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Objectives. The present pilot study was carried out to evaluate the periodontal status, the levels of interleukin-6 and tumor necrosis factor alpha in gingival crevicular fluid on hospitalized patients with colorectal cancer. Materials and Methods. The sample of our study was represented by 74 patients with colorectal cancer. They were assigned to one of the two study groups, based on cancer’s stages, as follows: (i) stage III-IV: 51 patients (A-group); (ii) stage III: 23 patients (B-group). For each participant periodontal parameters were recorded and gingival crevicular fluid samples were collected and immunologically assessed. Results. Statistically significant differences were found between the two groups, regarding probing pocket depth, clinical attachment loss, bleeding on probing, interleukin-6 and tumor necrosis factor alpha. In A-group, statistically significant correlations were found between the inflammatory markers and probing pocket depth and between their levels and bleeding on probing. In B-group, statistically significant correlation was found between the levels of interleukin-6 and bleeding on probing. Conclusions. Our results suggest an association between the severity of periodontitis, the studied immunologic inflammatory markers and colorectal cancer’s severity.

(1) Background: This cross-sectional investigation appreciated the role of serum C-reactive protein (CRP), several hematologic-cell markers, and salivary inflammation-related molecules [calprotectin (S100A8/A9), interleukin-1β (IL-1β), kallikrein] to predict periodontitis in patients with atherosclerotic cardiovascular disease (ACVD), arrhythmia, or both. Also, we appreciated the relationship between the inflammatory burden and periodontal destruction with the type of cardiac pathology. (2) Methods: Demographic, behavioral characteristics, periodontal indicators, blood parameters, and saliva samples were collected. (3) Results: All 148 patients exhibited stage II or III/IV periodontitis. Stage III/IV cases exhibited significantly increased S100A8/A9 levels (p = 0.004). A positive correlation between S100A8/A9 and IL-1β [0.35 (

To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.

Objectives: This randomized, placebo-controlled, double-masked clinical trial aimed to evaluate the clinical and microbiological efficacy of professional mechanical plaque removal (PMPR) with or without adjunctive application of piperacillin plus tazobactam gel in the treatment of peri-implant mucositis (PiM) for up to 6 months. Materials and Methods: The study included 31 patients with peri-implant mucositis (bleeding on probing (BoP) > 1 at at least one site at baseline, absence of peri-implant bone loss compared with a previous radiograph). After randomized assignment to test and control groups, patients received full-mouth supragingival scaling with or without piperacillin plus tazobactam gel. Clinical examination was performed at baseline and after 3 and 6 months, and a microbiological examination was performed at baseline and after 3 months. Results: After six months, both treatment modalities resulted in significant reductions and improvements in clinical parameters at the implant sites. Neither study group achieved a complete resolution of PiM (i.e., BoP ≤ 1 per implant). The number of implants with BoP decreased statistically significantly between subsequent time points (p < 0.001) in both the test and the control group. Significant BoP differences (p = 0.039) were observed between groups at 6 months (difference to baseline) following therapy. Conclusions: Within the limitations of the present study, the single use of a slow-release, locally applied antibiotic combination of piperacillin and tazobactam gel, adjunctive to PMPR, showed an improvement in clinical variable of implants diagnosed with PiM. The adjunctive treatment resulted in higher BoP reduction when compared to the control, but no significant differences were observed regarding the changes in other clinical and microbiological parameters.

(1) Background: This study aimed to assess the periodontitis burden in systemic sclerosis patients and the possible association between them, and the degree to which some potential risk factors and two potential diagnostic biomarkers may account for this association. (2) Methods: This cross-sectional study included a test group (systemic sclerosis patients) and a control group (non-systemic sclerosis patients). Both groups benefited from medical, periodontal examination and saliva sampling to determine the salivary flow rate and two inflammatory biomarkers (calprotectin, psoriasin). A systemic sclerosis severity scale was established. (3) Results: In the studied groups, comparable periodontitis rates of 88.68% and 85.85%, respectively, were identified. There were no significant differences in the severity of periodontitis among different systemic sclerosis severity, or in the positivity for anti-centromere and anti-SCL70 antibodies. Musculoskeletal lesions were significantly more common in stage III/IV periodontitis (n = 33, 86.84%) than in those in stage I/II (n = 1, 100%, and n = 3, 37.5%, respectively) (p = 0.007). Comparable levels of the inflammatory mediators were displayed by the two groups. There were no significant differences in calprotectin and psoriasin levels between diffuse and limited forms of systemic sclerosis. (4) Conclusions: Within the limitations of the current study, no associations between systemic sclerosis and periodontitis, or between their risk factors, could be proven.

