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Dentistry Journal
Special Issues
Periodontal Health: Disease Prevention and Treatment
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Periodontal Health: Disease Prevention and Treatment

A special issue of Dentistry Journal (ISSN 2304-6767). This special issue belongs to the section "Oral Hygiene, Periodontology and Peri-implant Diseases".

Deadline for manuscript submissions: 20 January 2025 | Viewed by 31569
Please submit your paper and select the Journal "Dentistry Journal" and the Special Issue "Periodontal Health: Disease Prevention and Treatment" via: https://susy.mdpi.com/user/manuscripts/upload?journal=dentistry Please contact the Managing Editor Ms. Adele Min ([email protected]) before submitting.

Special Issue Editor

Prof. Dr. Ioannis D. Vouros

E-Mail Website
Guest Editor
Department of Preventive Dentistry Periodontology and Implant Biology, Dental Faculty, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
Interests: clinical periodontology; implant dentistry; periodontal regeneration; evidence based dentistry; peri-implant diseases; Lasers in dentistry

Special Issue Information

Dear Colleagues,

Periodontal health is a conditio sine qua non for the rehabilitation of the oral cavity and should be established before any other restorative treatment is initiated. Considering this, the clinician should be capable of taking all the necessary measures to achieve and maintain optimal health, function and esthetics in periodontal tissues. It is beyond doubt that the primary etiologic factor of periodontal disease is biofilm and the residing periodontopathic bacteria. Moreover, a large body of scientific evidence has documented the involvement of other aspects such as genetic factors, systemic diseases and other endogenous and environmental factors modifying the host response to periodontal inflammation.

Nowadays, it is widely accepted that periodontal diseases are preventable. Recent advances in research have indicated that a number of strategies may be implemented to prevent these diseases, but only if routinely applied. However, we should mention that even though most preventive strategies seem to be simple and their employment in practice at individual and public health levels may be considered a routine, this is not the case.

Taking the above into account, the first aim of the present Special Issue is to provide evidence-based knowledge and new ideas supporting the implementation of protocols and strategies for the prevention of periodontal disease.

Conventional non-surgical mechanical treatment is undoubtedly the cornerstone of periodontal therapy and has been proven to lead to infection control and to an oral environment corresponding to periodontal health. Nevertheless, novel approaches targeting host response alteration such as nutrition habits, probiotics, anti-oxidant agents and new-generation chemotherapeutics may be new tools for periodontal disease management. Hence, an additional scope of the present Special Issue is the presentation of clinical as well as basic research findings supporting the implementation of modern technology and innovated therapeutical approaches for a more patient-orientated treatment plan in periodontal therapy.

Given all the above, it is my pleasure to invite you to submit your work, either research or narrative reviews, for publication in the upcoming Special Issue of the Dentistry Journal.

Prof. Dr. Ioannis D. Vouros
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Dentistry Journal is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • periodontal disease
  • periodontal disease prevention
  • non-surgical periodontal therapy
  • periodontal disease etiology
  • periodontal disease epidemiology
  • novel approach periodontal therapy
  • probiotic periodontal therapy
  • antimicrobial periodontal treatment
  • patient-orientated periodontal treatment

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Published Papers (14 papers)

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18 pages, 3338 KiB  
Article
A Synthetic Small Molecule, LGM2605: A Promising Modulator of Increased Pro-Inflammatory Cytokine and Osteoclast Differentiation by Aggregatibacter actinomycetemcomitans Cytolethal Distending Toxin
by Taewan J. Kim, Andrew S. MacElroy, Aleena Defreitas, Bruce J. Shenker and Kathleen Boesze-Battaglia
Dent. J. 2024, 12(7), 195; https://doi.org/10.3390/dj12070195 - 26 Jun 2024
Viewed by 1009
Abstract
Our research explores the interplay between Aggregatibacter actinomycetemcomitans (Aa) cytolethal distending toxin (Cdt) and the host’s inflammatory response in molar/incisor pattern periodontitis (MIPP). Cdt disrupts phosphatidylinositol-3,4,5-triphosphate (PIP3) signaling, influencing cytokine expression through canonical and non-canonical inflammasome activation as well as nuclear [...] Read more.
Our research explores the interplay between Aggregatibacter actinomycetemcomitans (Aa) cytolethal distending toxin (Cdt) and the host’s inflammatory response in molar/incisor pattern periodontitis (MIPP). Cdt disrupts phosphatidylinositol-3,4,5-triphosphate (PIP3) signaling, influencing cytokine expression through canonical and non-canonical inflammasome activation as well as nuclear factor-κB (NF-κB) activation, leading to inflammation in MIPP. THP-1 differentiated macrophages (TDMs) exposed to Cdt exhibited an upregulation of pro-inflammatory genes and subsequent cytokine release. We analyzed the ability of a small molecule therapeutic, LGM2605, known for its anti-inflammatory properties, to reduce pro-inflammatory gene expression and cytokine release in Cdt-exposed and Aa-inoculated TDMs. LGM2605’s mechanism of action involves inhibiting NF-κB while activating the Nrf2–transcription factor and antioxidants. Herein, we show that this small molecule therapeutic mitigates Cdt-induced pro-inflammatory cytokine expression and secretion. Our study also further defines Cdt’s impact on osteoclast differentiation and maturation in MIPP. Cdt promotes increased TRAP+ cells, indicating heightened osteoclast differentiation, specific to Cdt’s phosphatase activity. Cathepsin K levels rise during this process, reflecting changes in TRAP distribution between control and Cdt-treated cells. Exploring LGM2605’s effect on Cdt-induced osteoclast differentiation and maturation, we found TRAP+ cells significantly reduced with LGM2605 treatment compared to Cdt alone. Upon LGM2605 treatment, immunocytochemistry revealed a decreased TRAP intensity and number of multinucleated cells. Moreover, immunoblotting showed reduced TRAP and cathepsin K levels, suggesting LGM2605’s potential to curb osteoclast differentiation and maturation by modulating inflammatory cytokines, possibly involving Nrf2 activation. In summary, our research reveals the intricate connections between Cdt, pro-inflammatory cytokines, and osteoclast differentiation, offering novel therapeutic possibilities for managing these conditions. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Graphical abstract

