corrosion of dental implants, the mechanisms toward the release of metals and their role in the onset of peri-implant diseases are still under-investigated. Effective knowledge on the etiopathogenesis of corrosive products and preventive strategies mitigating the risks for surface degradation are thus in dire need. This review aimed to summarize evidence toward biocorrosion in the oral environment and discuss the current strategies targeting the improvement of dental implants and focusing on the methodological and electrochemical aspects of surface treatments and titanium-based alloys. Recent Findings Recent studies suggest the existence of wear/corrosion products may correlate with peri-implantitis progress by triggering microbial dysbiosis, the release of pro-inflammatory cytokines, and animal bone resorption. Furthermore, current clinical evidence demonstrating the presence of metal-like particles in diseased tissues supports their possible role as a risk factor for peri-implantitis. For instance, to overcome the drawback of titanium corrosion, researchers are primarily focusing on developing corrosion-resistant alloys and coatings for dental implants by changing their physicochemical features. Summary The current state-of-art discussed in this review found corrosion products effective in affecting biofilm virulence and inflammatory factors in vitro. Controversial and unstandardized data are limitations, making the premise of corrosion products being essential for peri-implantitis onset. On the other hand, when it comes to the strategies toward reducing implant corrosion rate, it is evident that the chemical and physical properties are crucial for the in vitro electrochemical behavior of the implant material. For instance, it is foreseeable that the formation of films/coatings and the incorporation of some functional compounds into the substrate may enhance the material’s corrosion resistance and biological response. Nevertheless, the utmost challenge of research in this field is to achieve adequate stimulation of the biological tissues without weakening its protective behavior against corrosion. In addition, the translatability from in vitro findings to clinical studies is still in its infancy. Therefore, further accumulation of high-level evidence on the role of corrosion products on peri-implant tissues is expected to confirm the findings of the present review besides the development of better methods to improve the corrosion resistance of dental implants. Furthermore, such knowledge could further develop safe and long-term implant rehabilitation therapy.

The hematopoietic tissue is highly susceptible to stimuli, and inflammation is a major modulator. One particular source for this inflammatory burden is periodontitis. We revisit how periodontal infection may modulate the activity of the bone marrow, the fate of hematopoietic stem cells, and its systemic consequences. We also examine periodontal manifestations of particular blood disorders. Herein, we provide a glimpse of the available knowledge and discuss gaps that may be explored in the future. Recent studies have demonstrated that Porphyromonas gingivalis governs osteoclastogenic differentiation by regulating nuclear factor-kappa B ligand and inhibiting noncommitted osteoclasts precursors. This governed cell population exhibits an antigen-specific T cell immune-suppressive activity benefiting the persistence of periodontal infection and compromising the host immune response. The persistence of this low-grade inflammation together with this particular cell population enhances osteoclastogenic precursors from myeloid-derived suppressor cells, increasing the age-associated bone loss in mice. Periodontitis patients exhibit serum biomarkers of anemia, attributed to a state of anemia of inflammation. In other words, the production of hepcidin through the action of cytokines results in higher iron trapping inside macrophages and liver cells ant his may shorten erythrocyte survival. Another possible hypothesis to explain this link is the inflammatory suppression of erythropoietic activity, through the levels of erythropoietin. Periodontal therapy is effective in reducing leukocytosis, but evidence is to scarce regarding red and platelet lineages. Furthermore, periodontitis patients suffering from white blood cells disorders seem more prone to severe periodontal destruction given the pathophysiology of periodontitis and the immune role of leukocyte cells. The systemic inflammatory burden of periodontitis modulates the fate of differentiation of particular bone marrow and interferes with the erythropoietic activity. The impact of periodontal therapy on leukocytosis is robust and based on high quality evidence-based estimates, though its influence on erythrocytic and platelet levels is still limited. The existence of a greater predisposition to periodontal disease in blood disorders is not consensual.

