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Background and objectives: Cementless total hip arthroplasty is a common surgical procedure and perioperative thromboprophylaxis is used to prevent deep vein thrombosis or pulmonary embolism. Osseointegration is important for long-term implant survival, and there is no research on the effect of different thromboprophylaxis agents on the process of osseointegration. Materials and Methods: Seventy rats were allocated as follows: Group I (control group), Group II (enoxaparin), Group III (nadroparin), and Group IV (fondaparinux). Ovariectomy was performed on all subjects, followed by the introduction of an intramedullary titanium implant into the femur. Thromboprophylaxis was administered accordingly to each treatment group for 35 days postoperatively. Results: Group I had statistically significantly lower anti-Xa levels compared to treatment groups. Micro-CT analysis showed that nadroparin had lower values compared to control in bone volume (0.12 vs. 0.21, p = 0.01) and percent bone volume (1.46 vs. 1.93, p = 0.047). The pull-out test showed statistically significant differences between the control group (8.81 N) compared to enoxaparin, nadroparin, and fondaparinux groups (4.53 N, 4 N and 4.07 N, respectively). Nadroparin had a lower histological cortical bone tissue and a higher width of fibrous tissue (27.49 μm and 86.9 μm) at the peri-implant area, compared to control (43.2 μm and 39.2 μm), enoxaparin (39.6 μm and 24 μm), and fondaparinux (36.2 μm and 32.7 μm). Conclusions: Short-term administration of enoxaparin, nadroparin, and fondaparinux can reduce the osseointegration of titanium implants, with nadroparin having the most negative effect. These results show that enoxaparin and fondaparinux are preferred to be administered due to a lesser negative impact on the initial implant fixation.

Conclusion: Thyroid carcinoma represents a complex pathology that can still be considered a medical challenge, despite having a better prognosis and life expectancy than most other neoplasms; also the scenario of multiple malignancies involving thyroid cancer is nowadays a common reality. Materials and Methods: We reviewed the literature regarding the aggressive presentation of synchronous thyroid and breast cancer. In the current paper, we report the case of a 59 years-old woman, diagnosed with invasive ductal breast carcinoma and papillary thyroid carcinoma, presenting a natural history of both aggressive synchronous tumors. At the moment of hospitalization, the diagnosis was breast carcinoma with multiple secondary lesions, suggestive of lung and bone metastases, and nodular goiter. Results: Searching the literature in PUBMED with the terms “thyroid carcinoma and synchronous breast carcinoma, we found 86 studies; introducing the term “aggressive,” the result included 4 studies, among which, none showed to be relevant to the terms aggressive and synchronous. A similar search was done in SCOPUS finding 92 documents and after introducing the term aggressive, the number of papers was 8, none including the literature on synchronous aggressive metastatic thyroid and breast carcinoma. A majority of imaging diagnostic tools were used in this particular medical case in order to ensure the best potential outcome. The final diagnosis was papillary thyroid carcinoma with lung and unusual multiple bone metastases and synchronous invasive ductal breast carcinoma with subcutaneous metastases. Conclusion: The case illustrates the challenges in the correct assessment of oncologic patients, despite the advances in medical imaging and technologies and underlines the essential role of nuclear medicine procedures in the diagnostic and therapy protocols.

Purpose The purpose of this study was to reveal the frequency between cleft lip/palate and leukemia in pediatric patients by a systematic analysis of the current literature. Materials and methods Electronic search on three database (PubMed, Web of Science, Cochrane) was carried out using the following keywords: cleft lip, cleft palate, facial cleft, oral cleft, orofacial cleft, leukemia, acute myeloid leukemia, acute lymphocytic leukemia, lymphoma. Studies published until March 2020 reporting an association between leukemia and cleft lip/palate (CL/P) were included in our research. Results Five articles (2 case-controls, 3 cohorts), met the inclusion criteria. Case-control studies involved 268 patients with acute lymphocytic leukemia (ALL) and 177 patients with acute myeloid leukemia (AML), of which 9 patients had CL/P. The cohorts studies involved 10 patients with ALL, of which 6 patients with CL/P, 2 patients with cleft palate and 1 patient with cleft lip and palate. Conclusion This research was able to indicate a limited evidence of the association between CL/P and leukemia. In order to draw a clear conclusion, studies with larger cohorts are needed to establish this correlation.