Graphical abstract
Full article ">Figure 1
<p>LGM2605 decreases Cdt-mediated upregulation of cytokine gene expression. TDM were pre-treated with increasing doses of LGM2605 for 30 min and 100 ng/mL of Cdt was added for 2 h. RNA was extracted and quantitative real-time PCR performed for pro-IL-1β, IL-6, and TNF-α and fold increase was calculated by normalization with a housekeeping gene (GAPDH) and compared to an untreated control (no Cdt and LGM2605 treatments). Data represent three independent experiments with technical triplicate. Statistical significance was determined using one-way ANOVA. ** denotes <span class="html-italic">p</span>-value &lt; 0.01 and *** denotes <span class="html-italic">p</span>-value &lt; 0.005 for Cdt only (0 uM LGM2605) vs. different doses of LGM2605.</p> Full article ">Figure 2
<p>LGM2605 decreases Cdt-induced pro-inflammatory cytokines. TDM were pre-treated with increasing doses of LGM2605 for 30 min and Cdt (increasing concentrations) was added for 5 h. Supernatants were collected and analyzed by ELISA specific for IL-1β (Panel (<b>A</b>)), IL-6 (Panel (<b>B</b>)), and TNF-α (Panel (<b>C</b>)). Cytokines were undetectable in the absence of Cdt. Data represent three independent experiments with technical triplicate for ELISA. Statistical significance was determined using two-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05, ** denotes <span class="html-italic">p</span>-value &lt; 0.01, *** denotes <span class="html-italic">p</span>-value &lt; 0.005, and **** denotes <span class="html-italic">p</span>-value &lt; 0.0001 for 0 uM LGM2605 vs. a different dose of LGM2605 within same concentration Cdt-treated group.</p> Full article ">Figure 3
<p>LGM2605 decreases <span class="html-italic">Aa</span>-induced inflammation. TDM were pre-treated with LGM2605 in increasing doses (25, 50, and 100 μM) for 30 min and inoculated with mid-log phase <span class="html-italic">Aa</span> (MOI of 1:10 and 1:100) for 4 h. Supernatants were collected and analyzed by ELISA specific for IL-1β (Panel (<b>A</b>)), IL-6 (Panel (<b>B</b>)), and TNF-α (Panel (<b>C</b>)). Data represent three independent experiments with technical triplicates for ELISA. Statistical significance was determined using two-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05, and **** denotes <span class="html-italic">p</span>-value &lt; 0.001 for 0 uM LGM2605 vs. a different dose of LGM2605 within same MOI group.</p> Full article ">Figure 3 Cont.
<p>LGM2605 decreases <span class="html-italic">Aa</span>-induced inflammation. TDM were pre-treated with LGM2605 in increasing doses (25, 50, and 100 μM) for 30 min and inoculated with mid-log phase <span class="html-italic">Aa</span> (MOI of 1:10 and 1:100) for 4 h. Supernatants were collected and analyzed by ELISA specific for IL-1β (Panel (<b>A</b>)), IL-6 (Panel (<b>B</b>)), and TNF-α (Panel (<b>C</b>)). Data represent three independent experiments with technical triplicates for ELISA. Statistical significance was determined using two-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05, and **** denotes <span class="html-italic">p</span>-value &lt; 0.001 for 0 uM LGM2605 vs. a different dose of LGM2605 within same MOI group.</p> Full article ">Figure 4
<p>Cdt dose-dependent increase in osteoclast differentiation. THP-1 monocytes treated with PMA for 2 days and osteoclast differentiation induced with RANKL and M-CSF (50 ng/mL each) for 6 days with increasing doses of Cdt (6.25, 12.5, 25, and 50 ng/mL). At the last day, TRAP staining was conducted and TRAP + TDO were counted. Data represent three independent experiments. Statistical significance was determined using one-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05 and ** denotes <span class="html-italic">p</span>-value &lt; 0.01 for the control (RANKL + M-CSF only) vs. different concentration Cdt-treated groups.</p> Full article ">Figure 5
<p>Phosphatase-dependent increase in osteoclast differentiation induced by Cdt. THP-1 monocytes underwent differentiation into macrophages using a high concentration of PMA (100 ng/mL). Osteoclast differentiation was initiated by exposing cells to RANKL and M-CSF (50 ng/mL each) for six days, with media replenishment every 48 h. Cdt treatments ((<b>A</b>) 50 ng/mL and (<b>B</b>) 500 ng/mL) for both Cdt<sup>R117A</sup> and Cdt<sup>WT</sup> were introduced concurrently with RANKL and M-CSF. At the endpoint, TRAP staining was conducted, and TRAP + TDO were quantified. The presented data are representative of three independent experiments. Statistical significance was determined using one-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05 for the control (RANKL + M-CSF only) compared to Cdt (Cdt<sup>R117A</sup> and Cdt<sup>WT</sup>) -treated groups.</p> Full article ">Figure 6
<p>LGM2605 reduces Cdt-mediated increases in osteoclast differentiation. First, THP-1 monocytes were treated with a high PMA concentration (100 ng/mL). Before RANKL and M-CSF (50 ng/mL each) induced TDO differentiation with or without Cdt treatment (50 ng/mL) for 6 days, THP-1 cells were pretreated with different concentrations of LGM2605 (25, 50, and 100 μM) for 30 min in media. Media with RANKL and M-CSF replenishment every 48 h was used with and without Cdt and LGM2605. TRAP staining was conducted at the 6th day of differentiation and TRAP+ cells were counted for three independent experiments. Data represent three independent experiments with technical triplicates. Statistical significance was determined using one-way ANOVA. * denotes <span class="html-italic">p</span>-value &lt; 0.05 and ** denotes <span class="html-italic">p</span>-value &lt; 0.01 for Cdt-treated vs. Cdt + LGM2605-treated groups. *** denotes <span class="html-italic">p</span>-value &lt; 0.005 for control vs. all other groups.</p> Full article ">Figure 7
<p>Impact of Cdt and LGM2605 on osteoclast maturation. THP-1 cells underwent treatment with a high concentration of PMA (100 ng/mL) for two days before osteoclast differentiation using RANKL and M-CSF (50 ng/mL each) for six days. PMA-treated cells were pretreated with 100 μM LGM2605 for 30 min before differentiation and Cdt (50 ng/mL) was added with differentiation media. Media replenishment with RANKL and M-CSF, with or without Cdt and LGM2605, occurred every 48 h. Immunostaining for TRAP, cathepsin K (CTSK), and nuclei was performed, followed by multi-fluor confocal imaging as detailed in the <a href="#sec2-dentistry-12-00195" class="html-sec">Section 2</a>. (<b>A</b>) Maximum intensity projection images depict control (only RANKL- and M-CSF-induced differentiation), Cdt treatment (50 ng/mL), and Cdt (50 ng/mL) + LGM2605 (100 μM) treatment for TRAP (<b>left</b>) and CTSK (<b>right</b>) in green, with nuclei in blue. (<b>B</b>) Quantification of TRAP (<b>left</b>) and CTSK (<b>right</b>) fluorescence intensity presented as a percentage relative to the control. Results are expressed as mean ± STDEV (five fields per condition) and compared using one-way ANOVA. Statistical significance indicated by *, <span class="html-italic">p</span>-value &lt; 0.05; **, <span class="html-italic">p</span>-value &lt; 0.01; ***, <span class="html-italic">p</span>-value &lt; 0.005; and ****, <span class="html-italic">p</span>-value &lt; 0.001 vs. other conditions. (<b>C</b>) Percentage of two nuclei per cell (<b>left</b>) and three or more nuclei per cell (<b>right</b>) in each condition. The number of nuclei per cell was counted from confocal images and calculated as a percentage of whole population per condition. Graphs displaying cells with two nuclei per cell and three or more nuclei per cell were generated to represent maturation. Mean ± STDEV (five fields per condition) and statistical comparisons using one-way ANOVA. **, <span class="html-italic">p</span>-value &lt; 0.01 vs. other conditions.</p> Full article ">Figure 8
<p>LGM2605 mitigates Cdt-induced osteoclast differentiation markers. THP-1 monocytes were initially treated with a high concentration of PMA (100 ng/mL) for two days. Subsequently, TDO differentiation was induced by RANKL and M-CSF (50 ng/mL each) for six days, with or without concurrent treatment of Cdt (50 ng/mL) after pretreating PMA-treated THP-1 cells with 100 μM LGM2605 for 30 min. Media containing RANKL and M-CSF, with or without Cdt and LGM2605, was replenished every 48 h. Lysates were collected and subjected to Western blot analysis as described in the <a href="#sec2-dentistry-12-00195" class="html-sec">Section 2</a>. (<b>A,B</b>) Quantitative data depict the mean ± STDEV of TRAP (<b>A</b>) and CTSK (<b>B</b>) levels, presented as a percentage relative to the untreated control. Data represent three independent experiments and are compared using one-way ANOVA. *, <span class="html-italic">p</span>-value &lt; 0.05 compared to other conditions; **, <span class="html-italic">p</span>-value &lt; 0.01. (<b>C</b>) Representative immunoblot images demonstrating TRAP and CTSK staining, with GAPDH used as an internal normalization protein.</p> Full article ">
16 pages, 798 KiB  
Article
Clinical Study on the Implications of Immunological Markers in the Diagnosis of Periodontitis in People with Diabetes Mellitus
by Andreea Dinu and Oana Raluca Antonescu
Dent. J. 2024, 12(6), 149; https://doi.org/10.3390/dj12060149 - 21 May 2024
Viewed by 972
Abstract
The basic idea from which the working hypothesis for this study started is the fact that the only systemic disease today that is clearly linked to periodontal disease by biochemical mechanisms is diabetes mellitus, as well as the clinical finding that diabetes causes [...] Read more.
The basic idea from which the working hypothesis for this study started is the fact that the only systemic disease today that is clearly linked to periodontal disease by biochemical mechanisms is diabetes mellitus, as well as the clinical finding that diabetes causes a number of specific periodontal changes. Highlighting the biochemical markers of inflammation during periodontal disease in patients diagnosed with type 2 diabetes is the main aim of the study. To achieve this objective, we used the human ELISA kit from Boster Biological Technology Co., Ltd. (Pleasanton, CA, USA), for the detection of IL-1β, IL-4, IL-8 and TNF-α. The data analysis shows that plasma levels of these cytokines are associated with the progression of periodontitis. In conclusion, we can state that the involvement of immunological markers is evident in the pathogenesis of periodontal disease. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Figure 1