Noncarious cervical lesions (NCCLs) are defined by the loss of hard dental tissues localized at the cervical area of the teeth, having different etiology as compared to carious lesions. They occupy an important place in dental pathology and can be a real challenge for the specialist in terms of diagnosis and treatment plan. The management of all the etiological factors involved in their occurrence, as well as the selection of the ideal restorative materials and techniques still remain controversial topics. NCCLs have a significant negative impact on dental and periodontal health while certain histo-morphological features make both the diagnosis and treatment phases difficult. The NCCLs clinical approach involves the identification and elimination of all ethiological and risk factors involved in their occurrence and the actual restoration of lost dental tissues. Both the characteristics of the lesion and the proximity of the periodontal tissues should be considered when choosing the working protocols and materials in order to maintain the periodontal health. The behaviour and specific features of composite materials derive from their composition and structure. Their major disadvantage is the polymerization shrinkage, which negatively influences the clinical performance of restorations, especially in the case of NCCLs. The aim of this article is to highlight certain important aspects regarding the properties and performance of flowable composites in restoring NCCLs.

Background and aims. Periodontal disease and NAFLD present similar risk factors, thus the possible influence of NAFLD on the clinical evolution of periodontal disease is being pursued. Material and Methods. For this study were selected 87 patients who presented themselves at the Clinic of Periodontology of the Faculty of Dental Medicine in Craiova and at the dental office S.C. MED-COM S.R.L, for periodontal reasons, and Gastroenterology Clinic within the County Clinical Emergency Hospital Craiova, between April 2018 and March 2019.The patients were diagnosed with periodontitis using periodontal measurements, having periodontal pocket depth (PD)≥ 4 mm, and with NAFLD using laboratory tests and abdominal ultrasound. Results. The participants with NAFLD had slightly more sites with PD≥ 4 mm than patients with only periodontitis, also in the cases where the laboratory test were inconclusive with normal levels of ASL, and mild elevated levels of ALT, GGT, total cholesterol and sugar levels.

Systemic sclerosis is a chronic, autoimmune, multisystemic disease characterized by aberrant extracellular matrix protein deposition and extreme progressive microvasculopathy. These processes lead to damage within the skin, lungs, or gastrointestinal tract, but also to facial changes with physiognomic and functional alterations, and dental and periodontal lesions. Orofacial manifestations are common in SSc but are frequently overshadowed by systemic complications. In clinical practice, oral manifestations of SSc are suboptimally addressed, while their management is not included in the general treatment recommendations. Periodontitis is associated with autoimmune-mediated systemic diseases, including systemic sclerosis. In periodontitis, the microbial subgingival biofilm induces host-mediated inflammation with subsequent tissue damage, periodontal attachment, and bone loss. When these diseases coexist, patients experience additive damage, increasing malnutrition, and morbidity. The present review discusses the links between SSc and periodontitis, and provides a clinical guide for preventive and therapeutical approaches in the management of these patients.

Oral microbiota have shown a higher bacterial diversity in patients with cancers of the digestive tract, with higher levels of periopathogens. Recent studies have shown that Fusobacterium links to gastro-intestinal neoplastic tissue and accelerates its progression, as well as worsening patient outcome. The present pilot study was carried out between February and December 2020 to evaluate the possible association between the abundance of some periopathogens (Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola and Tannerella forsythia) in subgingival plaque and periodontal status with characteristics of gastric cancer. The study was performed on a sample of 24 patients with gastric cancer from the 1st Department of Surgery and Department of Gastroenterology within the Clinical County Hospital of Emergency of Craiova, Romania. The patients’ oral cavity was examined, gingival crevicular samples were collected, and signs of periodontal disease were recorded. On the histopathological exam, the differentiation grade and size of the tumour were registered. Our results showed that, from the periopathogens studied, the most abundant bacteria were F. nucleatum followed by T. forsythia in all groups. In our present study, the strong correlation between tumour dimension and all periodontal parameters but also between tumour dimension and F. nucleatum could suggest a positive association between periodontal disease, tumoral growth and periopathogens implication in this process.