Patients with differentiated thyroid cancer who undergo radioiodine treatment often present oral complications with a significant impact on their oral cavity function. Any potential sources of systemic infections like periodontal disease, unfitted dentures, orthodontic appliances, deficient/rough fillings, or traumatic dentition must be treated by the dental practitioner, because they represent the main source of spread and dissemination. Any systemic complication of a dental foci may result from improper dental preparation of the patient before radioiodine therapy and inadequate post-radioiodine therapy oral care. Therefore, all patients proceeding into radioiodine treatment should be addressed by the oncological team to undergo thorough dental check-up and receive appropriate treatment in due time.

Background and objectives: The aim of this systematic review was to assess the electronic literature about the benefits of using hyaluronic acid (HA) in the surgical periodontal treatment of infrabony defects. Materials and methods: This review was conducted under the PRISMA guidelines. The electronic search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases until February 2022. The inclusion criteria consisted of human clinical trials that reported the use of HA in open-flap debridement (OFD) for infrabony defects. The assessment of risk of bias was performed using the Cochrane risk of bias tool. Statistical analysis was performed using Review Manager. Results: Overall, three RCTs were found eligible for the statistical analysis. Probing depth (PD) reduction and clinical attachment level (CAL) gain in the HA test group presented WMs of −1.11 mm (95% CI −2.38 to 0.16 mm; p = 0.09) and −1.38 mm (95% CI −2.26 to −0.49 mm; p = 0.002), respectively. However, the heterogeneity of the RCTs was high, and the risk of bias, in general, was low. Conclusions: The use of hyaluronic acid seems to have beneficial effects in periodontal surgery using OFD, in terms of PD and CAL. To draw a clear conclusion, more adapted and well-designed clinical trials are needed to assess the advantage of this product in comparison with other products.

Background and objectives: The aim of this systematic review with meta-analysis was to assess the performance of short implants in comparison with standard implants and sinus floor elevation in atrophic posterior maxilla. Materials and methods: The protocol of the study was registered in the PROSPERO database (CRD42022375320). An electronic search on three databases (PubMed, Scopus, Web of Science) was performed to find randomized clinical trials (RCTs) with ≥5 years’ follow-up, published until December 2022. Risk of bias (ROB) was calculated using Cochrane ROB. A meta-analysis was performed for primary (implant survival rate, ISR) and secondary outcomes (marginal bone loss, MBL; biological and prosthetic complications). Results: Of 1619 articles, 5 RCTs met the inclusion criteria. The ISR showed a risk ratio (RR) of 0.97 [0.94, 1.00] (CI 95%), p = 0.07. The MBL indicated a WMD of −0.29 [−0.49, −0.09] (CI 95%), p = 0.005. Biological complications showed a RR of 0.46 [0.23, 0.91] (CI 95%), p = 0.03. Prosthetic complications showed a RR of 1.51 [0.64, 3.55] (CI 95%), p = 0.34. Conclusions: The available evidence suggests that short implants might be used as an alternative to standard implants and sinus floor elevation. After 5 years, in terms of ISR, standard implants and sinus floor elevation showed a higher survival rate comparted to short implants, although statistical significance was not achieved. Future RCTs with long-term follow-up are needed to draw a clear conclusion on the advantages of one method over another.

Background and Objectives: The aim was to systematically review the available literature regarding the use of polymers as a bone substitute for the treatment of periodontal infrabony defect. Materials and methods: Three databases (PubMed, Scopus and Web of Science) were searched to find all relevant studies published in English from inception until September 2021 using a combination of keywords. The inclusion criteria consisted of human clinical studies which reported the use of a polymer-based bone substitute in the treatment of infrabony defects. Results: 164 studies were provided from the databases. Of these, five articles were eligible and reported favorable outcome in terms of probing depth, clinical attachment gain and defect fill at the follow-up (3 months and 6 months). Conclusions: Polymer based-bone substitutes may represent a useful alternative in treating infrabony defects. Due to the limited number of studies, more research is needed to sustain the advantages of these products.

F-FDG PET/CT might discover incidental pituitary lesions. We present the case of a 46-year-old woman with breast cancer metastasis in her pituitary. We analyzed 10,347 FDG PET/CT examinations from a tertiary center, finding 4 cases (0.038%) of pituitary metastatic disease from other cancers. We analyzed the differences between SUVmax in cases of physiological high uptake, primary tumor, and hypophysis metastases from other cancers in our database compared with the literature.