Figure 1
<p>Graphic representation of the mean differences between the age categories: (<b>a</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-1 (<span class="html-italic">p</span> &gt; 0.05), (<b>b</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-4 (<span class="html-italic">p</span> &gt; 0.05), (<b>c</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-8 (<span class="html-italic">p</span> &lt; 0.05), (<b>d</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding TNFα (<span class="html-italic">p</span> &gt; 0.05).</p> Full article ">Figure 1 Cont.
<p>Graphic representation of the mean differences between the age categories: (<b>a</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-1 (<span class="html-italic">p</span> &gt; 0.05), (<b>b</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-4 (<span class="html-italic">p</span> &gt; 0.05), (<b>c</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding IL-8 (<span class="html-italic">p</span> &lt; 0.05), (<b>d</b>) Differences between the age categories 30 and 40 and 51 and 60 regarding TNFα (<span class="html-italic">p</span> &gt; 0.05).</p> Full article ">Figure 2
<p>Graphical representation for cytokine values according to periodontal disease stages: (<b>a</b>) Differences relating to IL-1, (<b>b</b>) Differences relating to IL-4, (<b>c</b>) Differences relating to IL-8, (<b>d</b>) Differences relating to TNFα. (<span class="html-italic">p</span> &lt; 0.05).</p> Full article ">
10 pages, 3587 KiB  
Article
Effect of Dentifrice Ingredients on Volume and Vitality of a Simulated Periodontal Multispecies Biofilm
by Jelena Karacic, Moritz Ruf, Johannes Herzog, Monika Astasov-Frauenhoffer and Philipp Sahrmann
Dent. J. 2024, 12(5), 141; https://doi.org/10.3390/dj12050141 - 13 May 2024
Viewed by 3121
Abstract
The aim of this in vitro study was to investigate the effect of different toothpaste ingredients on biofilm volume and vitality in an established non-contact biofilm removal model. A multi-species biofilm comprising Porphyromonas gingivalis, Streptococcus sanguinis, and Fusobacterium nucleatum was grown [...] Read more.
The aim of this in vitro study was to investigate the effect of different toothpaste ingredients on biofilm volume and vitality in an established non-contact biofilm removal model. A multi-species biofilm comprising Porphyromonas gingivalis, Streptococcus sanguinis, and Fusobacterium nucleatum was grown on protein-coated titanium disks. Six disks per group were exposed to 4 seconds non-contact brushing using a sonic toothbrush. Four groups assessed slurries containing different ingredients, i.e., dexpanthenol (DP), peppermint oil (PO), cocamidopropyl betaine (CB), and sodium hydroxide (NaOH), one positive control group with the slurry of a toothpaste (POS), and a negative control group with physiological saline (NEG). Biofilm volume and vitality were measured using live-dead staining and confocal laser scanning microscopy. Statistical analysis comprised descriptive statistics and inter-group differences. In the test groups, lowest vitality and volume were found for CB (50.2 ± 11.9%) and PO (3.6 × 105 ± 1.8 × 105 µm3), respectively. Significant differences regarding biofilm vitality were found comparing CB and PO (p = 0.033), CB and NEG (p = 0.014), NaOH and NEG (p = 0.033), and POS and NEG (p = 0.037). However, no significant inter-group differences for biofilm volume were observed. These findings suggest that CB as a toothpaste ingredient had a considerable impact on biofilm vitality even in a non-contact brushing setting, while no considerable impact on biofilm volume was found. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Figure 1

