Search

Aim: Loss‐of‐function mutations in FAM20A result in amelogenesis imperfecta IG (AI1G) or enamel‐renal syndrome, characterized by hypoplastic enamel, ectopic calcification, and gingival hyperplasia, with some cases reporting spontaneous tooth infection. Despite previous reports on the consequence of FAM20A reduction in gingival fibroblasts and transcriptome analyses of AI1G pulp tissues, suggesting its involvement in mineralization and infection, its role in deciduous dental pulp cells (DDP) remains unreported. The aim of this study was to evaluate the properties of DDP obtained from an AI1G patient, providing additional insights into the effects of FAM20A on the mineralization of DDP. Methodology: DDP were obtained from a FAM20A‐AI1G patient (mutant cells) and three healthy individuals. Cellular behaviours were examined using flow cytometry, MTT, attachment and spreading, colony formation, and wound healing assays. Osteogenic induction was applied to DDP, followed by alizarin red S staining to assess their osteogenic differentiation. The expression of FAM20A‐related genes, osteogenic genes, and inflammatory genes was analysed using real‐time PCR, Western blot, and/or immunolocalization. Additionally, STRING analysis was performed to predict potential protein–protein interaction networks. Results: The mutant cells exhibited a significant reduction in FAM20A mRNA and protein levels, as well as proliferation, migration, attachment, and colony formation. However, normal FAM20A subcellular localization was maintained. Additionally, osteogenic/odontogenic genes, OSX, OPN, RUNX2, BSP, and DSPP, were downregulated, along with upregulated ALP. STRING analysis suggested a potential correlation between FAM20A and these osteogenic genes. After osteogenic induction, the mutant cells demonstrated reduced mineral deposition and dysregulated expression of osteogenic genes. Remarkably, FAM20A, FAM20C, RUNX2, OPN, and OSX were significantly upregulated in the mutant cells, whilst ALP, and OCN was downregulated. Furthermore, the mutant cells exhibited a significant increase in inflammatory gene expression, that is, IL‐1β and TGF‐β1, whereas IL‐6 and NFκB1 expression was significantly reduced. Conclusion: The reduction of FAM20A in mutant DDP is associated with various cellular deficiencies, including delayed proliferation, attachment, spreading, and migration as well as altered osteogenic and inflammatory responses. These findings provide novel insights into the biology of FAM20A in dental pulp cells and shed light on the molecular mechanisms underlying AI1G pathology. [ABSTRACT FROM AUTHOR]

Haemangiomas are benign proliferative tumours with vascular tissue origin. These neoplasms are recognised as benign tumours commonly found in infancy, characterised by a period of rapid growth accompanied by proliferation of endothelial cells, followed by gradual involution. The male to female ratio is observed to be 3:1, with a predominant impact on the female population, particularly during the early stages of their second decade of life. The diameter of the lesion spans from a few millimeters to several centimeters, with rare instances exceeding 2.5 cm. The present case report details the occurrence of Lobular Capillary Haemangioma (LCH) in a young male patient of six years, who exhibited gingival overgrowth in the anterior maxillary region. The patient presented with symptoms of discomfort during mastication, occlusal interference, and excessive hemorrhage during oral hygiene practices. Due to the lesion's extensive blood supply and the confirmation of the diagnosis in the histology report, it was surgically removed in a single session while the patient was under conscious anaesthesia. The patient underwent a thorough six-month follow-up examination, which demonstrated a favourable outcome with no evidence of lesion recurrence. Although haemangiomas are prevalent soft tissue tumours in the head and neck region, they are infrequently found in the oral cavity and rarely encountered by doctors. Intraoral haemangiomas most commonly occur in the lips, tongue, buccal mucosa, and palate. However, this case report describes a rare occurrence in the maxillary anterior site, which has limited documentation. The treatment involved the use of monopolar cautery, which effectively reduced bleeding at the surgical site after the use of a scalpel. The purpose of present case report is to report an unusual case of a benign tumour occurring in the anterior maxillary region, which was diagnosed as LCH. [ABSTRACT FROM AUTHOR]

Aim: This Bayesian network meta‐analysis of randomized controlled trials assessed the effect of adjuvant periodontal treatment in both periodontal and HbA1c outcomes in adult individuals with type 2 diabetes (T2DM). Materials and Methods: A systematic search was done up to February 2023 comparing sub‐gingival debridement (SD) in combination with local or systemic adjuvant treatment with SD alone for individuals with T2DM. The primary outcomes were changes in absolute HbA1c levels and full‐mouth probing depth reported at 3‐ to 6‐month post‐treatment. Results: Seventy‐two eligible publications evaluating 27 adjuvant treatments were retrieved. The combination of SD and systemic antibiotic metronidazole or SD and antioxidant alpha lipoic acid provided, respectively, 1.4% (95% credible interval [CrI] 0.48; 2.20) and 2.4% (95% CrI 1.50; 3.30) more significant improvement on HbA1c levels, and 0.89 mm (95% CrI 0.23; 1.50) and 0.92 mm (95% CrI 0.02; 0.92) greater periodontal probing depth reductions. Other adjuvant treatments provided added benefit to the periodontal outcomes without discernible effects on HbA1c. Conclusions: Adjuvant use of metronidazole or alpha lipoic acid was the best adjunct option to provide clinically meaningful HbA1c levels and probing depth reductions. However, no strong recommendation can be drawn due to the scarcity of studies for each adjuvant treatment and the low certainty of the resultant evidence. [ABSTRACT FROM AUTHOR]

Gingival enlargement is a side effect of several different medication, including immunosuppressants, anticonvulsants, and calcium channel blockers. It is an inflammatory response that starts when plaque and calculus build up on the tooth surface. The most prevalent long-term neurological condition affecting people is epilepsy. In affluent nations, the prevalence of epilepsy is ~ 1%, whereas in less developed countries, it may >2%. The preferred medication for the condition, phenytoin, has major side effects include gingival enlargement. In addition to being visually disfiguring, this enlargement frequently affects speech, chewing and eating. Furthermore, those with poor dental hygiene, causes disabilities with motor coordination and muscular limitations leading to mental disability and physical impairments are more prone to periodontal disease. This article enlightened the mechanism of drug induced gingival enlargement clinically, microbiologically, and surgically. [ABSTRACT FROM AUTHOR]

Objective: Idiopathic gingival fibromatosis (IGF) is a rare heterogeneous disease that results in the progressive and diffuse hyperplasia of gingival tissues. MicroRNAs are implicated in the development and progression of various tumors. The present study aimed to explore the potential roles and mechanisms of miR‐148a‐3p in IGF. Methods: Gingival fibroblasts (GFs) were transfected with miR‐148a‐3p mimics, miR‐148a‐3p inhibitors, or siNPTX1, and then, the proliferation and apoptosis of GFs and the expression of related genes were evaluated using Cell Counting Kit‐8 assays, 5‐ethynyl‐2′‐deoxyuridine assays, flow cytometry, reverse transcription‐quantitative polymerase chain reaction, and western blot analysis, respectively. Results: miR‐148a‐3p was highly expressed in GFs of IGF (IGF‐GFs) as compared with normal GFs (N‐GFs). Overexpression of miR‐148a‐3p promoted the proliferation and inhibited the apoptosis of N‐GFs, whereas downregulation of miR‐148a‐3p had the opposite effect in IGF‐GFs. Knockdown of NPTX1 reversed miR‐148a‐3p‐mediated effects in IGF‐GFs. Dual‐luciferase reporter assay confirmed that NPTX1 is a direct target of miR‐148a‐3p. Conclusion: These findings identify that miR‐148a‐3p could regulate cell proliferation and apoptosis by targeting NPTX1, providing new insights for the further study of the molecular mechanism and treatment of IGF. [ABSTRACT FROM AUTHOR]

