A profound understanding of the epidemiology of peri-implant diseases (PIDs) is essential for the development of preventive approaches to mitigate the occurrence and progression of peri-implant biological complications. The present systematic review and meta-analysis aimed to assess the incidence, prevalence, systemic, behavioral, and patient-related risk indicators and factors for PIDs in adult patients with dental implants.

Clinical studies assessing the prevalence, incidence, systemic risk indicators, and risk factors for PIDs were considered eligible for inclusion. MEDLINE-PubMed, EMBASE, Cochrane Central Library, and ClinicalTrials.gov electronic databases were searched for published articles. Pooled data analyses were performed using random-effects models to identify risk indicators and factors for PIDs.

Of 1120 potentially eligible records, 102 studies met the eligibility criteria and were included in this systematic review. Prevalence rates at the patient level for peri-implant mucositis and peri-implantitis were 46% (95% confidence interval [CI], 41-51) and 21% (95% CI, 17-24), respectively. Weighted mean incidence rates at the patient level for peri-implant mucositis and peri-implantitis were 53% and 22%, respectively, within 20 years of function. Pooled estimates identified periodontitis, obesity, and smoking habits as significant systemic risk indicators for mucositis. For peri-implantitis, the significant risk indicators were periodontitis, diabetes mellitus, smoking habits, and alcohol consumption. Only risk indicators could be identified in the selected evidence.

More than half of the patients treated with dental implants were affected by PID over a 10-year follow-up period, with peri-implant mucositis being the most prevalent condition. Periodontitis and smoking were identified as risk indicators for the development of both PID. Obesity was identified as a potential risk indicator for mucositis, while diabetes mellitus and alcohol consumption were recognized as potential risk indicators for peri-implantitis.

This systematic review looked at the causes and frequency of problems around dental implants, known as PID, which include conditions like peri-implant mucositis (inflammation around the implant) and peri-implantitis (more serious infection around the implant). Understanding these conditions and their etiology is important for finding ways to prevent them. This research reviewed 102 studies (including 13,030 patients) to gather data on how often these problems occur and what factors might increase the risk of developing them. The meta-analyses revealed that nearly half of people with dental implants had peri-implant mucositis, and about one in five had peri-implantitis. Over a period of 20 years, the incidence rates for developing these conditions were about 53% for mucositis and 22% for peri-implantitis. The study identified certain health and lifestyle factors that could increase the risk of these conditions. For mucositis, risk factors included having gum disease (periodontitis), obesity, and smoking. For peri-implantitis, the risks were similar, with periodontitis, smoking, and diabetes and alcohol use being important factors.

Periodontitis, a microbiome-driven chronic inflammatory disease that destroys the supporting structures of the teeth, is influenced by various environmental factors, including exposure to heavy metals such as lead and cadmium. This systematic review and meta-analysis aimed to evaluate the association between exposure to lead and cadmium and periodontitis.

A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and Embase up to February 1, 2025, following PRISMA guidelines. Observational studies examining the association between lead and/or cadmium exposure and periodontitis were included. Required clinical data were extracted, and study quality was assessed using the Newcastle-Ottawa Scale. Random-effects models were used to compute either standardized mean differences (SMD) of concentration or pooled adjusted odds ratios (aORs). Heterogeneity was assessed with I².

Fourteen studies (13 datasets for either lead or cadmium) comprising 72,467 participants were eligible for inclusion. The meta-analysis found that cadmium and lead exposure were significantly associated with higher odds of periodontitis, with pooled aORs of 1.22 (95% CI: 1.08-1.37) and 1.85 (95% CI: 1.42-2.41), respectively. Sensitivity analyses confirmed the robustness of the findings.

This study provides evidence that exposure to lead and cadmium is significantly associated with periodontitis. These findings highlight the importance of reducing environmental exposure to these heavy metals as part of preventive strategies for periodontal disease. Further research is needed to explore the underlying biological mechanisms and evaluate potential interventions to reduce exposure-associated periodontitis.