There is increasing evidence on the connections between chronic oral inflammation/infection and the pathophysiological conditions of the gastrointestinal tract and accessory organs of digestion. The aim of this review is to provide a critical synthesis regarding the epidemiological, clinical, and in vivo associations between periodontitis and the most relevant diseases of the digestive system. An increasing body of dental and medical literature is supporting the gum-gut axis as a relevant mechanism to explain the associations between periodontitis and systemic diseases. Indeed, shared microbiological and immunological pathways have been identified between periodontitis and gut diseases, and translocation of oral bacteria to the lower parts of the digestive system has been postulated as a driver for peptic ulcers, inflammatory bowel disease, liver disease, and ultimately digestive cancers. For the upper digestive tract, epidemiologic association between periodontitis and gastroesophageal reflux disease or squamous cell carcinoma remains conflicting, despite oral keystone pathogens having been consistently found in esophageal and gastric cancer tissue biopsies. The oral cavity represents a reservoir for Helicobacter pylori, with periodontal therapy increasing the eradication and the non-recurrence rate of the infection. Regarding bowel diseases, gut dysbiosis is being progressively ascertained in close relation to periodontal infection, and periodontitis is being investigated among the risk indicators for colorectal cancer. Lastly, non-alcoholic fatty liver disease and cirrhosis were epidemiologically linked to periodontitis, while its association with pancreatic tumors represents one of the most intriguing fields of research in periomedicine.

During the last few years, the interest in fabrication of computer-engineered removable complete dentures has grown intensively. Innovative clinical and technological advances are driving forces. They allow (i) the creation of new and more efficient workflows, (ii) an emergence of modified and easier procedures, and (iii) the use of alternative biomaterials with improved properties. The results are a better fit and retention of the digital complete dentures, as well as a generally high satisfaction of patient and clinician, while reducing the number of appointments and the technical input. The purpose of this narrative review is to present the historical, clinical, and technological developments in the field of digital removable complete dentures and to evaluate the future potential of this technology. The fabrication of a digital complete denture either by milling separately the base and the denture teeth set-up or by milling a monolithic denture is well investigated. Concurrently the trend for fabricating complete denture bases by using the 3D print technology is growing. There is plenty of research showing that milling dentures from standardized pre-polymerized polymethyl methacrylate pucks guarantee the fabrication of homogenous objects with excellent biomaterial properties. The results indicate a better base adaptation, a higher flexural strength, an improved resistance to denture staining, and no polymerization distortion while milling. Furthermore, a sophisticated milling strategy allows to obtain a detailed and accurate intaglio and cameo surface, which is even exceeded when 3D printing. The clinical and technological freedom, to either combine selectively analog and digital steps or to take a totally digital workflow ending with milling or 3D printing, opens countless opportunities in the field of removable complete dentures. Whatever steps are taken, whatever sophisticated technology is chosen, still only the professional and individual know-how of the dentist in combination with the manual skills and the experience of the dental technologist—including especially the finish of the final product—will lead to a superior teamwork result. Limitations inherent to the milling process are the waste of raw material, the wear of milling tools, and the challenge to access undercut areas; the reasons are the milling bur size, the number of milling axes, and the limited movements of the machining axes. The advantages of additive manufacturing lay in a high resolution of complex geometries and a reduced waste of the biomaterial. As a limitation, the accuracy of the object, i.e. deformation, may be affected by several fabrication parameters, such as the polymerization light intensity, the build direction and angle, the layer thickness and numbers, the amount of supporting structures, and the post-processing procedures. However, with improved materials and techniques, printing may also become a primary method for fabricating digital complete dentures. The available clinical and technical information and multiple research demonstrate that the integration of digital steps into the workflow for fabricating removable complete dentures opens countless options, leading to the achievement of an esthetically, functionally, biologically, and technically high-quality end product. However, a longer learning curve must be considered. To simplify the fabrication methods of complete dentures in specific clinical situations, with the aim to increase efficiency and to save resources, is indicated. However, the use of conventional step-by-step approaches may still be valid for complex clinical situations. It is foreseeable that for treating edentulous patients, the evolution of new biomaterials, the introduction of sophisticated digital methods, and the development of improved software will follow attractive workflows with more standardized, easier, achievable, and predictable results. It challenges the clinician to have a more direct impact on denture construction and to provide the patient with the opportunity to participate in the esthetic designing. A generally higher efficiency and satisfaction for all partners involved in the fabrication process of removable complete dentures—patient, dental technologist, and dentist/prosthodontist—is the result. For a dental technologist, it is a great challenge to set up esthetic and functional denture teeth in an edentulous 3D space defined by the maxilla, the mandible, and the oral soft tissues. It is a question of time and partly already existing that machine learning—a branch of artificial intelligence—has the capacity to recognize specific intramaxillary and intermaxillary situations and to deliver an acceptable functional and esthetic denture teeth set-up, at least as a working base. Furthermore, with the introduction of a face scanner, the patient becomes virtually present anytime. Transferring the virtual situation in a physical articulator makes judgments and changes possible in both worlds simultaneously. Innovations such as robot technology still are in their infancy; however, there are aspirations to automatically place denture teeth into a dental arch. There is a great responsibility for a dentist and a dental technologist for fabricating high-quality removable complete dentures. Factors, such as a meticulous diagnosis and treatment planning, a personal communication between the involved persons, and a profound knowledge of the clinical and technical possibilities, should lead to an easy, simple, cost-effective, and highly satisfying denture fabrication workflow. The digitalization in this field already has and will even more activate research and clinical opportunities in the near future. The globally existing many edentulous patients will highly appreciate the excellent results.

