The scanned abutment file for the digital design of restorations can be either obtained directly using the intraoral scanner (IOS) or scanning the impression or the working model with the extraoral scanner (EOS). The trueness of the scanned file pertains to its effect on the accuracy of the restoration. This study aimed to compare the trueness of scan files from different intraoral scanners (IOSs) and the hybrid workflow using the E3 extraoral scanner (EOS) for ceramic restoration. The model of the mandibular right first molar was prepared for the ceramic crown, and it was scanned with the EOS in reference Standard Tessellation Language (STL) file format. The following seven experimental groups were investigated. The IOSs-iTero Element 5D (IT), Trios 4 (TF), Medit i700 (MI), Primescan (PM), Virtuo Vivo (VV)-were directly scanned on the prepared model. The silicone impression of the prepared model was scanned with EOS (IS). The working model poured from the impression was scanned with the EOS (WS). The test STL file was trimmed and superimposed on the reference STL file for the trueness assessment using Geomagic Control X. The point deviation at the surface and margin of each group were compared. The mean deviation was calculated and statistically analyzed with One-way ANOVA (α=0.05). The minimum and maximum deviation of each area were also recorded. Compared with the other groups, the impression scan group had a significantly greatest deviation (p<0.05) in surface (37.65±1.14 µm), margin (63.57±5.85 µm) and overall (50.61±3.28 µm). The WS group showed significantly greater deviation (p<0.05) in surface (23.93±1.20 µm), margin (46.18±2.00 µm) and overall (35.05±1.16 µm) than the IOS groups. In some IOS groups, the deviation was also significantly different (p<0.05). The IOS is recommended for obtaining the scanned file due to its lesser deviation when compared to the hybrid workflow. While statistical differences exist among IOSs, the clinical relevance of these differences appears minimal. If the IOS does not exist, scanning the working model is preferred over scanning impressions directly. However, further clinical validation studies are necessary to confirm this finding.
Oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm in the oral cavity, characterized by high morbidity and mortality. Various proteins, including matrix metalloproteinases (MMPs), have been investigated as potential biomarkers for diagnosing and prognosing this disease. To evaluate the utility of MMP-2, MMP-9, and the tissue inhibitor of metalloproteinase-2 (TIMP-2) as biomarkers in diagnosing and prognosing OSCC. This retrospective case-control study involved 60 cases and 30 controls from the University Hospital Fundación Santa Fe de Bogotá, part of the Colombian cohort of the InterChange/Headspace study. Saliva samples were collected using a 60-second mouth rinse with 10 mL of sterile saline solution, along with serum and oral tissue samples and clinical and sociodemographic data. MMP-9, MMP-2, and TIMP-2 concentrations in saliva were determined using ELISA, whereas tissue samples were analyzed by immunohistochemistry. MMP activity in saliva was quantified using a generic activity assay. Salivary MMP-9 and MMP-2 concentrations were significantly higher in cases than in controls, whereas no significant differences were observed for TIMP-2. ROC curve analysis showed excellent discriminatory capacity for salivary MMP-9 (AUC=0.946; sensitivity=0.817; specificity=0.867), good performance for MMP-2 (AUC=0.708; sensitivity=0.717; specificity=0.633), and lower discriminatory ability for TIMP-2 (AUC=0.630; sensitivity = 0.617; specificity=0.500). Elevated MMP-9 concentrations were observed in 33% of the serological samples. The immunohistochemistry of MMP-2, MMP-9, and TIMP-2 showed differences between cases and controls. This study highlights salivary MMP-9 and MMP-2, together with MMP activity, as biomarkers of interest for OSCC that may contribute to the understanding of disease-related molecular changes detectable by liquid biopsy. While elevated salivary levels were observed in OSCC cases when compared to controls, these findings should be interpreted as exploratory. Elevated serological MMP-9 levels were observed in a small subset of cases. However, the limited sample size and the absence of a control group in this study preclude diagnostic interpretation. Larger, well-powered, and externally validated studies are required to determine the potential clinical utility of these biomarkers.