Aim of the study: to compare the metabolic status using chemical blood test markers for periodontal disease-diagnosed patients suffering or not from systemic conditions (diabetes mellitus and chronic viral hepatitis). Material and Methods. 195 patients diagnosed with various stages of chronic periodontal disease (PD) were divided into four groups: PD + diabetes mellitus (n=60), PD + hepatitis B (n=16), PD + hepatitis C (n=10) and PD only (n=109). The patients’ blood samples were analyzed for: biochemical parameters (blood sugar – glucose, total cholesterol, hepatic enzymes – transaminase ALT and AST, triglycerides) and cellular parameters (full blood count, erythrocyte sedimentation rate, prothrombin time and international normalized ratio). Data collection and statistical analysis t-test were performed for comparison, p < 0.05 for statistical significance. Results. Our retrospective study shows elevated levels of hepatic enzymes (both AST and ALT) for the periodontal patients diagnosed with chronic HCV/HBV infection than for systemic-healthy periodontal patients. The total cholesterol mean values expressed no statistically significant difference between the four group of patients. Triglycerides mean levels were lower than the physiological reference value for periodontal patients with no co-morbidities but expressed higher average values for systemic-diseased ones. Glucose levels were the highest for the periodontal patients with diabetes. Conclusion. Metabolic parameters in periodontal patients suffer alterations caused by diabetes and HBV/HCV infection.

The resin composite restoration of non-carious cervical lesions (NCCLs) still faces some drawbacks mostly related to the quality of the marginal seal. This study attempts to evaluate the adhesive capacities of two flowable and two conventional hybrid resin composite restorations of NCCLs having two types of cervical margins. Our null hypothesis assumes the same adhesive behavior of different materials. The relative composition of dental–restoration structures was also measured. Thus, restored wedge-shaped cervical cavities were realized on both the buccal and oral surfaces of extracted teeth. After immersion in dye solution, sectioning of the teeth was performed. We proposed an optical microscopy method to quantify the dye penetration along the restoration–tooth interface and scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX) to evaluate the quality of the peripheral seal. The data obtained revealed an amount of dentinal microleakage for all tested materials, despite the favorable results of the restoration peripheral seal. Therefore, data from this study failed to reject the null hypothesis. The adhesion is not influenced by the position of cervical margins. The SEM revealed occasional disruptions of the adhesive interface. EDX sustains the qualitative compositions as provided by the manufacturers. Conclusions: The four experimental composites are recommended to restore NCCLs in clinic.

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.

Metal-ceramic crowns (MC) have long been considered as gold standard for dental prosthetic restorations. Our study aims to evaluate the influence of MC, with conventional technology used for the framework, on the periodontal parameters and levels of C reactive protein, an inflammatory marker, in gingival crevicular fluid in patients diagnosed with periodontitis. Two groups were established: the test group T-28 teeth from the lateral area wearing a MC crown and the control group C-28 teeth without any wearing. These parameters were evaluated: probing depth, Gingival Index, and longevity of crowns. The quantitative assessment through enzyme-linked immunosorbent assay of the targeted pro-inflammatory mediator was performed. There is a difference statistically significant between the groups T and C regarding the marker’s levels and gingival index, a very strong correlation between these levels and probing depth and a strong correlation between longevity and Gingival Index. Periodontal clinical parameters are more pronounced the longer the time elapsed since the application of the crowns. Expression of C reactive protein is higher in the presence of MC crowns.