Figure 1
<p>Representative images by confocal laser scanning microscope (CLSM). Red indicates cells considered to be dead and green alive cells. (<b>a</b>) Dexpanthenol (DP), (<b>b</b>) peppermint oil (PO), (<b>c</b>) cocamidopropyl betaine (CB), (<b>d</b>) sodium hydroxide (NaOH), (<b>e</b>) positive control group with original toothpaste (POS), (<b>f</b>) negative control group with NaCl (NEG).</p> Full article ">Figure 2
<p>Overall biofilm volume (µm) after non-contact brushing for 4 seconds with a brushing distance (artificial tooth-to-bristle) of 0 mm, a toothbrush angulation of 45° and a simulated interdental space width of 1 mm: mean volumes from the independent experiments (<span class="html-italic">n</span> = 36) for group dexpanthenol (DP), peppermint oil (PO), cocamidopropyl betaine (CB), sodium hydroxide (NaOH), positive control group with original toothpaste (POS), and negative control group with NaCl (NEG). The boxplots indicate interquartile ranges (IQRs), the horizontal line indicate the medians, and the whiskers show the full range of values. No statistically significant inter-group differences were found (Kruskal–Wallis test with significance level of 0.05).</p> Full article ">Figure 3
<p>Overall biofilm vitality (%) after non-contact brushing for 4 seconds with a brushing distance (artificial tooth-to-bristle) of 0 mm, a toothbrush angulation of 45° and a simulated interdental space width of 1 mm: mean volumes from the independent experiments (<span class="html-italic">n</span> = 36) for group dexpanthenol (DP), peppermint oil (PO), cocamidopropyl betaine (CB), sodium hydroxide (NaOH), positive control group with original toothpaste (POS), and negative control group with NaCl (NEG). The boxplots indicate interquartile ranges (IQRs), the horizontal line indicate the medians, and the whiskers show the full range of values. The ° symbol represents an outlier greater than twice the median value. The statistically significant inter-group differences between CB and PO, CB and NEG, NaOH and NEG, and POS and NEG (Kruskal–Wallis test, <span class="html-italic">p</span> &lt; 0.05) are indicated by *.</p> Full article ">
17 pages, 2631 KiB  
Article
Assessing the Antioxidant Benefits of Topical Carvacrol and Magnolol Periodontal Hydrogel Therapy in Periodontitis Associated with Diabetes in Wistar Rats
by Georgiana Ioana Potra Cicalău, Gabriela Ciavoi, Ioana Scrobotă, Andreea Olivia Marcu, Ioana Romanul, Eleonora Marian, Laura Grațiela Vicaș and Mariana Ganea
Dent. J. 2023, 11(12), 284; https://doi.org/10.3390/dj11120284 - 8 Dec 2023
Cited by 2 | Viewed by 1974
Abstract
It is well recognized that oxidative stress contributes to chronic stress-induced cytotoxicity, which is a major factor in the progression of many diseases, including periodontitis and diabetes. Formulas based on natural extracts with antioxidant properties are alternative treatment perspectives in the management of [...] Read more.
It is well recognized that oxidative stress contributes to chronic stress-induced cytotoxicity, which is a major factor in the progression of many diseases, including periodontitis and diabetes. Formulas based on natural extracts with antioxidant properties are alternative treatment perspectives in the management of such diseases. The aim of our study was to assess how carvacrol and magnolol influence periodontitis associated with diabetes in Wistar rats. Ninety Wistar rats were distributed in nine groups: I—control group; II—diabetes group (D); III—periodontitis group (P); IV—periodontitis and diabetes group (PD); V—periodontitis and diabetes with vehicle alone (PDV); VI—periodontitis and diabetes treated with carvacrol (PDC); VII—periodontitis and diabetes treated with magnolol (PDM); VIII—periodontitis and diabetes treated with carvacrol and magnolol (PDCM); IX—healthy group with vehicle alone (CV). Blood malondialdehyde (MDA) levels and catalase activity levels (CAT) were measured as indicators of oxidative stress and antioxidant capacity, respectively. Where diabetes and periodontitis were induced, MDA was augmented and CAT was depleted significantly. Whether given alone (PDM) or in combination with carvacrol (PDCM), magnolol significantly decreased MDA. Between the PDM group and the PDCM group, there were no notable differences. In Wistar rats with periodontitis related to diabetes, topical use of hydrogels containing magnolol, either alone or in combination with carvacrol, may reduce oxidative stress. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Figure 1

Figure 1
<p>Schematic representation of the preparation of carvacrol hydrogels.</p> Full article ">Figure 2
<p>The percentage of carvacrol released in phosphate tampon: orange—hydrogel 1, yellow—hydrogel 2 and in mixture phosphate tampon-alcohol: green—hydrogel 1, brown—hydrogel 2.</p> Full article ">Figure 3
<p>The percentage of carvacrol released. (<b>A</b>) in phosphate tampon: orange—hydrogel 1, yellow—hydrogel 2; (<b>B</b>) in mixture phosphate tampon-alcohol: green—hydrogel 1, blue—hydrogel 2.</p> Full article ">Figure 4
<p>The percentage of magnolol released in phosphate tampon: green—hydrogel 3, blue—hydrogel 4 and in mixture phosphate tampon-alcohol: yellow—hydrogel 3, dark green—hydrogel 4.</p> Full article ">Figure 5
<p>Percentage of magnolol released; (<b>A</b>) in phosphate tampon: green—hydrogel 3, blue—hydrogel 4; (<b>B</b>) in mixture phosphate tampon-alcohol: blue—hydrogel 3, orange—hydrogel 4. When attempting to induce the diabetes, after streptozotocin administration we obtained a median value of glycemia of 300 ± 50 mg/dL. The values were not significantly modified after the hydrogels’ treatment.</p> Full article ">Figure 6
<p>Mean blood MDA and CAT values for all groups of rats.</p> Full article ">
10 pages, 856 KiB  
Article
Periodontal Disease and Nonsurgical Periodontal Therapy on the OHRQoL of the Patient: A Pilot Study of Case Series
by María José Moya-Villaescusa, Arturo Sánchez-Pérez, Jesús Esparza-Marín, Alfonso Jornet-García and José María Montoya-Carralero
Dent. J. 2023, 11(4), 94; https://doi.org/10.3390/dj11040094 - 3 Apr 2023
Cited by 3 | Viewed by 2302
Abstract
The objective of this prospective study was to assess oral health-related quality of life (OHR-QoL) in patients with periodontitis and nonsurgical periodontal treatment. A prospective, longitudinal case series study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in [...] Read more.
The objective of this prospective study was to assess oral health-related quality of life (OHR-QoL) in patients with periodontitis and nonsurgical periodontal treatment. A prospective, longitudinal case series study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia. Eighty periodontal patients with periodontitis, aged 22 to 72 years, were included in this study. The Spanish version of the Oral Health Impact Profile 14 (OHIP-14sp) questionnaire was used on two occasions: at the first visit and one month after completing the nonsurgical periodontal treatment. Clinical measurements of probing depth, plaque index and bleeding on probing were performed at baseline and after periodontal therapy. Data were analyzed using Student’s t-test and analysis of variance. We found statistically significant differences (p < 0.05) between the pre- and post-treatment in all the dimensions studied except disability. Similarly, statistically significant differences were also found according to the degree or stage of the disease. However, these differences were not observed with respect to the extent of periodontal disease. Periodontal disease has a negative impact on the OHRQoL of periodontal patients, especially in severe stages (III–IV). Basic periodontal treatment can improve the OHRQoL of periodontal patients one month after treatment. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Figure 1