Tinnitus is frequently reported in individuals with temporomandibular disorders (TMD), especially in the somatosensory subtype, which can be modulated by afferent input from orofacial and cervical structures. While the impact of orofacial dysfunctions on tinnitus has been explored, the potential reverse relationship remains understudied. To investigate the association between somatosensory tinnitus and orofacial myofunctional condition in individuals with TMD. An observational, cross-sectional study was conducted with 47 adults aged 18 to 45 years diagnosed with TMD and self-reported tinnitus. Participants were assessed in a university-based outpatient setting. The primary outcome was the orofacial myofunctional condition, measured using the Orofacial Myofunctional Evaluation with Scores (OMES) protocol. Additional variables included tinnitus intensity and frequency (via acuphenometry), tinnitus-related distress (Tinnitus Handicap Inventory - THI), cervical disability (Neck Disability Index - NDI), craniofacial pain and disability (Craniofacial Pain and Disability Inventory - CF-PDI), and psychological symptoms (Hospital Anxiety and Depression Scale - HADS). Data were analyzed using Spearman correlation and multiple linear regression, and adopted statistical significance was set at p<0.05. OMES scores showed negative correlations with tinnitus intensity (r=-0.353), THI, NDI, CF-PDI, and age. In the final regression model, only tinnitus intensity remained a predictor of OMES score (β =-0.356; R2=0.127, Confidence Interval -0.20 to -0.02), indicating that greater tinnitus intensity was associated with poorer orofacial myofunctional condition. These findings suggest that somatosensory tinnitus may negatively impact orofacial motor function in patients with TMD, underscoring the need for integrated and multidisciplinary assessment approaches.
This study aimed to evaluate the oral and hepatic changes, as well as the expression of caspase-8 in liver tissue damage, both associated with ligature-induced periodontitis in rats. A total of 16 female Wistar rats were divided into two groups (n=8): one received ligature around the first lower molar to promote periodontitis, and the other was the control group with no ligature. After the period of induction of the disease the animals were evaluated by clinical measures for periodontitis, euthanized, and the samples of gingival tissue, hepatic tissue, and serum were collected to the measurement of biomarkers for inflammation (myeloperoxidase), oxidative stress (glutathione, malonaldehyde, and nitrate [NO3]), liver damage and histopathological evaluation with immunohistochemistry for caspase-8. The data were expressed as mean and standard deviation for data with normal distribution or median and interquartile range for data with non-normal distribution. We used ANOVA followed by the Student-Newman-Keuls test for multiple comparisons of normally distributed data, and the Kruskal-Wallis test followed by Dunn's test for non-normally distributed data. The statistical tests were performed with GraphPad Prism Software (version 5.0), in which a p-value <0.05 was considered significant. Our study demonstrates that the group with ligature-induced periodontitis showed increased measurement of periodontal destruction, local and systemic biomarkers of inflammation as well as liver damage which we observed several hepatocytes with loss of conformation and steatosis in the periodontitis group. The histopathological evaluation evidenced the periodontitis-related steatosis and higher expression of Caspase-8 in comparison with the control group (p<0.0006). Our study demonstrates the high expression of Caspase-8 in liver damage related to ligature-induced periodontitis in rats.
Bioceramic materials are developed based on their biological properties and bioactive potential. NeoSealer Flo (NeoFlo, NuSmile, Houston) is a ready-to-use bioceramic endodontic sealer. The aim of this study was to evaluate the biocompatibility and bioactivity of NeoFlo compared to Bio-C Sealer (BC, Angelus) and AH Plus (AHP, Dentsply). The tissue reaction induced by materials in rat subcutaneous tissues was assessed at seven, 15-, 30-, and 60-days post-implantation (n=6/group). The number of inflammatory cells (ICs), fibroblasts, and osteocalcin (OCN)-labelled cells were recorded. Amorphous calcite was identified using the von Kossa method and polarized light. The data were evaluated using two-way ANOVA followed by Tukey's test, with a 5% significance level. OCN data were submitted to the Kruskal-Wallis test, with Dunn, Friedman, and Nemenyi post-hoc tests. NeoFlo capsules showed higher number of IC than BC and AHP (p<0.05) in all periods, with a reduction over time, and was considered moderate at 60 days. Moreover, significant reduction in the number of IC and an increase in the fibroblasts was accompanied by an increase in the amount of collagen in the capsules around all materials over time. Immunoexpression of OCN was only observed in the capsules of NeoFlo and BC, but the capsules of BC showed the highest values in all periods (p<0.05). In the present study, NeoFlo showed lower biocompatibility than BC, however, NeoFlo shows bioactivity in connective tissue.