The search for hereditary bleeding disorders (HBD) prior to invasive procedures in children is primarily based on personal and family bleeding history. Although several scores are available, they have only been evaluated in specific situations or in adults. Our monocentric retrospective study aimed to analyze the association between clinical history and four scores (HEMSTOP, PBQ, ISTH-BAT, TOSETTO) and the diagnosis of MHC in children referred to the University Hospital of Montpellier for hemostasis investigations. A total of 117 children were retrospectively included in the study. Of these, 57 (49%) were diagnosed with HBD, with 30 having primary bleeding disorders and 27 having coagulation disorders. The diagnosis of HBD was significantly associated with gingival bleeding, which was present in 30% of HBD patients. In our population, only the HEMSTOP score showed an association with the diagnosis of HBD, but it was positive in only 48% of patients. By including gingival bleeding as a factor, we modified the HEMSTOP score, which increased its sensitivity from 0.45 to 0.53. When examining primary bleeding disorders, the modified HEMSTOP score, with the inclusion of gingival bleeding, enables us to diagnose 63% of patients (see Fig. 1). Conclusion: Therefore, gingival bleeding should be considered a useful factor in bleeding history for HBD diagnosis. Adding this symptom to a screening score such as HEMSTOP improves its sensitivity. To confirm our findings, a prospective study is required. Trial registration: Study registration number: NCT05214300. What is Known: • Screening for hereditary bleeding disorder diseases is a necessity and a challenge in children. • Minor disorders of primary hemostasis are the most common, but often escape standard coagulation tests. What is New: • Gingival bleeding is a frequent symptom that is easy to investigate and may point to a primary hemostasis disorder. • Adding the gingival bleeding item to a routine screening score such as HEMSTOP improves sensitivity. [ABSTRACT FROM AUTHOR]

Objectives: This multicentre, assessor‐blinded, two‐arm cluster randomized trial evaluated the clinical and cost‐effectiveness of a behaviour change intervention promoting toothbrushing for preventing dental caries in UK secondary schools. Methods: Pupils aged 11–13 years with their own mobile telephone attending secondary schools with above average free school meals eligibility were randomized (at year‐group level) to receive a lesson and twice‐daily text messages or to usual care. Year‐groups (n = 84) from 42 schools including 4680 pupils (intervention, n = 2262; control, n = 2418) were randomized. Results: In 2383 participants with valid data at baseline and 2.5 years, the primary outcome of presence of at least one treated or untreated carious lesion (D4‐6 MFT [Decayed, Missing and Filled Teeth] in permanent teeth using International Caries Detection and Assessment System) was 44.6% in the intervention group and 43.0% in control (odds ratio [OR] 1.04, 95% CI 0.85–1.26, p =.72). There were no statistically significant differences in secondary outcomes of presence of at least one treated or untreated carious lesion (D1‐6 MFT), number of D4‐6 MFT and D1‐6 MFT, plaque and bleeding scores or health‐related‐ (Child Health Utility 9D) or oral health‐related‐ quality of life (CARIES‐QC). However, twice‐daily toothbrushing, reported by 77.6% of pupils at baseline, increased at 6 months (intervention, 86.9%; control, 83.0%; OR 1.30, 95% CI 1.03–1.63, p =.03), but returned to no difference at 2.5 years (intervention, 81.0%; control, 79.9%; OR 1.05, 95% CI 0.84–1.30, p =.69). Estimated incremental costs and quality‐adjusted life‐years (QALYs) of the intervention, relative to control, were £1.02 (95% CI −1.29 to 3.23) and −0.003 (95% CI −0.009 to 0.002), respectively, with a 7% chance of being cost‐effective (£20 000/QALY gained threshold). Conclusion: There was no evidence of statistically significant difference for caries prevalence at 2.5‐years. The intervention's positive 6‐month toothbrushing behaviour change did not translate into caries reduction. (ISRCTN 12139369). COVID‐19 pandemic adversly affected follow‐up. [ABSTRACT FROM AUTHOR]

While previous reports have established the anti-inflammatory effects of hangeshashinto, the intracellular signal transduction pathways involved have yet to be elucidated. We aim to employ an experimental system using oral cancer cells to assess the impact of hangeshashinto on intracellular signal transduction pathways in response to stimulation by Porphyromonas gingivalis pathogen-associated molecular patterns (PAMP). Hangeshashinto demonstrated the ability to inhibit the production of interleukin (IL)-6 and IL-8 induced by P. gingivalis PAMP. Furthermore, hangeshashinto suppressed the activation of the IL-6 promoter stimulated by PAMP. Hangeshashinto, like Toll-like receptor (TLR) signaling inhibitors (resatorvid and C29) and an immunosuppressant (dexamethasone), exhibited the ability to suppress TLR-mediated activation of the transcription factor nuclear factor-κB (NF-κB) in response to PAMP stimulation. This study suggests that the anti-inflammatory effects of hangeshashinto may be attributed to the inhibition of TLR signal transduction pathways including NF-κB activation, thereby suppressing NF-κB-dependent gene expression. [ABSTRACT FROM AUTHOR]

In-stent restenosis (ISR) remains the primary cause of target lesion failure following percutaneous coronary intervention (PCI), resulting in 10-year incidences of target lesion revascularization at a rate of approximately 20%. The treatment of ISR is challenging due to its inherent propensity for recurrence and varying susceptibility to available strategies, influenced by a complex interplay between clinical and lesion-specific conditions. Given the multiple mechanisms contributing to the development of ISR, proper identification of the underlying substrate, especially by using intravascular imaging, becomes pivotal as it can indicate distinct therapeutic requirements. Among standalone treatments, drug-coated balloon (DCB) angioplasty and drug-eluting stent (DES) implantation have been the most effective. The main advantage of a DCB-based approach is the avoidance of an additional metallic layer, which may otherwise enhance neointimal hyperplasia, provide the substratum for developing neoatherosclerosis, and expose the patient to a persistently higher risk of coronary ischemic events. On the other hand, target vessel scaffolding by DES implantation confers relevant mechanical advantages over DCB angioplasty, generally resulting in larger luminal gain, while drug elution from the stent surface ensures the inhibition of neointimal hyperplasia. Nevertheless, repeat stenting with DES also implies an additional permanent metallic layer that may reiterate and promote the mechanisms leading to ISR. Against this background, the selection of either DCB or DES on a patient- and lesion-specific basis as well as the implementation of adjuvant treatments, including cutting/scoring balloons, intravascular lithotripsy, and rotational atherectomy, hold the potential to improve the effectiveness of ISR treatment over time. In this review, we comprehensively assessed the available evidence from randomized trials to define contemporary interventional treatment of ISR and provide insights for future directions. [ABSTRACT FROM AUTHOR]

This article's goal is to describe a case of oral contraceptives-related drug-induced gingival hypertrophy that was treated with nonsurgical and surgical periodontal therapy. The most prevalent negative side effect of systemic medicine on the periodontal tissues continues to be drug-induced gingival overgrowth. Specific regulatory molecules known as hormones control a variety of bodily processes. Gingival hypertrophies are sometimes linked to oral contraceptives that contain oestrogen and/or progesterone. A 32-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the maxillary right quadrant region for a period of two months. The medical history documented the use of contraceptives for three months, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. Intraoral examination revealed that there was unilateral, generalized, diffuse gingival enlargement with pseudo pockets. Patient was diagnosed with gingival fibromatosis a based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful. Women who use oral contraceptives are a "risk group" for periodontal infections. On oral contraceptives, not every female reacts the same way. In periodontal therapy, plaque management is the most crucial step. Patient compliance is another element that affects a therapy's response. The patient demonstrated appropriate oral hygiene practices and adhered to home care guidelines adequately. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 60-year-old woman with diffusely hemorrhagic and erythematous lesions on the maxillary and mandibular attached gingiva, who has a medical history including suppurative otitis media, obstructive sleep apnea, hypertension, coronary artery disease, and recurrent pulmonary emboli, and is taking apixaban, with a family history of polycythemia vera.