Periodontal health is essential before and after a prosthetic restoration. Thus, the most accurate reproduction of the size and shape of dental crowns with that of natural teeth is the key to maintain a normal relationship between the joint and the occlusal relief and to maintain the integrity and health of periodontal tissues. Maintaining the periodontal health of the teeth with prosthetic restorations, with the placement of the margins in contact with the marginal gingival tissue, is a challenge, because the odonto-periodontal unit is constantly affected by microbial flora and the bacterial plaque accumulation can be stimulated by the presence of dental restorations. The objective of the present study was to analize the effects of fixed dental prostheses on periodontal inflammatory status and hygiene. After ethical approval, patients were clinically examined, their data was recorded and statistically processed. The results showed the existence of significant differences or correlations between the plaque, calculus or gingival indices and the characteristics of dental prosthesis in some situations. In conclusion, the presence of prosthetic restorations could influence the oral hygiene and be associated wih periodontal changes.

Oral hygiene is a dental procedure with the role of removing bacterial plaque and action to prevent oral diseases, including periodontal disease. Oral prophylaxis includes both daily dental hygiene (daily brushing, flossing and mouthwash) and the visits to the dentist for professional hygiene and prophylaxis. The correct brushing of the teeth is important not only for maintaining oral health but also for the health of the whole body, because there are correlations between diseases of the oral cavity and problems of the digestive tract or even heart disease.

The CD34 protein was identified almost four decades ago as a biomarker for hematopoietic stem cell progenitors. CD34 expression of these stem cells has been exploited for therapeutic purposes in various hematological disorders. In the last few decades, studies have revealed the presence of CD34 expression on other types of cells with non-hematopoietic origins, such as interstitial cells, endothelial cells, fibrocytes, and muscle satellite cells. Furthermore, CD34 expression may also be found on a variety of cancer stem cells. Nowadays, the molecular functions of this protein have been involved in a variety of cellular functions, such as enhancing proliferation and blocking cell differentiation, enhanced lymphocyte adhesion, and cell morphogenesis. Although a complete understanding of this transmembrane protein, including its developmental origins, its stem cell connections, and other functions, is yet to be achieved. In this paper, we aimed to carry out a systematic analysis of the structure, functions, and relationship with cancer stem cells of CD34 based on the literature overview.

In recent decades, researchers have investigated the bidirectional links between periodontal disease and systemic diseases, and the results have allowed the development of the concept of periodontal medicine. This concept incorporates and analyzes the mutually influential interactions that can occur between periodontitis and systemic diseases such as diabetes mellitus or cardiovascular diseases. Sjögren’s syndrome (SS) is a chronic autoimmune disorder that targets the exocrine glands of the body, such as the lacrimal and salivary glands. The amount of saliva produced may gradually decrease with the progression of the disease, which can have an impact on the structures within the oral cavity. Although the reduction in saliva flow produces negative effects in the oral cavity, a direct association between Sjögren’s syndrome and periodontal disease has not yet been demonstrated. Available studies on this topic have not identified significant differences in the periodontal status of patients with Sjögren’s syndrome and control groups at the clinical and bacteriological levels. On the other hand, other studies on this topic consider that patients with periodontitis have a higher risk of developing Sjögren’s syndrome than the general population. Therefore, the results remain inconclusive, highlighting the need for further complementary studies.

During odontogenesis, the interactions between the epithelium and the adjacent mesenchyme involve the participation of a complex system consisting of signaling molecules, corresponding receptors and transcriptional control systems. In this context, the tooth eruption is accompanied by numerous periodontal changes including bone remodeling and regressive changes in the periodontal ligament causing an increase in local cytokine production (MMP, TIMP). Understanding the ongoing process occurring in periodontal tissues during tooth development can prevent adverse consequences associated with eruption disturbances.

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

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

The term molar-incisor hypomineralization describes an uncommon pathological entity characterized by the hypomineralization of permanent first molars and commonly affecting permanent incisors. In this paper, we describe a case of a 12 years old male patient attended with severe dental sensibility, masticatory and phonetic difficulties. Clinical examination revealed extended atypical restorations on permanent first molars, associated with opacities at the border of the restorations, enamel breakdown and opaque stains affecting permanent incisors. MIH diagnosis for this case is justified not only by the visual aspect of the lesions, but also by dental affection pattern.