This study aims to comprehensively assess the bibliometric features of articles evaluating the utilization of calcium carbonate (CaCO₃) in dentistry by conducting a bibliographic search on the Web of Science databases until March 2025. The following data were collected: number and density of citations; authorship; year, journal of publication, and impact factor; study design and theme; keywords; institution and country of origin. VOSviewer software was used to generate collaborative network maps for authors and keywords. A total of 91 highly cited articles were identified, with citation counts ranging from 123 to zero. Most articles (74%) were published after 2010, with the highest prevalence in Asia (44%), especially China (10%). The most frequent study design was in vitro (55%), primarily focused on restorative dentistry (29%) and cariology (23%). The most common keywords were "Calcium Carbonate" and "Hydroxyapatite". DeVizio W. was the most prolific author, with four publications. Bibliometric analysis highlights a growing interest in the application of calcium carbonate in dentistry, with a progressive increase in scientific output over the years. The findings underscore the global distribution of research and emphasize the relevance of this biomaterial in various dental specialties. This study reinforces several key points for research groups worldwide engaged in the development of innovative dental materials, providing valuable direction for future investigations, which remain limited in scope, especially regarding clinical applications and long-term outcomes.
Probiotics and postbiotics have emerged as promising adjunctive therapies in managing periodontal disease. Bifidobacterium animalis subsp. lactis HN019 has shown antimicrobial and immunomodulatory effects in both experimental and clinical settings when administered orally. However, the systemic impact of this strain, independent of local oral effects, remains unclear. To evaluate the systemic effects of live and heat-killed B. animalis subsp. lactis HN019 in a rat model of ligature-induced periodontitis, excluding direct contact with the oral cavity. A total of 32 Wistar rats were randomly assigned to four groups (n=8): control (C), periodontitis only (EP), periodontitis + probiotic (PRO), and periodontitis + postbiotic (POS). Periodontitis was induced by placing a cotton ligature around the cervical region of the lower right first molar, inserted into the gingival sulcus. Treatments were administered via oral gavage for 30 days before and 15 days after periodontitis induction. Alveolar bone loss and periodontal parameters were assessed using micro-computed tomography (microCT) and histomorphometric analysis. MicroCT revealed that ligature effectively induced periodontitis, reducing BV/TV and Tb.N and increasing Tb.Sp and Po.Tot. Probiotic and postbiotic treatments did not improve outcomes. Bone loss was lowest in the control group, with no differences between EP, PRO, and POS. Systemic administration of Bifidobacterium animalis subsp. lactis HN019 or its derived postbiotic resulted in no significant improvements in periodontal outcomes in this experimental model. Further investigations using integrative approaches are needed to better characterize the systemic effects of probiotics and postbiotics.
Paracoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis and related species, which are endemic to Latin America. Oral manifestations are highly relevant for diagnosis, representing the primary anatomical site biopsied for confirmation. To investigate whether the virulence of P. brasiliensis influences the levels of circulating antigen in susceptible (B10.A) and resistant (A/Sn) murine models at multiple post-infection time points. The presence of oral lesions and their correlation with antigenemia were also assessed. One-week-old female B10.A and A/Sn mice were inoculated with the P. brasiliensis lineages Pb18 or Pb265, whereas controls received sterile saline. At four, eight, 12, and 16 post-inoculation weeks, sera were collected via sub-axillary plexus incision under anesthesia. Circulating antigen levels were quantified using competitive ELISA. Specific antibody titers were determined by indirect non-competitive ELISA and P. brasiliensis antigens. Intergroup comparisons were performed using two-way ANOVA, followed by multiple comparisons. Oral cavities were visually examined by three independent evaluators to find mulberry stomatitis. Prevalence was expressed as the percentage of affected animals. Significant differences in the circulating antigen levels were detected between susceptible mice infected with Pb18 and Pb265 and between susceptible and resistant mice infected with Pb18 16 weeks after inoculation. The highest levels of antibodies were found when both B10.A and A/Sn mice were infected with Pb18. During infection, no mice showed mulberry-like lesions in the oral cavity. The virulence of the infecting P. brasiliensis strain, although not specifically linked to the gp43 antigen, plays a critical role in antigenemia. Despite absent oral lesions-an inherent limitation of this murine model-this study provides relevant insights into the relationship between fungal virulence and circulating antigen levels.
