Search

The medical and dental fields are experiencing a significant shift in approach thanks to the integration of artificial intelligence (AI). With a vast influx of patient data, there is a pressing need for sophisticated software capable of organizing and preserving this information effectively. The emergence of AI-driven models and computer vision techniques for identifying patterns in clinical and histopathological images related to oral pathology lesions holds promise for enhancing diagnostic accuracy and prognostic predictions. While microscopic morphology remains the gold standard in diagnostic pathology, its reliance on individual pathologists introduces variability. Consequently, AI presents a potential solution for achieving consistent and more precise diagnoses. Moreover, by analyzing extensive data from the patients’ medical chart the artificial neural network could provide a presumptive diagnosis and an invaluable screening tool in predicting individual risk for oral pathology based on information regarding their risk factors, systemic diseases and conditions and clinical pathological data. Within oral and maxillofacial pathology, AI stands poised to elevate diagnostic accuracy, tailor treatment, and ultimately enhance patient outcomes. Nevertheless, the integration of AI in healthcare demands meticulous attention to ethical, legal, and regulatory complexities. Moreover, given the nascent nature of AI technology, prudence is paramount when deploying it in this specialized domain.

The orofacial region are often affected by a diverse spectrum of bacterial, viral, fungal, chlamydial, rickettsial, protozoal, and helminthic infections. Diagnosis of oral candidiasis is often made with a thorough history and the clinical examination findings. Some laboratory investigations can also be used as adjuncts to confirm the clinical presentation. Candida pathogens in a smear taken directly from the lesion are commonly identified using Gram staining or periodic acid Schiff staining, or by culturing the pathogen in Sabaraud’s dextrose agar. Regardless of the prevalence, incidence, and the advancement of treatment strategies, orofacial infections, either local or the manifestations of a generalized infection, may cause significant discomfort and suffering. Oral clinicians need to be equipped with up-to- date knowledge of the clinical pictures of new infections, approaches in accurate identification of orally limited infections vs oral manifestations of underlying systemic diseases. Treatment of oral candidiasis is primarily based on the identification of underlying predisposing factors and correcting them.

It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. Selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Patient education on oral hygiene is an important component of their overall treatment. Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. In conclusion, biofilm disruption mechanical methods integrated is indispensable for comprehensive oral healthcare.

Chronic periodontitis is a disease caused by several factors; therefore, it can be called a multifactorial disease. Such risk factors include smoking, diabetes, genetics, depression, and stress. Depression is one of the chronic conditions with the highest prevalence worldwide. There is evidence to support the association between psychological disorders and the physiological and behavioral precursors of caries and periodontal disease, suggesting that such a connection may exist. Antidepressant and anxiolytic medication have been associated with decreased salivary flow and poor oral hygiene. The present study aimed to examine the local inflammatory status of patients with periodontal disease and no other systemic conditions and patients with periodontal disease and depression. Between February 2024 and March 2024, we conducted this study on 40 patients aged 20 and 48, evaluating the Quigley Hein Plaque Index, the GI Index of Löe and Silness, and the PBI Index. Analyzing the obtained results, we observed that the values of the periodontal parameters, such as the hygiene index, the gingival inflammation index, and the papillary bleeding index, were significantly higher in the group of patients with periodontal disease and depression compared to the group of patients with only periodontal disease.

Patients with osteoporosis exhibit a nearly twofold higher diagnosis rate of periodontitis compared to the general population, indicating osteoporosis is a potentially significant risk factor for periodontitis development. This study explored changes in periodontal and radiological parameters after systemic alendronate use in osteoporotic patients with periodontal disease. Sixty-four post-menopausal adults diagnosed with osteoporosis and periodontal disease were divided into two groups: Group A, without bisphosphonate therapy, and Group B, receiving alendronate (70mg/week) for 12 months. Both groups underwent non-surgical periodontal treatment. Parameters including plaque index (PI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), and radiographic infrabony defect depth (IBD) were evaluated at baseline and after 12 months. Oral administration of alendronate at 70 mg/week for 12 months was found to be safe and effective in enhancing the outcomes of non-surgical periodontal therapy both clinically and radiologically. This suggests alendronate could be a valuable adjunctive treatment for managing periodontal disease in osteoporotic patients.

Pregnancy is a unique physiological state characterized by hormonal fluctuations and immunological adaptations that can impact various aspects of maternal health, including oral health. The influence of pregnancy on periodontal status has been the subject of extensive research, with studies highlighting the association between gestation and changes in the oral cavity. Elevated levels of estrogen and progesterone during pregnancy have been implicated in the exacerbation of gingival inflammation and periodontal disease progression. Immunological changes, including alterations in immune cell function and cytokine production, further contribute to the heightened inflammatory response observed in the periodontium of pregnant individuals. While the precise mechanisms underlying the relationship between pregnancy and periodontal status continue to be elucidated, preventive measures such as oral hygiene education, regular dental check-ups, and timely periodontal treatment are crucial for promoting optimal oral health outcomes for both mother and child during gestation. Understanding the influence of pregnancy on periodontal status is essential for providing comprehensive prenatal care and ensuring the well-being of pregnant individuals and their offspring.