Obesity alters the metabolic and endocrine functions of adipose tissues and increases the risk of developing type 2 diabetes mellitus. Reducing the volume of white adipose tissue (WAT) and activating the function of brown adipose tissue (BAT) are potential therapeutic approaches to treating and preventing obesity. This review aims to investigate the efficacy of photoreceptor-dependent light therapy targeting adipose tissues. To reduce the volume of WAT, phototherapy is performed for cosmetic purposes via low-level laser-assisted lipoplasty. However, the underlying mechanisms of such therapy have not been evaluated. Recently, photoreceptor opsins have been found to be expressed in both WAT and BAT. Opsins expressed in adipose tissues are capable of sensing light, and molecular signaling induced by this photoreception modulates the metabolic functions of adipose tissues. Light stimulation via opsins initiates G protein-coupled receptor (GPCR) signaling, increases the rate of lipolysis in WAT, and activates thermogenesis in BAT. These functional changes in adipose tissues upregulate whole-body energy expenditure. Photoreceptor opsins expressed in WAT and BAT respond to light to initiate GPCR-related signaling and increase metabolic activity. Opsins in adipose tissues are thus potential targets for phototherapy in the treatment and prevention of obesity and associated disorders. These findings offer a potential molecular foundation for the further development of light-based therapy.

Purpose of Review Obesity is a trigger for multiple diseases such as diabetes mellitus, hypertension, and cardiovascular diseases. Epidemiological studies have shown that obesity may be a risk factor for periodontal disease. Recently, there have been reports of presumed mechanisms of the associations between periodontitis and lipid metabolism or thermogenesis. This review aims to discuss the link between periodontal disease and energy regulatory function based on recent findings. Recent Findings It has been demonstrated that activation of the C–C motif chemokine ligand/C–C chemokine receptor 7 pathway in adipose tissue induces inflammation and impairment of lipid metabolism and energy regulation in mice. Porphyromonas gingivalis administration has been shown to induce further weight gain and increased adipose tissue in diet-induced obese mice. Additionally, it has been reported that Porphyromonas gingivalis–induced endotoxemia potentially affect obesity by altering endocrine functions in brown adipose tissue in mice. Several cohort studies have shown that obesity is associated with tooth loss 5 years later, and periodontal conditions of obese individuals are significantly worse 2 and 6 months after the treatment compared with those of non-obese individuals. It has also been reported that body mass index is positively associated with the periodontal inflamed surface area index, a measure of periodontal inflammation. These results suggest that not only the enhancement of inflammation due to obesity but also the activation of inflammatory signaling may affect energy regulation. Summary Loss of adipose tissue homeostasis induces increase and activation of immune cells in adipose tissue, leading to impaired immune function in obesity. Various cytokines and chemokines are secreted from obese adipose tissue and promote inflammatory signaling. Some of these signaling pathways have been suggested to affect energy regulation. The combination of obesity and periodontitis amplifies inflammation to levels that affect the whole body through the adipose tissue. Obesity, in turn, accelerates the exacerbation of periodontitis.