The number of patients undergoing hormone replacement therapy (HRT) to counterbalance hormonal changes is increasing. Patients follow HRT not only to avoid climatic symptoms but also to protect themselves from cardiovascular disease and osteoporosis. HRT is an option for women who need drug therapy to reduce the risk of osteoporosis, including women at high risk of fracture for the next 5-10 years. Oestrogen supplementation can modulate the periodontal destruction rate through mechanisms involving inhibition of matrix metalloproteinases (MMP-8 and MMP-13) and cytokines involved in bone resorption

The metabolic syndrome is a complex pathology, multisystemic, with numerous consequences that include: high blood sugar, hypertension, visceral obesity, dyslipidemia with high levels of triglycerides (TG) and low levels of HDL. Recent studies have published in the specialty literature, data that suggest the existence of a possible association between obesity and periimplantitis. The purpose of this report cases is to explore the possible relation between the metabolic syndrome and the development of periimplantitis. To reach the proposed objective we have evaluated the characteristics of periimplant tissues in patients that have a metabolic syndrome associated.

Implantology aims at the lasting restoration of masticatory function and also of aesthetics, phonetics and patient comfort. But, at the same time, among the purposes of treatment with dental implants is the stabilization of the peri-implant bone, whose resorption is thus stopped at the time of implant insertion, as well as the peri-implant soft tissues, which are supported by the peri-implant bone and after their collapse, in the event of bone atrophy, it appears an unsightly appearance of the teeth and the contour of the gingival mucosa.

Local risk factors could influence directly the periodontium, the most often involved local risk factors being dental calculus, malocclusions, improper or aged and degraded dental or prosthetic treatments, orthodontic appliances, affecting also the masticatory, esthetical and phonetical function consequently decreasing the quality of life. A good domestic plaque control performed by the patient and its removal professionally may be insufficient for the resolution of periodontal inflammation, as the local/systemic risk factors may still favour plaque accumulation or cause a misbalance of the host immune response. Therefore, plaque removal should be always accompanied by a sustained effort of the dental practitioners’ team to correct, or to, at least, control the predisposing local and systemic risk factors.

Achievement of holistic oral health is dependent upon first carrying out a thorough examination, so as to establish a comprehensive diagnosis of patient etiologies, needs, and required therapies. Restorative therapy often includes splinting of mobile teeth, coverage of sensitive roots, and correction of occlusal abnormalities to improve periodontal prognoses. The components of a thorough clinical examination include periodontal probing depths, assessment of clinical attachment levels, hard – and soft – tissue examination, models, and face – bow records. However, it is important to realize that a complete examination begins with an open discussion with the individual patient, as a step in determining the patient’s needs and desires. In this way, treatment plans may be formulated that are in the best interest of the patient and represent a greater value for the patient. Conclussion. Simple and complex patients may be successfully treated in this periodontaly challenging context, with success being defined as long – term stability and maximization of patient comfort, function, and aesthetics.

Background and objectives: this study aims to evaluate the clinical and microbiological effects of a single subgingival administration of a locally delivered antibiotic gel containing piperacillin plus tazobactam and compare it with a slow-release doxycycline (14%) gel and a placebo gel, following subgingival instrumentation (SI) in patients with severe periodontitis. Materials and methods: sixty-four patients diagnosed with stage III–IV periodontitis were enrolled, were randomly assigned into three groups, and were treated additionally with a single subgingival administration of piperacillin plus tazobactam gel (group A); doxycycline gel (group B); and placebo gel (group C). The primary outcome variable was the change in mean probing pocket depth (PPD) 6 months after the intervention. Secondary outcome variables were changes in mean full-mouth bleeding score (FMBS); full-mouth plaque score (FMPS); overall bleeding index (BOP); pocket closure; and clinical attachment level (CAL), along with changes in the numbers of five keystone bacteria: Aggregatibacter actinomycetemcomitans (A.a.), Porphyromonas gingivalis (P.g.), Prevotella intermedia (P.i.), Tannerella forsythia (T.f.), and Treponema denticola (T.d.). Intergroup and intragroup differences were evaluated at 3 and 6 months. Results: at baseline, the three groups were comparable. An improvement in clinical parameters such as PPD, CAL, and BOP between groups was observed at 3 and 6 months, but without statistical significance (p > 0.05). At 6 months, the intragroup analysis showed a significant reduction in clinical parameters. Even though the piperacillin plus tazobactam group showed slightly higher PPD reduction, this was not statistically significant when compared to both control groups. Conclusions: The groups had similar results, and subgingival instrumentation can be executed without adjunctive antimicrobials, reducing the costs for the patient and the working time/load of the professional.