Clinical research documents causal relationships between periodontitis and depression. Furthermore, it has been revealed that clinical depression can also negatively affect periodontal treatment outcomes. The present study aimed to analyze subgingival microbial profiles in patients with periodontal disease and those with depression by qualitative and quantitative determination of 4 periodontal pathogens. Material and method. The study was carried out on a number of 40 patients between the ages of 20 and 48 within the Periodontology Clinic of the Faculty of Dental Medicine, within the “Grigore T. Popa” University of Medicine and Pharmacy Iași or in an office with private practice within the radius of the city of Iași. Analyzing the obtained results, it can be seen that the average age is significantly lower for the group of patients with periodontal disease compared to the average age of patients with periodontal disease and depression (p=0.02). Regardless of which method, the individualized determination of periodontal pathogens helps guide targeted systemic antibiotic therapy (individualization of the treatment plan). It limits self-medication or the possibility of developing bacterial resistance.

Periodontology has adapted over the years to demands for better healing, a more comfortable solution, treatment of marginal tissue recessions, and better aesthetics. This has become one of the main goals of this discipline. Platelet-enriched fibrin (PRF) is an autologous platelet concentrate similar to a scar matrix that guides the various cellular elements and releases growth factors and cytokines near the injury. It is an autogenous alternative to conjunctive grafting in treating gingival recession that would allow optimal healing quickly. This review presents the different types of PRF, the protocols for obtaining them, and the practical features of their surgical applications. The use of PRF in oral surgery signifies not just a trend but a fundamental shift towards patient-centered, evidence-based, and minimally invasive practices that redefine the boundaries of what is achievable in modern oral healthcare.

The interplay between oral health and systemic conditions continues to unfold, with an emerging focus on the association between periodontal disease and chronic kidney disease (CKD). Periodontal disease, a chronic inflammatory condition affecting the supporting structures of the teeth, has garnered attention beyond its oral implications. Recent research suggests a bidirectional link between periodontal health and CKD, with inflammatory mediators and immune responses serving as potential conduits for mutual influence. The review navigates through the current understanding of how periodontal disease may contribute to the progression of CKD and vice versa. Inflammatory pathways, oxidative stress, and microbial translocation are among the key elements linking these seemingly distinct entities. Recognizing periodontal disease as a potential modifiable risk factor in CKD emphasizes the importance of comprehensive oral health assessments in renal care. Furthermore, understanding the shared inflammatory cascades opens avenues for integrated preventive strategies that span both dental and nephrological disciplines. As research in this field advances, a holistic approach to patient care that considers both periodontal and renal health becomes paramount for effective prevention and management strategies.

This review article makes an effort to provide a comprehensive view of the relationship between osteoporosis and periodontitis, with a focus on clarifying how those risk factors in osteoporotic populations modify the alveolar bone homeostasis in the periodontitis niche. Periodontitis is a periodontal inflammatory condition that results from disrupted periodontal host–microbe homeostasis, manifested by the destruction of tooth-supporting structures, especially inflammatory alveolar bone loss. Osteoporosis is characterized by systemic deterioration of bone mass and microarchitecture. The roles of many systemic factors have been identified in the pathogenesis of osteoporosis, including endocrine change, metabolic disorders, health-impaired behaviors and mental stress. Recent studies suggest that individuals with concomitant osteoporosis are more vulnerable to periodontal impairment.

There is ample literature evidence to support that periodontal therapy has an impact on the local and systemic host immune responses, despite contradicting data from the literature reporting both a decrease and increase in systemic antibody levels following treatment. The clinical guidelines for the treatment of patients with periodontitis stages I–III published from the European Federation of after the patient has been informed about his/her condition, the first step in the treatment process is directed toward motivation, targeting behavioral changes to achieve adequate self-performed oral hygiene practices and controlling local and systemic modifiable risk factors. A systematic review indicates positive associations across patient-reported experiences, self-rated and objectively measured health outcomes in relation to a wide range of areas and settings. Despite patient-reported experiences and patient-reported outcomes of therapy being closely related, there are differences between the two concepts. Frequent re-evaluation of oral hygiene reinforcement outcomes is suggested, aiming to reinforce a patient’s motivation and keep the patient up to date with any changes that might occur in the periodontal status, enabling the patient to actively participate in the progress of the treatment plan. In conclusion, short-term perturbations of antibody responses occur during the active phase of periodontal therapy.

Medical devices that come into contact with sterile tissues or body fluids are considered critical items. In dentistry, conventional manual decontamination of medical device surfaces is used, and this requires a two-step procedure that includes rehydration of the surface followed by decontamination, for effective inactivation of bacteria and viruses on dry surfaces The most effective decontamination agents are ethanol in high concentration while sodium hypochlorite and hydrogen peroxide require a minimum concentration to be effective with little impact on human health. The bactericidal action of quaternaries has been attributed to inactivation of energy-producing enzymes, denaturation of essential cellular proteins, and disruption of the cell membrane. Sterilization destroys all microorganisms on the surface of an item or in a fluid to prevent the transmission of diseases associated with the use of that item Most medical and surgical devices used in medical facilities are made of materials that are heat stable and therefore undergo high temperature sterilization, primarily with steam.

Diabetes mellitus and periodontal disease are among the most common chronic diseases of mankind and, remarkably, they share many common features. The most common forms of periodontal diseases, gingivitis and periodontitis, are characterized by a microbially driven series of host responses that lead to periodontal tissue damage.The host response is central to the development of periodontitis, as it is to the development and progression of several human chronic diseases, including diabetes mellitus. In the next sections we will review the main features of diabetes mellitus, with the main focus being the association between type 2 diabetes mellitus and periodontitis. Peri-implant diseases are infectious conditions affecting dental implants, ranging from peri-implant mucositis, which is an inflammatory lesion of the peri-implant mucosa, to peri-implantitis, which also affects the supporting bone. As well as potentially sharing some similar risk factors, diabetes mellitus and periodontal disease patients have exceptionally similar tendencies to develop comorbidities that tend to cluster in the same individuals. Attention to the patient’s medical history is one of the cornerstones for efforts in the prevention of periodontal and peri-implant diseases.