Articular cartilage has a complex structure and metabolism which allow for a proper movement within joints. Nevertheless, several systemically administered pharmacological agents have been proved to improve the anabolic response in the case of cartilage lesions. Alendronate, glucosamine, chondroitin sulfate, hyaluronic acid, collagen hydrolysate, vitamin C, vitamin D, aspirin and strontium ranelate have shown positive results in clinical trials. On the other hand, calcitonin, risedronate, doxycycline, and celecoxib did not slow the progression of cartilage lesions in clinical trials. Other systemic drugs or supplements such as teriparatide, leptin, zoledronic acid, bevacizumab, atorvastatin, omega-3 fatty acid, naringin, MSM, selenium, zinc, magnesium, resveratrol, donepezil, naproxen, etodolac, ursodeoxycholic acid (UDCA), lithium chloride, and rebamipide showed positive results in in vitro and animal studies but clinical trials are needed to confirm the positive impact on cartilage repair. A number of molecules, not currently available on the market, have also shown promising results in cartilage healing, such as licofelone, sclerostin, cyclopamine, cyclodextrin polysulfate, AG-041R, osteoprotegerin, rhMK, β-cryptoxanthine, NF-κb essential modulator binding domain (NBD), TGF-β-neutralizing antibody, osteogenic protein-1 (BMP-7), fibroblast growth factor 2 (FGF2), and RhBMP-2. Currently available systemic drugs that impair cartilage healing are represented by corticosteroids, vitamin A, and fluoroquinolones.

Bone is a complex tissue with unique properties such as high strength and regeneration capabilities while carrying out multiple functions. Bone regeneration occurs both in physiological situations (bone turnover) and in pathological situations (e.g. fractures), being performed by osteoblasts and osteoclasts. If this process is inadequate, fracture nonunion or aseptic loosening of implants occurs and requires a complex treatment. Exogenous factors are currently used to increase bone regeneration process when needed, such as bisphosphonates and vitamin D, but limitations do exist. Cannabinoid system has been shown to have positive effects on bone metabolism. Cannabinoids at bone level mainly act on two receptors called CB-1 and CB-2, but GPR55, GPR119, TPRV1, TPRV4 receptors may also be involved. The CB-2 receptors are found in bone cells at higher levels compared to other receptors. Endocannabinods represented by anandamide and 2-arachidonoylglycerol, can stimulate osteoblast formation, bone formation and osteoclast activity. CB-2 agonists including HU-308, HU-433, JWH133, and JWH015 can stimulate osteoblast proliferation and activity, while CB-2 antagonists such as AM630 and SR144528 can inhibit osteoclast differentiation and function. CB-1 antagonist AM251 has been shown to inhibit osteoclast differentiation and activity, while GPR55 antagonist cannabidiol increases osteoblast activity and decreases osteoclast function. An optimal correlation of dose, duration, moment of action, and affinity can lead to an increased bone regeneration capacity, with important benefits in many pathological situations which involve bone tissue. As adverse reactions of cannabinoids have not been described in patients under controlled medication, cannabinoids can represent future treatment for bone regeneration.

Background and Objectives: Cementless total hip arthroplasty leads to an early periprosthetic bone loss, which can impair the osseointegration process and lead to a femoral implant migration during early weight-bearing. An altered osseointegration process can lead to aseptic loosening, which is the most frequent late complication in these surgical procedures. The objective of this study was to compare the effect of alendronate and simvastatin in the prevention of early periprosthetic bone loss found in osteoporotic patients. This can lead to earlier weight-bearing in patients, as well as reduce the rate of aseptic loosening. Materials and Methods: Forty-five patients undergoing cementless total hip arthroplasty were equally distributed into three groups: group I (alendronate), group II (simvastatin), and group III (control). The alendronate group received 5 mg of alendronate postoperatively, daily for 8 weeks, and the simvastatin group received 20 mg daily for 4 weeks postoperatively, followed by 40 mg daily for 4 weeks. We determined bone mineral density (BMD), as well as bone serum markers beta cross-laps (β-CTx) and alkaline phosphatase (ALPL) preoperatively, 4 weeks postoperatively, and 8 weeks postoperatively. All patients were not allowed to fully bear weight for 6 weeks postoperatively. Results: Alendronate statistically significantly increases the BMD at one month postoperatively compared to the control group in Gruen zones 5 and 6 (p = 0.042 and p = 0.039). Overall, the BMD was higher in the alendronate group compared to the control group at one month postoperatively (p = 0.043). Alendronate decreased β-CTx bone serum marker compared to control at one month and two months (p = 0.024 and p = 0.012). Moreover, alendronate showed a higher decrease in β-CTx compared to simvastatin at both timelines (p = 0.028 and p = 0.03, respectively). Conclusions: The study shows that alendronate administration following cementless total hip arthroplasty offers better protection against periprosthetic bone loss compared to simvastatin.