To evaluate the formation of mixed-species biofilms of Candida albicans and methicillin-sensitive Staphylococcus aureus (MSSA) on the surface of a 3D-printed denture base resin, as well as its surface properties, under varying printing parameters. Discs (n=40 per group, 10×1.2 mm) of a denture base resin (priZma 3D Bio Denture) were fabricated using two 3D-printers-Liquid Crystal Display (LCD) and Digital Light Processing (DLP)-at three different angles (0°, 45°, or 90°). Surface roughness was measured using a digital profilometer and expressed as Ra (µm). For surface energy (SE) analysis, contact angles were measured using a tensiometer. Discs were incubated at 37 °C for 90 minutes and 48 hours to enable biofilm formation using C. albicans and MSSA inocula. Cell viability was assessed by colony-forming unit (CFU/mL) counts, and metabolic activity was evaluated using the XTT assay (absorbance). Microbial counts and XTT results were analyzed by three-way ANOVA (printer type, printing angle, incubation period). Surface roughness was analyzed by two-way ANOVA (printer type, printing angle), with Tukey's test and a significance level of 0.05. For both CFU/mL and XTT assays, incubation period was the only significant factor (p<0.001 and p=0.006, respectively), while other factors and interactions were not statistically significant (p>0.05). Surface roughness was significantly influenced by printer type, printing angle, and their interaction (p=0.027). The LCD 0° and LCD 90° groups produced smoother surfaces compared with LCD 45° (p=0.002), which showed similar values to all DLP groups regardless of angle (p>0.05). The DLP printer did not show significant roughness variations across the tested angles (p>0.05). The LCD groups presented numerically lower SE values compared to the DLP groups. The LCD system performs better than DLP in reducing surface roughness at 0° and 90°. Moreover, the analyzed factors did not significantly affect microbial adhesion or the formation of mixed-species biofilms.
The oral microbiome is one of the most complex microbial ecosystems in the host. This study aimed to investigate and characterize the oral microbiome composition in Kazakhstani adolescents associated with dental caries. The study included 312 adolescents, with 241 individuals presenting with caries and 71 caries-free, aged 12-15 years. Dental caries assessment was performed using DMFT (Decayed, missed, filled teeth) index. Oral samples were collected, and 16S rRNA (16S ribosomal ribonucleic acid) gene sequencing targeting the V3-V4 hypervariable regions on an Illumina MiSeq platform was performed to profile the microbial communities. Functional metagenomic predictions were generated using PICRUSt2 v2.5.0, using the KEGG database for bacterial pathway abundance estimation. Data analysis was conducted using Python 3.9.16 and R 4.2.2. The alpha diversity was insignificant, while beta diversity analysis demonstrated clear distinctions by Bray-Curtis (F=2.5, p=0.003) and weighted UniFrac distances (F=4.4, p=0.002). The Neisseria and Prevotella genera, and Gammaproteobacteria class showed significant associations with dental caries (MaAsLin2 p≤0.05, LDA≥2), stronger predictive power (AUC=0.65, F1=0.83), and higher predicted functional activity through glutathione metabolism, RNA degradation, and unsaturated fatty acid metabolism pathways. This study identified specific oral microbiome patterns associated with dental caries in Kazakhstani adolescents, revealing interactions between key bacterial taxa and metabolic pathways.
Tooth discoloration is a frequent concern among dental patients. While many professionals and patients choose veneers or other invasive solutions, Minimal Intervention Dentistry (MID) recommends non- and microinvasive approaches to preserve tooth structure. To assess Brazilian dentists' knowledge and practices on tooth discoloration and how education and professional profile may influence them. A cross-sectional observational study was conducted with 384 volunteer dentists via an online series of questions on causes, diagnosis, treatment (per tissue removal), and professional-patient relationship. Answers were scored (1=correct/affirmative, 0=incorrect/negative). Descriptive and multivariate regression analyses were performed (α=0.05). Most respondents were female, aged 20-49, from the Southeast region. Correct answer rates: 69.9% for causes, 69.4% for diagnosis, 48.8% for treatment, 83.6% for professional-patient relationship, 56.4% overall. Graduation from public universities and holding graduate training in Operative or Pediatric Dentistry or Orofacial Harmonization were associated with better outcomes. Knowledge of non- and microinvasive approaches to tooth discoloration remains limited. Broader educational efforts are needed, especially among specific groups of professionals who showed lower performance.