Objectives: To provide a 3‐year follow‐up of previously treated patients to assess and compare the periodontal responses and clinical performance of proximal subgingival open sandwich restorations. Materials and Methods: Ninety‐five adults participated in the study, with a combined total of 120 compound Class II cavities. These cavities had gingival margins located below the CEJ. Four different restorative materials were used to elevate the dentin/cementum gingival margins of the cavities: resin‐modified glass ionomer, glass hybrid, flowable bulk‐fill composite, or ion‐releasing material, which were then completed with the same overlaying composite. Different periodontal and clinical evaluations, based on the criteria set by the World Dental Federation (FDI) criteria, were performed at different time intervals, including baseline, 6 months, 1, 2, and 3 years. Results: The type of base material did not affect the periodontal evaluations. There were no statistically significant differences between different time intervals or base material groups in any of the evaluated FDI parameters. However, the ion‐releasing material scored significantly worse in the radiographic evaluation than any of the other groups. Conclusions: All tested materials are suitable for proximal subgingival open sandwich restorations, as long as the restoration/tooth margin is at least 2‐mm away from the bone crest. Clinical Significance: Clinicians can confidently choose any of the tested materials for proximal subgingival open sandwich restorations, as they have shown good outcomes from both periodontal and clinical perspectives. [ABSTRACT FROM AUTHOR]

Objective: Non‐alcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by excessive fat deposition in hepatocytes caused by non‐alcoholic liver injury. Porphyromonas gingivalis (P.g) is the main pathogen causing periodontitis, which can aggravate the progression of NAFLD in our previously study. The objective of this study was to further investigate the pathogenesis and moleculer michanisma of NAFLD aggravated by P.g. Methods: A mouse model of NAFLD was established, and the changes of inflammatory factors and NF‐κB signaling pathway in liver tissue and L‐02 cells were analyzed by transcriptome sequencing, Western blot, IHC and RT‐PCR. In addition, the NF‐κB signaling pathway inhibitor QNZ and ferroptosis inhibitor Fer‐1 were used to analyze the relationship between NF‐κB signaling pathway and ferroptosis in vitro. Results: In vivo and in vitro experiments, P.g can induce liver inflammation and activate NF‐κB signaling pathway. At the same time, P.g promotes ferroptosis and inflammation in L‐02 in vitro. QNZ alleviates ferroptosis and inflammatory activation in L‐02. Fer‐1 can relieve the L‐02 inflammation caused by P.g products. Conclusion: Porphyromonas gingivalis can induce ferroptosis and inflammation in hepatocytes and further worsen liver lesions. The mechanism of ferroptosis in hepatocytes depends on NF‐κB signaling pathway, which provides a new strategy for clinical treatment and prevention of NAFLD. [ABSTRACT FROM AUTHOR]

Background: Tuberous sclerosis complex (TSC) is a rare, complex genetic disorder characterized by hamartomas and neoplastic lesions in various organ systems. With the development of radiology and gene testing, the diagnostic criteria for TSC were updated in 2012 at the International Consensus Conference. Intraoral fibromas have long been associated with TSC. However, the incidence of giant cell angiofibroma (GCA) in TSC patients is extremely rare. Here, we report the first case of GCA in the gingival tissue of a patient with TSC. Case presentation: A 41-year-old woman first visited the Department of Oral and Maxillofacial Surgery, Chonnam National University Dental Hospital, complaining of gingival enlargement. Clinical examination revealed several manifestations associated with TSC, including intraoral fibromas, facial angiofibromas, dental enamel pits, ungual fibromas, "confetti" skin lesions, hypomelanotic macules, and a shagreen patch. Intraoral examination revealed a 6.0 × 5.0 cm gingival overgrowth on the left mandible. Surgical excision was performed, and subsequent histopathological examination confirmed the diagnosis of GCA. There was no evidence of recurrence within the 24- months of surgery. Conclusions: We report the first case of GCA in the gingival tissue of a patient with TSC. This report would contribute to an improved understanding of this rare disease. However, further case reports are necessary to clarify the relationship between GCA and TSC. [ABSTRACT FROM AUTHOR]

Background: The utilization of dermal fillers for cosmetic procedures has increased dramatically in the past several years, and so is the number of reported adverse events and complications. Most of these reports are centered on extraoral facial structures such as skin, nose, forehead, and eyes. However, as this report illustrates, intraoral complications are also possible and require appropriate management. Our extensive search of the medical and dental literature has failed to yield any such report. Methods and Results: An injection of dermal filler composed of hyaluronic acid for managing a deep nasolabial fold resulting in an arterial occlusion is presented. Patient exhibited facial skin necrosis, with ecchymoses and crusting, extending to the right eye. Transient diplopia and vision changes were also present. Additionally, intraoral necrosis of the palatal mucosa extending from the right central incisor to the molars and approaching the midline was noted. Patient was managed palliatively until complete re‐epithelization was noted, with no further loss of periodontal attachment. Conclusion: This case illustrates a rare oral complication of extraoral injection of a dermal filler, and its management. The clinicians should be aware of the potential risks of these cosmetic procedures. Early detection and timely management may prevent lasting damage and discomfort. Additionally, some of these complications may require a well‐coordinated multidisciplinary involvement to restore health and functions (plastic surgeon, dermatologist, ophthalmologist, and a periodontist). Key points: Why is this case new information?Previous reports of adverse effects linked to dermal fillers were limited to extraoral structures such as the facial skin, nose, forehead, and eye. To the authors' best knowledge, this is the first and only documented case of intraoral necrosis following dermal filler injection What are the keys to successful management of this case?The most important step in managing intra‐arterial filler injection and occlusion is the immediate injection of hyaluronidase enzyme to minimize the extent of tissue necrosis. In the case of ocular involvement, immediate referral to an ophthalmologist is required What are the primary limitations to success in this case?Success of managing the adverse effects of vascular occlusion following filler injection depends on several factors, including the anatomical area of occlusion, its extend, along with timely treatment [ABSTRACT FROM AUTHOR]