Background and objectives: The purpose of the present systematic review was to analyze the effectiveness of erythritol-based air-polishing in non-surgical periodontal therapy. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42021267261). This review was conducted under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, and Web of Science databases to find relevant clinical trials published until January 2022. The inclusion criteria consisted of human clinical trials which reported the use of non-surgical periodontal treatment and erythritol air-polishing compared to non-surgical periodontal treatment alone in patients with good systemic health requiring treatment for periodontal disease. Results: 810 studies were imported into the Covidence Platform. Of these, seven clinical trials met the inclusion criteria. In active periodontal therapy, for PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing), no statistical significance was achieved at 6 months follow-up. In supportive periodontal therapy for PD, CAL, and BOP, no statistical significance was achieved at 3 months follow-up. Conclusions: The findings suggest that erythritol air-polishing powder did not determine superior improvements of periodontal parameters compared to other non-surgical periodontal therapies. Future randomized clinical trials (RCTs) with calibrated protocols for diagnosis, therapeutic approaches, and longer follow-up are needed to draw a clear conclusion about the efficiency of erythritol air-polishing powder.

Background and objectives: The aim of this systematic review with meta-analysis is to assess the available evidence from human clinical studies of using self-ligating brackets compared to conventional brackets in maintaining periodontal health. Materials and methods: The protocol details were registered in the PROSPERO database (CRD42022302689). This review was performed under the PRISMA guidelines. The electronic search was performed in PubMed, Scopus, Web of Science and grey literature databases, as well as manual searches to find relevant articles published until January 2022. The inclusion criteria consisted of human clinical studies which reported the use of fixed orthodontic treatment with self-ligating brackets (SLBs) or conventional brackets (CBs) in maintaining periodontal health. Results: A total of 453 studies were imported into the Covidence Platform from the databases. Of these, six articles met the inclusion criteria. For plaque index, statistical significance was achieved for SLBs compared to CBs (0.31 (95% CI (0.15 to 0.48), p = 0.0001). For gingival index, probing depth and bleeding on probing no statistical significance was achieved. None of the included studies assessed clinical attachment level. Conclusions: The present systematic review with meta-analysis was considered to provide relevant data on periodontal health during orthodontic treatment in patients with SLBs in comparison with patients wearing CBs. Our findings indicated that SLBs are not superior to CBs in terms of periodontal health.

Some previous studies reported that probiotics might decrease the severity of chemotherapy-induced mucositis. This study assessed the potential protective effect of Lactobacillus plantarum ATCC 8014 on 5-fluorouracil (5-FU) induced intestinal mucositis in the Wistar rats. The Crl:WI rats were divided into two groups of six animals (F, L) and one group of 5 animals (M). Group L received for 9 days 3.32x109 CFU/ml of Lactobacillus plantarum orally. In the 7th day of the experiment 400 mg of 5-FU was administered intraperitoneally in groups L and F. Group M received only the vehicles. All animals were sacrificed in the 9th day. Eleven histological characteristics of mucositis were quantified from 0 (normal) to 3 (severe) for duodenum, jejunum and colon. Semiquantitative grades measured Toll-like receptor 4 (TLR4) immunopositive cells. The independent groups were analyzed using the Kruskal-Wallis test, Mann-Whitney U test, with a Bonferroni correction for alpha (P≤0.016). In the group F, treated with 5-FU, the most affected areas were the jejunum and the duodenum. The medium score of histological lesions was 27 for jejunum (minimum 25, maximum 32) and 21 for duodenum (minimum 18, maximum 29). Graded microscopic mucosal changes of the jejunum were significantly lower in group L compared with group F (U=0, P=0.009, Mann-Whitney test). The histological changes depicted on the duodenal and colonic mucosa were less severe in group L than in group F, but without reaching the statistical significance (duodenum: U=6, P=0.172, Mann-Whitney test; colon: U=12, P=0.916, Mann-Whitney test). Although the TLR4 immunoexpression was more intense in group L, no significant statistical difference was revealed at duodenum, jejunum or colonic mucosa. Significantly fewer microscopic changes were depicted in L group on the jejunum, suggesting a potential beneficial effect of Lactobacillus plantarum at this level in 5-FU induced mucositis.