To evaluate the effects of gastric administration of the highly leukotoxic Aggregatibacter actinomycetemcomitans JP2 strain (Aa JP2), with or without ligature-induced periodontitis, on periodontal and small intestinal tissues in a rat model. Forty-eight-week-old male Wistar rats were divided into four groups (n=10/group): Control (CG), Periodontitis (PG), Periodontitis and Aa JP2 (PAaG), and Aa JP2 only (AaG). Ligatures were placed in PG and PAaG on day one and maintained for 42 days. After six weeks of twice-weekly gastric Aa JP2 inoculation, mandibles and small intestines were analyzed using stereomicroscopy, micro-computed tomography (CT), and histopathology to assess alveolar bone loss, trabecular architecture, inflammatory infiltrate, vascular congestion, goblet cell density, and villus morphology. Statistical analyses included the Kruskal-Wallis, Mann-Whitney, and Chi-square tests for group comparisons (p<0.05), as well as Spearman's correlation test. PG and PAaG exhibited significantly greater bone loss compared to CG and AaG (p<0.05). Micro-CT analysis revealed reduced trabecular thickness in AaG (342.4±23.1µm) compared to PG (378.2±28.1µm) and PAaG (385.5±45.1µm) (p<0.05). PAaG and AaG presented higher inflammatory infiltrate scores (>751 inflammatory cells) compared to CG and/or PG (p<0.05). Elevated vascular congestion and/or goblet cell hyperplasia in the jejunum and ileum were observed in PAaG and AaG compared to CG and PG (p<0.05). Villus height (duodenum/ileum) and villus width (jejunum/ileum) differed significantly among groups (p<0.0001). Significant correlations were identified: the alveolar bone volume/total volume ratio was positively associated with duodenal vascular congestion (rho=0.738; p=0.037); the periodontal inflammatory infiltrate was positively associated with jejunal goblet cell counts (rho=0.704; p=0.007); alveolar bone loss was positively associated with both duodenal and jejunal villus height (rho≥0.762; p<0.05); and bone volume was negatively associated with both jejunal vascular congestion (rho=-0.696; p=0.003) and jejunal goblet cell counts (rho=-0.617; p=0.011). Gastric inoculation with Aa JP2 exacerbates ligature-induced periodontitis and independently induces intestinal morphological changes.
The incorporation of bioactive agents into resin-modified glass ionomer cement (RMGIC) is a promising strategy to improve its mechanical strength and biofilm control, especially for patients with active dental caries. This study aimed to evaluate the effects of incorporating ZnONPs and CaGP into RMGIC on its mechanical and microbiological properties. Six groups were tested: 1) RMGIC (without CaGP/ZnONPs); 2) RMGIC-1.0%ZnONPs; 3) RMGIC-2.0%ZnONPs; 4) RMGIC-3.0%CaGP; 5) RMGIC-3.0%CaGP-1.0%ZnONPs; and 6) RMGIC-3.0%CaGP-2.0%ZnONPs. The compressive strength (CS), diametral tensile strength (DTS), and surface hardness (SH) were evaluated after 24 hours and 7 days. Antimicrobial and antibiofilm activity were evaluated using agar diffusion and biofilm metabolic activity (XTT) assays. After 24 hours, all the groups showed similar DTS values (p>0.05), except for RMGIC-3.0%CaGP-1.0%ZnONPs, which showed the highest DTS value (p<0.05). Comparing 24 hours and 7 days, the DTS values of RMGIC-3.0%CaGP-2.0%ZnONPs, RMGIC-3.0%CaGP, and RMGIC-3.0%CaGP-2.0%ZnONPs were similar (p=0.360). After 24 hours, the RMGIC group showed the CS highest value, followed by RMGIC-2.0%ZnONPs (p < 0.05). After 7 days, the RMGIC-3.0%CaGP-1.0%ZnONPs group exhibited the highest CS value, approximately 15% higher than RMGIC (p<0.05). The RMGIC-1.0%ZnONPs group exhibited significantly higher SH at 24 hours (p=0.621). At 7 days, the highest SH value was observed for the RMGIC-3.0%CaGP-1.0%ZnONPs group (p<0.05). Regarding antimicrobial and antibiofilm activity, including results from biofilm metabolism assays, the RMGIC-3.0%CaGP-1.0%ZnONPs group demonstrated the most effective antimicrobial and inhibitory effects (p<0.05). This study demonstrated that adding ZnONPs and CaGP to RMGIC enhanced its mechanical and antimicrobial and antibiofilm properties, suggesting enhanced mechanical performance and improved protection against cariogenic biofilms-critical factors for successful restorative treatments. Therefore, the addition of ZnONPs and CaGP is a promising strategy to develop advanced restorative materials that improve clinical outcomes, especially for patients with active dental caries.