Figure 1
<p>Study flow chart.</p> Full article ">Figure 2
<p>Spanish version of the oral health impact profile 14 questionnaire (OHIP-14sp).</p> Full article ">
14 pages, 1181 KiB  
Article
Surgical Treatment of Peri-Implantitis Using a Combined Nd: YAG and Er: YAG Laser Approach: Investigation of Clinical and Bone Loss Biomarkers
by Ioannis Fragkioudakis, Antonios Kallis, Evangelia Kesidou, Olympia Damianidou, Dimitra Sakellari and Ioannis Vouros
Dent. J. 2023, 11(3), 61; https://doi.org/10.3390/dj11030061 - 24 Feb 2023
Cited by 3 | Viewed by 2221
Abstract
The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly [...] Read more.
The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n = 10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n = 10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA). Baseline clinical values were similar for both groups, with no statistical differences between them. The study results indicated statistically significant improvements in the clinical parameters during the 6-month observation period in both groups. More specifically, PPD, PAL, and REC were improved in the test and control groups with no differences in the between-groups comparisons. However, a greater reduction in the BoP-positive sites was noted for the laser group (Mean change 22.05 ± 33.92 vs. 55.00 ± 30.48, p = 0.037). The baseline and six-month comparisons of sRANKL and OPG revealed no statistically significant differences between the two groups. The combined Nd: YAG—Er: YAG laser surgical therapy of peri-implantitis seemed to lead to more favorable improvements in regard to bleeding on probing six months after treatment compared to the conventional mechanical decontamination of the implant surface. None of the methods was found superior in the modification of bone loss biomarkers (RANKL, OPG) six months after treatment. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>Treatment Timeline.</p> Full article ">Figure 2
<p>Er: YAG Laser on the Implant Surface.</p> Full article ">Figure 3
<p>Patient Inclusion.</p> Full article ">
13 pages, 15273 KiB  
Article
Effect of EDTA Gel on Residual Subgingival Calculus and Biofilm: An In Vitro Pilot Study
by Charles M. Cobb, Stephen K. Harrel, Donggao Zhao and Paulette Spencer
Dent. J. 2023, 11(1), 22; https://doi.org/10.3390/dj11010022 - 9 Jan 2023
Cited by 4 | Viewed by 2778
Abstract
Background: Residual calculus, following scaling and root planing (SRP), is associated with persistent inflammation and the progression of periodontitis. This study examined the effects of a 24% neutral ethylenediaminetetraacetic acid (EDTA) gel on subgingival calculus and biofilms. Methods: Eleven single-rooted teeth extracted because [...] Read more.
Background: Residual calculus, following scaling and root planing (SRP), is associated with persistent inflammation and the progression of periodontitis. This study examined the effects of a 24% neutral ethylenediaminetetraacetic acid (EDTA) gel on subgingival calculus and biofilms. Methods: Eleven single-rooted teeth extracted because of severe periodontal disease were randomly assigned to the following treatment groups: (1) three teeth served as untreated controls; (2) three teeth were treated by scaling and root planing (SRP) only; and (3) three teeth were treated by SRP + EDTA. The remaining two teeth, one SRP only and the other SRP + EDTA were designated for energy-dispersive X-ray spectroscopy (EDS) analysis. EDTA gel was placed on the SRP surface for 2 min and then burnished with a sterile cotton pellet. Results: SRP + EDTA treated specimens exhibited severely damaged biofilm and the disruption of the extracellular polymeric matrix. EDS scans of the smear layer and calculus featured reductions in the Weight % and Atomic % for N, F, Na, and S and increases in Mg, P, and Ca. Conclusions: A 25% neutral EDTA gel was applied after SRP severely disrupted the residual biofilm and altered the character of dental calculus and the smear layer as shown by reductions in the Weight % and Atomic % for N, F, Na, and S and increases in Mg, P, and Ca. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>SRP-only treated specimen exhibiting deposits of calculus (<b>yellow arrows</b>) and several cavitation-like defects in root surface (<b>white arrows</b>). Original magnification of 40×; Bar = 500 μm.</p> Full article ">Figure 2
<p>Untreated root surface showing calculus of a calculus shelf covered with biofilm. Note bacteria embedded in extra-cellular matrix of the lateral wall of the calculus shelf. Original magnification of 2000×; Bar = 10 μm.</p> Full article ">Figure 3
<p>Untreated root surface at high magnification showing biofilm magnification view of biofilm microbes embedded in the extracellular matrix. In this view, most of the microbes are a short rod morphotype of ≈2 μm length. Original magnification of 10,000×; Bar = 2 μm.</p> Full article ">Figure 4
<p>SRP-only treated specimen characterized by a smear layer consisting of loosely attached debris and a parallel pattern of instrumentation streaks. Original magnification of 1000×; Bar = 20 μm.</p> Full article ">Figure 5
<p>SRP + EDTA-treated specimen. Treated surface features a smearing or smudged appearance (<b>white rectangle</b>). Original magnification. 200×; Bar = 100 μm.</p> Full article ">Figure 6
<p>SRP + EDTA-treated specimen. High magnification view of a dense aggregate of coccoid bacteria showing the effect of the EDTA. Many of the microbes appear to have ruptured. Additionally, note the loss of extracellular matrix. Original magnification of 5000×; Bar = 5 μm.</p> Full article ">Figure 7
<p>SRP + EDTA-treated specimen. High magnification view of a cluster of rod-shaped microbes showing loss of EPM, rupture of terminal ends of many of the microbes, and general loss of distinctive morphology. Original magnification of 5000×; Bar = 5 μm.</p> Full article ">Figure 8
<p>Area of residual biofilm following treatment with SRP + EDTA. Note the honeycomb appearance of the EPM indicating loss of structural integrity and loss of embedded microbes. Original magnification of 2000×; Bar = 10 μm.</p> Full article ">Figure 9
<p>SEM of SRP-only specimen with overlay of color-coded EDS line scan showing peaks (from baseline) for F, Al, S, N, Ca, P, and O. Mg and N are present but in low concentrations and are barely discernable. The scan traversed a line of ≈3 mm in length which included the smear layer resulting from SRP. Original mag. 39×; Bar = 1 mm. Working distance of 10 mm.</p> Full article ">Figure 10
<p>Conversion of the line scan seen in <a href="#dentistry-11-00022-f009" class="html-fig">Figure 9</a> (SRP only specimen) to an EDS spectrum shows relative peak height of the various elements of interest. Dominate peaks are O, P, and Ca and lesser peaks for N, F, Na, Mg, and S. Peaks for Al and C are likely derived from the carbon sputter coating and aluminum mounting stub.</p> Full article ">Figure 11
<p>SEM of SRP + EDTA specimen with overlay of color-coded EDS line scan showing peaks (from baseline) for F, S, N, Na, Mg, Ca, P, and O. Compared to <a href="#dentistry-11-00022-f009" class="html-fig">Figure 9</a>, this scan shows obvious differences in location and presence of N, Na, and Mg. The scan started and stopped on calculus deposits with an intervening area of SRP in between. The scan traversed a line of ≈3 mm in length. Original mag. 39×; Bar = 1 mm. Working distance of 10 mm.</p> Full article ">Figure 12
<p>Conversion of the line scan seen in <a href="#dentistry-11-00022-f011" class="html-fig">Figure 11</a> to an EDS spectrum shows relative peak height of the various elements of interest. As with the SRP-only specimen (<a href="#dentistry-11-00022-f010" class="html-fig">Figure 10</a>), the dominate peaks are O, P, and Ca, with lesser peaks for N, F, Na, Mg, and S.</p> Full article ">Figure 13
<p>Data from SRP-only specimen generated for the elements of interest, expressed as Weight % and Atomic %. Both represent the relative concentration of the element in the sample. Atomic % is calculated by dividing the element Weight % by its atomic weight. Note the analysis uncertainty of 10.70% indicating the error of measurement which is influenced by the irregular topography of the root surface.</p> Full article ">Figure 14
<p>Data generated for the elements of interest, expressed as Weight % and Atomic %. Note the analysis uncertainty of 11.86%. Compared to data in <a href="#dentistry-11-00022-f013" class="html-fig">Figure 13</a>, there are decreases in Weight % and Atomic % or N, F, Na, and S and increases in Mg, P, and Ca. Oxygen was nearly equal in both specimens (49.1 for SRP only vs. 49.6 for SRP + EDTA).</p> Full article ">
11 pages, 1680 KiB  
Article
Express Diagnostics of Proteolytic Activity of Periodontopathogens—Methodological Approach
by Ekaterina Aronova, Marina Dmitrienko, Anastasija Ivanova, Yulia Gaykova, Anna Kurochkina, Alisa Blinova, Julia Bazarnova and Elizaveta Paponova
Dent. J. 2022, 10(11), 217; https://doi.org/10.3390/dj10110217 - 21 Nov 2022