The aim of the study was to identify the most relevant patient-related factors directly involved (alone or in combinations) in the long-term survival and functionality of the abutment teeth of extensive stabilizing bridges and removable prosthesis, in patients treated for Stage IV periodontitis, adhering to SPT over a period of at least 5 years. Seventy-six patients treated between 2000–2022, rehabilitated with FDPs and RDPs, adhering to SPT for at least 5 years were included. Patient-related factors influencing retention of RDPs and FDP, survival rates in regular (RCs) and irregular compliers (ICs), and incidence of biological and technical complications were assessed. During a follow-up of 69 months, from 57 patients with FDPs and 19 patients with RDPs, 39 (51.32%) were ICs, while 37 (48.68%) were RCs. An overall statistically significant association (p = 0.04) was identified between biological complications and the type of prostheses. The RDP patients had more complications than FDP patients. In 5.26% of the RDP patients, root caries were identified, and 10.53% were diagnosed with a periapical (endodontic) lesion, while 3.51% of the FDPS patients presented root caries. In five (6.57%) cases, abutment loss resulted in the loss of the prosthesis. Statistically significant correlations were observed between systemic diseases and tooth loss, and between type of tooth lost and the reason for tooth loss, irrespective of the type of prosthesis. A total of 66.67% of the lost incisors, 85.71% of the lost premolars, and 88.89% of the lost molars occurred due to periodontal causes. Furthermore, 93% of the FDPs and RDPs were still in place and in function.

Sampling of saliva is simple and effective. It is a simple method in that it does not require expertise for collection and is less expensive. Periodontal disease is a chronic microbial and inflammatory process characterized by the presence of pathogenic bacteria. Saliva, by its importance in biofilm formation and in host defense, secretes biomarkers that can play a significant role in the establishment and progression of periodontal disease. Determining salivary biomarkers helps in the early diagnosis of diseases and increases the success rate of the treatment.

The periodontal apparatus is very well connected with the rest of the human body, by means of vascular, lymphatic and nervous structures. These connections make the periodontal structures easily accessible to different distant pathologic mechanisms, such as inflammatory reactions, that can influence the onset and evolution of periodontal diseases. In certain situations, these influences have a mutual nature, transforming the relationship of the periodontal pathology with the systemic conditions into a bi-directional one. Understanding the mechanisms that drive and promote these pathogenic connections is important for offering periodontal patients a comprehensive treatment and for including periodontal screening for certain systemic diseases’ patients.

Obesity is a chronic , complex, multifactorial disease, which develops as a result of the interaction between genotype and life style. Up to now has not been fully elucidated the mechanism by which it occurs and is developing obesity, but it has been noted that it involves both social factors, as well as those cultural, behavioural, physiological, metabolic, and genetic. The aim of this review is to evaluate how different sistemic diseases, beside type 2 diabetes,smoking , obesity may be risk factors in the onset of perimplantitis. The association between periodontal disease and obesity has been shown in several studies to different age groups. Excessive adipose tissue produces a reduced inflammation which is a cause of oral amendments. In obesity was noticed this inflammation which can be a point of contact between this and periodontal disease or periimplantitis disease.