Protein-energy wasting and inflammation are major risk factors for complications in hemodialysis patients. As these risk factors are triggered by a pro-inflammatory state, oxidative stress and hemodynamic dysfunction, which overlap in hemodialyzed subjects, we aimed to assess the efficacy of a cost-effective and straightforward screening tool, the Prognostic Inflammatory and Nutritional Index (PINI), in regularly screening maintenance hemodialysis (MHD) patients, to detect early signs of inflammation and malnutrition. A 12-month follow-up was carried out on a cohort of 102 adult patients undergoing maintenance dialysis, during which the Prognostic Inflammatory and Nutritional Index (PINI) was calculated using the formula alpha1-Acid Glycoprotein (AGP) × C-reactive protein (CRP)/albumin (ALB) × transthyretin (TTR). A PINI score < 1 was considered normal. The patients were stratified based on their PINI score: 66 patients (64.70%) had a normal score, below 1, while 36 patients (35.30%) had a PINI score ≥ 1. Despite the absence of clinical evidence of inflammation at enrollment, the latter group exhibited higher levels of CRP. During the follow-up period, all patients with a PINI score ≥ 1 experienced at least one acute event, compared to only 6% of patients with a normal PINI score, which presented COVID-19 infection as an acute event. The evaluation of the PINI can effectively identify the silent malnutrition–inflammation syndrome and predict the risk of acute events. This straightforward test appears to be a rapid tool that is independent of the examiner’s experience and subjectivity, thereby potentially reducing hospitalization costs.

The clinical guidelines for the treatment of patients with periodontitis stages I–III published from the European Federation of after the patient has been informed about his/her condition, the first step in the treatment process is directed toward motivation, targeting behavioral changes to achieve adequate self-performed oral hygiene practices and controlling local and systemic modifiable risk factors. Frequent re-evaluation of oral hygiene reinforcement outcomes is suggested, aiming to reinforce a patient’s motivation and keep the patient up to date with any changes that might occur in the periodontal status, enabling the patient to actively participate in the progress of the treatment plan. Periodontology in 2020, suggest treatment being provided to patients with periodontitis by a pre-established stepwise approach. The second step is focused on professional interventions to reduce and possibly eliminate subgingival biofilms and calculus. Promotes periodontal wound healing via reduction of tissue inflammation and shifts in the host responses.

The purpose of this study was to evaluate the characteristics of three types of composite resins used for periodontal immobilization systems’ realization, the G-aenial Flo X (GC Corporator—Tokyo, Japan), the GrandioSO (VOCO—Cuxhawen, Germany), and the Clearfil Majesty ES flow (Kuraray Noritake Dental Inc.—Okayama, Japan). The structural analyses were realized by scanning electron microscopy, using a QUANTA 200 3D scanning electronic microscope (FEI, Netherlands), and the determination of the elemental composition of the materials was realized via X-ray spectroscopy with energy dispersion (EDX). The results showed that the GrandioSO composite demonstrated the most resistant nonporous structure, due to the presence of a homogeneous matrix characterized by low proportions of silicon and carbon. Further research is required in order to analyze the mechanical parameters of these resins and their behavior in different biological environments, in vitro and in vivo.

Periodontal disease is considered to be connected with some very well-known anaerobic etiological agents. Many studies are analysing the associations between Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Tannerella forsythia with periodontal disease. Still, the prevalence of this disease is increased. In this review we aimed to present a possible new bacteria connected with periodontal disease: Cryptobacterium curtum. We performed a search in PubMed and we identified 8 articles, published between 1999 and 2018. Here we present a summary about this bacterial species regarding its microscopic, cultivation and genomic features. New molecular biology techniques, such as NGS (next generation sequencing) or mRNA technology, identified this bacteria to be associated with acute dental abscesses, and with chronic periodontitis. The virulence factors of this bacteria are not yet identified, but with the recent highly sensitive techniques, there is hope to completely establish the role of C. curtum in the pathogenesis of periodontal disease.

In each study we have tried to illustrate typical scenarios encountered in the clinic that may be accompanied by complications and possibly even be induced by treatment errors, together with recommendations on how they can be avoided or how they can be rescued, based on the currently available evidence and on expert opinion. The interplay between the application of orthodontic forces to stimulate tooth movement and the reaction of the affected periodontal tissues is complex. While most of the time possible damage to the periodontal tissues is transient with no long-term detrimental effects on periodontal health, in some instances major undesirable consequences have been reported. In other situations, orthodontic therapy can be of benefit in solving problems caused by periodontitis. In conclusion, the present review has identified several areas of concern, in which orthodontic treatment, can have unwanted adverse effects on periodontal disease, but also areas with great potential for synergies between orthodontic and periodontal therapy.

Orthodontic treatment is performed in children and adolescents with healthy periodontal conditions. While clinical periodontal health and also the end points of successful periodontal therapy to establish periodontal health on a reduced periodontium are clearly defined, these may differ from how clinical success of orthodontic treatment is defined. While most of the time possible damage to the periodontal tissues is transient with no long-term detrimental effects on periodontal health, in some instances major undesirable consequences have been reported. In general, these treatment goals may be definedas achievement of oral health, esthetics, occlusion, function, and stability, although the treatment goals may vary among patients. It is obvious that all of these problems may have implications for the status of the periodontal tissues involved. In conclusion orthodontic treatment is considered successful when the treatment goal is achieved and the result remains stable.