The search for bone reconstruction materials and methods is an ongoing challenge. The aim of this review is to systemically search the available literature concerning the clinical performance of eggshell as a substitute material in guided bone regeneration in oral surgery. Five databases (PubMed, Cochrane, Web of Science, Scopus, and Embase) were searched up to February 2020. Clinical trials that used eggshell as a bone substitute material were included in the review. Animal and in vivo studies were excluded from the review. ROBINS-I was used to evaluate the risk of bias. A total of 840 studies were retrieved, out of which 55 full-text articles were screened. Five studies were finally included: one study showed critical and four serious risk of bias. A total of 74 patients and 88 intervention sites were included in the five studies. Clinical and radiological evaluation showed complete healing during the follow-ups. Statistically significant radiological and clinical evidence of new bone formation was achieved for socket preservation, grafting after third molar extraction, and cystic/apicectomy grafting. One patient with complications was reported. Histological analysis and micro computed tomography confirmed that it promotes bone regeneration. A comparison with synthetic hydroxyapatite showed similar healing characteristics. Within the limitations of the included studies, the eggshell can be safely and efficiently used in guided bone regeneration procedures, but more research is needed to completely evaluate the full potential of this material.

Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn’s disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn’s disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn’s disease may determine early and late implant failure. Besides Crohn’s disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy.

Aseptic loosening is the main late postoperative complication of cementless total hip arthroplasties (THAs), leading to pain and functional impairment. This article aims to update the orthopedic surgeon on the various methods by which the aseptic loosening rate can be reduced. We performed a systematic review by searching the PubMed database for hip aseptic loosening. We included meta-analysis, randomized controlled trials, reviews, and systematic reviews in the last 10 years, which provided information on techniques that can prevent aseptic loosening in total hip arthroplasty. From a total of 3205 articles identified, 69 articles (2%) met the inclusion criteria, leading to a total of 36 recommendations. A lot of research has been conducted in terms of septic loosening in the last decade. Currently, we have various techniques by which we can reduce the rate of aseptic loosening. Nevertheless, further randomized clinical trials are needed to expand the recommendations for aseptic loosening prevention.

The goal of periodontal therapy is to regenerate the periodontal structures: cement, periodontal ligament and alveolar bone. Stem cell-based tissue engineering raised novel therapeutic strategies for periodontal repair. In vivo dental follicle stem (DFSC) cells give rise to cementoblasts, osteoblasts and fibroblasts. Based on this idea, we have assessed DFSC potential to regenerate the periodontal structures, and by that to elaborate a new biomaterial. An experimental study was performed on male Wistar rats which were subjected to a procedure of periodontitis induction through placing silk thread ligatures around the lower incisors, under general anesthesia. Clinically, the changes of the periodontal tissue (bleeding on probing, dental mobility, dental plaque, presence of pus) induced by the periodontitis progression were daily assessed. The subjects were divided in two groups: a control and a study group. After 7 days from placing silk thread ligatures, subjects from the study group received an injection in the gingival sulcus. The injected biomaterial contained dental follicle stem cells seeded on fibrinogen. Bleeding on probing at the end of the treatment period was significantly reduced in the study group (study vs control group - 0% vs 100%, p=0.01.). In terms of dental mobility statistical significant results were obtained (p=0.04): for 20% from the subjects from the study group dental mobility was absent, while in the control group all subjects presented different degrees of mobility (33.3% degree II- v-o/m-d, 66.6% degree III-v-o/m-d/ax). In the control group pus was present in 66.7% from the subjects, and absent in the study group (p=0.10). Dental plaque was present in 40% of the subjects from the study group and in 100% in the control group. The clinical and histological results of our study demonstrate that dental follicle stem cells are a valuable cell source for tissue engineering the periodontal tissue.