This study evaluated the clinical relevance of EBI3 polymorphisms, along with tumor Epstein-Barr virus (EBV) and Human Cytomegalovirus (HCMV) status, in prognostically adverse HPV-negative OSCCs. EBI3 (rs4740, rs4905, rs428253) genotyping was performed by qPCR in 95 HPV-negative OSCC patients and 108 age- and sex-matched controls. Tumor HPV, EBV, and HCMV status were assessed by qPCR. EBV viral load was calculated by exponential approach and a relative estimate of EBV copies per 105 cells. Associations with overall survival (OS) and recurrence-free survival (RFS) were evaluated by Kaplan-Meier and Cox regression analyses. EBV-positive tumors showed a significant association with increasing nodal stage (P=0.020). EBV viral load stratification (negative, low, high) presented a non-significant trend toward association with advanced tumor stage (P=0.060). Notably, EBI3 rs428253 predicted worse OS in EBV-positive patients, whereas rs4740 and rs4905 variants were associated with advanced tumor stage (P=0.024 and P=0.018). rs4740 and rs4905 variants were inversely associated with OSCC risk in dominant and overdominant models. Analysis detected HCMV in 7.4% of tumors but was not clinically relevant. EBI3 genetic variants and EBV status may have prognostic relevance in HPV-negative OSCC. EBV may interact with the host genetics to influence nodal metastases and outcomes, suggesting a potential EBV-EBI3 axis, which warrants further investigation. Future precision oncology approaches may incorporate host and viral genetic markers to identify and stratify high-risk HPV-negative OSCC patients.
This study aimed to evaluate the capacity of fibroblasts from permanent and deciduous dental pulp to express inflammatory mediators when exposed to bacterial and inflammatory antigens. It also sought to assess the presence of components of the renin-angiotensin system (RAS) and the potential modulatory role of ANG-II in this response. Fibroblasts were cultured from the pulp of permanent and deciduous teeth obtained from three adult and four pediatric donors with informed consent. Cells were stimulated with Porphyromonas gingivalis and Escherichia coli lipopolysaccharides (LPS) either alone or in combination with ANG-II and, in some cases, with IL-1β. Gene expression of RAS components and various inflammatory mediators was analyzed by qRT-PCR. ANG-II receptor expression was quantified by flow cytometry. The results showed that both bacterial antigens and IL-1β significantly upregulated the expression of genes encoding key inflammatory mediators. However, ANG-II, either alone or in combination with other antigens, failed to alter the expression levels of these mediators. These findings clearly show that ANG-II has no influence on the expression of inflammatory mediators by human dental pulp fibroblasts under the tested conditions.