This randomized double-blind placebo-controlled clinical trial aimed to evaluate the adjunctive use of Streptococcus salivarius M18 probiotic lozenges in the treatment of periodontitis. Following non-surgical periodontal therapy (NSPT), 55 participants with stage III or IV periodontitis were administered either S. salivarius M18 lozenges (test group) or a placebo for 12 weeks. Clinical assessments, including pocket probing depth (PPD), clinical attachment loss (CAL), bleeding on probing (BoP), and plaque index (PI), were performed at baseline (before treatment), immediately after treatment, and during post-treatment follow-ups at 12 and 24 weeks. Microbial analysis was conducted on the subgingival plaque samples collected. The test group demonstrated significantly improved PPD, BoP, and PI compared to the placebo group at post-treatment follow-ups, although no significant difference was observed in CAL. Microbiological analysis revealed a reduction in periodontal pathogens or a shift in the subgingival microbiota toward a decreased pathogenic profile in the test group. This trial is the first to demonstrate the safety and efficacy of S. salivarius M18 as an adjunctive treatment for periodontitis, supporting its potential for broader clinical use in managing periodontal health.

The online version contains supplementary material available at 10.1007/s13205-025-04363-w.

Oral ulcers commonly occur in Behçet disease, but severe alveolar bone loss is rarely documented. We report a case where marked periodontal destruction preceded the diagnosis of suspected intestinal Behçet disease. A 21-year-old man presented with extensive palatal ulcers and severe maxillary alveolar bone loss extending to the root apices. Radiographic examination revealed localized bone destruction confined to the palatal region. Subsequent evaluation revealed intestinal lesions characteristic of Behçet disease. A combination of systemic medications (prednisolone, mesalazine, and infliximab) and periodontal care stabilized both oral and intestinal conditions. This case highlights that severe alveolar bone destruction can manifest as a complication of intestinal Behçet disease, underscoring the importance of thorough oral examinations and integrated medical-dental care.

Coronary artery disease (CAD) is a prevalent and high-mortality condition globally. The awareness regarding adequate oral care in China was insufficient. This study investigates the outcomes of CAD patients in southwest China based on their tooth brushing frequency. A total of 841 CAD patients were selected from a cohort of 32,709 residents. Over a four-year follow-up period, the incidence of three-point major adverse cardiovascular events (3P-MACEs) was evaluated. The results indicated that the hazard ratios (HR) with 95% confidence intervals (CIs) for 3P-MACEs among the three groups of tooth brushing frequency (twice, once, and thrice daily) were: reference, 1.61 (1.09-2.37) (p = 0.017), and 0.49 (0.15-1.62) (p = 0.241). Patients who brushed their teeth only once a day had a 1.71 (1.18-2.46) times higher risk compared to those who brushed twice or more daily (p = 0.004). In conclusion, insufficient tooth brushing frequency appears to be associated with a higher risk of adverse outcomes among CAD patients.

This study aimed to comprehensively evaluate the impact of periodontitis on Oral Health-Related Quality of Life (OHRQoL) using the OHIP-14 questionnaire. A quantitative meta-analysis was conducted to estimate the average effect size, taking into account the characteristics of periodontitis and the features of control groups. Additionally, associations between OHRQoL and periodontitis were explored based on participant demographics and clinical factors.

We systematically searched the PubMed, Embase, and Scopus databases up to March 8, 2024. Studies included in the analysis assessed OHRQoL in patients with periodontitis (exposed group) compared to non-periodontitis individuals (non-exposed control group). A valid periodontitis diagnosis required Clinical Attachment Loss (CAL) and Pocket Probing Depth (PPD) assessments during full-mouth clinical examinations. The choice of meta-analysis model was based on an assessment of heterogeneity. The quality of the included studies was assessed using the tool developed by The National Heart, Lung, and Blood Institute (NHLBI).

Nine studies, encompassing 2,287 individuals, met the inclusion criteria. Periodontitis significantly affected the mean OHIP-14 total scores compared to controls [Weighted Mean Differences WMD random = 6.11 (95% CI: 4.23, 7.99), p < 0.0001], with substantial heterogeneity. Subgroup analysis did not reveal significant regional variations. Restricting the analysis to studies using the American Academy of Periodontology/European Federation of Periodontology consensus definition from 2017 yielded similar results. The negative impact of periodontitis on OHRQoL was associated with disease severity and female sex but was not influenced by the region or age of the study participants.