Background and Objectives: Enamel matrix derivative (EMD) is a biomaterial used for periodontal regenerative therapy due to its properties of stimulating cementum development and bone synthesis. Diabetes is a chronic condition that affects healing and predisposes to infection. The aim of this review was to evaluate the current studies available on the application and results of EMD for periodontal regenerative therapy under diabetic conditions. Materials and Methods: Five databases (PubMed, ResearchGate, Scopus, Web of Science and Google Scholar) were searched for relevant articles, using specific keywords in different combinations. The inclusion criteria were clinical trials, case reports, case studies, and animal studies published in English, where periodontal treatment for bone defects includes EMD, and it is performed under diabetic conditions. Results: Of the 310 articles resulted in search, five studies published between 2012 and 2020 met the inclusion criteria and were selected for the current review. In human studies, the use of EMD in infrabony defects showed favorable results at follow-up. In animal studies, periodontal regeneration was reduced in diabetic rats. Conclusions: EMD might promote bone healing when used under diabetic conditions for the regenerative periodontal therapy. Due to limited number of studies, more data are required to sustain the effects of EMD therapy in diabetic settings.

"Dental practitioners, sometimes, are facing patient’s requests to overtreatment care, which in many situations is completely unnecessary or even dangerous/ risky/ disproportionate to the patient’s (oral) health state/condition. It can include procedures such as: teeth whitening, removal of amalgam fillings, closing diastema, veneers, dental extractions, root canal treatment, dental implants or fixed orthodontic appliances. It is known that dentistry practice belongs to two different and conflicting worlds, medical and business. In front of such situations, dentists should decide the right way of doing their job: being a medical doctor and treating patients or doing business and executing exactly what patients are asking for. Due to these facts, this presentation aims to: 1) identify the main issues related to this dilemma of dentists and 2) offer a better perspective on realizing dental esthetics treatments without jeopardize the oral health of the patient, but also the dentist’s profession and professional integrity. "

Background and Objectives: The endodontic system and the periodontium are closely interrelated and the infection of both leads to the appearance of endodontic-periodontal lesions. Along with the endodontic and periodontal classic treatment, in most cases, there is a need for regenerative periodontal therapy for the repair of the damaged tissue. One material that stimulates bone healing is represented by platelet-rich fibrin (PRF). The aim of this study was to determine if the inclusion of PRF in the treatment protocol of endodontic-periodontal lesions is effective. Materials and Methods: This review was conducted according to the PRISMA guidelines. Four databases, MEDLINE (through PubMed), Scopus, Web of Science, and Google Scholar, were used in order to find all significant articles on the topic. Relevant keywords were used in different combinations. Results: The inclusion criteria were met by six studies, published between 2014 and 2020 and they were selected for the review. The use of PRF for the regenerative therapy of endodontic-periodontal lesions showed favorable outcomes in all of the studies included, with significant reductions in the probing depths. Conclusion: While platelet-rich fibrin may be beneficial, further research is needed.

Proton pump inhibitors (PPIs) have become known for the treatment of gastric-acid related disorders. Similar to any other drugs, PPIs have possible adverse reactions, being associated with bone fractures, infections, kidney disease, mineral deficiency, dementia, and pneumonia. Multiple analyses have stated that PPIs therapy may affect bone regeneration and osseointegration process, causing an increased risk of bone fracture, deterioration of bone metabolism and impaired bone healing. In this review, we emphasized the current literature regarding the influence of proton pump inhibitors in the bone regeneration process. Results from the studies suggest a link between PPIs intake and bone regeneration, but several concerns are raised regarding inadequate recipient bone, surgical trauma, limitations on the titanium surface, comorbidities or interference with other pharmacological agents. Further studies are needed to determine whether the impaired bone regeneration process is due to PPI or coexisting factors.