The study is aimed at assessing the impact that periodontal disease and chronic hepatitis C could have on gingival crevicular fluid levels of the NLRP3 inflammasome, caspase-1 (CASP-1), and interleukin-18 (IL-18) and at evaluating whether the increased local inflammatory reaction with clinical periodontal consequences is correlated to their upregulation. Patients were divided into four groups, according to their periodontal status and previously diagnosed hepatitis C, as follows: (i) CHC group, chronic hepatitis C patients; (ii) P group, periodontal disease patients, systemically healthy; (iii) CHC + P group, patients suffering from both conditions; and (iv) H group, systemically and periodontally healthy controls. Gingival crevicular samples were collected for quantitative analysis of the NLRP3 inflammasome, CASP-1, and IL-18. CHC + P patients expressed the worse periodontal status and the highest NLRP3, CASP-1, and IL-18 levels, the difference being statistically significant (p

Dental extraction can trigger certain sequences of complex processes that involve both hard (alveolar bone) and soft tissue (periodontal ligament, gingiva) remodeling. Type 2 diabetes is a serious risk factor for many oral pathologies, both in terms of progression and severity, but also regarding subsequent rehabilitation possibilities. The aim of this study was to establish whether certain molecules: osteoprotegerin (OPG), kappa B nuclear factor receptor activator ligand (RANKL), hepatocyte growth factor (HGF), tumor necrosis factor-α (TNF-α), interleukin 18 (IL-18), matrix metalloproteinase 9 (MMP-9) and oxidative stress markers—total oxidant status (TOS), total antioxidant capacity (TAC)—evaluated in saliva are modified post-extraction in type 2 diabetes mellitus subjects and whether there is a correlation with HbA1c levels. The aforementioned markers plus HbA1c were investigated in a group of systemically healthy subjects (n = 45) and in a type 2 diabetes mellitus group (n = 41) before and three months after a tooth extraction. Diabetes patients’ recorded increased levels of OPG, RANKL, TNF-α, MMP-9, IL-18 and TOS compared to controls both pre- and post-extraction. In both study groups, the average OPG, HGF and TAC level recorded an upward trend three months post-extraction. TNF-α registered a statistically significant decrease only in the diabetes group after dental extraction, together with a decrement of mean HbA1c levels in the diabetes group. By plotting the ROC (receiver operating characteristic) curve, at baseline RANKL, TNF-α, IL-18, MMP-9, TOS and OPG were good predictors of HbA1c levels. Post-extraction, there was a significant correlation between HbA1c and oxidative status biomarkers, however the linear regression model indicated the influence of all studied salivary markers in HbA1c determinism, in a considerable proportion. In conclusion, our study demonstrated that several oxidative status markers and proinflammatory biomarkers are modified in the saliva of diabetic patients and they correlate to HbA1c levels, thus being potential indicators of the post-extraction healing status in the oral cavity.

(1) Background: The aim of this split-mouth design study was to analyze the clinical periodontal indexes and oxidative stress markers in gingival crevicular fluid modifications after three periodontal disease treatment possibilities (scaling and root planning—SRP; SRP and diode laser—L; SRP and photodynamic therapy—PDT). (2) Methods: The study was conducted on 52 patients: systemically healthy subjects with periodontal disease—non-RA (n = 26); and test group (n = 26) subjects with rheumatoid arthritis and periodontal disease—RA. Clinical periodontal measurements (probing depth—PD; Löe and Silness gingival index—GI; papillary bleeding index—PBI; and periodontal community index of treatment needs—CPITN) and oxidative stress markers (8-hydroxy-2’-deoxyguanosine (8-OHdG) and 4 hydroxynonenal (4-HNE)) were analyzed at baseline (T0), after three sessions of periodontal treatment (T1), and 6 months after treatment (T2). (3) Results: Periodontal therapy improved clinical periodontal measurements and oxidative stress markers in both analyzed groups, with supplementary benefits for laser- and PDT-treated periodontal pockets. (4) Conclusions: The analyzed oxidative stress markers decreased significantly following non-surgical periodontal therapy in both rheumatoid arthritis and systemically healthy patients. All the periodontal disease treatment possibilities analyzed in this study offered clinical and paraclinical improvements; however, the association of laser with SRP and photodisinfection with SRP yielded the best clinical and paraclinical outcomes when compared to SRP alone.

