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Purpose: To assess the clinical concept of patient treatment with fixed tooth- and implant-supported restorations in a university-based undergraduate program after 13 to 15 years. Materials and Methods: In total, 30 patients (mean age 56 years) who had received multiple tooth- and implant-supported restorations were recalled after 13 to 15 years. The clinical assessment comprised biologic and technical parameters as well as patient satisfaction. Data were analyzed descriptively, and the 13- to 15-year survival rates for tooth- and implant-supported single crowns and fixed dental prostheses (FDPs) were calculated. Results: The survival rate of tooth-supported restorations amounted to 88.3% (single crowns) and 69.6% (FDPs); in implants, it reached 100% for all types of restorations. Overall, 92.4% of all restorations were free of technical complications. The most common technical complication was chipping of the veneering ceramic (tooth-supported restorations: 5.5%; implant-supported restorations: 13% to 15.9%) regardless of the material used. For tooth-supported restorations, increased probing depth = 5 mm was the most frequent biologic complication (22.8%), followed by endodontic complications of root canal-treated teeth (14%) and loss of vitality at abutment teeth (8.2%). Peri-implantitis was diagnosed in 10.2% of implants. Conclusions: The results of this study indicate that the clinical concept implemented in the undergraduate program and performed by undergraduate students works well. The clinical outcomes are similar to those reported in the literature. In general, the majority of biologic complications occur in reconstructed teeth, whereas implant-supported restorations are more prone to technical complications. [ABSTRACT FROM AUTHOR]

Purpose: To study the influence of tooth mobility on the accuracy of conven6onal impressions. Materials and Methods: In total, 10 pa6ents with mobile anterior teeth and 10 healthy pa6ents were treated with conven6onal impressions and intraoral digital impressions. The digital impression group was recorded as standard data, the mobile teeth group was recorded as the experimental group, and the healthy anterior teeth group was recorded as the control group. We imported digital impression and irreversible hydrocolloid impression files into Geomagic Wrap and marked reference points to execute N-point alignment, then we recorded the coordinates. Paired-samples t test was used to analyze whether the point coordinates of mobile teeth were statistically significant (α = .05). One-way ANOVA was used to analyze whether there was a rela6onship between coordinate differences and tooth mobility in the distal, coronal, and buccal directions (α = .05). Results: In the buccal and coronal directions, the difference was statistically significant between the conven6onal and digital impression groups. In the buccal direction, the accuracy differences of I-degree and II-degree mobile teeth were 0.149 mm and 0.401 mm, respectively. In the coronal direction, the differences were 0.128 mm and 0.233 mm, respectively. Meanwhile, ANOVA analysis showed that there was a rela6onship between point coordinate difference and tooth mobility in the buccal and coronal directions. Conclusions: Conventional impressions can influence the accuracy of mobile tooth impressions. Therefore, digital impressions should be adopted for mobile teeth impressions. [ABSTRACT FROM AUTHOR]

Objective: This article describes an interdisciplinary treatment that helped a patient with displaced upper anterior teeth. A gingivectomy, root canal therapies, digital smile design, digital wax‐up, and guided tooth preparations were applied. Clinical Considerations: A patient with pathologically migrated teeth asked for treatment without orthodontic involvement due to a primary failed orthodontic treatment history. A smile photo was taken and superimposed with the dentition in a CAD software to accomplish a digital smile design. The jaw movements were recorded with two different methods, a mechanical articulator and an intraoral scanner with Patient‐Specific‐Motion function. The occlusal contacts during protrusive and lateral movements were compared and the digital wax‐up was designed according to the later occlusal data. An aesthetic crown lengthening and pre‐op root canal treatment were carried out in advance accordingly. After guided tooth preparation with a silicone index, the final fixed restorations were manufactured and cemented. A 2‐year follow‐up showed that our prosthesis functions well. Conclusions: This clinical report revealed that an intraoral scanner with Patient‐Specific‐Motion function can effectively record individual dynamic occlusal patterns and these data can be integrated into the CAD/CAM process to enhance the fulfillment of clinical requirements. Clinical Significance: This clinical procedure with a 2‐year follow‐up demonstrated that a prosthodontic‐based interdisciplinary treatment of pathologically migrated teeth using dynamic occlusal recording with an intraoral scanner could achieve satisfactory esthetics in a relatively short treatment period. The Patient Specific Motion module may be used to record a personalized functional movement and the data can be integrated into the design process of the final restorations. [ABSTRACT FROM AUTHOR]

The faunal remains from the late Neolithic site of Ness of Brodgar on the Orkney Islands (UK) provide a unique opportunity to investigate past adaptations of animal husbandry strategies to the Northern island environment, as well as the potential management of red deer. In this study, sheep and red deer mandibles and loose teeth (dP4 & M3) from the Ness of Brodgar were studied to construct age-at-death profiles, and analysed for δ13C, δ15N and δ18O. The mortality profile showed that around half of the analysed sheep were slaughtered when they reached maturity (i.e. after 2–4 years of life), consistent with a husbandry regime targeted at meat production. The stable isotope evidence indicates seaweed consumption in winter by several sheep (domesticates), but not by red deer (wild, possibly managed fauna). This dietary difference may have resulted from anthropogenically mediated influences, e.g. restriction of red deer habitats to upland areas. The varying extent of seaweed consumption between individual sheep and between Neolithic Orkney sites suggests differences in sheep husbandry practices across Orkney, indicating that the adaptation to consume seaweed was not ubiquitous on Orkney in the Neolithic, and did not follow a linear development. [ABSTRACT FROM AUTHOR]

Periodontal patients may face orthodontic problems because of bone support loss, such as maxillary incisor proclination, spacing, rotation, extrusion, pathologic tooth migration (PTM) or traumatic occlusion. Orthodontic treatment is therefore an element within the comprehensive treatment of periodontitis after the periodontal condition has stabilized. The presence of fixed appliances (FAs) promotes the accumulation of bacterial biofilm and impedes hygiene procedures. The increasing popularity of clear aligner (CA) treatment is due to the convenience of use, less discomfort, better esthetics, easier hygiene, lower failure rate, and shorter, less frequent visits. Therefore, the question arises whether treatment with aligners is a good solution for periodontal patients. To answer this question, the PubMed/Medline, Cochrane Library and EMBASE databases were searched using the following keywords: periodontitis, orthodontic treatment, clear aligners, multibracket orthodontic appliances, fixed appliance, root resorption, gingival recession and pathologic tooth migration. The search strategy identified 18 relevant studies. A total of 1090 participants took part in the analyzed studies. The available literature was analyzed in terms of the occurrence of root apex resorption, the possibility of treating pathologic tooth migration, the occurrence of gingival recession, periodontal health status and occlusal stability in patients treated with CAs and FAs. Despite statistically significant differences in terms of Plaque Index (PI), probing depth (PD), apical root resorption and gingival recession favor the use of CAs. However, these values are mostly of no clinical significance. It is possible to treat PTM with CAs, but it is limited by the high degree of tooth mobility and incisor inclination. Obtaining perfect occlusion is comparably difficult in both CA and FA treatment. When planning orthodontic treatment in patients with reduced periodontium, the use of both CAs and FAs should be considered. The choice of method would ultimately depend on the patient's dental condition. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed at detailing a technique for digitally fabricated fixed restoration for both immediate replacement after extraction and splinting of the adjacent mobile teeth. Clinical Considerations: Demand for a fixed restoration of the missing teeth in the mandibular anterior region is very common but sometimes problematic for dentists. It often happens that there is significant loosening of the remaining teeth adjacent to the missing tooth, which should be splinted. This case report describes a digitally fabricated fixed restoration for both replacing lost teeth and splinting periodontally compromised mobile teeth. With the CAD‐CAM technique, patients can receive the restoration immediately after the extraction. The digital design and fabrication of the restoration were elaborated using the restorative process of a patient with a mandibular anterior tooth to be extracted and multiple loose lower anterior teeth. The immediate restoration process and the pontic modification when the extraction socket had healed were also described. Conclusions: The digital process avoids the nudging of the loose tooth by the traditional impression technique, improves the accuracy of the restoration, and avoids undue stress on the loose tooth when the restoration is in place. In addition, this method allows the patient to obtain a fixed restoration immediately after extraction, and if damage occurs after the restoration has been cemented, such as fracture or debonding, a new restoration can be prepared before the patient's return visit. Clinical Significance: This minimally invasive restorative method achieved the fixation of loose teeth while restoring the missing teeth, but the success of the treatment needed long‐time observation. [ABSTRACT FROM AUTHOR]