To investigate the effects of different types of impacted mandibular third molar (IMTM) on lesions in situ and on adjacent tissues at different ages. Cone Beam Computed Tomography (CBCT) images of 1007 IMTM cases were retrospectively analyzed. Associations between age, gender, impaction type, distal alveolar bone condition of mandibular second molar (MSM), IMTM-MSM contact status and occurrence of lesions on IMTM and its adjacent tissues were evaluated using Pearson's chi-squared test and Fisher's exact test. MSM distal alveolar bone defects showed the highest incidence among all IMTM-related lesions (79.2%), followed by MSM distal external root resorption (ERR) (25.5%) and MSM distal caries (10.4%). Mesioangular (96.2%, p<0.001) and horizontal (95.9%, p<0.001) IMTM were associated with more severe bone defects and the incidence increased with age. IMTM-MSM surface-to-surface contact was significantly associated with MSM distal caries severity (12.5%, p<0.001) and distal ERR (29.5%, p<0.001). Inflammatory resorption of MSM distal alveolar bone was significantly correlated with MSM distal caries (47.1%, p<0.001), ERR (36.5%, p<0.05), distal alveolar bone defects (100%, p<0.001), and IMTM caries (14.1%, p<0.05). Study design followed the STROBE guidelines. Mesioangular impaction, horizontal impaction, MSM-IMTM surface-to-surface contact, and MSM distal alveolar bone in a state of inflammatory resorption greatly affect lesions on IMTM and its surrounding tissues. These findings suggest the prophylactic extraction in young adults (18-25 years) with high-risk impactions, while recommending observation or cautious management for asymptomatic older patients without signs of inflammatory bone resorption.
Gingival recession is characterized by the apical displacement of the marginal gingiva, exposing the root surface and causing aesthetic and functional issues such as dentin hypersensitivity and cervical lesions. Subepithelial connective tissue grafts (SCTG) are considered the gold standard for root coverage. Recently, ozone-enriched advanced platelet-rich fibrin (A-PRF) has emerged as a promising alternative due to its regenerative potential and biocompatibility. To compare the clinical efficacy of ozone-enriched A-PRF and SCTG combined with the coronally advanced flap (CAF) technique to treat Cairo Class I gingival recessions. This randomized, double-blind, controlled clinical trial included 22 healthy patients (mean age 32.23±11.86 years, range 20-60 years), each with bilateral Cairo Class I recessions. Sites were treated with either CAF + SCTG (control) or CAF + ozone-enriched A-PRF (test). Clinical parameters were assessed at baseline, 90, and 180 days. Data were analyzed using the Shapiro-Wilk, repeated measures ANOVA, Tukey, and Friedman tests (α=0.05) on GraphPad Prism 8.0®. This study adhered to the CONSORT guidelines for randomized clinical trials. Complete root coverage (100%) was achieved in 13 of 22 sites (60%) in the SCTG group and in nine of 22 cases (43%) in the ozone-enriched A-PRF group. Both groups statistically and significantly improve over time in selected clinical parameters (p<0.05). The SCTG group showed significant gains in all evaluated outcomes, whereas the ozone-enriched A-PRF group showed significant improvements in clinical attachment level, recession height, recession width, and dentin hypersensitivity. SCTG more greatly increased gingival thickness (0.77±0.52 mm) and keratinized tissue width (0.81±0.95 mm) than ozone-enriched A-PRF (0.27±0.55 mm and 0.22±0.42 mm, respectively). Both treatment approaches effectively managed Cairo Class I gingival recessions. SCTG promoted superior soft tissue augmentation, whereas ozone-enriched A-PRF achieved comparable reductions in recession-related parameters. The limitations of this study include its short follow-up period and the absence of histological assessment. Clinical Trial Register: RBR-537bzqt.
This study investigates the role of peroxisome proliferator-activated receptor alpha (PPARα) in regulating macrophage polarization and inflammatory signaling under stimulation by periodontal pathogens. THP-1-derived macrophages were stimulated with Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) in the presence or absence of PPARα agonists fenofibrate and WY14643, or the antagonist GW6471. Protein expression levels of TNF-α, IL-10, and phosphorylated NF-κB were assessed by Western blot. Immunofluorescence staining was used to evaluate IL-10, NF-κB, and CD36 expression. Flow cytometry quantified changes in macrophage polarization markers, including CD14+CD86+ (M1) and CD68+CD206+/CD163+ (M2) populations. THP-1 cells transfected with a secreted embryonic alkaline phosphatase (SEAP) reporter plasmid were treated with Pg-LPS (1 μg/mL) ± fenofibrate (50 μM) to assess NF-κB/AP-1 activity. PPARα reporter cells were treated with increasing concentrations of GW590735 or WY14643 and exposed to TNF-α, LPS, or GW6471+LPS to evaluate PPARα transcriptional activity. PPARα activation by fenofibrate reduced TNF-α expression in Pg-LPS-stimulated macrophages and attenuated NF-κB signaling via both TLR2 and TLR4 pathways. Fenofibrate significantly increased IL-10 and CD36 expression, inhibited Pg-LPS-induced NF-κB nuclear translocation, and promoted a phenotypic shift from pro-inflammatory M1 to anti-inflammatory M2 macrophages. Moreover, inflammatory stimuli such as TNF-α and LPS suppressed PPARα activity, which could be restored by potent PPARα agonists. These findings suggest that PPARα activation modulates macrophage polarization and suppresses inflammatory signaling in response to periodontal bacterial antigens.