This article describes the clinical management of a patient who had a severely damaged dentition due to periodontal disease for several years. The following clinical case is developed from the integral and global aspect, including surgical conditioning, implant placement and the elaboration of a prosthetic prototype that can give a successful outcome for the definitive restoration. A full series of a diagnostic workup was made, and a treatment plan specific to the needs of the patient was laid out, with an emphasis on the difficulty of the management of these types of patients in which a dental practice is familiar with. There are complications on these rehabilitations due to the severe damage of the dentition with extensive osseous atrophies that make a challenging situation in order to provide a comfortable, esthetic and functional rehabilitation. Implant-supported fixed dental prosthesis is a well-accepted treatment option for edentulism. Loss of teeth due to extensive caries or severe periodontitis presents a challenge to the clinicians.

Purpose of Review Periodontitis and obesity are characterized by a dysregulated inflammatory state. Obese individuals have a higher chance of presenting periodontitis. Clinical studies in different populations demonstrate that individuals with obesity have worse periodontal conditions. This current review aims to explore recent literature to understand what the impacts of obesity on periodontal treatment outcomes are and to learn whether periodontal treatment can improve systemic biomarkers in obese individuals. Recent Findings Short- and long-term evaluations demonstrated that non-surgical periodontal treatment could improve clinical parameters in obese individuals, represented as the reduction in mean probing depth, sites with probing depth ≥ 4 mm, and extension of bleeding on probing. However, obese individuals may have less clinical improvement when compared to normal-weight individuals with a similar periodontal profile. Additionally, periodontal treatment may contribute to a reduction in systemic levels of retinol-binding protein 4 and leptin, while promoting an increase in systemic levels of adiponectin. Summary Overall, obese individuals with periodontitis can significantly benefit from non-surgical periodontal treatment. However, clinical improvements seem to be less prominent in obese individuals with periodontitis compared to non-obese individuals with similar periodontal status. Nevertheless, periodontal treatment may impact significantly on the reduction of several biochemical biomarkers of obesity with or without weight reduction. Further investigations are needed to improve our comprehension of the mechanisms underlying those findings.

Purpose of Review The aim of this case report was to illustrate the clinical procedure integrating augmented reality (AR) for complex patient cases requiring full mouth rehabilitation. Recent Findings The introduction of AR technology to the fields of medicine and dentistry has led to numerous applications in education, surgery, and esthetics. Recently, a new AR software was introduced in esthetic dentistry which allows for real-time smile projection and thus improves communication with patients and the dental laboratory. Summary The presented case shows a patient with multiple missing teeth, diastemata, and an impaired masticatory and phonetic ability. After reconstruction of the posterior zone, the AR software was used for the conception of the esthetic zone, integrating the patient into the decision-making process. The result was an esthetic rehabilitation applying palatal and buccal veneers which corresponded to the chosen AR design. The patient appreciated the opportunity to pre-visualize a possible final outcome in an interactive way which increased his confidence in the chosen treatment. Further studies are needed to assess the precision and reproducibility of the described protocol.

Purpose of Review: Cone-beam computed tomography (CBCT) is an imaging modality with high-resolution diagnostic value that provides accurate and high-quality three-dimensional information on the elements of the maxillofacial complex. Therefore, this study aimed to present an up-to-date status of the main indications for the use of CBCT in endodontics, and to discuss its main limitations relative to diagnosis in endodontics. Recent Findings: The data captured by CBCT devices and processed by a specific software programs create a reconstruction of the scanned volume. Thus, they allow dynamic and interactive analysis of the information, by means of simultaneously scanning the object in different anatomical planes of imaging: axial, coronal, or sagittal, and their subsequent reconstruction thereby revealing structures that are not visible in periapical radiographs. Although periapical radiographs continue to be the imaging method of choice for the evaluation of endodontic treatment, a significant leap has occurred in the growth of CBCT use Endodontics in recent years. However, the importance of recognizing the different types of artifacts generated during the image acquisition and reconstruction process is emphasized, especially in the presence of high-density endodontic materials that can compromise the quality of the diagnosis. Summary: Considering the findings of this study, and based on international guidelines, it was concluded that the possibilities of using CBCT during endodontic treatment were mainly focused on diagnosis, assessment [of existent dental conditions], and preoperative treatment; establishing the morphology, diagnosis, and treatment planning of root canal systems; evaluation of root resorption; planning and evaluation of the treatment of traumatic dental injuries, perforations, fractures, and for the preparation of endodontic guides.