Background: Previous studies have suggested a potential link between the crown-to-root ratio (CRR) and root morphology in patients with mild chronic periodontitis, which may be associated with tooth mobility. However, these findings have not been thoroughly investigated. Our previous study found that 76% of patients with aggressive periodontitis, particularly those with premolar involvement, exhibited abnormal root morphology, severe alveolar bone loss, and increased tooth mobility, leading to poor clinical outcomes. This study aims to investigate the specific correlations among alveolar bone resorption, root morphology, CRR, and periodontal clinical indicators with premolar mobility in stage III/IV grade C periodontitis patients aged ≤ 35 years. Materials and methods: A total of 1,064 premolars from 151 stage III/IV grade C periodontitis patients aged ≤ 35 years were included in the study. Clinical periodontal parameters and radiographic measurements were recorded. Logistic regression analysis was used to explore the relationships between these indicators and tooth mobility. Results: Significant variations in premolar root lengths were observed, ranging from 6.80 mm to 20.96 mm. Teeth with shorter roots (mean length: 10.22 mm) exhibited grade I mobility with only 28% alveolar bone resorption, whereas those with medium-length (mean length: 12.67 mm) and longer roots (mean length: 14.91 mm) exhibited mobility at 34% and 37% bone resorption, respectively. Regression models incorporating the bone-level CRR, average probing depth, and root length demonstrated strong predictive accuracy for tooth mobility (P < 0.001, AIC = 1700.574). Conclusion: Premolar mobility is influenced by variations in root length, alveolar bone resorption, and probing depth. The bone-level CRR is an effective predictor for assessing tooth mobility, especially when there are differences in root length and alveolar bone resorption. [ABSTRACT FROM AUTHOR]

Background: The aim of this case report was to present a translational approach to tooth autotransplantation using jiggling forces to enlarge the periodontal ligament (PDL) space before autotransplantation, with the goal of improving treatment success and long‐term survival. Methods: A 23‐year‐old patient, undergoing orthodontic therapy and with an unrestorable maxillary first molar, was proposed to have a healthy and fully‐erupted maxillary third molar transplanted in the socket of the first molar. Jiggling forces were applied to the third molar to enlarge the PDL space and facilitate the preservation of PDL fibers on the root surfaces during the extraction. Results: Jiggling forces induced hypermobility and widened PDL space of the third molar. The autotransplantation was successful and the patient was followed regularly over a 27‐year period. At the 27‐year visit, the patient showed optimal chewing function, oral plaque control, and absence of gingivitis. The transplanted molar exhibited periodontal health and absence of mobility. Probing depth of 5 mm and radiographic external root resorption was noted on a localized area of the transplanted tooth which had experienced traumatic and unintentional removal of PDL fibers during the extraction. Conclusions: A translational approach was proposed by integrating knowledge from the fields of orthodontics, trauma from occlusion, and replantation. It validated the crucial importance of maintaining healthy PDL fibers on the root surface and demonstrated clinically the successful autotransplantation of a fully formed third molar into the socket of a first molar with a retention of 27 years. Key points: Why is this case new information?This case provided evidence of successful autotransplantation of a molar with complete root formation. It reported the longest‐term follow‐up (27 years) present in the literature. Most importantly, it used a translational medicine approach to apply concepts from the fields of orthodontics and traumatic occlusion to improve the success of the autotransplantation procedure. What are the keys to the successful management of this case?Jiggling forces induced tooth hypermobility and increased the PDL space of the tooth planned for autotransplantation. In turn, they facilitated the atraumatic extraction and preservation of the PDL fibers on the transplanted tooth, improving the success of the reattachment of periodontal fibers. What are the primary limitations to success in this case?Traumatic extraction resulting in the unintended removal of PDL fibers from the tooth planned for autotransplantation, or intentional removal of PDL fibers with root planing are expected to decrease the success rate of the autotransplantation procedure. This is due to the lack of viable PDL cells necessary for reattachment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of newly introduced ozonated gels compared with conventional chlorhexidine gel in the home management of periodontal patients. Materials and Methods: 30 patients with bilateral periodontal disease (severity I, complexity II) were enrolled (split‐mouth study design). After nonsurgical mechanical periodontal debridement, the teeth were randomly divided into two groups: teeth in the Control group were treated with a chlorhexidine‐based gel to aid oral hygiene maneuvers for 2 weeks after the first visit, while teeth in the Test group were treated in the same way with ozone‐based gels. After the baseline assessment, the follow‐up included assessments at 1, 2, and 6 months. The variables evaluated were clinical attachment loss (CAL), probing pocket depth (PPD), bleeding on probing (BoP), plaque control record (PCR), recession (R), and tooth mobility (TM). Results: For CAL, PPD, BoP, and PCR, significant intragroup differences were found for both groups (p < 0.05), in contrast to intergroup differences (p > 0.05). No significant differences were found for R and TM. Conclusion: Nonsurgical mechanical periodontal debridement with adjunctive use of ozone and chlorhexidine was found to be effective in periodontal treatment. Ozone could be suggested as an alternative to chlorhexidine. [ABSTRACT FROM AUTHOR]

Current standardized in vitro bending experiments for orthodontic archwires cannot capture friction conditions and load sequencing during multi-bracket treatment. This means that clinically relevant forces exerted by superelastic wires cannot be predicted. To address these limitations, this study explored a novel test protocol that estimates clinical load range. The correction of a labially displaced maxillary incisor was simulated using an in vitro model with three lingual brackets. Deflection force levels derived from four different protocols were designed to explore the impact of friction and wire load history. These force levels were compared in nickel-titanium (NiTi) archwires with three commonly used diameters. The unloading path varied between protocols, with single or multiple sequences and different load orders and initial conditions. Deflection forces from the new protocol, employing multiple continuous load/unload cycles (CC incr), consistently exceeded those from the conventional protocol using a single continuous unloading path (CU decr). Mean differences in plateau force ranged from 0.54 N (Ø 0.014" wire) to 1.19 N (Ø 0.016" wire). The CC inr protocol also provided average force range estimates of 0.47 N (Ø 0.012" wire), 0.89 N (Ø 0.014" wire), and 1.15 N (Ø 0.016" wire). Clinical orientation towards CU decr carries a high risk of excessive therapeutic forces because clinical loading situations caused by friction and load history are underestimated. Physiological tooth mobility using NiTi wires contributes decisively to the therapeutic load situation. Therefore, only short unloading sequences starting from the maximum deflection in the load history, as in CC incr , are clinically meaningful. • Friction and load history affect deflection forces of orthodontic NiTi wires. • Conventional in vitro 3-bracket bending tests underestimate clinical force levels. • Physiological tooth movement must be considered to derive clinically relevant loads. • Reactive forces from wire deflection may vary because of physiological conditions. • Sequential short unloading sequences allow characterization of clinical load range. [ABSTRACT FROM AUTHOR]