Absorbable atelo-collagen type 1 represents a new approach for guided bone regeneration with several reported advantages such as: osteoblast attachment, proliferation, mineralization potential, absorption of growth factors and inhibition of bacterial pathogen colonization. The aim of this study was to assess the clinical, radiological (preoperative width, re-entry width, gain), Periotest measurements and histologic benefits of atelo-collagen-derived bovine bone grafts (ImploBone) in combination with an atelo-collagen type I barrier membrane (ImploSorb) for guided bone regeneration (GBR) of atrophic alveolar crest in thirteen patients. Eleven patients underwent simultaneous GBR with implant insertion, two had initial GBR procedure followed by implant placement after 6 months of healing. Ridge augmentation was performed using an atelo-collagen membrane (ImploSorb, Bioimplon, Germany) and a combination of 50% ABBM (ImploBone, granule size 0.5-1mm, BioImplon Germany) mixed with 50% autologous bone. It was found that simultaneous GBR with implant placement resulted in a 35% gain at bone defect level (preoperative width 5.03±1.25 mm, re-entry width 6.81±0.98 mm, gain 1.78±1.71 mm). Implant placement performed in a 2 stage surgery 6 months following GBR was linked with a 63,9% gain at bone defect level (preoperative width 3.79±1.10 mm, re-entry width 6.22±1.41 mm, gain 2.43±1.43 mm). The total gain in both groups was 41,9% utilizing these novel biomaterials (preoperative width 4.68±1.32 mm, re-entry width 6.65±1.12 mm, gain 1.96±1.64 mm). This case series study presents a protocol where GBR can be performed either simultaneously to implant placement or delayed with this innovative biomaterial to favor bone regrowth. Future randomized controlled clinical trials are needed to further validate the bone-promoting potential of atelo-collagen-based biomaterials for bone regeneration.

Some previous studies reported that probiotics might decrease the severity of chemotherapy-induced mucositis. This study assessed the potential protective effect of Lactobacillus plantarum ATCC 8014 on 5-fluorouracil (5-FU) induced intestinal mucositis in the Wistar rats. The Crl:WI rats were divided into two groups of six animals (F, L) and one group of 5 animals (M). Group L received for 9 days 3.32x109 CFU/ml of Lactobacillus plantarum orally. In the 7th day of the experiment 400 mg of 5-FU was administered intraperitoneally in groups L and F. Group M received only the vehicles. All animals were sacrificed in the 9th day. Eleven histological characteristics of mucositis were quantified from 0 (normal) to 3 (severe) for duodenum, jejunum and colon. Semiquantitative grades measured Toll-like receptor 4 (TLR4) immunopositive cells. The independent groups were analyzed using the Kruskal-Wallis test, Mann-Whitney U test, with a Bonferroni correction for alpha (P≤0.016). In the group F, treated with 5-FU, the most affected areas were the jejunum and the duodenum. The medium score of histological lesions was 27 for jejunum (minimum 25, maximum 32) and 21 for duodenum (minimum 18, maximum 29). Graded microscopic mucosal changes of the jejunum were significantly lower in group L compared with group F (U=0, P=0.009, Mann-Whitney test). The histological changes depicted on the duodenal and colonic mucosa were less severe in group L than in group F, but without reaching the statistical significance (duodenum: U=6, P=0.172, Mann-Whitney test; colon: U=12, P=0.916, Mann-Whitney test). Although the TLR4 immunoexpression was more intense in group L, no significant statistical difference was revealed at duodenum, jejunum or colonic mucosa. Significantly fewer microscopic changes were depicted in L group on the jejunum, suggesting a potential beneficial effect of Lactobacillus plantarum at this level in 5-FU induced mucositis.

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Thyroid neoplastic pathology is the most common form of cancer associated with radiation exposure. The most common histopathological type of thyroid carcinoma is the differentiated thyroid cancer (these include papillary and follicular type), which represents over 90% of all cases, especially affecting girls rather than boys. Although patients are diagnosed in advanced stages as compared to adults, the prognosis of the disease is very good, with a 30-year survival rate of over 95% but post-therapeutic morbidity remains quite high. The treatment is based in particular on the therapeutic guidelines for adults, but as children have some histopathological and genetic characteristics of thyroid cancer, as well as different initial clinical presentations, we decided to review the literature on this pathology among the pediatric population, focusing on cases in Europe. The major interest is the impact of the Chernobyl accident.