Periodontitis patients are known to have increased circulating lipopolysaccharide activity and metabolic disturbances, which may be either the cause or effect of endotoxemia. This review approaches endotoxemia as a possible molecular mediator between periodontitis and increased risk of cardiometabolic disorders. Observations that bacteria disseminate into circulation after toothbrushing and periodontal procedures and assumptions that endotoxin may disseminate through inflamed periodontium and bleeding gums support the idea of endotoxemia in periodontitis. However, the evidence that periodontitis-associated dysbiosis contributes to endotoxemia is not as strong as in the case of gut microbiome dysbiosis. Although the causality is insufficiently demonstrated thus far, many studies have associated changes of the gut microbiome composition, function, and specific bacterial metabolites with cardiometabolic diseases, whereas research on the oral microbiome has severely fallen behind.

Oral and periodontal health impact systemic health, and vice versa. Special at-risk populations bring to bear this bidirectional relationship between oral and systemic health. Although bidirectional relationships are discussed, the potential for multiple comorbidities, relationships, and connections (multimodal relationships) also exists. Periodontal disease has been associated with diabetes, metabolic syndrome, obesity, eating disorders, liver disease, cardiovascular disease, Alzheimer disease, rheumatoid arthritis,adverse pregnancy outcomes, and cancer. Proposed mechanisms that mediate this connection between oral and systemic health in a susceptible host include predisposing and precipitating factors, such as genetic factors (gene polymorphisms), environmental factors (stress,habits—such as smoking and high-fat diets/consumption of highly processed foods), medications, microbial dysbiosis and bacteremias/ viremias, and an altered host immune response. These associations exist within a framework of bacteremias/viremias/microbemias, systemic inflammation, and/or disturbances of the immune system in a susceptible host.

Periodontitis patients are known to have increased circulating lipopolysaccharide activity and metabolic disturbances, which may be either the cause or effect of endotoxemia. This review approaches endotoxemia as a possible molecular mediator between periodontitis and increased risk of cardiometabolic disorders. Observations that bacteria disseminate into circulation after toothbrushing and periodontal procedures and assumptions that endotoxin may disseminate through inflamed periodontium and bleeding gums support the idea of endotoxemia in periodontitis. However, the evidence that periodontitis-associated dysbiosis contributes to endotoxemia is not as strong as in the case of gut microbiome dysbiosis. We describe the structure-function relationship of lipopolysaccharide, the local and systemic inflammatory and immunological responses caused by lipopolysaccharide, current knowledge on endotoxemia in periodontitis, factors affecting the levels of endotoxemia, and its relation to cardiometabolic disorders. They are physically, microbiologically, and biochemically connected to each other, and only crumbs of information are known about this connection. Although the causality is insufficiently demonstrated thus far, many studies have associated changes of the gut microbiome composition, function, and specific bacterial metabolites with cardiometabolic diseases, whereas research on the oral microbiome has severely fallen behind.

Studies of periodontal biodynamics in patients with orthodontic appliances play an important role in the interdisciplinary ortho-periodontal cooperation. Material and method. The aim of the present research was to carry out an etiological, prospective and longitudinal incidence follow-up study. The study population consisted in 495 patients who benefited from orthodontic and periodontal care in the period 2010-2019. They were selected from three private practices in Iaşi, Rădăuţi and Paşcani, being treated interdisciplinary by the same team of doctors, one orthodontist and one periodontologist. The data were analysed using SPSS V.21 software. (IBM). The statistical study addressed two aspects: descriptive statistics and analytical statistics. Results. The study population consisted in 495 patients, of which 169 were men and 326 were women, mostly children (66%), while teenagers (13%) and adults (20%), with temporary dentition 1.52%, mixed 74.39 % and permanent 24%. In the study population, class I anomalies were found in 54.14% of cases, class II/1 in 21.62%, class II/2 in 15.15% and class III in 9.09%. A statistically significant correlation is observed between the type of periodontal involvement and age, in the sense that periodontal pockets and gingival recessions are predominant in adults, which demonstrates the worsening of the periodontal condition in the absence of orthodontic treatment performed in adolescence. Conclusions. Periodontal involvement following orthodontic treatment decreased on average by 5%, and by age group, a decrease in the number of periodontal pockets, but also an increase in the number of recessions, was observed in adults.

Periodontal pathology and early clinical manifestations in the context of leukemia are influenced by the host organism, by immunological, microbiological and genetic factors, but also by environmental factors (physical agents (ionizing radiation, x-rays) and chemical agents (drugs such as cytostatics, exposure to organic solvents or to pesticides, herbicides, exposure to cigarette smoke). The purpose of this article is to emphasize both the importance of the health status of the marginal periodontium and the severity of gingival-periodontal manifestations in the context of haematological diseases. We also want to draw attention to the role of periodontal treatment: the elimination of periodontal inflammation, the reduction of periodontal pockets, the maintenance of rigorous oral hygiene and the periodic check-up in a dental practice in this category of patients. Clinical and radiological evidence-gathering is very important in the recognition and diagnosis of gingival-periodontal manifestations in haematological diseases, as when they are not treated in time, they become a source of infection of the oral cavity and in the entire body. Conclusions. It is essential to analyze this interaction in all aspects, from a clinical, microbiological, immunological and genetic point of view, in order to make a diagnosis and implement a correct and complete treatment plan.