Background: Self‐reported measures of periodontitis developed for use in population surveillance are increasingly used in causal research. Numerous studies evaluate the validity of these measures against clinical parameters of periodontitis, yet few include validation parameters outside of multivariable models. Individual item validity is necessary to adequately inform use of these measures in causal research. Methods: We used data from the National Health and Nutrition Examination Survey 2011‐2014 in which dentate participants completed full‐mouth periodontal examinations (N = 6966). We evaluated six self‐report questionnaire items related to periodontal disease status against periodontitis case definitions developed by the Centers for Disease Control and Prevention and American Academy of Periodontology (CDC‐AAP). We estimated the sensitivity and specificity of individual items using severe and moderate‐to‐severe periodontitis classifications. We additionally combined items to evaluate the validity of joint measures. Results: Sensitivity was highest when measures were evaluated against severe periodontitis. Self‐rated oral health of fair/poor demonstrated the highest sensitivity for severe (0.60) and moderate‐to‐severe periodontitis (0.48). Specificity was highest when evaluated against moderate‐to‐severe periodontitis, with self‐reported history of tooth mobility as the most specific measure (0.87 for severe disease; 0.92 for moderate‐to‐severe) followed by a history of bone loss (0.88 for severe; 0.91 for moderate‐to‐severe). Combining questions generally improved specificity at the expense of sensitivity. Conclusions: Our findings related to item‐specific validity and the associated clinical profiles facilitate needed considerations for the use of self‐reported measures of periodontitis in causal research. Additionally, item‐specific validity can be used to inform assessments of misclassification bias within such investigations. [ABSTRACT FROM AUTHOR]

Background: There have been limited studies with statistically sufficient sample sizes for assessment of suitable bone defect morphology for combination therapy with enamel matrix derivative (EMD) and bone grafting. The aim of this study was to investigate the appropriate feature of intrabony defects, such as bone defect angle (DA) and the containment by bony wall, for yielding the additional benefit of bone grafting in combination with periodontal regenerative therapy using EMD. Methods: Following periodontal regenerative therapy using EMD with or without autologous bone grafting, 282 intrabony defects of 177 participants were maintained for 3 years. Multilevel linear regression analysis was performed to evaluate the radiographic bony defect depth (RBD) reduction after adjusting for confounders. Results: The baseline parameters, except for the proportion of contained bony defects and tooth mobility, did not differ significantly between the groups with and without bone grafts. There was no significant difference in the improvement of clinical parameters between the groups. The 1‐ and 3‐year reduction of RBD showed significant inverse correlations with preoperative DA only in the group without bone graft. Furthermore, multivariate analysis showed a significant interaction between DA at baseline ≥40° and adjunctive bone grafting in the reduction of RBD, regardless of the number of bony walls. Conclusion: Adjunctive autologous bone grafting with enamel matrix derivative might be significantly beneficial for defect depth improvement in the case of DA at baseline ≥40°. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies have suggested a potential link between the crown-to-root ratio (CRR) and root morphology in patients with mild chronic periodontitis, which may be associated with tooth mobility. However, these findings have not been thoroughly investigated. Our previous study found that 76% of patients with aggressive periodontitis, particularly those with premolar involvement, exhibited abnormal root morphology, severe alveolar bone loss, and increased tooth mobility, leading to poor clinical outcomes. This study aims to investigate the specific correlations among alveolar bone resorption, root morphology, CRR, and periodontal clinical indicators with premolar mobility in stage III/IV grade C periodontitis patients aged ≤ 35 years. Materials and methods A total of 1,064 premolars from 151 stage III/IV grade C periodontitis patients aged ≤ 35 years were included in the study. Clinical periodontal parameters and radiographic measurements were recorded. Logistic regression analysis was used to explore the relationships between these indicators and tooth mobility. Results Significant variations in premolar root lengths were observed, ranging from 6.80 mm to 20.96 mm. Teeth with shorter roots (mean length: 10.22 mm) exhibited grade I mobility with only 28% alveolar bone resorption, whereas those with medium-length (mean length: 12.67 mm) and longer roots (mean length: 14.91 mm) exhibited mobility at 34% and 37% bone resorption, respectively. Regression models incorporating the bone-level CRR, average probing depth, and root length demonstrated strong predictive accuracy for tooth mobility (P

Aim: The aim of this study is to investigate the expression of inflammatory biomarkers (TNF‐α, IL‐10, IL‐1β) and the pulpitis‐associated miRNA (miR‐30a‐5p and miR‐128‐3p) in pulp tissue samples from unrestored teeth with a vital normal pulp (NP), teeth with symptomatic irreversible pulpitis (IP) and in unrestored teeth with periodontal disease, unresponsive to periodontal therapy, and a vital pulp (EP). Methodology: Thirty patients were included in this observational study (10 teeth with NP, 10 teeth with IP, 10 teeth with EP). Dental pulp tissues samples were collected from patients during root canal treatment (RCT). RNA was extracted and qRT‐PCR of target genes (tumour necrosis factor [TNF]‐α, interleukin [IL]‐1β, IL‐10) and miRNAs (has‐miR‐30a‐5p, has‐miR‐128‐3p) performed to assess the expression profile. Fold‐change in expression was calculated using the formula 2−(ΔCt(Exp)−ΔCt(Ctrl)). One‐way anova with post‐hoc Tukey's was used to determine significant differences between groups. The significance level was set at 5% (p <.05). All teeth were also followed up clinically for 1 year and evaluated for a range of endodontic and periodontal‐related outcomes. Results: All investigated genes significantly increased in expression and miRNAs significantly decreased in expression in the IP and EP groups compared with the NP group (p <.05). With regards to TNF‐α and IL‐1β there were no significant differences in expression between the IP and EP groups (p >.05), whereas IL‐10 expression levels were significantly reduced in the EP compared with the IP group (p <.05). Both miR‐30a‐5p and miR‐128‐3p showed significantly reduced expression in both IP and EP lesions, compared with NP (p <.05); however, no significant differences in miRNA expression were observed between IP and EP groups (p >.05). One year after root canal treatment and periodontal maintenance, tooth mobility and probing depth were significantly reduced in the EP group (p <.05). Conclusion: Pulp tissues from teeth with IP and EP presented similar levels of altered inflammatory markers compared with NP. TNF‐α, IL‐10, IL‐1β cytokines and miRNAs (miR‐30a‐5p and miR‐128‐3p) are potential objective biomarkers to indicate pulpal inflammatory status, aiding diagnosis and directing clinical decision‐making. RCT may be beneficial to improve stage III periodontitis unresponsive to non‐surgical periodontal treatment, but further research is required. [ABSTRACT FROM AUTHOR]