Objectives: To identify etiologic variants and perform deep dental phenotyping in patients with amelogenesis imperfecta (AI). Methods: Three patients of two unrelated families were evaluated. Genetic variants were investigated by exome and Sanger sequencing. An unerupted permanent third molar (AI1) from Patient1 and a deciduous first molar (AI2) from Patient2, along with three tooth‐type matched controls for each were characterized. Results: All three patients harbored biallelic pathogenic variants in FAM20A, indicating AI1G. Of the four identified variants, one, c.1231C > T p.(Arg411Trp), was novel. Patient1 possessed the largest deletion, 7531 bp, ever identified in FAM20A. In addition to hypoplastic enamel, multiple impacted teeth, intrapulpal calcification, pericoronal radiolucencies, malocclusion, and periodontal infections were found in all three patients, gingival hyperplasia in Patient1 and Patient2, and alveolar bone exostosis in Patient3. Surface roughness was increased in AI1 but decreased in AI2. Decreased enamel mineral density, hardness, and elastic modulus were observed in AI1 enamel and dentin and AI2 dentin, along with decreased phosphorus, increased carbon, and increased calcium/phosphorus and carbon/oxygen ratios. Severely collapsed enamel rods and disorganized dentin–enamel junction were observed. Conclusions: We report a novel FAM20A variant and, for the first time, the defective mineral composition and physical/mechanical properties of AI1G teeth. [ABSTRACT FROM AUTHOR]

Oral cancer is the most prevalent head and neck cancer. Although tumor markers have been investigated for detecting the progression and prognosis of oral cancer, no reliable marker has been identified. We investigated the expression of ATP binding cassette subfamily B member 5 (ABCB5) positive stem cells in oral squamous cell carcinoma (OSCC) and in inflammatory gingival hyperplasia. We used tissue samples from normal subjects, patients with inflammatory gingival hyperplasia, and patients with OSCC. Samples were investigated using anti-ABCB5 monoclonal antibody immunohistochemistry to detect epithelial stem cells. Staining density, intensity, and immunoreactive scores of ABCB5 were analyzed for the three study groups. We found ABCB5 immunostaining in all three study groups, but different distributions of ABCB5 expression in different layers of the epithelium. We found no significant difference in staining intensity between inflammatory hyperplasia and normal mucosa, but we found significantly stronger expression in OSCC compared to normal and inflammatory hyperplasia individually. Elevated expression of ABCB5 in OSCC suggests an increased subpopulation of tumor cells with an undifferentiated stem cell phenotype, which facilitates cancer initiation and progression. [ABSTRACT FROM AUTHOR]

Enamel renal gingival syndrome is a rare clinical condition characterized by the presence of amelogenesis imperfecta hypoplastic type, gingival fibromatosis and delayed tooth eruption, in addition to nephrocalcinosis with normal blood calcium levels. It is inherited as an autosomal recessive trait caused by mutations in the FAM20A gene located on chromosome 17q24.2. The purpose of this report is to describe a case of enamel renal gingival syndrome and discuss its distinct features and management. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this case series is to present the potential applications of the GingivalStat approach, that is, the use of temporary gingival stabilizers, to favor early gingival margin remodeling and prevent the occurrence of gingival rebound following esthetic clinical crown lengthening. Clinical Considerations: Four patients requiring clinical crown lengthening were treated for esthetical and functional reasons. The surgical approach included: (a) gingival margin recontouring; (b) full‐thickness flap elevation; (c) osteotomy (to achieve an adequate dimension between the alveolar bone crest and the CEJ) and osteoplasty (to reduce the bone thickness and improve the buccal bone anatomic profile, where indicated); (d) temporary gingival stabilizer placement using a block‐out resin or a composite (the GingivalStat approach); and (e) flap repositioning, adaptation, and suture. One‐ to five‐year follow‐ups, reported in the different case scenarios, show evidence of clinically stable gingival margins around the treated teeth. Conclusions: Within the limits of this case series, it can be concluded that the GingivalStat approach appears as a further maneuver to cope with clinical crown lengthening procedures at esthetic sites. GingivalStat seems to favor gingival margin contour remodeling during the early phase of healing as well as prevent the occurrence of gingival rebound. Clinical Significance: GingivalStat approach may guide gingival margin remodeling and prevent gingival rebound after wound healing of sites submitted to esthetic clinical crown lengthening. [ABSTRACT FROM AUTHOR]

These days, laser systems and their use in oral surgery and dentistry are developing quickly. Diode lasers operating in continuous or pulsed modes with wavelengths between 810 and 980 nm are considered as a potential soft tissue surgery modality in the oral cavity. An 8-month-old baby girl with Ullrich muscular dystrophy was referred to the pediatric surgery service of our hospital for therapeutic management. The child had a global developmental disorder and growth failure, and the clinical examination of the oral cavity revealed marked, bimaxillary, bilateral gingival hyperplasia at the canine-molar level. In order to improve the weight curve by facilitating age-appropriate nutrition, we considered the surgical excision of the hyperplastic gingival tissue necessary. Since the hematological parameters were at the lower limit of normal, we decided that the minimally traumatic method was the laser intervention. Ten days after the laser intervention, the gum had a normal appearance both in terms of volume and coloration, the canines and first temporary molars were fully exposed and functional, allowing the feeding of semi-solid and, with caution, even solid foods. Lasers are now more appealing in pedodontic applications (including pediatric surgery) due to recent advancements in technology, as they can be utilized as an addition to or substitute for conventional methods. Keywords: di [ABSTRACT FROM AUTHOR]

Introduction: This article describes the management of two patients who presented with localized juvenile spongiotic gingival hyperplasia. This disease entity is poorly understood, and literature regarding successful treatment is scant. However, there are common themes to management including proper diagnosis and treatment via removal of the affected tissue. The biopsy demonstrates intercellular edema and neutrophil infiltrate with epithelial and connective tissue disease components, so surgical deepithelialization may not be adequate to definitively treat the disease. Methods and Results: This article presents two cases of the disease and suggests the use of the Nd:YAG laser as an alternative management modality. Conclusion: To our knowledge, we present the first cases of localized juvenile spongiotic gingival hyperplasia treated with the Nd:YAG laser. Key points: Why are these cases new information? To our knowledge, this case series illustrates the first use of an Nd:YAG laser to treat the rare pathology localized juvenile spongiotic gingival hyperplasia. What are the keys to successful management of these cases? To properly manage this rare presentation, proper diagnosis is paramount. Following diagnosis with microscopic evaluation, deepithelialization and treatment of underlying connective tissue infiltrate via the Nd:YAG laser offers an elegant option to treat the pathology and maintain esthetic outcomes. What are the primary limitations to success in these cases? The primary limitations of these cases include the small sample size, which is attributable to the rarity of the disease. [ABSTRACT FROM AUTHOR]

Metastatic disease is a complex and sequential process that involves the migration of tumor cells from the primary site to distant areas. This metastatic pathway is not always predictable. Therefore, this paper presents three rare cases of unusual metastases, due to their primary site: two metastases of a clear cell renal cell carcinoma, one gingival, and one nasal, as well as a mandibular metastasis of a hepatocellular carcinoma. In all cases, an incisional biopsy was performed in order to find out the diagnosis. After microscopical examination of morphological Hematoxylin and Eosin-stained slides, for all cases, immunohistochemical reactions were performed to support the primary tumor site. Two cases had a previous histopathological diagnosis of a primary tumor, while for the third case, the metastatic lesion represented the first manifestation of the neoplastic disease, with an unfavorable prognosis. [ABSTRACT FROM AUTHOR]