This review provides an overview of the objectives, activities, and accomplishments of the CDC-AAP collaboration on public health aspects of periodontitis focusing mostly on surveillance. Dr. Robert Genco was co-chair of this effort. This initiative developed new standard periodontitis case definitions for surveillance and implemented for the first time a full-mouth periodontal examination protocol for NHANES 2009–2014. Measurements from this survey resulted in a significantly greater estimate of the national prevalence of periodontitis in US adults and improved our understanding of population risk factors associations with periodontitis. Notably, this initiative also developed, and validated by field-testing, a battery of eight questions for multivariable modeling of self-report measures for predicting periodontitis in populations. This initiative resulted in significant improvements of surveillance of periodontitis and produced unique findings with important implications for advancing our understanding of population aspects of periodontitis in US adults at the national, state, and local levels. At long last, the world finally had a set of periodontitis case definitions that applied globally would enable valid comparisons between populations in different geographic settings and at different times.

Alveolar boundaries dictate the limitations of orthodontic tooth movement. Evaluation of the hard and soft tissues in terms of quality and quantity in conjunction with a sound orthodontic treatment plan that includes the amount and direction of desired tooth movement is essential. Prophylactic intervention may be required to support orthodontic goals and objectives without undesired iatrogenic periodontal consequences. The purpose of this article is to provide a review on current methods utilized for augmentation procedures prior to orthodontic treatment. Orthodontic treatment can have a significant impact on periodontal health. Increased demands by patients for non-extraction treatment and for camouflaged treatment of skeletal discrepancies to avoid orthognathic surgery can place challenges on orthodontists. Dental arch expansion and placing teeth beyond biologically acceptable limits can result in unfavorable periodontal outcomes, such as the development of fenestrations and dehiscences. Phenotype modification therapy via soft and/or hard tissue augmentation may expand the range of orthodontic movement without the risk of undesired periodontal outcomes during orthodontic treatment.

Natural disasters occur frequently in Japan. A disaster medical system was rapidly developed in Japan following the Great Hanshin-Awaji Earthquake in 1995. Dentistry has become increasingly important in disaster medicine. This review summarizes the roles of dental professionals in disaster medicine, highlights relevant issues, and identifies new directions for research to improve disaster relief activities based on our previous experiences as dental professionals supporting the victims of major disasters.Many preventable deaths after a disaster are caused by aspiration pneumonia, which occurs against a background of factors that are compounded by a harsh living environment. An important aim of dental care in disaster medicine is to prevent these disaster-related deaths in vulnerable persons such as the elderly. This can be achieved through interventions to maintain oral hygiene, preserve and enhance oral function (i.e., chewing and swallowing), and improve the diet, since these interventions help to prevent the development of malnutrition and frailty in vulnerable people. Dental identification of disaster victims could be improved through the use of intraoral three-dimensional scanners and artificial intelligence to automate the acquisition of dental findings and through the construction of a national database of digitized dental records. Advances in personal identification methods will be needed given the prediction that a catastrophic earthquake will occur on the Nankai Trough during the next 30 years and claim more victims than the 2011 Great East Japan Earthquake.Disaster-related deaths due to aspiration pneumonia can be prevented by providing appropriate dental care to those in need. The process of identifying victims could be made more efficient through the use of intraoral three-dimensional scanning, artificial intelligence, and a digital database of dental records. Establishing and strengthening relationships between professionals in different regions will help to optimize the multidisciplinary response to future large-scale disasters.