Purpose: To present a minimally invasive treatment approach for the replacement of two missing adjacent teeth with two single-retainer resin-bonded fixed dental prostheses (RBFDPs). Materials and Methods: Two missing adjacent premolars were restored by two RBFDPs with an innovative design of the proximal section. Both RBFDPs were digitally designed and milled from monolithic 3Y-TZP zirconia ceramic using CAD/CAM. Following construction of the anterior RBFDP, a shallow interlock was designed in the area of proximal contact in the same insertion direction as the posterior RBFDP. In this way, different paths of insertion of the RBFDPs could be provided without compromising the proximal hygiene capability. Results: The presented minimally invasive restorations were successful over 5 years of clinical observation without any complications. Conclusion: The presented restoration design secures the transversal position of the RBFDPs while maintaining physiologic tooth mobility. In addition, it allows for varying paths of insertion while improving hygienic conditions. Last, in case of a unilateral debonding of one retainer wing, rebonding might be possible. [ABSTRACT FROM AUTHOR]

Background: Periodontal tissue loss is the main reason for tooth mobility and loss caused by periodontal disease. Dental follicle stem cells (DFSCs) have significant therapeutic potential in periodontal regeneration, which maybe mainly depends on their potent immunomodulatory capacity. Consequently, this study aims to elucidate the impact of implanted xenogenous DFSCs on innate immune responses during early and late stages in the periodontal defect repair period. Methods: To trace and investigate the immunomodulation mechanisms of DFSCs in vivo, DFSCs were engineered (E-DFSCs) using lentiviral vectors expressing CD63-enhanced green fluorescent protein (CD63-EGFP) and β-Actin-mCherry protein (ACTB-mCherry) to exhibit green and red fluorescence. The biological characteristics and functions of E-DFSCs were verified by proliferation, differentiation, and co-culture experiments in vitro. In vivo, the periodontal regeneration capacity of E-DFSCs was detected by implantation of murine periodontal defect model, and the response of innate immune cells was detected at the 1st, 3rd, and 5th days (early stage) and 4th week (late stage) after implantation. Results: In vitro assessments showed that E-DFSCs retain similar properties to their non-engineered counterparts but exhibit enhanced macrophage immunomodulation capability. In mice models, four-week micro-CT and histological evaluations indicated that E-DFSCs have equivalent efficiency to DFSCs in periodontal defect regeneration. At the early stage of repair in mice periodontal defect, fluorescence tracking showed that implanted E-DFSCs might primarily activate endogenous cells through direct contact and indirect actions, and most of these cells are myeloperoxidase-positive neutrophils. Additionally, compared with the control group, the neutrophilic infiltration and conversion of N2-type were significantly increased in the E-DFSC group. At the late stage of defect regeneration, more M2-type macrophages, fewer TRAP + osteoclasts, and an upregulated OPG/RANKL ratio were detected in the E-DFSC group compared to the control group, which indicated that immune balance tilts towards healing and bone formation. Conclusion: The xenogenous implanted DFSCs can induce the N2 phenotype of neutrophils in the early stage, which can activate the innate immune mechanism of the host to promote periodontal tissue regeneration. [ABSTRACT FROM AUTHOR]

Background: Posttreatment changes after orthodontic treatment are challenging. One of the main reasons for such a phenomenon is the lack of patient compliance with removable retainers especially in the maxillary arch, due to palatal coverage, deterioration of speech, decreased masticatory efficiency, and loss of retainers. Fixed retainers have been introduced to overcome patient compliance and provide longer stable results. However, teeth still show movements when a six-unit fixed retainer is in place. Thus, in this study, an eight-unit fixed retainer was evaluated in an attempt to eliminate unwanted movements. The aim of this research: was to assess short-term positional changes associated with an eight-unit extended maxillary fixed retainer. Materials and methods: A single-arm clinical trial was conducted to address the aim of the study. This research was approved by the institutional review board of the Faculty of Dentistry, Alexandria University (IORG:0008839, No-0479–8/2022). The registration date of this study was 5/06/2023. Twenty-eight patients (19.8 ± 4.5 years) who had finished the active orthodontic phase and started retention had an eight-unit extended maxillary fixed retainer that was bonded to the palatal surface of the maxillary incisors, canines, and the first premolars or the second premolars. Pre-retention and one-year post-retention intra-oral scans were made to produce STL files that were superimposed to determine the amount of tooth change. Additionally, analysis of digital casts and lateral cephalometric radiographs was performed. Results: Statistically significant changes in all planes and the rotation of teeth after one year of retention were found. The upper right lateral incisor exhibited the most evident change in the vertical plane, while the upper right central incisor exhibited the greatest change overall. Minimal changes in the cast measurements were observed. Lateral cephalometric measurements showed minimal changes after one year of retention, and these changes were not statistically significant except in the interincisal angle and the angle between the upper incisor and the line connecting the A-point to the pogonion. Conclusion: Increasing the extension of maxillary fixed retainers did not eliminate unwanted tooth movement in the first year of retention. [ABSTRACT FROM AUTHOR]

Background/Objectives: Maintenance of good oral health is relevant to overall health and quality of life. Results of many analyses showed that stroke patients had worse oral health than the control population. The aim of this study was a clinical assessment of oral condition in post-stroke patients and a healthy population. Methods: Oral health was assessed in stroke patients on the first day of ischemic stroke, and in a control group of healthy subjects. The number of teeth, the presence of active carious foci, fillings, and prosthetic restorations were evaluated. To assess oral hygiene, the Approximal Plaque Index (API) was used. In periodontal examinations, the presence of dental deposits, the depth of the existing periodontal pockets, tooth mobility, and the Sulcus Bleeding Index (SBI) during probing were assessed. Results: Significantly higher mean values of Decayed Teeth (DT), Missing Teeth (MT), and Decayed, Missing, and Filled Teeth (DMFT) indices were recorded in the study group. The incidence of dental caries, API, and SBI was also significantly higher in the study group. The study and control groups did not differ significantly in the average number of pockets 3 mm deep and deeper and in the frequency of having prosthetic restorations. Conclusions: Oral health and the level of oral hygiene in patients hospitalized because of ischemic stroke, in comparison with that in a healthy population, is not satisfactory. Active interdisciplinary collaboration between various medical specialists in the therapy of patients with general illnesses, including stroke, is strongly recommended. [ABSTRACT FROM AUTHOR]

Background: The purpose of this randomized clinical study was to clinically evaluate and compare the efficiencies of platelet‐rich fibrin (PRF), concentrated growth factor (CGF) and autogenous bone graft (ABG) in the treatment of intrabony pockets and to assess the alveolar bone gain (AB gain) radiographically (panoramic and CBCT images). Methods: Eighty intrabony pockets were divided into four groups: ojnly open flap debridement (OFD), OFD+PRF, OFD+CGF and OFD+ABG; each group consisted of 20 defects. Plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and tooth mobility (TM) by using Periotest M device were evaluated. Radiographic images were also taken to evaluate the AB gain. PRF was produced using a protocol of 2,700 RPM for 12 min and the relative centrifugal force (RCF) was evaluated. CGF was prepared as follows: 2 min 2700 rpm, 4 min 2400 rpm, 4 min 2700 rpm, 3 min 3000 rpm. Results: The study results revealed a similar improvement in PI and GI values in all groups (p > 0.05). There was a statistically significant decrease in PD and CAL in favor of ABG group at day 180 in comparison with other groups (p = 0.001). There was also a statistically significant decrease in TM and alveolar bone height loss (ABHL), whereby the AB gain gradually increased among the groups with the best group being ABG, followed by CGF, PRF, and control groups, respectively (p = 0.001). Conclusions: The study results support the treatment of periodontal intrabony pockets using OFD in combination with ABG, CGF, and PRF, as ABG showed the best results followed by CGF and PRF. [ABSTRACT FROM AUTHOR]