Several risk factors have been associated with severe coronavirus disease and include factors such as advanced age and sex (male) and comorbidities such as obesity and the presence of underlying diseases (eg, hypertension, cardiovascular disease, cerebrovascular disease, chronic kidney disease, and diabetes). These predisposing conditions share several standard features that could explain why they are associated with worse disease outcomes. Persistent and uncontrolled inflammation is a key manifestation of several diseases, such as periodontitis, cardiovascular diseases, neurodegenerative diseases, diabetes, and coronavirus disease infection. The oral cavity is a reservoir for respiratory pathogens, especially among patients with poor oral hygiene and periodontitis, and dysregulated inflammatory and immune response. In fact, periodontal pockets in the elderly have been associated with increased risk of mortality from pneumonia, and periodontitis patients are more likely to develop hospital-acquired, pneumonia than healthy ones are. Conclusions; Periodontitis shares several common features with coronavirus disease including similarities in comorbidities and effects on systemic inflammation. However, further research would be needed to confirm these hypotheses.

The aim of this review is to provide an overview of the current evidence of some popular food supplements and superfoods that might be of interest in periodontology. Although the number of publications investigating the effect of these products on human health and their possible use in medicine is increasing, only little is known so far regarding their effects on periodontal tissues and their possible use in periodontal treatment or medicine. In summary, an increasing number of studies have revealed aspects and effects of these so-called lifestyle or fitness supplements and superfoods that may have an impact on periodontal health and healing after treatment. However, some the current evidence is of a very low quality, and more validated scientific data are required before their possible use in prevention or treatment of periodontal diseases can be made.

The aim of this study was to evaluate the effects of melatonin supplementation accompanied by non-surgical periodontal therapy on serum melatonin, as well as inflammatory and oxidative stress markers in patients with type 2 diabetes with chronic periodontitis. The study was conducted on 50 subjects with periodontitis and diabetes mellitus type 2 (study group n = 25: patients with scaling and root planing + melatonin; control group = 25: patients with scaling and root planing + placebo). The melatonin, interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-α) and high-sensitivity C-reactive protein (hs-CRP), total antioxidant capacity (TAC) and total serum oxidant (TOS) levels were measured at baseline and after 8 weeks. Melatonin systemic intake reduced inflammation and oxidative stress markers in diabetic patients with chronic periodontitis.

Concerns about occlusal overload and the presumed consequences of occlusal trauma have led to meticulous replacement of missing teeth and the incorporation of a large number of supporting teeth into fixed dentures. For the experimental study of the state of tension and deformation that arises in the masticatory system during mastication, various methods are used, of which the most used in Romania are the methods that use resistive electrical tensometry, optical methods. Among the optical methods that provide the most commonly used qualitative and quantitative results are: the brittle varnish method and the holographic method. The obtained results are congruent with the results obtained by other researchers and through the conclusions drawn, the methodologies designed can be used for the experimental analysis of the state of tension and deformation in the masticatory system.

Studies in the biology of viral infection and clinical disease management have shown that differences in the prevalence and severity of COVID-19 are associated with the high affinity of Covid-19 S protein for ACE2, suggesting that populations with higher ACE2 expression may be more susceptible to the COVID-19 infection. Current information indicates that induced hyperglycaemia affects the phagocytic function of mononuclear and polymorphonuclear cells, contributing to the growth of aggressive pathogenic subgingival flora. As a result, periodontal infection can cause systemic inflammation by releasing cytokines and metalloproteinases (MMP) into the circulatory system derived from periodontal disease and destroying tissues, which can exacerbate or aggravate chronic insulin resistance. In the periodontitis – diabetes mellitus – COVID-19 triad, uncontrolled hyperglycaemia increases the risk of periodontitis and the onset of ACE2 overexpression, as well as decreased MMP activity in the periodontal tissue of patients with type 2 diabetes; these events could be essential for SARS-CoV-2 infection and COVID-19 development.

This article focuses on herpesviruses and major periodontopathic bacteria in the etiology of localized juvenile periodontitis. The joint association of herpesvirus with severe periodontitis and systemic diseases argues for a possible systemic involvement of periodontal herpesviruses in medical disorders and for periodontal therapy that targets both herpesviruses and bacterial pathogens. The etiopathogenesis of severe periodontitis includes active herpesviruses, specific bacterial pathogens, and pro-inflammatory cytokines. The inflamed periodontium constitutes an important reservoir of herpesviruses outside of the hematopoietic compartment. Several rationales prompted studies on periodontal herpesviruses. Severe periodontitis lesions can contain hundreds of millions of active herpesviruses and bacterial pathogens that may. Systemic and topical anti-herpesvirus therapy can neutralize active herpesviruses, and effective patient self-care can help prevent inflammatory cells containing latent herpesviruses from entering the periodontium.

Mucous membranes and skin the in the orofacial region are often affected by a diverse spectrum of bacterial, viral, fungal, chlamydial, rickettsial, protozoal, and helminthic infections. Such conditions may clinically appear as small, localized lesions to diffuse and invasive varieties that extend beyond natural barriers, often causing potentially life-threatening complications. Regardless of the prevalence, incidence, and the advancement of treatment strategies, orofacial infections, either local or the manifestations of a generalized infection, may cause significant discomfort and suffering. Thus, the recognition of the clinical presentation of these infections is paramount to their diagnosis, clinical management, and appropriate referral. The following sections describe orofacial manifestations of human herpesvirus and fungal infections.