Our findings confirm that periodontitis significantly impairs OHRQoL, with potential associations related to disease severity and sex. However, the limited availability of studies with matched control groups and poor data reporting quality constrains a more comprehensive assessment.

The limited understanding of factors influencing the disease progression of oral lichen planus (OLP) poses challenges in delivering effective and personalized treatment for this condition, known to increase the risk of oral cancer and have an adverse impact on patients' quality of life.

To systematically identify clinical predictors of disease severity in patients with OLP.

This cross-sectional and single-site prospective study was conducted between December 2021 and February 2024 in the Departments of Oral Medicine and Oral & Maxillofacial Surgery (Aberdeen Royal Infirmary, Aberdeen, UK). Patients presenting with OLP aged 18 years or older diagnosed using Van der Meij and Van der Waal criteria were eligible for the study. Out of a total of 270 eligible patients with OLP presenting consecutively to the outpatient clinics during the study period, 89 patients agreed to participate and were enrolled into the study. Participants demographic and relevant clinical data, namely medical history, smoking status, alcohol consumption, perceived stress levels, oral hygiene status and haematological and biochemical parameters, including full blood count, haematinics and vitamin D, were recorded. The outcome measure was OLP disease severity measured as the Oral Disease Severity Score (ODSS), Gingival ODSS and the Reticular/hyperkeratotic, Erosive/erythematous, Ulcerative (REU scoring system).

In total, 89 participants were recruited into the study. The median age of the study population was 66 (interquartile range 58-73) years, and 65 (73%) patients were women. The median total ODSS score was 10 (range 0-44). After adjustment for confounding factors, patients with lichen planus affecting skin or other mucosal sites had a 5.76-unit higher OLP severity score [B = 5.76, 95% confidence interval (CI) = 0.74-10.78, P = 0.03] than those without extraoral involvement as measured by the ODSS. Patients with insufficient vitamin D exhibited a 5.49-unit increase in disease severity (B = 5.49, 95% CI = 1.13-9.84, P = 0.01) compared with those with adequate vitamin D levels.

This study identified the importance of cutaneous and/or genital lichen planus in phenotyping OLP disease severity. We also highlight the role of vitamin D as a significant predictor of disease severity of OLP, suggesting the importance of adequate vitamin D levels in patient management.

Antibiotics are used in periodontal therapy in selected cases, but therapy is rarely guided by antimicrobial susceptibility testing (AST). Direct AST of the oral microbiota using a combination disk with different antibiotics could provide a new way of AST to guide treatment planning.

We performed AST of 46 strains of Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum complex, Prevotella species, and Porphyromonas gingivalis, with a combination disk of amoxicillin (AMX) and metronidazole (MET). The AMX-MET was compared to the largest inhibition zone diameter (IZD) obtained with AMX or MET disks, using an ordinary least square linear regression model.

The IZD of the AMX-MET correlated with the AMX for A. actinomycetemcomitans (interception 0.3) and with the MET for Fusobacterium (interceptions -1.25). For Prevotella, the AMX-MET was compared to AMX and MET after 20 and 44 h resulting in a superior correlation after 20 h (interception 0.06 vs 6.61 after 44 h). For P. gingivalis, the AMX-MET was compared to MET after 44 h resulting in an inferior correlation (interception 16.65).

The IZD of AMX-MET was comparable to that of AMX and MET for important periodontal pathogens, which opens for studies on direct AST of oral samples with a mixed microbiota.

The amoxicillin-metronidazole disk for antimicrobial susceptibility testing results in comparable inhibition zone diameters to that of AMX and MET for important periodontal pathogens.

The aim of the study is to evaluate saliva levels of Soluble urokinase plasminogen activator receptor (suPAR), Hypoxia-inducible factor-1 alpha (HIF-1α) and tumor necrosis factor-alpha (TNF-α) in stage III grade A, grade B, grade C periodontitis and periodontal health and to understand the roles of these molecules in periodontal inflammation process and also to compare the three biomarkers' discriminative efficacy in periodontal disease.

A total of 80 individuals, 20 with stage III grade A periodontitis (group A), 20 with stage III grade B periodontitis (group B), 20 with stage III grade C periodontitis (group C) and 20 with healthy periodontium (group H) were recruited for this study. Full-mouth clinical periodontal measurements were recorded in periodontal charts. Whole saliva samples were collected to determine the levels of suPAR, HIF-1α and TNF-α in study groups using enzyme-linked immunosorbent assay (ELISA) method.