Background: Orthodontic pain affects the physical and mental health of patients. The spinal trigeminal subnucleus caudalis (SPVC) contributes to the transmission of pain information and serves as a relay station for integrating orofacial damage information. Recently, glial cells have been found to be crucial for both acute and maintenance phases of pain. It has also been demonstrated that rho kinase (ROCK) inhibitors can manage different pain models by inhibiting glial cell activation. Here, we hypothesized that orthodontic pain is related to glial cells in the SPVC, and Fasudil, a representative rho/rock kinase inhibitor, can relieve orthodontic pain by regulating the function of glial cells and the related inflammatory factors. In this study, we constructed a rat model of tooth movement pain and used immunofluorescence staining to evaluate the activation of microglia and astrocytes. Quantitative real-time PCR was used to detect the release of related cytokines and the expression of pain-related genes in the SPVC. Simultaneously, we investigated the effect of Fasudil on the aforementioned indicators. Results: In the SPVC, the expression of c-Fos peaked on day 1 along with the expression of OX42 (related to microglial activation), CD16 (a pro-inflammatory factor), and CD206 (an anti-inflammatory factor) on day 3 after tooth movement, followed by a gradual decrease. GFAP-staining showed that the number of activated astrocytes was the highest on day 5 and that cell morphology became complex. After Fasudil treatment, the expression of these proteins showed a downward trend. The mRNA levels of pro-inflammatory factors (IL-1β and TNF-α) peaked on day 3, and the mRNA expression of the anti-inflammatory factor TGF-β was the lowest 3 days after tooth movement. Fasudil inhibited the mRNA expression of pain-related genes encoding CSF-1, t-PA, CTSS, and BDNF. Conclusion: This study shows that tooth movement can cause the activation of glial cells in SPVC, and ROCK inhibitor Fasudil can inhibit the activation of glial cells and reduce the expression of the related inflammatory factors. This study presents for the first time the potential application of Fasudil in othodontic pain. [ABSTRACT FROM AUTHOR]

Periodontal abscess is a localized accumulation of pus in periodontal tissue. It is an important disease because it is the most common dental emergency. The 2017 workshop classification is a periodontal abscess in periodontitis and non-periodontitis patients because they have different etiologies. Periodontal abscess treatment is considered an emergency, as delayed treatment can lead to complications such as tooth loss and the spread of infection. This study aims to determine and map the classification, etiologic factors, and treatment of periodontal abscesses. This scoping review was carried out according to the PCC (population, concept, context) framework. Article searches were performed in 3 databases. Articles were selected using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). The number of articles that met the inclusion criteria in this study was 8 articles. 4 articles stated that pain was the main complaint of periodontal abscess. Probing depth and tooth mobility were also reported in 3 articles. 2 articles mentioned specific classifications of periodontal abscesses, with the majority occurring due to systemic disease and periodontitis. Periodontal abscess treatments performed were incision, drainage, and antibiotics, only 1 article mentioned the most common treatment with extraction. The classification, etiological factors, and treatment of periodontal abscesses should be clarified to facilitate early diagnosis and emergency treatment, minimize the risk of medical complications, or prevent long-term dental complications. [ABSTRACT FROM AUTHOR]

Intact extraction of the mandibular first molar tooth is an interesting model for studies of alveolar bone healing. The aim of this study was to describe a new experimental technique for extraction of rat mandibular first molar teeth with crown and all 4 roots intact using controlled forces applied to the teeth. One hundred and twenty female Sprague-Dawley rats were used from a center for experimental animal research. Animals underwent general anesthesia and were then placed in a special dental unit (designed by Moghadam) for the extraction of rat teeth. After syndesmotomy, luxation of the tooth began with a tipping movement in the buccal direction with a very low range of motion for 1 s. A tipping movement in the lingual direction was then used to continue luxation. After a maximum of 10 repetitions, the tooth was left alone for 30 s. After 3-4 stages of this cycle, the tooth loosened. To complete the luxation, the same forces were applied in the buccal and lingual directions with larger amplitude for 3 s. After this step, the tooth was loose enough to be easily extracted. The alveolus was then sutured closed. The results showed no hemorrhage or fracture of crowns and mesial or distal roots, and only 8% of the buccal and lingual roots fractured. The technique designed and used in this study was shown to be an effective model for complete molar tooth extraction in the rat. This technique could also be used in the treatment of other rodents. [ABSTRACT FROM AUTHOR]

This retrospective cohort study aimed to evaluate long-term healing outcomes (10–17.5 years) after contemporary endodontic microsurgery (EMS) and identify the associated prognostic factors. Clinical and radiographic data of an EMS cohort (2006–2013) from the electronic database of the dental hospital were reviewed retrospectively by 2 independent examiners to determine their survival and healing outcomes, and potential prognostic factors were analyzed by Cox proportional hazards regression and logistic regression (α = 0.05). Through strict inclusion and exclusion criteria and 721 EMS-treated teeth in the cohort, 309 (42.9%) were included (male = 35.0%; female = 65.0%; age = 45.83 ± 15.53 years) with a mean final follow-up of 152.26 ± 26.37 months (range, 120–211 months; median = 148 months). Clinical and radiographic assessments found an 80.5% 10-year survival rate with 63.4% of success. Collectively, tooth type, tooth mobility, preoperative lesion size, clinical crown-to-root ratio, and crown restorations at follow-up were significantly associated with long-term success and survival over 10 years. The preoperative status and condition of the tooth including its alveolar bone support and adequate full-crown restorations may be relevant prognostic determinants of success and survival after EMS over time. [ABSTRACT FROM AUTHOR]

Periodontitis is a complex and chronic inflammation of the periodontium and can be diagnosed clinically by gingival inflammation, attachment loss, and loosening of teeth. Both nonsurgical and surgical periodontal therapies are used to treat periodontal diseases. However, in some cases, solely mechanical therapy is ineffective, especially in inaccessible areas. Hence, in such cases, systemic and local drug therapy is well‑advised adjuvant to scaling and root planning. Local drug therapy provides specificity at the site of infection. Various antimicrobial agents are used for local applications into periodontal pockets such as chlorhexidine and tetracycline; however, these drugs have certain adverse reactions. To overcome these unfavorable side effects, herbal extracts came into the limelight. Therefore, this review gives an insight into the properties and benefits of natural extracts used as local drug delivery for periodontal treatment. [ABSTRACT FROM AUTHOR]