Aim: To determine the effects of RVX‐208, a selective bromodomain and extra‐terminal domain (BET) inhibitor targeting bromodomain 2 (BD2), on periodontal inflammation and bone loss. Materials and Methods: Macrophage‐like cells (RAW264.7) and human gingival epithelial cells were challenged by Porphyromonas gingivalis (Pg) with or without RVX‐208. Inflammatory gene expression and cytokine production were measured by reverse transcription polymerase chain reaction and enzyme‐linked immunosorbent assay, respectively. RAW264.7 cells were induced to osteoclast differentiation. After RVX‐208 treatment, osteoclast differentiation was evaluated by histology, tartrate‐resistant‐acid‐phosphatase (TRAP) activity and the expression of osteoclast‐specific genes. The effect of RVX‐208 on osteoclast transcriptome was studied by RNA sequencing. Periodontitis was induced in rats by ligature and local RVX‐208 treatment was administered every other day. Alveolar bone loss was measured by micro‐computed tomography. Results: RVX‐208 inhibited inflammatory gene expression and cytokine production in Pg‐infected cells. Osteoclast differentiation was inhibited by RVX‐208, as evidenced by reduced osteoclast number, TRAP activity and osteoclast‐specific gene expression. RVX‐208 displayed a more selective and less profound suppressive impact on transcriptome compared with pan‐BET inhibitor, JQ1. RVX‐208 administration prevented the alveolar bone loss in vivo. Conclusions: RVX‐208 regulated both upstream (inflammatory cytokine production) and downstream (osteoclast differentiation) events that lead to periodontal tissue destruction, suggesting that it may be a promising 'epi‐drug' for the prevention of periodontitis. [ABSTRACT FROM AUTHOR]

The article present a case study of a 57-year-old woman with a mandibular gingival swelling and osteolysis & complications due to prolonged immunosuppressive chemotherapy for multiple myeloma. Topics include the patient's medical history; intraoral and extraoral examinations; radiographic findings; the histopathological diagnosis of the gingival soft-tissue lesion; and highlighting the need for a comprehensive approach in managing oral health in patients with complex medical conditions.

The article focuses on the pharmacology of chemotherapy and immunosuppressants, detailing their mechanisms of action and side effects. Topics include the classification of chemotherapeutic agents based on their mechanism of action, the cell cycle, and the anaesthetic implications of these drugs, including interactions with anaesthetic agents and their impact on cancer recurrence.

Objectives: Ferroptosis is associated with multiple inflammatory diseases. Periodontitis is an inflammatory disease mainly caused by oral opportunistic pathogens. However, the ferroptosis–periodontitis relationship has not been thoroughly described. We here analyzed whether ferroptosis is involved in periodontitis. Materials and methods: Human gingival fibroblasts (HGFs) were stimulated with P. gingivalis‐LPS and ferrostatin‐1 (Fer‐1, a ferroptosis inhibitor), and changes in mitochondrial morphology, ferroptosis‐related factors, and inflammation levels were detected. After the rat experimental periodontitis model was established, changes in ferroptosis‐related factors and inflammation levels were re‐evaluated in the same manner. Results: Porphyromonas gingivalis‐LPS‐induced mitochondrial shrinkage, an increase in mitochondrial membrane density, and upregulation of reactive oxygen species in HGFs. The expression of prostaglandin‐endoperoxide synthase 2, transferrin receptor 1, and malondialdehyde and inflammation levels were upregulated, whereas the expression of solute carrier family seven member 11, glutathione peroxidase 4, superoxide dismutase, and glutathione were downregulated. Fer‐1 attenuated these aforementioned changes and inflammation levels induced by P. gingivalis‐LPS. The in vivo experiment results were consistent with the in vitro experiment results. Conclusions: Ferroptosis is involved in inflammatory processes in HGFs upon P. gingivalis‐LPS stimulation. Ferroptosis is observed in the gingival tissue of periodontitis rats. [ABSTRACT FROM AUTHOR]

A 4-year-old boy presented with multiple nodular swellings on his skin, gingival hyperplasia, and joint contractures. The boy had been experiencing these symptoms for approximately 3.5 years, with the lesions starting as small papules and gradually progressing to larger nodules. The patient also had macrocephaly, a depressed nasal bridge, and a frog-like posture. Radiologic examination revealed lytic lesions in the left hip joint. The diagnosis was determined to be hyaline fibromatosis syndrome, a rare inherited disorder characterized by the deposition of amorphous hyalinized fibrous tissue in the skin and other tissues. Treatment options for this condition are limited, but physical therapy and nutritional supplementation can improve quality of life. Surgical excision of lesions may be considered, although recurrences are common. [Extracted from the article]

Objective: To describe a strategy using digital technologies for improving the diagnosis, treatment planning, and surgical execution of patients with excessive gingival display (EGD) due to altered passive eruption (APE). Clinical Considerations: An important component for successful patient's management is to fulfill their esthetic expectations whilst delivering predictable and long‐term therapeutic outcomes. To achieve this goal in patients with excessive gingival display due to altered passive eruption, it is essential to perform an accurate diagnosis and to communicate to the patient the expected customized results using digital technologies. Computer‐aided designed and manufactured multifunctional anatomical prototypes (MAPs) may contribute to these purposes. Additionally, they can guide the surgical crown lengthening procedure or serve as a reference during the surgical guide fabrication providing information of the required anatomical landmarks. Conclusions: This novel strategy protocol for diagnosis, communication, and treatment management of patients with excessive gingival display follows functional and biological principles within the frame of a digital workflow, which improves the diagnostic capabilities, enhances communication, and guides the surgical treatment as shown in the 12 months follow‐up of the reported case. Clinical Significance: Developing a virtual patient by combining multiple digital data sets including cone‐beam computed tomography (CBCT), intra‐oral scans and digital photography, supports the clinician and the patient to achieve a comprehensive diagnosis and to better communicate the expected results to the patient. Furthermore, this digital treatment exercise based on anatomical and biological principles will facilitate the surgical precision and the achievement of successful outcomes, thus fulfilling the patient needs and expectations. [ABSTRACT FROM AUTHOR]

Background: Oral complications from cancer treatments are among the adverse effects breast cancer survivors can face. Yet such complications are often overlooked in cancer survivorship care. Many breast cancer survivors are receiving adjuvant endocrine therapy, but there is limited understanding of potential oral complications from this therapy. Purpose: This study aimed to compare aspects of oral health in female breast cancer survivors who were taking adjuvant endocrine therapy with those of survivors not taking such therapy. Methods: National Health and Nutrition Examination Survey data collected from January 2009 through March 2020 were used for the analysis. Female adults ages 20 years and older who had been diagnosed with breast cancer were included. Linear regression and χ2 analyses were conducted to examine aspects of oral health, using IBM SPSS Complex Samples software, version 27. Results: In our sample of 423 female breast cancer survivors, 7.1% were taking tamoxifen, 7.8% were taking anastrozole, 4.3% were taking letrozole, and 2.9% were taking exemestane. Compared with the survivors not taking such therapy, a greater proportion of those taking it had decayed teeth, gum disease/problems, and were recommended for imminent dental care after oral health examination by dentists. The survivors who were not taking adjuvant endocrine therapy had more coronal cavities. Conclusions: Data analysis showed that female breast cancer survivors taking adjuvant endocrine therapy appear more likely to have oral health issues than those not taking such therapy. Improved awareness of these issues is critical. Assessment and management guidelines to address these oral health issues are needed by health care providers. To learn more about the potential oral complications of adjuvant endocrine therapy in breast cancer survivors, the authors aimed to compare aspects of oral health in those who were taking the therapy with those who were not. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Drug‐induced gingival overgrowth can occur as a side effect of specific drugs and lead to poor oral function. Appropriate dental management of the overgrowth may improve oral function and improve cognitive deficits after cerebrovascular accidents. [ABSTRACT FROM AUTHOR]