The therapeutic efforts for controlling periodontal diseases focus on the removal of dental biofilm from the affected lesion, as active treatment centers on non-surgical mechanical debridement with antimicrobial and sometimes anti-inflammatory adjuncts. The surgical therapy aims at gaining access to the lesion and correcting unfavorable gingival ⁄ osseous contours to achieve a periodontal architecture that will provide for more efficient oral hygiene and periodontal maintenance. In addition, recent advances in tissue engineering have provided an efficient means to regenerate ⁄ repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors ⁄ biologic mediators. A systematic review confirmed that patients who are seen at regular intervals for supportive periodontal therapy experience less attachment loss and lose fewer teeth

Smoking and diabetes mellitus have been recognized as significant modifying factors of the evolution of periodontitis, being considered at the moment as descriptive factors in the periodontitis grading system. The purpose of this study was to assess the consequence of smoking, type 2 diabetes, and the combination of these two factors on clinical periodontal parameters, on the levels of gingival crevicular fluid (GCF), and also on ratios of pro-inflammatory and anti-inflammatory cytokines by using a commercially available kit-based multiplex fluorescent immunoassay. The study was carried out on 124 volunteers (control (C) group = 29, diabetes mellitus (DM) group = 32, smoking (S) group = 31, and S + DM group = 32). Total mean bleeding on probing was significantly lower in the S and S + DM groups, compared to that of the other groups (p < 0.05). Total amounts of TGF-β, MIP-1α, IL-6, IL-2, and IL-17 were significantly increased in the periodontally healthy sites of diabetes patients (p < 0.05), compared to those of the controls. Systemically healthy smoking patients had higher values of GM-CSF, TGF-β, IL-4, TNF-α, IL-5, and IL-7, while diabetic smoking patients showed higher values of IL-4, TGF-β, and MIP-1α. In smoking and systemically healthy patients, IL-23, IL-7, and IL-12 showed increased concentrations, while concentrations of TGF-β, MIP-1α, IL-2, IL-7, IL-12, IL-17, IL-21, and IL-23 were higher in smoking DM patients. In conclusion, in our study, diabetes mellitus induced a general pro-inflammatory state, while smoking mainly stimulated immunosuppression in the periodontal tissues of periodontitis subjects.

Periodontology has been defined as the scientific study of the periodontium in health and disease. The objective of this overview of principles of periodontology is presentation of current and established concepts. Aspects of the history, classification and epidemiology of the most common periodontal diseases are discussed. People exhibiting periodontal abnormalities, for example impairments of tissue integrity or function, are said to have periodontal diseases. Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. The new classification is complex and will take time to fully incorporate into patient care globally.

Periodontal diseases are arguably among the most ancient and common infectious diseases affecting humans, leading to permanent destruction of the supporting structures of the dentition and ultimately tooth loss. It has been established that dental biofilm (‘‘plaque’’), consisting of many microbial species and their products, is an etiological agent of periodontal disease. It is widely accepted that immunological and inflammatory responses to dental plaque via hostparasite interaction are manifested by clinical signs 40 Dentino et al. and symptoms of periodontal diseases.

Fluoridation plays a key role in the prevention and control of dental caries in general public health. However, this success is not without cost and has resulted in strong debates within the dental profession. Dental fluorosis is a cosmetic effect that ranges in appearance from scarcely discernible to a marked staining or pitting of the teeth in severe forms. It is caused by an elevated fluoride level in, or adjacent to, the developing enamel, usually from birth to approximately six to eight years of age. Dental fluorosis in an adult is a result of high fluoride exposure when the adult was a child or adolescent. In its mildest (and most common) form it may manifests barely noticeable whitish striations, while more severe forms involve confluent pitting and staining of the dental enamel. The American Dental Association (ADA) defines it as a hypomineralization of tooth enamel that results from excessive fluoride ingestion prior to tooth eruption (ADA Reports, 2005). An increase in the prevalence of dental fluorosis has been reported simultaneously in both fluoridated and non-fluoridated communities. Although most of fluorosis is mild or very mild, and has little or no impact on quality of life of affected people, a judicious use of fluoride to avoid moderate and severe fluorosis is needed. In order that the maximum benefit of fluoride for caries control can be achieved with a minimum risk of side effects, it is necessary to have a comprehensive understanding of the mechanisms by which fluoride promotes caries control, thus regulating the amount of fluoride intake is essential.

Gingival recession is one of the most frequent undesirable conditions of the periodontal tissues, affecting a significant number of adult individuals worldwide. Gingival recessions can be the result of many etiological factors and occur, due to different factors acting simultaneously. Plaque-induced recession, can be recovered by surgical root coverage procedures, if it does not advance to the interdental papillae, while the periodontitis-related recession is harder to be restored. The most common traumatic etiologic factor, and one of the most common etiologic factors in general, is brushing-induced trauma. Another factor that can, in specific occasions, lead to gingival recession, is occlusal trauma. In general, abnormal occlusion is not a causative factor for recession. The reason is that there is no scientific evidence proving this relationship and that, after surgical treatment of the recession without fixing the pathological occlusion, there is no recurrence. Orthodontic patients have increased probability to form gingival recessions and, hence, orthodontic therapy is a major predisposing factor, especially at the area of mandibular incisors. Furthermore, prosthetic treatment is an iatrogenic predisposing factor of gingival recessions, due to trauma, either during impression taking, or during abutment preparation. Yet, there are some cases of gingival recessions that are not caused by the etiologic factors described above and, therefore, they are considered recessions of unknown etiology. These lesions are manifested as bright red inflammation of the tissue, surrounding the clinically visible roots. Gingival recessions are difficult to treat especially whenever the etiology is not clear. For a favorable prognosis is essential to identify specifically the etiological factors and correct them prior the surgical treatment.