The saliva concentration of suPAR, HIF-1α, and TNF α was significantly higher in group A, group B, and group C compared with group H (p < .05). Additionally, salivary suPAR concentration was significantly higher in group C than in groups A and B (p < .05). Positive statistically significant correlations were observed between three biomarkers and all clinical parameters (p < .05).

Increased levels of saliva suPAR, HIF-1α, and TNF α suggest that these molecules may play a role in periodontitis. In addition, the higher salivary suPAR levels in grade C periodontitis compared to other grades suggest that suPAR may be one of the potential molecules that can be used to predict disease progression and periodontal disease classification.

Before starting the study, the study plan was uploaded to clinicaltrials.gov.tr ​​and an identification number was obtained (Date: 21.05.2024, İdentification number: NCT06430450).

An underlying pro-inflammatory status is related to recurrence and persistence of inflammatory susceptibility in obesity and periodontitis, two of the most prevalent chronic inflammatory diseases. Elevated levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), part of the inflammatory network linking these two conditions, persist even after periodontal treatment, with high salivary cytokine levels being linked to overweight and obesity risk. This trial assessed the effect of a novel composition comprising olive oil, trimethylglycine and xylitol, delivered topically to the oral mucosa, on salivary cytokines in periodontally healthy normal and overweight/pre-obese individuals. In a randomized placebo-controlled double-blind clinical trial, adult patients were randomly assigned to use a test toothpaste (intervention group, IG) or a placebo toothpaste (control group, CG) three times a day for 1 month. Primary outcomes were levels of salivary cytokines IL-1β, TNF-α and interleukin-4 (IL-4). Significant differences between IG and CG were observed for IL-1β (p = 0.003; Z = 2.901; r = 0.62) and TNF-α (p = 0.001; Z = 3.23; r = 0.69), but not for IL-4 (p = 0.203; Z = 1.321; r = 0.28). A significant reduction in IL-1β (p = 0.008) and a near significant reduction in TNF-α (p = 0.059) was found in the IG at the end of the trial. Additionally, the effect of body mass index on cytokine levels response was analyzed. A significantly different behavior was shown between IG and CG in the overweight/pre-obesity subgroup for IL-1β (p = 0.014; Z = 2.430; r = 0.63) and TNF-α (p = 0.029; Z = 2.199; r = 0.57). Moreover, a significant decrease in IL-1β in the IG (p = 0.028) was observed. The rapid reduction in IL-1β and TNF-α after 1 month of use of the intervention composition suggests a safe and effective novel strategy for reducing pro-inflammatory cytokines that may offer an opportunity to diminish the inflammatory status in patients with overweight/pre-obesity.

Periodontitis, a chronic inflammatory disease driven by bacterial plaques, causes tooth loss and systemic health issues. Traditional therapies, including mechanical debridement, anti-inflammatory medications, and surgery, often fail to concurrently resolve infection, inflammation, and tissue regeneration, limiting their effectiveness. Using a platform rooted in function-based synthesis and architecture-guided design, miR126@CuxO nanoparticles was engineered through a hybrid approach, melding bottom-up assembly of metal-phenolic precursors with top-down phased calcination tailoring. The hollow mesoporous CuxO nanoparticles, enriched with oxygen vacancies, exhibiting enhanced peroxidase activity for efficient disinfection and structural adaptability for miRNA-126 delivery. In vitro studies demonstrate that miR126@CuxO NPs effectively facilitated endosomal escape, up-regulated targeted gene expression by threefold, and fostered a favorable environment for regeneration. Furthermore, miR126@CuxO NPs effectively reduces inflammation and exhibits therapeutic effects in skin defect and periodontitis model. These findings highlight the potential of miR126@CuxO NPs as a promising strategy for managing periodontitis, bridging gene therapy and nanotherapeutic regeneration.

This study aimed to analyse the impact of different antibiotic regimens during non-surgical periodontal therapy on the microbial load of selected periodontitis-associated bacteria (PAB) and the primary therapy outcomes.