PURPOSE: Robert (“Bob”) Genco was a member of the research team that established the Buffalo Osteoporosis and Periodontal Disease (OsteoPerio) study. Here we detail the scientific discoveries emanating from this enduring collaboration. STUDY COHORTS: OsteoPerio is ancillary to the Women’s Health Initiative Observational Study (WHI-OS). WHI-OS is a longitudinal study of 93,000 postmenopausal women aged 50–79 enrolled at 40 U.S. centers (enrolled 1993–1998). OsteoPerio enrolled 1342 women 3 years later (1997–2001) from the Buffalo WHI-OS participants to study the association of osteoporosis and periodontal disease. OsteoPerio has 5-year (N=1026) and 17-year (N=518) follow-up examinations. PARTICIPANTS: In addition to information on health status from the WHI-OS, OsteoPerio further included comprehensive oral examinations assessing probing pocket depth, clinical attachment loss, gingival bleeding, alveolar crestal height, and DMFT. Systemic bone density (measured by DXA), blood, saliva and plaque also were collected at all three visits. SUMMARY: Findings from these studies are summarized here.

This study aims to review the literature on the use of Nile tilapia-derived extracellular matrix (ECM) proteins as naturally derived scaffold material for tissue regeneration. Nile tilapia has emerged as a particularly relevant specie for the development of fish-derived biomaterials. The skin, scale, and spine of various fish species have been extensively demonstrated as a potential source of native ECM proteins for use in regenerative medicine. When compared to synthetic polymers, collagen-based biomaterials introduce some disadvantages due to their lower biomechanical stiffness and rapid biodegradation. However, collagen-based biomaterials continue to be one of the most highly investigated natural materials for bone regeneration. Studies have pointed to tilapia as a satisfactory source of collagen for its quality and cost benefit, with good responses in vitro and in vivo, especially studies involving the skin as the main source of production. For both soft and hard tissue regenerations, Nile tilapia skin is being considered as a good source of collagen. Other sources (scales and spine) are less addressed in comparison to skin, which in turn, brings more consistent perspective in relation to clinical use.

The increased implementation of intraoral scanners (IOSs) in different dental fields has created the need for IOS’s accuracy assessment by the scientific community. Hence, the aim of this literature review is to provide the current ``state of the art´´ regarding the accuracy of optical impression systems. The reported IOS’s accuracy in dentistry is highly variable and controversial among studies. Researches performed either in vitro or in vivo considering digital intraoral impressions a valuable alternative to conventional impression techniques; however, the clinical situation has to be taken into consideration. Most studies coincide that IOSs show highly accurate results when partial-arch scans are performed, whereas in cross-arch scans especially in implant dentistry, the choice of a complete digital workflow sometimes has to be avoided if the clinical situation is highly challenging. New versions of IOSs guarantee scan accuracy in most clinical situations. However, blood and saliva in prepared teeth impressions continue affecting the reading of the surfaces. On the other hand, multiple implant scenarios in edentulous mandibular arches still result in accuracy limitations.

Purpose of Review The goal of the present review is to update the reader on the scientific background of zirconia ceramic implants. Clinical investigations using zirconia ceramic implants over the last couple of years have brought up some new developments and questions. Can we be confident in placing zirconia ceramic implants given the recently published data? Is there a difference in the application of one- and two-piece implants? Recent Findings Systematic reviews on preclinical investigations of zirconia implants revealed that one-piece zirconia implants (> 4 mm) are sufficiently stable for clinical use. The same is true for some clinically available two-piece implant systems. Osseointegration and soft tissue integration are, according to the reviews, similar between titanium and zirconia implants with similar surface topographies. Regarding the clinical outcome, a meta-review exists evaluating systematic reviews. The findings of the systematic reviews and the meta-review are that there are good short-term clinical results for one-piece zirconia implants. However, the data for two-piece implants is not robust. Summary In certain applications (single tooth restorations and small bridges), the results of zirconia implants are comparable with titanium implants in short-term studies. Some mid-term investigations support the short-term results. However, according to the current scientific data available, zirconia implants cannot yet be considered an alternative to titanium implants because there are many areas where there is a lack of clinical studies on zirconia implants. Currently, they are an addendum to the titanium implant armamentarium for situations where they are useful (patient request, known hypersensitivity to titanium, or questions of esthetics when titanium might appear inappropriate for a certain situation/condition), but long-term studies are needed. Without a doubt, there is a need for two-piece zirconia implants, but limited research exists to support their clinical use at the moment.