The management of malocclusion has developed greatly in terms of treatment simulation and biomechanics, but treatment duration has been a great concern to the clinician as well as the patient. 1-25dihydroxycholecalciferol (biologically active form of Vitamin D) stimulates both osteoclasts and osteoblasts and was found to be the most significant in Orthodontic Tooth Movement acceleration. Inflammatory cytokines like IL-17A also play an important role in osteoclastogenesis and can enhance the rate of Orthodontic Tooth Movement. To perform a simultaneous evaluation of pro-inflammatory salivary cytokine IL-17A and salivary 1-25dihydroxycholecalciferol and to correlate their role on orthodontic tooth movement. A prospective cohort study was conducted among n = 97 patients. Saliva samples were collected from the patients at three phases of the orthodontic treatment, centrifuged and stored at 4℃ for evaluation of salivary 1-25dihydroxycholecalciferol levels and Pro-inflammatory cytokine IL-17A using ELISA. The mean salivary 1-25dihydoxycholecalciferol levels were 41.250 ng/ml, 33.246 ng/ml and 35.043 ng/ml during the initial phase, lag phase and post lag phase of orthodontic treatment. The mean pro-inflammatory cytokine IL-17 A levels were 107.79 pg/ml, 102.98 pg/ml and 66.156 pg/ml during the initial phase, lag phase and post lag phase of orthodontic treatment. There was a correlation between the salivary 1-25dihydroxycholecalciferol level and salivary cytokine IL-17A levels during the various phases of orthodontic treatment using Spearman's correlation rho test and linear regression analysis. There was no significant difference (p > 0.05) between 1-25dihydroxycholecalciferol levels and gender during the various phases (initial phase, lag phase and post lag phase) of Orthodontic treatment. There was a negative correlation between salivary 1-25dihydroxycholecalciferol level and salivary cytokine IL-17A levels during the various phases of orthodontic treatment. The level of 1-25dihydroxycholecalciferol and salivary cytokine IL-17A have been quantified during the various phases of Orthodontic treatment and this can be used clinically for the supplementation of Vitamin D in patients with low vitamin D levels and can enhance the treatment duration for the patient with less damaging effects to the surrounding tissues. [ABSTRACT FROM AUTHOR]

Objectives: Oro‐dental manifestations of hyperoxaluria and dental management of affected patients are rarely reported in the literature. We describe a new oral presentation of primary hyperoxaluria (PH) and review relevant literature about oro‐dental manifestations and management of dental complications of hyperoxaluria. Methods: A case report of a 44‐year‐old female who presented with symptoms of temporomandibular joint dysfunction due to hyperoxaluria was described according to the CARE guidelines. In addition, an extensive search of biomedical databases (PubMed, Medline, Google Scholar, and Embase) for articles describing oro‐dental manifestations and/or dental management in patients with hyperoxaluria was performed using the key words ("oral" and/or "hyperoxaluria" and/or "dental" and/or "oxalosis"). Included articles were reviewed and data about patient demographics, disease type and stage, oral and dental manifestations, and dental treatment outcome were retrieved and analyzed. Results: A total of 14 articles describing the oral and dental manifestations in 15 patients with hyperoxaluria were included. Tooth mobility, root resorption, and radiographic alterations were consistently described in all cases. Oral manifestations were described mainly in PH at late stages, and only after the onset of chronic renal disease. Dental management in all reported cases was palliative and aimed to relive pain and treat periodontal infection. Tooth loss due to extraction or uncontrolled mobility was the ultimate outcome in almost all reported cases. Conclusion: Oral and dental manifestations in hyperoxaluria are rarely reported in the literature. Management of tooth mobility and root resorption in hyperoxaluria is challenging and clinical guidelines and evidence‐based recommendations are lacking. Early diagnosis and treatment of hyperoxaluria might be the only effective approach to prevent dental and periodontal complications of the disease. [ABSTRACT FROM AUTHOR]

This narrative review addresses conventional diagnostic criteria used in clinical practice to discriminate between periodontal health, gingivitis, and periodontitis. Visual examination of the color and texture of the periodontal tissues, assessment of plaque deposits, periodontal probing assessments, and diagnostic imaging enable the collation of information to make a periodontal diagnosis, followed by an appropriate treatment plan. The periodontal probe is an essential diagnostic tool to assess probing pocket depth, clinical attachment level, bleeding on probing, and the degree of furcation involvement at multirooted teeth. When clinical signs and symptoms of periodontitis are identified, diagnostic imaging enables evaluation of the level and extent of bone destruction and bone defect morphology. The diagnostic process requires clinicians who are trained to evaluate, record, and interpret these measures. This narrative review focuses on conventional clinical diagnostic parameters which, despite their limitations, are considered the current standard of care. [ABSTRACT FROM AUTHOR]

For many years, space human factors research has focused on the impact of microgravity on human physiology and the health risks astronauts face during space flights of various durations. Our review paper reveals that microgravity leads to both reversible and non-reversible effects on astronauts' oral health. In addition to oral health concerns, astronauts often experience muscle degeneration during space missions, which is closely tied to bone loss. Despite our knowledge of high bone resorption and rapid mineral and calcium loss in microgravity, the exact underlying mechanisms remain unclear. However, to fully understand these processes and develop effective strategies to counteract the consequences of microgravity, more research is needed. This includes a deeper exploration of how these molecules and other biomarkers work, identification of early mechanotransduction sensors, and a comprehensive understanding of the physiological effects of weightlessness. Current solutions primarily involve administering antioxidants, regular exercise, and appropriate nutrition. Additionally, innovative approaches such as experimental drug therapies using anti -myostatin antibodies and r-irisin have gained attention. Further large-scale, long-term studies are required to understand the effects of microgravity on the oral cavity and prevent its adverse consequences. • Impact of Microgravity on Dental Health: Discuss the physiological changes experienced by astronauts in microgravity environments, including fluid redistribution, decreased mechanical loading, and altered bone metabolism, and their implications for oral health. • Weight-Bearing vs. Non-Weight-Bearing Bones: Examines the relationship between microgravity and bone loss, with a focus on distinguishing its effects on weight-bearing and non-weight-bearing bones. • Comprehensive Impact Assessment: Calls for comprehensive research on how microgravity affects various bones in both animals and humans, including analyses of bone structure, density, and strength. • Bone Loss and Tooth Mobility: Examine how microgravity-induced bone loss affects the integrity of the jawbone, leading to increased tooth mobility and potential dental complications such as loosened crowns, dental implants, or even tooth loss. • Differential Recovery: Investigates how weight-bearing and non-weight-bearing bones recover following bone loss in microgravity conditions and the underlying mechanisms at play. • Addressing Inconsistencies: Highlights the need to resolve inconsistencies in existing literature regarding the influence of microgravity on osteogenic proliferation and differentiation. • Osteocytes and Osteoclasts in Microgravity: Emphasises the importance of understanding the roles of osteocytes and osteoclasts in microgravity-induced bone loss to identify potential therapeutic targets. [ABSTRACT FROM AUTHOR]

Aim: To evaluate site‐related changes in periodontal pocket depth (PPD) after non‐surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis. Materials and Methods: PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow‐ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi‐level logistic regression analysis was performed to identify factors influencing PPD changes during SPC. Results: This retrospective study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (−1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p <.001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118–0.540), residual pockets (p <.001, OR: 0.503, 95% CI: 0.429–0.590) and TM Degrees I–III (Degree I: p =.002, OR: 0.765, 95% CI: 0.646–0.905; Degree II: p =.006, OR: 0.658, 95% CI: 0.489–0.886; Degree III: p =.023, OR: 0.398, 95% CI: 0.180–0.879) correlated significantly with increasing PPD. Conclusions: Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I–III and residual pockets after APT lead to worsening of periodontal pockets. [ABSTRACT FROM AUTHOR]