Segmental odontomaxillary dysplasia (SOD) is an uncommon and likely underrecognized developmental condition. In rare cases, SOD can also result in anomalies of the ipsilateral mandibular alveolar process and teeth. This report presents two cases of SOD with mandibular involvement to highlight this potential variation in SOD presentation. These cases help shed new light on our understanding of the disease mechanism and pathoetiology, while also informing clinicians to be diligent in imaging the ipsilateral mandible for dental anomalies in their patients with SOD. Based on the involvement of both jaws, the name change to 'segmental ipsilateral odontognathic dysplasia' is justified to better reflect its pathophysiology. [ABSTRACT FROM AUTHOR]

Background and objective: Some studies support the superiority of diode laser gingivectomy to scalpel surgery and nonsurgical treatments. However, a systematic review on this topic is lacking. This study aimed to compare gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy (NSPT) in the treatment of orthodontic treatment-induced gingival enlargement (GE). Materials and methods: In this systematic review, an electronic search of the relevant literature was conducted in Web of Science, Medline/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ProQuest with no language restriction. Randomized clinical trials published between 1985 and 2020 on comparative treatment of orthodontic treatment-induced GE by diode laser gingivectomy and scalpel surgery or NSPT regarding intraoperative and postoperative bleeding and/or pain were included. Risk of bias was assessed by the Cochrane 1 tool. Results: Of the initially retrieved 288 articles, 40 were duplicates and excluded; 236 articles were excluded following title and abstract screening, and 5 others were excluded following full-text assessment. Finally, 7 studies underwent systematic review. In the risk-of-bias assessment, 5 studies scored 2, and 2 studies scored 3 out of 6. Intraoperative and postoperative bleeding and pain were found to be significantly lower in the laser group. Conclusions: Within the limitations of this systematic review and with respect to the quality of evidence, the present results revealed lower level of pain and bleeding in diode laser gingivectomy compared with the conventional scalpel surgery and NSPT for treatment of orthodontic treatment-induced GE. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Understanding the role of hormones in periodontitis is important. Periodontal microscopic surgery approach in the treatment of fibrous epulis is not indicated. Wider flap access with root planning is indicated to control the lesion in one phase. We present a case of a 40‐year‐old female who presented with a gingival hyperplastic lesion around the maxillary left permanent central and lateral incisors. Patient's medical history reveals a recent pregnancy, hypothyroidism, ulcerative colitis, and schizoaffective disorder. All medical conditions were controlled by medications. The lesion was excised using a minimally invasive periodontal surgical technique, and the biopsy results confirmed a diagnosis of ulcerative fibrous epulis with osseous metaplasia. No curettage or local debridement was done under the assumption that the patient's oral hygiene was satisfactory and due to aesthetic concerns of gingival recession and creation of black triangles. The lesion recurred after 3 months and was removed using a traditional more invasive surgical technique. The patient was followed up for 2 years, and there was no further recurrence due to the complete excision of the lesion in the second surgery and the disappearance of the hormonal‐related factors post‐pregnancy that could have contributed to the gingival hyperplasia. The unique component of the case we are presenting is the comparison between two different surgical techniques and the conduction versus absence of local periodontal debridement after surgical excision as well as the possible correlation between oral supplements and the calcific nature of the lesion(s) reported. The case we present demonstrates that a more invasive traditional surgical approach together with local periodontal therapy provide an optimum treatment outcome in conjunction with elimination of any associated etiological factors. We also propose that hormones are more important as an etiological factor in developing fibrous epulis lesions than medical conditions and medications. [ABSTRACT FROM AUTHOR]

Aim: Biallelic loss‐of‐function FAM20A mutations cause amelogenesis imperfecta (AI) type IG, better known as enamel renal syndrome (ERS), characterized by severe enamel hypoplasia, delayed/failed tooth eruption, intrapulpal calcifications, gingival hyperplasia and nephrocalcinosis. FAM20A binds to FAM20C, the Golgi casein kinase (GCK) and potentiates its function to phosphorylate secreted proteins critical for biomineralization. While many FAM20A pathogenic mutations have been reported, the pathogeneses of orodental anomalies in ERS remain to be elucidated. This study aimed to identify disease‐causing mutations for patients with ERS phenotypes and to discern the molecular mechanism underlying ERS intrapulpal calcifications. Methodology: Phenotypic characterization and whole exome analyses were conducted for 8 families and 2 sporadic cases with hypoplastic AI. A minigene assay was performed to investigate the molecular consequences of a FAM20A splice‐site variant. RNA sequencing followed by transcription profiling and gene ontology (GO) analyses were carried out for dental pulp tissues of ERS and the control. Results: Biallelic FAM20A mutations were demonstrated for each affected individual, including 7 novel pathogenic variants: c.590‐5T>A, c.625T>A (p.Cys209Ser), c.771del (p.Gln258Argfs*28), c.832_835delinsTGTCCGACGGTGTCCGACGGTGTC CA (p.Val278Cysfs*29), c.1232G>A (p.Arg411Gln), c.1297A>G (p.Arg433Gly) and c.1351del (p.Gln451Serfs*4). The c.590‐5T>A splice‐site mutation caused Exon 3 skipping, which resulted in an in‐frame deletion of a unique region of the FAM20A protein, p.(Asp197_Ile214delinsVal). Analyses of differentially expressed genes in ERS pulp tissues demonstrated that genes involved in biomineralization, particularly dentinogenesis, were significantly upregulated, such as DSPP, MMP9, MMP20 and WNT10A. Enrichment analyses indicated overrepresentation of gene sets associated with BMP and SMAD signalling pathways. In contrast, GO terms related to inflammation and axon development were underrepresented. Among BMP signalling genes, BMP agonists GDF7, GDF15, BMP3, BMP8A, BMP8B, BMP4 and BMP6 were upregulated, while BMP antagonists GREM1, BMPER and VWC2 showed decreased expression in ERS dental pulp tissues. Conclusions: Upregulation of BMP signalling underlies intrapulpal calcifications in ERS. FAM20A plays an essential role in pulp tissue homeostasis and prevention of ectopic mineralization in soft tissues. This critical function probably depends upon MGP (matrix Gla protein), a potent mineralization inhibitor that must be properly phosphorylated by FAM20A‐FAM20C kinase complex. [ABSTRACT FROM AUTHOR]

Aim: Periodontitis is an inflammatory, infectious disease of polymicrobial origin that can damage tooth‐supporting bone and tissue. Tree shrews, evolutionarily closer to humans than commonly used rodent models, have been increasingly used as biomedical models. However, a tree shrew periodontitis model has not yet been established. Materials and Methods: Periodontitis was induced in male tree shrews/Sprague–Dawley rats by nylon thread ligature placement around the lower first molars. Thereafter, morphometric and histological analyses were performed. The distance from the cemento‐enamel junction to the alveolar bone crest was measured using micro‐computed tomography. Periodontal pathological tissue damage, inflammation and osteoclastogenesis were assessed using haematoxylin and eosin staining and quantitative immunohistochemistry, respectively. Results: Post‐operatively, gingival swelling, redness and spontaneous bleeding were observed in tree shrews but not in rats. After peaking, bone resorption decreased gradually until plateauing in tree shrews. Contrastingly, rapid and near‐complete bone loss was observed in rats. Inflammatory infiltrates were observed 1 week post operation in both models. However, only the tree shrew model transitioned from acute to chronic inflammation. Conclusions: Our study revealed that a ligature‐induced tree shrew model of periodontitis partly reproduced the pathological features of human periodontitis and provided theoretical support for using tree shrews as a potential model for human periodontitis. [ABSTRACT FROM AUTHOR]