Streptococcus mutans serotypes (c, e, f, k) are linked to dental caries, with less common serotypes (e, f, k) and collagen-binding genes (CBG: cnm and cbm) suggested to be associated with cardiovascular diseases. This study investigated the presence of S. mutans serotypes and collagen-binding genes (CBGs) in dental plaque and their possible association with acute myocardial infarction (AMI) in adults. A total of 31 infarcted and 17 non-infarcted patients underwent oral and blood examinations. DNA from plaque samples was analyzed using PCR to identify S. mutans serotypes and cnm/cbm genes. S. mutans was detected in 22.6% (7/31) of infarcted patients and 11.8% (2/17) of non-infarcted patients. Serotype c was the most prevalent in infarcted patients (57.1%, 4/7), followed by e (42.9%, 3/7) and k (14.3%, 1/7); serotype f was not detected. Only serotype c was found in non-infarcted patients. Less common serotypes (e, k) and co-occurring serotypes (c, k) were exclusive to infarcted patients. No CBGs were detected in any serotypes. No association was found between S. mutans and dental caries in either group. Patients with cholesterol levels <190 mg/dL and no S. mutans had a 47.4% lower risk of infarction. Although S. mutans, including less common serotypes, was more prevalent in infarcted patients, no significant association with AMI was observed. Further research is needed to elucidate the role of S. mutans in cardiovascular diseases.
This study aimed to compare the mechanical, biological, and structural properties of a leukocyte- and platelet-rich fibrin (L-PRF) membrane in periodontally healthy patients and those with periodontitis. A total of 30 individuals (17 men and 13 women) with a median age of 41 years were divided into two groups as periodontally healthy (control group) and as having periodontitis (test group). Blood samples were collected and centrifuged at 2700 rpm for 12 minutes. A tensile test was performed to determine the mechanical properties of L-PRF membranes. Elasticity-modulus, tensile strength, and stretch at rupture were calculated. Platelet and leucocyte counts and ratios were calculated. Fibril thickness and density were evaluated by scanning electron microscopy imaging. The comparisons between groups were analyzed by the Mann-Whitney U test, and a p<0.05 value was considered statistically significant. In the comparison of the control group versus the test group, pocket depth (3.55 (1.59-3.97) vs. 1.52 (1.47-3.53)), clinical attachment level (3.11 (1.77-4.23) vs. 0.06 (0.05-3.68)), plaque index (1.63 (0.05-1.75) vs. 0.04 (0.04-1.58)), gingival index (1.55 (0.04-1.63) vs. 0.05 (0.04-1.49)), and bleeding on probing (56.25 (3.7-70.11) vs. 3.57 (2.67-47.12)) were statistically significantly higher in the test group than in the control group (p= 0.009, p=0.008, p=0.008, p=0.009, p=0.009, respectively). Elasticity-modulus, tensile strength, and stretch at rupture values showed no statistically significantly differences between groups (p=0.745, p=0.754, p=0.602, respectively). Fibril thickness and density values showed no statistically significant differences between groups (p=1.000, p=0.753, respectively). Platelet count and platelet and leukocyte ratio values showed no statistically significant differences between groups (p=0.754, p=0.600, p=0.142, respectively). Leukocyte count was found to be statistically significantly higher in the control group than in the test group (p=0.028). This study showed no effect of Stage I-II periodontitis on the mechanical, structural, and biological properties of L-PRF. Further studies with larger sample sizes are required to confirm these findings.