This report outlines 2 digitally planned cases in which the teeth underwent magnetic extrusion to preserve the supracrestal tissue attachment and regain the ferrule, followed by their restoration. Case 1: A 42-year-old man with the chief concern of a fractured right maxillary second premolar. Following the completion of root canal treatment, the remaining tooth structure was insufficient to create a ferrule for tooth restoration. For this scenario, a rapid magnetic extrusion technique was performed on tooth #4 to obtain an approximate 3-mm ferrule. The condition of both the dentition and the restorative margin was acceptable 18 months following treatment. Case 2: A 62-year-old man with the chief complaint of mobility on both sides of the maxillary arch in relation to a tooth-supported fixed partial denture (FPD). Following removal of the FPD, multiple extractions were carried out and tooth #6 was subjected to magnetic extrusion in 3 stages to a maximum of 4 mm to obtain a ferrule. At the 18-month and 3-year follow-up appointments, the tooth had no symptoms and the gingiva around the restorations had optimal architecture and margins. The 3-dimensional digital planning was helpful in precisely positioning the magnets within the tooth and the provisional restorations to facilitate axial extrusion. The extruded teeth were restored with zirconia crowns in both cases. The beneficial outcomes observed from these cases provides evidence that the integration of digital planning and magnetic extrusion holds promise as a method for reconstructing teeth with crowns that are significantly compromised. [ABSTRACT FROM AUTHOR]

The objective was to assess how ovariectomy or the administration of artificial female sex hormones affects orthodontic tooth movement (OTM) with fixed appliances. An electronic search of indexed databases was completed without language or time restrictions up to June 2022. The following eligibility criteria were utilized: (i) prospective original controlled clinical studies; (ii) experimental studies on animal models; (iii) subjects undergoing orthodontic therapy with fixed appliances; (iv) clearly defined control groups not undergoing ovariectomy or administration of artificial female sex hormone; and (v) studies with experimental groups receiving the intervention of interest (ovariectomy or artificial female sex hormone administration). Review articles, letters to the editor, case reports, case series, commentaries, cross‐sectional studies, retrospective studies, and studies with no well‐defined control group were excluded. The quality of the available evidence and the risk of bias within the studies were assessed. All disagreements were resolved via discussion. Seven animal studies were included in the systematic review. Five studies reported that ovariectomy increased the rate of orthodontic tooth movement. Two studies reported that the administration of artificial female sex hormones decreased the rate of orthodontic tooth movement. There is an association between ovariectomies and OTM and between the administration of artificial female sex hormones and OTM. The full extent of the association remains unclear due to the biases that are present and the length of time of orthodontic therapy. [ABSTRACT FROM AUTHOR]

Expeditious strides in the fields of biomaterials, computer-aided design, and manufacturing have catapulted clear aligner therapy (CAT) to become a comprehensive orthodontic treatment modality. The efficiency of achieving planned tooth movement with clear aligners is a significant consideration while setting up the final treatment goals, as well as calculating treatment times and costs based on the available evidence. Contemporary research outcomes confirm that one of the most commonly reported clinical concerns with CAT is the discrepancy between the prescribed outcome in the digital treatment plan and the clinically achieved outcome from a given series of aligners. Inaccurate prediction of tooth movements may not only lead to a prolonged duration of aligner treatment with an additional need for refinement strategies; but it may also cause other concerns, such as patient burnout and increased potential for relapse. The authors of this paper have elucidated some of the critical elements that may help address this discrepancy between digitally prescribed and clinical outcomes based on an evidence-based approach with regard to the predictability and accuracy of CAT. A strong diagnostic acumen, judicious case selection, solid biomechanical understanding of various types of orthodontic tooth movements, a research framework that keeps pace with technological and material developments and provides evidence-based knowledge of the limitations of CAT; and above all, the ability of the clinician to continually innovate as per different clinical scenarios, all contribute to attaining treatment predictability, efficacy, and efficiency with CAT. [ABSTRACT FROM AUTHOR]

The present-day physics mainly comprises the following five fields: mechanics, thermodynamics, wave mechanics, electromagnetism and quantum mechanics. Each of these fields is closely related to dentistry and the basic knowledge in all these fields have been applied to dental devices. In our research, we have especially applied the knowledge of mechanics, electromagnetics and quantum mechanics to the development of dental devices and diagnostic methods. In the field of electromagnetism, we proposed the relative value method as a method to electrically measure the root canal length in 1984, and then the device based on the principle of our method was put into practical use. Subsequently, extending the electrochemical findings of the reamer electrodes studied during the development of our device, we invented the method to quantitatively analyze elicitation of galvanic pain caused by contact between different metals, i.e. implant materials and superstructures in the oral cavity. In the field of mechanics, we developed the method to objectively measure tooth mobility. Finally, in the field of quantum mechanics, we are developing a preoperative planning support system in oral surgery, for example, a system to make mandibular models using a three-dimensional printer on the bases of digital imaging and communications in medicine (DICOM) data from dental computed tomography (CT) imaging, a stress analysis system of the mandible using the finite element method, etc. In this paper, our work on the development of dental devices and our basic research on diagnostic methods are introduced. [ABSTRACT FROM AUTHOR]

Stem cell therapy for periodontal defects has shown good promise in preclinical studies. The purpose of this study was to evaluate the impact of stem cell support on the regeneration of both soft and hard tissues in periodontal treatment. PubMed, Cochrane Library, Embase, and Web of Science were searched and patients with periodontal defects who received stem cell therapy were included in this study. The quality of the included articles was assessed using Cochrane's tool for evaluating bias, and heterogeneity was analyzed using the I2 method. An Mendelian randomization investigation was conducted using abstract data from the IEU public databases obtained through GWAS. Nine articles were included for the meta-analysis. Stem cell therapy effectively rebuilds periodontal tissues in patients with periodontal defects, as evidenced by a reduction in probing depth, clinical attachment level and bone defect depth. And delta-like homolog 1 is a protective factor against periodontal defects alternative indicator of tooth loosening. The findings of this research endorse the utilization of stem cell treatment for repairing periodontal defects in individuals suffering from periodontitis. It is recommended that additional extensive clinical investigations be carried out to validate the efficacy of stem cell therapy and encourage its widespread adoption. [ABSTRACT FROM AUTHOR]

Objectives: To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints. Material and methods: Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression. Results: Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture. Conclusions: Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often. Clinical relevance: Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture. [ABSTRACT FROM AUTHOR]

Tooth mobility leads to a reduced quality of life characterized by patient discomfort, masticatory dysfunction and aesthetic concern. It may be caused by different factors that are important to identify in order to aid management, which may be non-surgical (monitoring, periodontal debridement, splinting and/or occlusal adjustment) or surgical (periodontal surgery or extractions). This article addresses the diagnostic process, aetiology and management of tooth mobility. The aim is to deliver and maintain a healthy periodontium and improve quality of life by restoring function and comfort to the patient. CPD/Clinical Relevance: Tooth mobility is a common yet challenging problem within dentistry to identify and manage. [ABSTRACT FROM AUTHOR]

Stage IV Periodontitis is characterized by complex symptoms, including the loss of teeth, occlusal instability/collapse, ridge defects and increased tooth mobility. The management of such issues requires interdisciplinary collaboration to optimise outcomes. This article outlines the key guidelines from the recent EFP clinical practice guidelines on the efficacy of prosthodontic rehabilitation (fixed/removable) in the management of these complex patients. CPD/Clinical Relevance: An understanding of the clinical decision making when considering tooth replacement options in stage IV periodontitis patients is important. [ABSTRACT FROM AUTHOR]