Cited by 1 | Viewed by 2028
Abstract
The species spectrum of the oral microbiome is considered to be the key factor in the development and progression of periodontal inflammatory disorders. The “red complex” including Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola has the highest pathogenic potential. These bacteria have [...] Read more.
The species spectrum of the oral microbiome is considered to be the key factor in the development and progression of periodontal inflammatory disorders. The “red complex” including Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola has the highest pathogenic potential. These bacteria have several biochemical mechanisms that allow them to colonize and destroy periodontal tissues. Proteolytic enzymes play a crucial role in this process. Early diagnosis of pathological conditions induced by microbial contamination allows for the timely treatment of periodontitis. Otherwise, the development of the disease may lead to tooth loss. A total of 48 patients aged 18 to 65 years old who required professional oral hygiene were recruited for this clinical study. Microbial content analysis of dental plaque from the interdental space and the back of the tongue was performed using real-time PCR. To determine the proteolytic activity of oral bacteria, the new express diagnostic method was applied (diagnostic sensitivity, 0.875; specificity, 0.928). The results demonstrate a strong and significant correlation between the new method and the PCR analysis (r = 0.785, p < 0.001). These results show that the new express method can be valuable as an early diagnostic method for periodontal inflammatory disorders caused by the “red complex” bacteria. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>The scheme of the device layers for the express diagnostics of the proteolytic activity in the oral cavity: (Layer 1) the chromogenic test substrate; (Layer 2) the element containing color development dyes.</p> Full article ">Figure 2
<p>The reaction of chromophore formation that is the basis of the express diagnostics of proteolytic activity.</p> Full article ">Figure 3
<p>The color change scale for the proteolytic activity determination in the oral cavity.</p> Full article ">Figure 4
<p>Amplification curves of the internal control in the biological samples.</p> Full article ">Figure 5
<p>Comparison of the amplification curves and the results of the express diagnostics of the interdental space samples for patients <b>d19</b>, <b>d05</b>, <b>d01</b> and <b>d10</b>. PCR diagrams: the <span class="html-italic">Porphyromonas gingivalis</span> DNA amplification curve is blue; the <span class="html-italic">Tannerella forsythensis</span> DNA amplification curve is red; the <span class="html-italic">Treponema denticola</span> DNA amplification curve is green. Σrc—the total “red complex” bacterial load in genome equivalents in ml.</p> Full article ">Figure 6
<p>(<b>a</b>) Trypsin-like enzyme activity dependence on the temperature conditions. (<b>b</b>) The amount of proteolytic activity detected by the device when the color spot appeared after the trypsin solution application at 5, 10, 15 and 20 min.</p> Full article ">
8 pages, 247 KiB  
Article
Tooth Wear Epidemiology and Its Associated Periodontal Health and Sociodemographic Factors in a Cluster of Senior Citizens in Northern Greece
by Charis Theodoridis, George Menexes, Vasiliki Topitsoglou and Sotirios Kalfas
Dent. J. 2022, 10(11), 216; https://doi.org/10.3390/dj10110216 - 18 Nov 2022
Cited by 2 | Viewed by 2282
Abstract
Tooth wear (TW) is an irreversible and cumulative phenomenon causing aesthetic and functional compromise. Increasing wear has been associated with age, and various other factors have been reported to influence its type and/or severity both in individuals and groups. Increased TW may constitute [...] Read more.
Tooth wear (TW) is an irreversible and cumulative phenomenon causing aesthetic and functional compromise. Increasing wear has been associated with age, and various other factors have been reported to influence its type and/or severity both in individuals and groups. Increased TW may constitute a major future problem for the elderly. The present cross-sectional study aims at determining the prevalence of TW in senior citizens from Northern Greece and evaluating the patient-level associations between TW, periodontal condition, and sociodemographic factors. A sample of 363 dentate individuals, aged between 65 and 74 years, was considered according to the WHO guidelines for national pathfinder surveys and three different dentists examined the representative population groups from different urban and rural areas in Northern Greece. The examiners were calibrated prior to the survey, with an interexaminer agreement of over 85%. The simplified TWI, community periodontal index (CPI), attachment loss (AL), plaque index (DI), calculus index (CI), and sociodemographic factors were detected and measured. TW is very prevalent among senior citizens in Northern Greece, with males having been found to experience more wear. Age and oral health status, when measured by the periodontal indices AL, DI, and CI, are significantly combined with TW in both urban and rural areas. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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12 pages, 16063 KiB  
Article
Viability and Adhesion of Periodontal Ligament Fibroblasts on a Hydroxyapatite Scaffold Combined with Collagen, Polylactic Acid–Polyglycolic Acid Copolymer and Platelet-Rich Fibrin: A Preclinical Pilot Study
by Leonor C. Espitia-Quiroz, Andrés L. Fernández-Orjuela, Lina M. Anaya-Sampayo, Adriana P. Acosta-Gómez, Luis Gonzalo Sequeda-Castañeda, Sandra Janeth Gutiérrez-Prieto, Nelly S. Roa-Molina and Dabeiba A. García-Robayo
Dent. J. 2022, 10(9), 167; https://doi.org/10.3390/dj10090167 - 6 Sep 2022
Cited by 6 | Viewed by 2294
Abstract
Background: Conventional periodontal therapy relies on bone regeneration strategies utilizing scaffolds made of diverse materials, among which collagen, to promote cell adhesion and growth. Objective: To evaluate periodontal ligament fibroblast (HPdLF) cell adhesion and viability for periodontal regeneration purposes on hydroxyapatite scaffolds containing [...] Read more.
Background: Conventional periodontal therapy relies on bone regeneration strategies utilizing scaffolds made of diverse materials, among which collagen, to promote cell adhesion and growth. Objective: To evaluate periodontal ligament fibroblast (HPdLF) cell adhesion and viability for periodontal regeneration purposes on hydroxyapatite scaffolds containing collagen (HAp-egg shell) combined with polylactic acid–polyglycolic acid copolymer (PLGA) and Platelet-Rich Fibrin (PRF). Methods: Four variations of the HAp-egg shell were used to seed HPdLF for 24 h and evaluate cell viability through a live/dead assay: (1) (HAp-egg shell/PLGA), (2) (HAp-egg shell/PLGA + collagen), (3) (HAp-egg shell/PLGA + PRF) and (4) (HAp-egg shell/PLGA + PRF + collagen). Cell adhesion and viability were determined using confocal microscopy and quantified using central tendency and dispersion measurements; significant differences were determined using ANOVA (p < 0.05). Results: Group 1 presented low cell viability and adhesion (3.70–10.17%); groups 2 and 3 presented high cell viability and low cell adhesion (group 2, 59.2–11.1%, group 3, 58–4.6%); group 4 presented the highest cell viability (82.8%) and moderate cell adhesion (45%) (p = 0.474). Conclusions: The effect of collagen on the HAp-egg shell/PLGA scaffold combined with PRF favored HPdLF cell adhesion and viability and could clinically have a positive effect on bone defect resolution and the regeneration of periodontal ligament tissue. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>Experimental processes. (<b>A</b>) Human periodontal ligament fibroblasts culture; the cells show their characteristic spindle shape. (<b>B</b>) HAp-egg shell/PLGA scaffold used for all groups in the form of a 5 mm disc with 2 mm height. (<b>C</b>) Platelet-Rich Fibrin (PRF), with gelatinous consistency, a characteristic of this biomaterial. (<b>D</b>) Experimental design in a 96-well plate, containing the HPdLF culture medium. (<b>E</b>) Figure illustrating the four evaluated groups: red (HAp-egg shell/PLGA + HPdLF), blue (HAp-egg shell/PLGA + HPdLF + Collagen), yellow (HAp-egg shell/PLGA + HPdLF + PRF) and green (HAp-egg shell/PLGA + HPdLF + Collagen + PRF).</p> Full article ">Figure 2
<p>Images captured under a confocal fluorescence microscope (CFM); <span class="html-italic">n</span> = 3 (i, ii, iii). (<b>A</b>). HAp-egg shell/PLGA + HPdLF. (<b>B</b>). HAp-egg shell/PLGA + HPdLF + Collagen. (<b>C</b>). HAp-egg shell/PLGA + HPdLF + PRF. (<b>D</b>). HAp-egg shell/PLGA + HPdLF + PRF + Collagen. Live cells are green, dead cells are red.</p> Full article ">Figure 3
<p>Comparison among the evaluated groups of cell adhesion (<b>A</b>) and viability (<b>B</b>). Mean ± SD.</p> Full article ">