This paper aims to summarize recent scientific evidence regarding the clinical performance of veneered zirconia prostheses. In addition, the residual thermal stress studies were critically analyzed and associated with the veneering ceramic chipping issue. Despite extensive materials and technique developments, the chipping of the veneering layer in zirconia-based crowns is still not fully solved. Randomized clinical trials (RCTs) published within the last 5 years showed that the extension of chipping fracture is more significant for zirconia-based compared to the metal-based prostheses. Residual and transient thermal stresses might be associated with the chipping fracture in veneered zirconia crowns. In vitro and in silico studies should evaluate anatomically correct crown specimens to obtain relevant evidence regarding thermal treatments and fracture resistance of porcelain-veneered zirconia. Clinical studies should provide a more in-depth investigation of the chipping failure mechanisms to help further material development and technical protocols to solve this clinical complication.

This review aimed to illustrate the utility of additive manufacturing technologies for the fabrication of polymer, metal, and ceramic components within the confines of their current and potential clinical applications in dentistry. The literature reviewed on five additive manufacturing technologies, namely, vat-polymerization, material jetting, material extrusion, powder-based fusion, and binder jetting, have been investigated in relevance to their dental applications. These technologies have the following existing or potential clinical applications: diagnostic and definitive casts, custom trays, positioning guides for custom abutments, tooth preparation guides, interim dental restorations, all-ceramic crowns, metal crowns and copings, silicone indices, occlusal devices, complete dentures, wax patterns for intra- and extra-coronal restorations, surgical guides, removable partial dentures, and tooth- or implant-supported frameworks. Vat-polymerization, material jetting, and powder-based fusion technologies have existing clinical applications utilizing mainly polymers and metals. Additive manufacturing technologies need further development to be used with ceramic materials for dental applications.

Cone-beam computed tomography (CBCT) imaging has become a significant imaging modality in periodontology, and its applications to dentoalveolar disease and conditions are frequently updated. This review highlighted some of the current evidence of the use of CBCT scans for imaging the most common conditions related to periodontal diseases. CBCT imaging should not be the first choice for the routine assessment of vertical or horizontal bone loss, and its use should be preferable for cases where clinical information and conventional 2D images are insufficient or unclear for diagnosis and treatment decision. On the other hand, the use of CBCT appears to be prudent for an accurate diagnosis of furcation defects in patients with advanced periodontal disease, and in cases where dehiscence and fenestration are suspected. Should volumetric evaluation of those periodontal bone defects be required, it is important to use small voxel sizes for a more accurate measurement. CBCT exams provide little additional benefit in the decision-making and disease managing in most cases of periodontal disease, being advocated only on patient-specific situations involving more complex conditions such as alveolar defects with intricate morphology, dehiscence, and fenestration.

Peri-implant diseases represent the biological complications associated with implant therapy. They are defined as inflammatory responses of the peri-implant soft tissues with or without progressive loss of marginal bone. The term peri-implantitis is used when the bone loss extends beyond initial bone remodeling after loading. Knowledge of the etiology and case definitions of peri-implant diseases are used to evaluate the impact of peri-implant diseases on the long-term survival and maintenance of dental implants. The present review summarizes the current knowledge about case definitions and contemporary understanding of the etiopathogenesis of peri-implant diseases. Recent studies have evaluated the instigation of peri-implant mucositis and its natural deterioration to peri-implantitis. Animal models, similar to the ones used for showcasing biofilm-induced periodontal disease, have been utilized to understand the inflammatory response of supporting soft and hard tissue around dental implants. In addition, similarities have been drawn regarding the microbial composition around diseased natural teeth and implants. A better insight of the pattern of disease progression and understanding of the host response to the increased inflammatory overload provides a foundation on which future research studies can focus on host-microbial interactions and therapies that could lead to more favorable outcomes in prevention and treatment of peri-implant diseases.