For this aim, 259 patients received steps I and II of periodontal therapy and were included in this clinical trial. 202 patients were treated without the adjunctive use of systemic antibiotics, 18 received amoxicillin (AMOX) as well as metronidazole (MET) and 39 only MET. Subgingival biofilm samples were quantitatively analysed for selected PAB using DNA-DNA-hybridisation-based detection assays for microbial loads of PAB before and 6 months after treatment. Changes in the microbial load of PAB and achievement of a "treat-to-target" endpoint (T2T) (≤4 sites with probing depth ≥5 mm) were analysed. Patients' subgingival microbial load was significantly reduced following therapy.

38.2% of the patients achieved T2T. Binary logistic regression adjusted for confounders indicated a relationship between residual PAB levels and not achieving T2T. In patients not receiving systemic antibiotics a 2.4-fold increased risk of not reaching T2T after steps I and II therapy was observed (none vs. MET aOR = 2.38 p = 0.44). Linear regression analysis adjusted for T0 PAB concentration and confounders revealed an increased reduction of PAB levels in patients with systemic antibiotics. No difference in PAB reduction or chance of achieving T2T was observed between MET and MET + AMOX.

Microbial loads of PAB were found directly associated with periodontal status. As antibiotic treatment with both MET and MET + AMOX similarly reduced microbial loads of PAB, treatment with MET alone may be sufficiently effective as adjunctive to non-surgical periodontal treatment. To confirm this, further prospective studies with bigger sample size are needed.

Gingivitis and periodontitis, are widespread conditions with diverse influence on oral and systemic health. Traditional diagnostic methods in periodontology often rely on subjective clinical assessments, which can lead to variability and inconsistencies in care. Imbibing artificial intelligence (AI) facilitates a significant solution by enhancing precision metrics, treatment planning, and personalized care. Studies published between 2018 and 2024 was conducted to evaluate AI applications in periodontal maintenance. Databases such as PubMed, Cochrane, Web of Science and Scopus were searched using keywords like "artificial intelligence," "machine learning," and "periodontitis." Studies employing AI for diagnosis, prognosis, or periodontal maintenance using clinical or radiographic data were included. Deep learning algorithms such as convolutional neural networks (CNNs) and segmentation techniques were analyzed for their diagnostic accuracy. AI demonstrated superior performance in detecting periodontal conditions, with accuracy rates surpassing 90% in some studies. Advanced models, such as Multi-Label U-Net, exhibited high precision in radiographic analyses, outperforming traditional methods. Additionally, AI facilitated predictive analytics for disease progression and personalized treatment strategies. AI has transformed periodontal care, offering accuracy, personalized care, and efficient workflow integration. Addressing challenges like standardization and ethical concerns is critical for its broader adoption.

Type 2 diabetes mellitus (T2DM) affects millions globally and is strongly associated with oral health issues, particularly periodontitis. The bidirectional relationship between T2DM and periodontitis is well established, with poorly managed T2DM increasing the risk of inflammation, tissue damage, and dental implant failure. Advances in treatment, such as glucagon-like peptide 1 receptor agonists (GLP-1RAs), have led to better glycemic control and may reduce T2DM-related complications, highlighting their potential in addressing interconnected oral-systemic health challenges. This narrative review critically evaluates the literature on the impact of GLP-1RAs on periodontal and peri-implant health. 10 in vitro studies, nine preclinical animal studies, and one clinical study were explored to investigate their effects on periodontal regeneration, implant therapy, and related mechanisms. In vitro research revealed that GLP-1RAs, including exenatide and liraglutide, promoted osteogenic differentiation of periodontal ligament stem cells (PDLSCs) through pathways such as the mitogen Wnt/β-catenin and mitogen-activated protein kinase pathways, even in high glucose or inflammatory conditions. Synergistic effects with stromal cell-derived factor-1 further promoted PDLSC proliferation and bone regeneration. Animal studies demonstrated that GLP-1RAs mitigated periodontal inflammation, oxidative stress, and alveolar bone resorption while promoting bone remodeling and implant osseointegration, independently of glycemic control. Importantly, advanced delivery systems, such as exenatide-loaded chitosan-poly(lactic-coglycolic acid) microspheres, further increased peri-implant osseointegration in diabetic models. The sole clinical study, a retrospective cohort study, assessed peri-implant marginal bone loss in peri-implantitis patients treated with different hypoglycemic drugs. Results showed significantly less clinical and radiographic bone loss in the GLP-1RA group compared to insulin and metformin groups (p < 0.01). Overall, while GLP-1RAs have promising anti-inflammatory, osteoprotective, and pleiotropic properties, their role appears more aligned with preserving periodontal and peri-implant health in T2DM individuals than directly treating periodontitis or peri-implantitis. By delineating current evidence and research directions, this review calls for medical and dental professionals to collaborate in leveraging these novel treatment options in future studies to improve patient care and address the intricate challenges that diabetes presents to oral health.