Review

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10 pages, 546 KiB  
Review
Minimally Invasive Non-Surgical Technique in the Treatment of Intrabony Defects—A Narrative Review
by Styliani Anoixiadou, Andreas Parashis and Ioannis Vouros
Dent. J. 2023, 11(1), 25; https://doi.org/10.3390/dj11010025 - 11 Jan 2023
Cited by 4 | Viewed by 3299
Abstract
Intrabony defects occur frequently in periodontitis and represent sites that, if left untreated, are at increased risk for disease progression. Although resective or repair procedures have been used to treat intrabony defects, aiming at their elimination, the treatment of choice is surgical periodontal [...] Read more.
Intrabony defects occur frequently in periodontitis and represent sites that, if left untreated, are at increased risk for disease progression. Although resective or repair procedures have been used to treat intrabony defects, aiming at their elimination, the treatment of choice is surgical periodontal regeneration. The development of periodontal regeneration in the last 30 years has followed two distinctive, though totally different, paths. The interest of researchers has so far focused on regenerative materials and products on one side, and on novel surgical approaches on the other side. In the area of materials and products, three different regenerative concepts have been explored namely, barrier membranes, bone grafts, and wound healing modifiers/biologics, plus many combinations of the aforementioned. In the area of surgical approaches, clinical innovation in flap design and handling, as well as minimally invasive approaches, has radically changed regenerative surgery. Recently, a minimally invasive non-surgical technique (MINST) for the treatment of intrabony defects was proposed. Initial clinical trials indicated comparable results to the surgical minimally invasive techniques in both clinical and radiographic outcomes. These results support the efficacy of this treatment approach. The aim of this review is to present the evidence on the application of minimally invasive non-surgical techniques and their efficacy in the treatment of intrabony defects. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>MINST + EMD application: (<b>A</b>,<b>B</b>) Initial clinical and radiographic images; (<b>C</b>) Use of ultrasonic delicate tip; (<b>D</b>) Use of mini curette; (<b>E</b>) After MINST (notice the minimal tissue trauma); (<b>F</b>) EDTA application; (<b>G</b>) Dried tooth surface; (<b>H</b>) EMD application; (<b>I</b>,<b>J</b>) Clinical and radiographic images at 12 months.</p> Full article ">