The aim of this systematic review and meta-analysis was to update evidence answering four questions: (1) Is there an association between periodontitis and obstructive sleep apnea (OSA)? (2) Is there evidence of causality? (3) Is there a dose-response relationship between the two conditions? (4) Is there evidence on efficacy of periodontitis interventions on the occurrence and/or severity of OSA or vice versa? Thirteen studies were included in the qualitative analysis, and nine of them were included in the quantitative analysis. Seven studies were case-control and six were cross-sectional. All studies assessed the association between periodontitis and OSA, five studies evaluated the dose-response relation, and one examined the efficacy of periodontal interventions on OSA occurrence. There is a significant positive association between periodontitis and OSA (adjusted OR = 1.66, 95% CI,1.28, 2.17; P = 0.0002). Evidence on a dose-response gradient was conflicting. Evidence was insufficient and non-existent for efficacy of interventions and causality, respectively. There is mounting evidence that supports an association between periodontitis and OSA. However, future studies are warranted to determine does-response relation, causality, and reversibility.

Purpose of Review This review focuses on recent advances in our understanding of the interactions between psychological stress, the immune system, and periodontitis, including the dynamic role of host stress responses in altering immune function, altering the oral microbiome and biofilm formation, and promoting local and systemic disease progression. Recent Findings Within the context of periodontal health and disease, stress leads to an impairment of effective antimicrobial defense, shifts in oral microbiome profiles toward more pathogenic gene expression and taxa composition, increased translocation, and biofilm formation. The link between stress and periodontitis is multiform and includes hypothalamic–pituitary–adrenal (HPA) axis and catecholamine activation, production of immune mediators of inflammation and, clinically, syndromes of depression, bipolar disorder, anxiety disorders, and sleep-wake disorders. Summary Psychological stress appears to be an important modifiable risk factor for the development and progression of periodontitis and other periodontal diseases.

The present review aimed at assessing the primary and secondary diagnostic tools currently used to monitor peri-implant conditions. There has been much debate on the diagnostic accuracy of clinical parameters in monitoring peri-implant conditions. Given the association between pocket depth measured around teeth and implants and the extent of microbial plaque biofilm deposits, it seems plausible for probing pocket depth to be indicative of disease progression or stability. Moreover, understanding the inflammatory nature of peri-implantitis, it seems reasonable to advocate that bleeding, erythema, tumour and suppuration are indicators of pathology. However, cautiousness must be exercised when interpreting clinical findings, since the morphology of peri-implant tissues differ significantly from the periodontal structures. The routine clinical assessment of dental implants, including probing and visual examination, may lead to the accurate diagnosis of peri-implant disorders. Nevertheless, the definitive diagnosis should be based on agreement with progressive radiographic bone loss. In fact, primary diagnostic tools seem to be highly specific for monitoring peri-implant conditions, while their sensitivity is lower compared with their use in monitoring periodontal stability.

Purpose of Review To provide an overview of current surgical peri-implantitis treatment options. Recent Findings Surgical procedures for peri-implantitis treatment include two main approaches: non-augmentative and augmentative therapy. Open flap debridement (OFD) and resective treatment are non-augmentative techniques that are indicated in the presence of horizontal bone loss in aesthetically nondemanding areas. Implantoplasty performed adjunctively at supracrestally and buccally exposed rough implant surfaces has been shown to efficiently attenuate soft tissue inflammation compared to control sites. However, this was followed by more pronounced soft tissue recession. Adjunctive augmentative measures are recommended at peri-implantitis sites exhibiting intrabony defects with a minimum depth of 3 mm and in the presence of keratinized mucosa. In more advanced cases with combined defect configurations, a combination of augmentative therapy and implantoplasty at exposed rough implant surfaces beyond the bony envelope is feasible. Summary For the time being, no particular surgical protocol or material can be considered as superior in terms of long-term peri-implant tissue stability.