This cross-sectional study compared the subgingival microbiome in periodontal health (PH) and periodontitis, focusing on distinguishing Stage III Grade B periodontitis (PD-S3gB) and Stage III Grade C periodontitis (PD-S3gC) as defined by the 2018 Classification of Periodontitis.

Subgingival samples from subjects with PH, PD-S3gB, and PD-S3gC were analyzed using metagenomic sequencing. Taxonomic and functional annotations were performed, followed by analyses of microbial diversity, differential abundance, interspecies networks, predictive modeling, and functional pathway enrichment.

Significant differences in both alpha and beta diversity were observed between PH and periodontitis. Several periodontal pathogens were more abundant in disease states, with Capnocytophaga granulosa and Capnocytophaga sp. CM59 enriched in PD-S3gC compared to PD-S3gB. The PD-S3gC group also exhibited a more complex microbial network with increased interspecies connectivity. An 11-species diagnostic model effectively distinguished PH, PD-S3gB, and PD-S3gC. Furthermore, pathways related to motility, chemotaxis, and methane metabolism were significantly enriched in periodontitis.

Distinct structural and functional differences in the subgingival microbiome characterize periodontal health and periodontitis. Periodontitis with a rapid rate of progression is marked by specific pathogen overgrowth and enhanced microbial interactions, supporting the development of microbiome-based diagnostics and personalized therapies.

Chinese Clinical Trial Registration: ChiCTR2000039426.

The current study aimed to automatically detect tooth presence, tooth numbering, and types of periodontal bone defects from cone-beam CT (CBCT) images using a segmentation method with an advanced artificial intelligence (AI) algorithm.

This study utilized a dataset of CBCT volumes collected from 502 individual subjects. Initially, 250 CBCT volumes were used for automatic tooth segmentation and numbering. Subsequently, CBCT volumes from 251 patients diagnosed with periodontal disease were employed to train an AI system to identify various periodontal bone defects using a segmentation method in web-based labelling software. In the third stage, CBCT images from 251 periodontally healthy subjects were combined with images from 251 periodontally diseased subjects to develop an AI model capable of automatically classifying patients as either periodontally healthy or periodontally diseased. Statistical evaluation included receiver operating characteristic curve analysis and confusion matrix model.

The area under the receiver operating characteristic curve (AUC) values for the models developed to segment teeth, total alveolar bone loss, supra-bony defects, infra-bony defects, perio-endo lesions, buccal defects, and furcation defects were 0.9594, 0.8499, 0.5052, 0.5613 (with cropping, AUC: 0.7488), 0.8893, 0.6780 (with cropping, AUC: 0.7592), and 0.6332 (with cropping, AUC: 0.8087), respectively. Additionally, the classification CNN model achieved an accuracy of 80% for healthy individuals and 76% for unhealthy individuals.

This study employed AI models on CBCT images to automatically detect tooth presence, numbering, and various periodontal bone defects, achieving high accuracy and demonstrating potential for enhancing dental diagnostics and patient care.

Current diagnostic methods of inflammatory periodontal diseases, e.g., visual evaluation, periodontal probing, and radiographs, are either subjective or insensitive. Intra-oral high-frequency ultrasound was investigated to quantify inflammation by detecting tissue dimensional and perfusion changes.

A cohort of 15-month-old mini-pigs, 4 female/male each, was analyzed. Pre-molars (PM) 3 and 4, as well as first molars (M1), were scanned. In bi-weekly time intervals all 4 quadrants were randomly enrolled and bacterial injection followed each quadrant scan in a weekly fashion. Soft tissue dimensions were obtained from B-mode images and statistically analyzed to identify correlations to inoculation time, i.e., response to bacterial loading, tooth type and sex, using analysis of variance and regression analysis. Color flow velocity and power-weighted color pixel density was obtained and statistically analyzed analogous to soft tissue.