Other

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16 pages, 2528 KiB  
Systematic Review
Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies
by Alessandro Campagna, Giacomo Baima, Federica Romano, Federico Amoroso, Federico Mussano, Giacomo Oteri, Mario Aimetti and Matteo Peditto
Dent. J. 2024, 12(5), 145; https://doi.org/10.3390/dj12050145 - 16 May 2024
Cited by 1 | Viewed by 1152
Abstract
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide [...] Read more.
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?”. Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (−0.88, 2.97) p = 0.29] and PPD reduction [MD = 1.32; 95% CI (−0.25, 2.88) p = 0.10]. The same also applied to GR [MD = −0.08; 95% CI (−0.79, 0.63) p = 0.83] and RBG [MD = 0.50; 95% CI (−0.88, 1.88) p = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Full article ">Figure 1
<p>PRISMA flowchart illustrating the experimental study search and selection process.</p> Full article ">Figure 2
<p>Assessment of the risk of bias in the included studies. +, criterion met; ?, unclear; X, criterion not met.</p> Full article ">Figure 3
<p>Comparison between the results of studies comparing periodontal regeneration with or without the adjunctive use of orally derived stem cells in terms of clinical attachment level (CAL) gain [<a href="#B54-dentistry-12-00145" class="html-bibr">54</a>,<a href="#B55-dentistry-12-00145" class="html-bibr">55</a>,<a href="#B56-dentistry-12-00145" class="html-bibr">56</a>,<a href="#B57-dentistry-12-00145" class="html-bibr">57</a>].</p> Full article ">Figure 4
<p>Comparison between the results of studies comparing periodontal regeneration with or without the adjunctive use of orally derived stem cells in terms of probing pocket depth (PPD) reduction [<a href="#B54-dentistry-12-00145" class="html-bibr">54</a>,<a href="#B55-dentistry-12-00145" class="html-bibr">55</a>,<a href="#B56-dentistry-12-00145" class="html-bibr">56</a>,<a href="#B57-dentistry-12-00145" class="html-bibr">57</a>].</p> Full article ">Figure 5
<p>Comparison between the results of studies comparing periodontal regeneration with or without the adjunctive use of orally derived stem cells in terms of gingival recession (GR) [<a href="#B55-dentistry-12-00145" class="html-bibr">55</a>,<a href="#B56-dentistry-12-00145" class="html-bibr">56</a>,<a href="#B57-dentistry-12-00145" class="html-bibr">57</a>].</p> Full article ">Figure 6
<p>Comparison between the results of studies comparing periodontal regeneration with or without the adjunctive use of orally derived stem cells in terms of radiographical bone gain (RBG) [<a href="#B55-dentistry-12-00145" class="html-bibr">55</a>,<a href="#B56-dentistry-12-00145" class="html-bibr">56</a>,<a href="#B57-dentistry-12-00145" class="html-bibr">57</a>].</p> Full article ">
10 pages, 535 KiB  
Systematic Review
Efficacy of Periodontal Endoscopy during Subgingival Debridement to Treat Periodontitis: A Systematic Review of Randomized Clinical Trials
by Carlos M. Ardila and Annie Marcela Vivares-Builes
Dent. J. 2023, 11(5), 112; https://doi.org/10.3390/dj11050112 - 25 Apr 2023
Cited by 3 | Viewed by 2230
Abstract
This study aims to evaluate the clinical efficacy of periodontal endoscopy (PEND) during subgingival debridement to treat periodontitis. A systematic review of randomized clinical trials (RCTs) was performed. The search strategy included four databases: PubMed, Web of Sciences, Scopus, and Scielo. The initial [...] Read more.
This study aims to evaluate the clinical efficacy of periodontal endoscopy (PEND) during subgingival debridement to treat periodontitis. A systematic review of randomized clinical trials (RCTs) was performed. The search strategy included four databases: PubMed, Web of Sciences, Scopus, and Scielo. The initial online exploration generated 228 reports, and 3 RCTs met the selection criteria. These RCTs described a statistically significant decrease in probing depth (PD) in the PEND group compared to controls after 6 and 12 months of follow-up. The improvement in PD was 2.5 mm for PEND and 1.8 mm for the control groups, respectively (p < 0.05). It was also described that the PEND group presented a significantly inferior proportion of PD 7 to 9 mm at 12 months (0.5%) as compared to the control group (1.84%) (p = 0.03). All RCTs noted improvements in clinical attachment level (CAL). It was described as having significant differences in bleeding on probing (BOP) in favor of PEND, with an average reduction of 43% versus 21% in the control groups. Similarly, it was also presented that they were significant differences in plaque indices in favor of PEND. PEND during subgingival debridement to treat periodontitis demonstrated efficacy in reducing PD. Improvement was also observed in CAL and BOP. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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<p>Flowchart of the randomized clinical trial selection process.</p> Full article ">
14 pages, 1488 KiB  
Systematic Review
Periodontal Disease in Obese Patients; Interleukin-6 and C-Reactive Protein Study: A Systematic Review
by Julieta Cruz-Ávila, Elizabeth Hernández-Pérez, Rogelio González-González, Ronell Bologna-Molina and Nelly Molina-Frechero
Dent. J. 2022, 10(12), 225; https://doi.org/10.3390/dj10120225 - 29 Nov 2022
Cited by 5 | Viewed by 2278
Abstract
Periodontal disease (PD) and obesity are characterized by a dysregulated inflammatory state. Both conditions trigger inflammatory and immune responses with an increase in proinflammatory cytokines such as Interleukin 6 (IL-6) and the release of inflammatory mediators such as C-reactive protein (CRP). Individuals with [...] Read more.
Periodontal disease (PD) and obesity are characterized by a dysregulated inflammatory state. Both conditions trigger inflammatory and immune responses with an increase in proinflammatory cytokines such as Interleukin 6 (IL-6) and the release of inflammatory mediators such as C-reactive protein (CRP). Individuals with a high body mass index (BMI) present a chronic inflammatory state. The aim of the present study was to perform a systematic review of inflammatory markers (IL-6 and CRP) in obese patients with PD and their possible relationship by analyzing the levels of these markers. A digital literature search was performed in three databases—PubMed, SciElo and Medigraphic—through an advanced search for original articles, employing IL-6 and CRP in obese patients with PD, within a publication period from 2010 to 2021. PRISMA guidelines, the JADAD scale and a qualitative analysis of scientific evidence were performed using the Cochrane collaboration method and the RoB 2 assessment tool. Ten articles were included in this analysis with the variables recorded and associated with subjects with obesity and PD. Of the ten articles included, three analyzed IL-6 and CRP, four analyzed IL-6 and three analyzed CRP. In conclusion, and based on the available evidence, the aforementioned markers of inflammation demonstrate that there is a relationship between PD and obesity. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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Full article ">Figure 1
<p>PRISMA flow diagram for the systematic review. Of the 990 articles found in the three databases included in the search, 10 studies were selected for analysis in this study.</p> Full article ">Figure 2
<p>Risk of bias for each of the articles included.</p> Full article ">Figure 3
<p>Risk of bias according to each domain and overall risk of bias.</p> Full article ">
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