Purpose The aim of this systematic review was to determine a potential association between periodontal disease and graft versus host disease (GVHD). Design PubMed, Scopus and Web of Science databases were searched to identify all relevant articles. The eligibility criteria were prospective, retrospective, cross-sectional, cohort, case-control studies and interventional studies that assessed periodontal parameters in GVHD adults’ patients. Results Seven studies, published between 2000 and 2018, were eligible. The aggravation of periodontal tissues is due to inadequate oral hygiene, dental plaque, decays, gum recession, retained roots, tooth loss, periodontally infected teeth. Several studies have indicated that periodontitis treatment performed before transplantation showed the reduction of gingival inflammation and maintenance of periodontal health. Conclusions Periodontitis might be a risk factor for GVHD. However, due to the limited number of studies included in the review and their heterogeneity, more data are needed to sustain the correlation between periodontitis and GVHD.

Background The aim was to assess the effects of periodontal disease in promoting liver fibrosis in a rat model of ligature-induced periodontitis. Methods Twenty-four Wistar rats were divided into four groups: control (CTRL), experimental periodontitis group at day 7 (PER7), at day 14 (PER14), at day 21 (PER21). Experimental periodontitis was induced by the placement of a silk ligature around mandibular incisors. The following parameters were assessed: gingival index, tooth mobility; liver status, and portal vein caliber by ultrasound examination; bone retraction, bone mineral density (BMD), bone volume/tissue volume (BV/TV) by micro-CT analysis; aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT); oxidative stress (malondialdehyde [MDA], reduced glutathione/oxidative glutathione ratio [GSH/GSSG]), and matrix metalloproteinase-8 (MMP-8) levels; and histopathological evaluation of periodontal and liver tissues. Results Periodontal parameters showed the development of periodontitis in experimental groups. Micro-CT results indicates an increase of bone retraction and BMD values and a decrease of BV/TV value in PER groups. Liver fibrosis could not be diagnosed with ultrasound examination in any of the groups. Elevated levels of ASAT and ALAT in PER groups compared with CTRL group were found. MDA have indicated elevated levels and a decrease of GSH/GSSG ratio in PER group compared with the CTRL group. Levels of MMP-8 have indicated high values in PER21 compared with the other groups. Histological analysis of the periodontal and liver tissues sustains the link between periodontal and hepatic injury. Conclusion This study demonstrates a positive correlation between periodontal lesions and liver disease. Periodontitis may be an independent risk factor for liver fibrosis.

In vitro studies showed that high-frequency pulsed electromagnetic fields (HF-PEMFs) increase the activity/expression of early and late osteogenic markers and enhance bone mineralization. The main aim of this study was to investigate the in vivo effects of HF-PEMFs on fracture healing using a rat model. A femur fracture was established by surgery in 20 male Wistar rats. Titanium nails were implanted to reduce and stabilize the fracture. After surgery, 20 rats were equally divided into untreated control and treated group (from the first postoperative day HF-PEMFs at 400 pulses/sec [pps] were applied for 10 minutes/day, for two weeks). Quantitative and qualitative assessment of bone formation was made at two and eight weeks following surgery and included morphological and histological analysis, serological analysis by ELISA, micro-computed tomography (micro-CT), and three-point bending test. At two weeks in HF-PEMF group, soft callus was at a more advanced fibrocartilaginous stage and the bone volume/total tissue volume (BV/TV) ratio in the callus area was significantly higher compared to control group (p = 0.047). Serum concentration of alkaline phosphatase (ALP) and osteocalcin (OC) was significantly higher in HF-PEMF group (ALP p = 0.026, OC p = 0.006) as well as the mechanical strength of femurs (p = 0.03). At eight weeks, femurs from HF-PEMF group had a completely formed woven bone with dense trabeculae, active bone marrow, and had a significantly higher BV/TV ratio compared to control (p = 0.01). HF-PEMFs applied from the first postoperative day, 10 minutes/day for two weeks, enhance bone consolidation in rats, especially in the early phase of fracture healing.

Acute myeloid leukemia is a highly aggressive malignancy with a high morbidity rate, for which an accurate and rapid diagnostic is essential. Acute myeloid leukemia manifestations frequently include oral abnormalities. Still, there is a limited number of studies reporting the incidence of oral manifestations in acute leukemia, the prevalence of periodontal status and periodontal parameters in these patients. Our aim was to emphasize the importance of early recognition by the dental practitioners of oral cavity manifestations as signs of acute myeloid leukemia, so that prompt referral to the hematologists is being done, and appropriate treatment is offered.