Hepatitis C virus (HCV) infections could have an important impact on the oral health status of patients, favoring conditions such as periodontal disease and oral cancer. The review of the existing scientific literature written in English was performed, searching for oral and periodontal manifestations of HCV infection and its impact on the oral fluids. HCV infection can determine direct extrahepatic manifestations at the oral and periodontal level including oral lichen planus, Sjögren-like sialadenitis, and oral cancer. The changes caused by the infection in the subjects’ immune system, diet, and lifestyle can facilitate the development of oral conditions such as periodontal disease. Important changes also occur in the composition of the infected patients’ saliva and gingival fluid. HCV-infected patients need to be carefully monitored in terms of oral health since the infection with the virus can result in oral complications. The cellular and molecular particularities of the gingival fluid of HCV-infected patients can answer some questions regarding its impact upon periodontium impairment and whether this refers to a possible bidirectional relationship, with hepatic biomarker adjustments being induced by the periodontal patients’ inflammatory status.

Aim of the study The main goal of our study was to highlight the changes of preclinical and clinical periodontal status indices in a group of children and teen-agers with insulin-dependent diabetes (IDDM). Material and methods For objectifying our purpose 60 children, aged 7 to 18 years divided into three groups of 20 subjects each were examined: control group - children without diabetes, with good general condition, but with varying degrees of periodontal involvement, IDDM batch with good metabolic control (HbA1c ˂7,5%) and IDDM group with poorly metabolic control (HbA1c ˃7,5%). On all these subjects the following parameters were assessed: plaque index - Quigley-Hein (QHI), gingival index (GI), clinical attachment loss (CAL). The gingival crevicular fluid (GCF) volume from mesial sites of the incisors and first permanent molars was also evaluated. Results Our results show no significant differences in plaque index values between control and diabetic groups. Statistically significant differences were recorded when considering gingival index, higher values being recorded in children with IDDM and especially those with poorly controlled metabolic control, compared to control group. Clinical attachment loss registered augmented levels in children with IDDM compared to the control group, and in terms of measuring the GCF volume, values have been found significantly elevated in diabetics compared to control group, the largest being recorded in poorly metabolic controlled diabetic children and teen-agers. Conclusions Among the values of the evaluated indices, the highest increases were observed with parameters associated to significant inflammation, GI and GCF volume respectively. Our results are consistent with scientific literature in the field that claims inflammation as a major mechanism involved in the pathogenesis of both disorders: periodontal disease and diabetes.

Diabetes, a pathology that is extremly widespread, involves an alteration homeostasis in the glucose metabolism. Periodontitis is a infectious disease resulting in irreversible destruction of the tooth attachment apparatus. At present, periodontitis is one of the major reasons for adult tooth loss. The periodontal clinical examination determined the following diagnosis categories: chronic gingivitis and chronic periodontitis , all of them being modulated by the systemic disease. Aim of the study is to highlight possible correlations between periodontal status and diabetic clinical parameters characterizing patients diagnosed with type 1 diabetes(T1D). Material and methods This study was conducted on 62 patients. We analysed the general information of the patients and an oral examination for establishing the parodontal diagnosis. The probing depth has been established, number of teeth with pockets Larbert than 6mm and the plaque index Silness and Loe. Results Significant differences were found between the IP values on children and adults but there were no significant differences between IP on GTA and GCA or between IP on GTC and GCC. We did not find a statistically significant correlation between HbA1c and severity of periodontal diagnosis GTC. But found a direct correlation between HbA1c and statistically significant in periodontal diagnosis GTA. Conclusions The results obtained in this study show a possible relationship between metabolic changes caused by periodontal T1D and, especially in the group of adult patients.

Background. Wound healing is a tissue repair process after an injury, and two of its main components are inflammation and angiogenesis, in which course a cascade of mediators is involved. The aim of this research was to evaluate the involvement of Pentraxin 3 and Thrombospondin 1 in wound healing after periodontal surgery (gingivectomy) for gingival overgrowth during orthodontic treatment with or without magnification devices, by assessing their levels in GCF. Methods. From 19 patients with gingival overgrowth as a result of fixed orthodontic treatment, the overgrown gingiva was removed by gingivectomy, from one half of the mandibular arch without magnification and from the other under magnification. Pentraxin 3 and Thrombospondin 1 were determined from gingival crevicular fluid by ELISA tests. Results. Statistically significant differences (p