Use of snus, a moist, smokeless tobacco product, may lead to local changes in the oral mucous membrane in the area where the snus is placed. It can also cause irreversible gingival retraction. This cross-sectional study aimed to investigate the relationship between use of snus, oral mucosal lesions (snus induced lesions) and gingival retractions among adolescents in Norway. All 18–20 years olds visiting public dental health clinics in the south-eastern region of Norway between October 2015 and December 2016 were invited to participate. All participants (n = 1363) filled in an electronic questionnaire before a clinical examination. Of these, 216 used snus daily. Snus induced lesions were observed in 79.2% of daily snus using participants. In adjusted regression analyses, the odds of having a more severe lesion as opposed to a less severe lesion were 1.12 times greater for each additional box of snus used in a month (p <.01). Women were 46% less likely to have a severe lesion than men (p =.03). Gingival retractions were observed in 18.4% of the participants. The odds for dental retraction were significantly higher by 34% for each year of snus use. Most of the adolescents using snus had snus induced lesions, whereas approximately one-fifth had gingival retractions. The severity of the lesion and gingival retraction increased with the amount of snus boxes used and the duration of the snus use, respectively. [ABSTRACT FROM AUTHOR]

The article discusses a case study of a 64-year-old woman who presented with oral lesions and weight loss. It mentions that despite previous treatment, the condition did not improve until the diagnosis of a fungal infection called Paracoccidioidomycosis (PCM) was made. The study highlights the importance of considering opportunistic infections and underlying immunosuppressive disorders when patients do not respond to conventional treatments.

Introduction: The study aimed to assess and compare the effectiveness of chlorhexidine and hyaluronic acid when used as an adjuvant to professional mechanical plaque removal (PMPR) in the treatment of orthodontically induced gingival enlargement. Methods: The study conducted was a randomized controlled clinical trial involving 45 patients. The patients will be categorized into 3 groups; control group receiving conventional PMPR, study 1 group receiving PMPR and chlorhexidine (CHX), and study 2 group receiving PMPR and hyaluronic acid (HA). Probing depth (PD), Gingival overgrowth index (GOI), gingival bleeding index (GBI), and plaque index (PI), will be recorded at baseline, 1 month, 2 months, and 4 months’ post therapy. A bivariate analysis was conducted to evaluate the parameters in function of the three study groups, and to evaluate the changes in PD and GBI between baseline, month 1, month 2 and month 4 in the three study groups. Results: A significant reduction in probing depth and gingival bleeding was observed in the three groups (p<0.05) at all stages of the study except for month 1. No significant differences were found regarding GOI and PI values (P>0.05). The change in PD, PI, GBI and GOI was more in Group 1 and Group 2 than in the control group. Hyaluronic acid demonstrated the same effect of chlorhexidine. Conclusions: HA is just as effective as CHX in treating gingival enlargement. Based on the acceptance of HA by patients generally and the negative effects of CHX, HA may be a potential alternative to CHX. [ABSTRACT FROM AUTHOR]

The article focuses on the potential health benefits of sesame seeds and their constituents. Topics discussed include the origins and uses of sesame seeds, their traditional medicinal uses, their antioxidant and anti-inflammatory properties, and their effects on blood glucose, lipid profiles, and pain management.

Aim: To investigate whether there is an association between subgingival microbial diversity and reduced respiratory function. Materials and Methods: A group of dentate 58–72‐year‐old men in Northern Ireland had a comprehensive periodontal examination including subgingival plaque sampling. DNA was extracted from plaque samples and the V1–V3 regions of the 16S rRNA gene were analysed by high‐throughput sequencing and a microbial diversity index (MDI) was derived. Spirometry measurements were made using a wedge bellows spirometer. The primary outcome variable of interest was the percentage of predicted forced expiratory volume in 1 s (% predicted FEV1). Analysis included multiple linear regression with adjustment for various confounders. Results: Five‐hundred and seven men were included in the analysis. The mean age was 63.6 years (SD = 3.1). Of these, 304 (60.0%) men had no or mild periodontitis, 105 (20.7%) had moderate periodontitis and 98 (19.3%) had severe periodontitis. Multiple linear regression analysis showed that a one unit increase in MDI was associated with a 0.71% loss (95% confidence interval: 0.06%–1.35%; p =.03) in % predicted FEV1 after adjustment for all confounders. Conclusions: In this group of dentate men from Northern Ireland, subgingival microbial diversity was associated with reduced respiratory function. [ABSTRACT FROM AUTHOR]

Introduction: The physiological changes in mother-infant pairs during pregnancy increase the susceptibility to a series of infections, including those of the oral cavity. Therefore, the oral and systemic health of pregnant women is related to adverse pregnancy outcomes. Objective: This cross-sectional study aimed to evaluate the systemic profile and periodontal status of women with a high-risk pregnancy. Methods: Eighty-nine pregnant women at risk of preterm labor admitted to a hospital in southern Brazil were interviewed and received a periodontal examination. Data related to obstetric complications during pregnancy (pre-eclampsia, infections, medication use, and gestational diabetes) and systemic diseases were collected from medical records. The periodontal parameters of probing pocket depth, bleeding on probing, and clinical attachment level were evaluated. The data were tabulated, and statistical analysis was performed (p < 0.05). Results: The mean age of participants was 24 years (SD = 5.62). Gingival bleeding was recorded in 91% of the participants. The prevalence of gingivitis was 31.46%, and periodontitis was 29.21%. No association between systemic conditions and periodontal disease was observed. Conclusions and Implications for Practice: Periodontal inflammation was not associated with the systemic profile during pregnancy. However, women with high-risk pregnancies showed higher levels of gingival inflammation, emphasizing the importance of dental care during pregnancy. Significance: The gestational period is marked by a series of physiological changes that can be influenced by local and systemic conditions. Thus, investigating the periodontal status of pregnant women considered at risk for premature birth and evaluating associations with the systemic health of these patients can present important risk indicators for maternal and fetal health. [ABSTRACT FROM AUTHOR]

The aim of the present study was to perform a systematic review of the literature regarding the effect of different mouthwashes on gingival healing after oral surgery in adults. Searches were conducted in seven databases (PubMed/MEDLINE, Cochrane Library, Clinical Trials Registry, Embase, LILACS, Web of Science, and Google Scholar) for relevant randomized controlled trials (RCTs) published up to April 2022. The selection of studies, data extraction, and risk of bias appraisal were performed independently by two reviewers, and a third researcher was consulted to resolve disagreements. Data syntheses were presented narratively for the different criteria of gingival wound healing. Among 4502 articles retrieved from the databases, 13 studies met the eligibility criteria and were included in the present review. Chlorhexidine was the most frequent mouthwash studied (eight studies) and was used in different concentrations and combinations. Cetylpyridinium chloride, H2Ocean Sea Salt, Commiphora molmol 0.5%, chlorhexidine 0.12%, and essential oils reported better healing than a negative control. However, the uncertain risk of bias in most RCTs included in this review precludes definitive conclusions. Well‐designed RCTs are therefore still needed in this area. [ABSTRACT FROM AUTHOR]