Background and aim: Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors. Materials and methods: Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings' validity. Results: Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01–2.77]); dental prosthetics had an OR of 1.45 [1.20–1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30–2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09–1.81]). Conclusions: Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health's role in multidisciplinary disease management. [ABSTRACT FROM AUTHOR]

Periodontitis, a chronic inflammatory condition caused by bacteria, often causes gradual destruction of the components that support teeth, such as the alveolar bone, cementum, periodontal ligament, and gingiva. This ultimately results in teeth becoming loose and eventually falling out. Timely identification has a crucial role in preventing and controlling its progression. Clinical measures are used to diagnose periodontitis. However, now, there is a hunt for alternative diagnostic and monitoring methods due to the progress of technology. Various biomarkers have been assessed using multiple bodily fluids as sample sources. Furthermore, conventional periodontal categorization factors do not provide significant insights into the present disease activity, severity and amount of tissue damage, future development, and responsiveness to treatment. In recent times, there has been a growing utilization of nanoparticle (NP)-based detection strategies to create quick and efficient detection assays. Every single one of these platforms leverages the distinct characteristics of NPs to identify periodontitis. Plasmonic NPs include metal NPs, quantum dots (QDs), carbon base NPs, and nanozymes, exceptionally potent light absorbers and scatterers. These find application in labeling, surface-enhanced spectroscopy, and color-changing sensors. Fluorescent NPs function as photostable and sensitive instruments capable of labeling various biological targets. This article presents a comprehensive summary of the latest developments in the effective utilization of various NPs to detect periodontitis. [ABSTRACT FROM AUTHOR]

The aim of this research was to evaluate the short-term effects of initial periodontal treatment (IPT) with occlusal adjustment (OA) on lower incisors on Oral Health Impact Profile-14 (OHIP-14), clinical parameters such as probing depth (PD), bleeding on probing (BoP), gingival index (GI), clinical attachment loss (CAL), and tooth mobility using the periostest device in 30 patients with periodontitis. The patients were randomly divided into two equal groups as the test and control groups. The control group received IPT alone, while the test group received IPT+OA. The OA was applied to only four lower incisors (42, 41, 31, 32) and data were recorded at baseline (T0) and at one month after treatment (T1). There was no significant difference in the total OHIP-14 scores between the groups. The inter-group comparison revealed a significant difference in the GI of 42 teeth and in the CAL of 41 teeth (p<0.05). A significant difference was observed in the periotest value of 42 teeth between the t ime points (p<0.05). There was a significant difference in the clinical periodontal parameters in both groups at T0 and T1, while there was a significant difference in the tooth mobility of 42 teeth in the test group (p<0.05). In conclusion, IPT yields pos itive effects on clinical periodontal parameters in both groups in both time points. However, IPT combined with OA seems not to be superior to IPT only as evidenced by OHIP-14 scores, periodontal parameters, and tooth mobility in the short -term. Further long-term studies are needed to draw more reliable conclusions. [ABSTRACT FROM AUTHOR]

Oral piercing habits are associated with various degrees of complications. Tongue piercing increases the risk of gingival recession and infrabony defects, subsequently leading to localized periodontitis. In the case presented, the patient had persistent swelling and suppuration around her mandibular anterior teeth attributed to tongue piercing jewelry that was placed approximately 12 years prior. Intraoral examinations revealed a localized deep pocket, purulent discharge, swelling, plaque accumulation, bleeding on probing, gingival recession, and teeth mobility. The patient was diagnosed with localized stage III, grade C periodontitis. Following full-mouth debridement and the placement of an extracoronal lingual splint, minimally invasive, papillae-sparing incisions were made, and regenerative therapy with bone allograft and collagen membrane was used to manage the infrabony defects. During the 18-month postoperative follow-up, complete soft-tissue healing was observed along with a significant reduction in pocket depth and the absence of bleeding on probing or suppuration. Radiographic evaluation showed evidence of bone fill. The reported case demonstrates how careful diagnosis and treatment planning are crucial for managing different periodontal defects and emphasizes the importance of proficient periodontal management, which can save teeth that would otherwise be extracted and replaced with implant therapy or fixed bridgework. [ABSTRACT FROM AUTHOR]

Periodontal disease is a term for a disease that affects the periodontal tissues that surround and support the teeth. In its severe form, the tissue cannot heal itself; thus, special treatment and external materials are needed to help in tissue restoration. PRF is widely used in dentistry to help accelerate wound healing and tissue regeneration. A 45- year-old woman came with complaints of loose teeth and frequently swollen gums for the last 3 years. The clinical examination showed multiple tooth mobility, abscesses, and deep pockets. OPG showed severe bone loss, indicating periodontitis. The patient was treated by GTR surgery with the application of bone graft and freeze-dried PRF. This case report shows that bone graft combined with freeze-dried PRF produces satisfactory treatment outcomes, indicated by reduced tooth mobility, loss of pockets, and healthier periodontal tissue. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate alveolar bone dimensions and its relationship with tooth movement (retraction, intrusion and torque) during orthodontic treatment with fixed appliance and clear aligners. Methods: Thirty‐two patients were included in this retrospective clinical study. Cone beam computed tomography (CBCT) was collected before and after treatment to measure the volume of dehiscence and fenestrations in the maxillary anterior region, anterior alveolar bone thickness and height and degree of tooth movement. Rank‐sum tests were used to compare the differences in alveolar bone defect volumes between clear aligners and fixed appliance, multiple linear regression analysis was used for study evaluation, and kappa statistics were used to assess internal consistency and test‐retest reliability. Results: Post‐operatively, most alveolar bone defects occurred on the labial side. The incidence of bone fenestration was 23.96% in the clear aligner group and 26.18% in the fixed appliance group, which was higher than the incidence of bone dehiscence (5.21%). The labial bone height decreased by 0.272 mm, and the palatal bone height increased by 0.617 mm for every 1 mm downward intrusion of the anterior tooth apex in the fixed appliance group. In the clear aligner group, there was no significant change in the labial bone height, and the palatal bone height decreased by 0.447 mm for every 1 mm of anterior tooth retraction coronally. Conclusions: In the fixed appliance group, anterior tooth intrusion and retraction may have led to alveolar bone resorption by its compression at the cervical level. This study provides a three‐dimensional tooth movement evaluation method by using CBCT. [ABSTRACT FROM AUTHOR]

This article from the Romanian Journal of Oral Rehabilitation examines the effects of functional overload on the dental system. The study looks at changes in the periodontal tissues of both guinea pigs and patients, with the main cause of functional overload being the absence of teeth and poorly placed prostheses. The study highlights the importance of prosthetic treatment in preventing histomorphological changes caused by functional overload. The article provides data on the length of time patients have been without teeth and the corresponding damage to their oral cavity, including gingival lesions, poorly constructed prostheses, and periodontitis. The document also discusses the microscopic and macroscopic changes observed in patients and animals, as well as the correlation between the length of time without teeth and the atrophy of the alveolar process. The conclusion emphasizes the importance of addressing tooth loss through therapeutic-prosthetic procedures to minimize damage to the stomatognathic apparatus. [Extracted from the article]

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