The specialized literature exhibits a multitude of studies that highlight the role of general factors, of some chronic systemic diseases, that can contribute to the appearance or modulation of periodontal disease, carious disease but also of other oral diseases. The oral cavity can be affected by diabetes, which can lead to several complications, including tooth decay, periodontal disease, disorders of the oral mucosa and dysfunction of saliva, which have a significant effect on the quality of life of diabetic patients. The importance of the host lies in the association of systemic diseases to the process of periodontal destruction of tissues in the oral cavity (periodontal tissues, dental tissues, tissues of the oral mucosa and salivary glands). The biomolecular and biocellular mechanisms involved in the pathology of the oral cavity in case of systemic diseases involve the mechanisms of local and systemic inflammation governed by proinflammatory cytokines (IL-6, IL-18, IL-17, IL-1B, IL-8, TNF- alpha and prostaglandins E2-PGE2, protein-2 inhibitory macrophages, MCP-1, interferon gamma, adipokines more common in diabetes. Inflammatory-mediated cytokines and proteins are practical markers of increased risk of cardiovascular disease, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor – alpha (TNF-α), fibrinogen.

Toothpaste formulas have evolved over time. Today they contain about 20 ingredients. Toothpastes normally contain: active ingredients, abrasives, surfactants, gelling agents, buffers, flavors and sweeteners, dyes and preservatives, water, moisturizers. Among these ingredients are compounds that fight and prevent the appearance of carious lesions, gingival diseases, halitosis, calculus, dental erosions, staining and dentinal hypersensitivity. Herbal toothpastes, which contain natural antibacterial agents, are a good alternative to reduce the risk of oral conditions in both children and adults.

Orthodontic treatment can successfully align pathologically migrated teeth leading to improved periodontal stability in patients with periodontal disease. Periodontal-orthodontic approaches have gained increasing attention in recent years. A considerable number of adult patients with periodontal disease are interested in orthodontics in order to improve the alignment of their teeth. However, the severity of periodontal disease and dental incongruence or demographic factors cannot be indicative of these. Elderly patients were significantly more frequently interested in orthodontic treatment. Most study participants were not provided with information on orthodontic treatment options for adults. Very importantly, this group of patients must be aware of the need to stabilize their periodontal condition, to maintain high standards of oral hygiene, before any orthodontic intervention. Therefore, practitioners need to be aware of the patient’s need, deliver patient-centered and provide them with relevant information and, if necessary, plan interdisciplinary treatment.

For a long period of time, natural remedies were the only ailment available for a multitude of diseases, and they have proven effective even after the emergence of modern medicine. Due to their extremely high prevalence, oral and dental disorders and anomalies are recognized as major public health concerns. Herbal medicine is the practice of using plants with therapeutic characteristics for the purpose of disease prevention and treatment. Herbal agents have made a significant entry into oral care products in recent years, complementing traditional treatment procedures due to their intriguing physicochemical and therapeutic properties. There has been a resurgence of interest in natural products because of recent updates, technological advancements, and unmet expectations from current strategies. Approximately eighty percent of the world’s population uses natural remedies, especially in poorer nations. When conventional treatments have failed, it may make sense to use natural drugs for the treatment of pathologic oral dental disorders, as they are readily available, inexpensive, and have few negative effects. The purpose of this article is to provide a comprehensive analysis of the benefits and applications of natural biomaterials in dentistry, to gather relevant information from the medical literature with an eye toward its practical applicability, and make suggestions for the directions for future study.

The aim of this study was to evaluate the influence of smoking on salivary RANKL and OPG levels in patients with generalized, stage III, grade B periodontitis. Material and methods: The salivary concentrations of RANKL and OPG were determined for 18 patients, aged between 23 and 50 years old, of which 8 were smokers, all presenting with a form of generalized, stage III, grade B periodontitis. Results: smokers had higher salivary levels of RANKL (p=0,0009) and a higher RANKL/OPG ratio (p=0,019), compared to non-smokers. OPG salivary levels did not differ much between smokers and non-smokers. Conclusions: Smoking has a higher impact on RANKL than on OPG salivary levels, for patients with generalized, stage III, grade B, periodontitis.

The influence of orthodontic treatment on periodontitis-susceptible patients is a subject of interest. Dental malposition caused by periodontal disease are often observed in this type of patients. Also, these patients often are undergoing orthodontic treatment in order to restore the esthetics and functions of the dental and periodontal apparatus. Thus, it is important to question and verify in what conditions and parameters the orthodontic treatment improves the status of the periodontium. This review analyses several studies concerning this important topic and highlights the parameters that influence the outcome of orthodontic treatment.