Introduction: Granulomatosis with polyangiitis (GPA), is a rare systemic disease that if left untreated, it may lead to death within 6–12 months. This case report describes a 15‐year‐old female with a 14‐month history of epiphora, nasal breathing difficulties, headaches, and jaw pain. The patient reported having various medical procedures attempted to address her symptoms. The classical presentation of strawberry gingivitis led to the diagnosis of GPA. Based on a multi‐language search, this is the first reported case, that GPA is mistaken as Temporomandibular Joint Disorders (TMD). Case Presentation: A 15‐year‐old female with nearly 14 months of numerous complaints, including headaches and jaw pain, was referred for an orofacial pain (OFP) consultation. The patient had completed a dental examination and was prescribed chlorhexidine for gingivitis control. The OFP examination was not consistent with signs and symptoms of TMD. However, the gingival appearance of strawberry gingivitis was suggestive of GPA. A rheumatologist confirmed the diagnosis of GPA based on the clinical interview, serology testing, and dental findings. A course of rituximab and corticosteroids, and regular dental cleanings were recommended. A 4‐month follow‐up visit demonstrated complete resolution of her jaw pain and headaches. Gingival tissue appeared normal. Conclusion: This case emphasizes the need for familiarity with systemic diseases that can present oral manifestations. It also stresses the importance for dental professionals to be knowledgeable of differential diagnoses for TMD, headaches, and autoimmune disorders. Why is this case new information?This is believed to be the first published case mistaking GPA as TMD.This is a case in which a multidisciplinary approach and management were keys for a successful treatment outcome. What are the keys to successful management of this case?Obtain a thorough clinical history.Know the oral manifestation of systemic diseases.Know differential diagnosis of TMD and headaches. What are the primary limitations to success in this case?Having no access to the medical records during the OFP consultation.Having no awareness of differential diagnosis for gingivitis: strawberry, plaque‐induced. [ABSTRACT FROM AUTHOR]

Introduction: Gingival fenestration (GF) is scarcely reported in the literature. We present a unique case of GF defect combined with gingivitis and altered passive eruption (APE). Case Presentation: An 18‐year‐old female patient with gingivitis, APE, and GF in the mandibular left central incisor presented for periodontal treatment. The gingival lesion was successfully treated with basic periodontal therapy gingivectomy, and gingivoplasty and resulted in an excellent aesthetic long‐term outcome. This case report shows its 8‐year clinical follow‐up. Conclusion: There are no earlier reports dealing with the use of gingivoplasty for the treatment of GF, as it is not the usual therapeutic intervention for these defects. Gingivoplasty proved to be effective in treating GF. Why is this case new information?Available literature on gingival fenestration defects does not describe gingivectomy and gingivoplasty as a treatment of choice.Gingivectomy and gingivoplasty proved to be effective in treating gingival fenestration defects. What are the keys to successful management of this case?Proper diagnosis. What are the primary limitations to success in this case?Gingival fenestration has been defined when the overlying gingiva is denuded, exposing the root to the oral cavity. However, in this case report, only the crown was exposed because the patient had altered passive eruption. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to analyze the distribution and frequency of individuals diagnosed with histo-pathologically non-plaque-induced gingival lesions and categorize them according to the non-plaque-induced gingival disease classification published at the 2017 World Workshop of Periodontology. Materials and Methods: Clinical features of the gingival lesion with histopathological diagnosis data in the period 1998-2003 were retrospectively analyzed. The lesions were classified as reactive lesions, malignant neoplasms, premalignant neoplasms, autoimmune disorders, benign neoplasms, hypersensitive reactions, and genetic lesions. Their distribution according to age, gender, histopathological diagnosis, and oral sites was examined. Variables were analyzed using descriptive statistics. Results: Among a total of 217 biopsied gingival samples, the most frequent pathologic nature of biopsied non-plaque gingival lesions were reactive lesions (n = 80, 36.87%) and premalignant neoplasms (n = 64, 29.49%). In addition, the 5 most frequent types of all cases included pyogenic granuloma (n = 45, 20.74%), epithelial dysplasia (n = 40, 18.43%), papilloma (n = 33, 15.21%), epithelial hyperplasia (n = 24, 11.06%), and calcifying fibroblastic granuloma (n = 13, 5.99%). Conclusions: In a Turkish population, the most frequently biopsied non-plaque-induced gingival lesions were reactive lesions and premalignant neoplasms. This study shows that the types of lesions that clinicians, in general, especially periodontologists, can expect to encounter in their practice are the most frequently applied gingival lesions. [ABSTRACT FROM AUTHOR]

A correction to the article "Kava-241 reduced periodontal destruction in a collagen antibody primed Porphyromonas gingivalis model of periodontitis" is presented.

A quiz about the case of a young girl with abnormal teeth and renal calcifications is presented.

Pregnancy epulis is a common and benign vascular tumor that reaches 5% of pregnant women; it respects adjacent structures, such as bone, teeth, and sinus mucosa. This paper reports a rare case of extensive pregnancy epulis with alveolar bone lysis, tooth displacement, and sinusal floor lysis. A 23‐year‐old pregnant woman with 23 weeks of amenorrhea was referred to the Department of Oral and Maxillofacial Surgery with a large maxillary mass and spontaneous bleeding, causing difficulty in speaking and swallowing. Due to the rapid development, the stage of pregnancy, and the need for a sure diagnosis of a benign lesion, a surgical excision was performed. After 1 month, the patient recovered from swallowing and speaking. Pregnancy epulis can be locally aggressive and involve alveolar bone. Biopsy allows to confirm the diagnosis. Surgery during pregnancy or birth waiting should be well ponderated in correlation with the size of the tumor and the delay to birth. [ABSTRACT FROM AUTHOR]

Oronasal fistula following cleft palate repair is a considerable complication with a recurrence rate of 33% to 37% and remains a challenging problem for surgeons. Furthermore, many patients have undergone several operations and experienced scar problems and other forms of morbidity. Therefore, we report a multilayered technique for oronasal fistula closure using an endoscopic nasal inferior turbinate composite graft with a palatal advance flap. This will increase the success rate after closure of small-sized oronasal fistula surgery without complications or recurrence (IRB: 2020-1671-0001). [ABSTRACT FROM AUTHOR]

Actinomyces odontolyticus is an anaerobic gram-positive bacterium that rarely causes necrotizing ulcerative gingivitis (NUG). A 15-year-old male was referred to Oral Medicine Clinic with acute myeloblastic leukemia (AML) and long coronavirus disease 2019 (COVID-19) syndrome. The chief complaints were pain, spontaneous gum bleeding, and foul-smelling breath. Extraoral examination showed an anaemic, asymmetrical face, swelling at the left buccal, and lymphadenitis. Intraoral examination showed localized gingival enlargement, tend to bleed, crater-like with punched-out of interdental papilla at posterior left mandibular gingiva, and deep caries in tooth 36. Oral microbiological examination revealed Actinomyces odontolyticus. He was diagnosed with NUG. The treatment included debridement with 1.5% hydrogen peroxide followed by 0.9% NaCl, 0.12% chlorhexidine digluconate mouthwash, metronidazole tablets 500 mg, and amoxicillin-clavulanic acid tablets 500 mg/125 mg. In conclusion, NUG caused by Actinomyces odontolyticus in a leukemic child that may relate to pulmonary long COVID-19 syndrome is particularly rare. [ABSTRACT FROM AUTHOR]