Worldwide the rate of edentulism due to an increasingly aging population is as high as 70%, according to region, country, socio-ecconomic status, etc. The habit of using a removable prosthesis, can alter the delicate ecological balance of the oral cavity can cause denture candidiasis. Chronic atrophic candidiasis, or denture candidiasis, is a common infection of the oral cavity caused by overgrowth of mainly Candida species and it affects mostly patients with an affected immune system. Risk factors for the development of this pathology can be divided in two, systemic or local. Drugs like steroids, broad spectrum antibiotics, immunosuppressives can increase the risk of oral candidiasis by suppressing cellular immunity and phagocytosis. Timely diagnosis of the ethiopathogenic pathogenic fungal microorganisms and the susceptibility to antifungal medication are crucial to the correct treatment of the infection and to implement preventive healthcare-associated strategies. Mirroring bacterial resistance, fungal infections, both non-Candida albicans but also antifungal resistant isolates have up-surged; thus, reliable diagnostic methods and new treatment modalities (utilizing novel antifungal agents or alternative therapies such as photodisinfection) are much sought-after in the management of candidiasis.

The health of periodontal tissues is the key to the long-term success of prosthetic restorations. A negative impact on it can have subgingival margins, an inaccurate marginal fit, materials that favor the accumulation of plaque and can suffer the corrosion process. All these characteristics can stimulate the appearance of a biological response, that can be translated by increased proinflammatory markers (interleukins, matrix metalloproteinases) in gingival crevicular fluid. The acquisition of the aspects that describe the relationship between the two elements mentioned above, could ensure a favorable prognosis of fixed prosthetic therapy.

Periodontal treatment of tissue defects which comprises guided tissue regeneration and mucosal plastic surgery still remains nowadays a challenge in the dental office due to the lack of absolute predictability. New treatment techniques and biomaterials have emerged in order to counteract the different risks generated by the periodontal surgical methods. 3D and 4D printing technologies offer new possibilities in terms of patient-tailored materials, with lower complications and trauma and with the promise of a more accurate treatment plan and success.

In restorative dentistry, in situ replication of intra-oral situations is based on a method of evaluating non-invasive and non-destructive scanning electron microscopy (SEM). SEM is one of the electron microscope technique that produces images of a sample by scanning the surface with a focused beam of electrons. The technique has multiple indicationsand also is suitable for investigating restorative materials, dental hard and soft tissues and their interfaces. Biomaterials are now widespread in general, either for therapeutic purposes or in the supply of missing biological structures. The environment of the oral cavity into which biomaterials are introduced is very complex. It can be variable depending on the salivary pH but also depending on the general pathology and the medication administered to the respective patients. Since its inception and introduction in dental research electron microscopy has a wide range of applications involving dental biomaterials.

Aim:The aim of this study was analyze peri-implantary marginal bone loss one year after the prosthetic load in association with body mass index (BMI) and other general favoring factors: metabolic disorder and high blood pressure (HTA). Material and Methods:One hundred and twenty-four patients attended the examination, 69 females and 59 males (mean age 54, range: 27-82 ). Patients were examined for demographic information, medical health history, diabetes, smoking, patient-reported height and weight, also the clinical (oral examination, periodontometry) and radiological evaluation. To determine the degree of peri-implantary marginal bone loss, it was used radiological measures. The measures were made one year after the prosthetic load with complying with the same sites and range of report for all the analyzed patients.The data were analyzed to observe the association between peri-implantary marginal bone loss one year after the prosthetic load in association with BMI and other general favoring factors: metabolic disorder and high blood pressure(HTA). Results: A reduced statistically association (r=0.111) was noticed in the correlation analysis between variables: peri-implantary bone loss and the body mass index(BMI>24.9) value. After analyzing the correlation between peri-implantary bone loss and the presence of general illnesses (metabolic disease, high blood pressure) it was noticed the existence of a reduced, but statistically significant, association (r=0.224). Conclusion:The correlation between peri-implantary bone loss and coexistence of general factors (general health issues, high BMI) is low in patients from the analyzed studygroupduring the period taken into consideration for evaluation and treatment.

SARS-CoV-2 was first discovered in December 2019 as the etiologic agent of a serious respiratory illness later called COVID-19 or coronavirus disease 2019. The first COVID-19 case was reported in Wuhan, China and since then, has reached a pandemic level, spreading all over the world and multiplying faster than any other respiratory disease known until now in modern times, with more than 85 million confirmed cases and almost 2 million deaths, according to the latest information from the World Health Organization (WHO). Periodontal disease is one of the most common diseases of the oral cavity that has systemic implications in the overall health homeostasis. It is an inflammatory disease that involves a series of dysbiotic events caused by periodontopathogenic microflora that causes destruction of the periodontal tissues locally, and an exacerbated proinflammatory status systemically. Diabetes mellitus, metabolic syndrome and obesity, hypertension, cardiovascular disease, chronic kidney disease, chronic obstructive pulmonary disease and autoimmune diseases have been identified as risk factors for both periodontitis and severe Covid-19 infections. These diseases have similar inflammatory pathways that are involved in the progression of these conditions, thus, it is fair to assume a pathological common link.

Lasers are used in oral surgery and periodontology liberally nowadays, however, solid therapeutic protocols are still lacking in some medical areas. An epulis is defined clinically as hyperplasia of the gingival tissues, usually situated in the proximity of the interdental papilla, however it may also occur in the edentulous ridges. Regarding the origin of this particular lesion the periodontun and the periosteum are considered principal components. In this case report we present an orthodontic patient with a recurrent fibrous epulis that was treated by ablation with a diode laser (940nm). This particular method was chosen due to the reduced treatment time and diminished intrasurgical bleeding. Furthermore, an improved gingival healing compared with classical scalpel blade surgical treatment was observed. We demonstrated that diode lasers are particularly useful tools in orthodontic patients that are predisposed to gingival hyperplasia and this treatment method has supplementary advantages compared to the classical scalpel regarding the presence and intensity of pain and postoperative discomfort