Soft tissue thickness increased significantly post-inoculation at 1 and 2 mm below the free gingival margin for both genders and all observed teeth. The significance lasted for weeks 2, 4 and 6, except for female M1s (4 weeks). Color flow velocity was significantly higher compared with baseline for 6 weeks, except for male PM4 (2 weeks). Color flow power did not show significance for PM3 and 4, only in M1 (except male week 4). Significance also extended to tooth type and sex.

Periodontal tissue dimension and color flow velocity increased in correlation to bacterial inoculation. Further studies are needed to obtain an understanding of the underlying biology observed here. Eruption of dentition may have been a confounding factor for inflammation interpretation.

Periodontitis is an oral immunoinflammatory disease, and macrophages play a crucial role in its pathophysiology. However, macrophage death during antibacterial activities will exacerbate inflammation and tissue damage. Porphyromonas gingivalis is a major constituent of subgingival biofilm plaques in periodontitis, but the effects and precise molecular mechanisms by which it triggers macrophage death remain unknown. Here we found that P. gingivalis infection notably activated multiple death pathways in bone-marrow-derived macrophages, including pyroptosis, apoptosis and necrosis. Furthermore, using RNA sequencing, we identified that P. gingivalis infection markedly increased the expression of Z-DNA binding protein 1 (Zbp1) in bone-marrow-derived macrophages. Initially identified as an interferon-induced tumor-associated protein, Zbp1 serves as an upstream sensor that regulates cell death by activating PANoptosis. Mechanistically, P. gingivalis induced a mitochondrial stress response, prompting the release of mitochondrial DNA. This mitochondrial DNA then interacted with Zbp1, consequently augmenting its downstream PANoptosis signals. In addition, P. gingivalis stimulated macrophage Zbp1 expression through the Tlr2/4-JNK-Stat3/5 pathway, exacerbating macrophage death. Importantly, blocking the biosynthesis of endogenous Zbp1 by pharmacological delivery with microneedles improved the survival of P. gingivalis-infected macrophages and inhibited periodontal tissue destruction. These findings highlight Zbp1 as a potential therapeutic target for P. gingivalis-induced periodontitis.

This study aimed to investigate the presence of asprosin hormone in the biological fluids of patients with periodontal inflammation and compare it to those with periodontal healthy.

Seventy-five individuals between the ages of 18 to 45, 25 periodontal healthy, 25 with gingivitis, and 25 with periodontitis, were included in the study. Gingival crevicular fluid (GCF), blood serum and saliva were obtained from individuals in each group. Tumour necrosis factor-alpha (TNF-α) and asprosin levels in these fluids were determined using the ELISA. Clinical periodontal measurements were recorded and body mass index was calculated. One-way ANOVA and Bonferroni tests were performed for statistical analysis. Spearman test was used to evaluate correlations. The significance level was determined as p < 0.05.

Body mass index values were not different between the groups (p = 0.446). Clinical periodontal measurements were significantly higher in the periodontitis group. Concentrations of TNF-α in GCF, serum and saliva increased significantly in patients with gingivitis and periodontitis (p < 0.001). The higher TNF-α levels were obtained in patients with periodontitis than in individuals with gingivitis (p = 0.001). While asprosin levels were found to be significantly higher in patients with gingivitis and periodontitis (p < 0.001), no significant difference was observed between both groups (p > 0.05). GCF-asprosin levels were positively correlated with the concentrations in serum and saliva in all individuals included in the study (p < 0.05).

The periodontal inflammation caused an increase in asprosin hormone in gingival crevicular fluid independently of the type of periodontal disease.

This study is registered with number of "NCT06627972" in ClinicalTrials.gov website from the date of October 3, 2024.

Periodontitis is a significant health challenge caused by a complex interaction between bacterial infection, host immune response, and environmental factors, leading to tooth loss, bone loss, and potential associations with major systemic diseases and conditions. While the determinants of periodontitis have been extensively investigated in other populations, such studies are lacking in South Africa, which represents a high-risk population. Therefore, this study was conducted to characterize the subgingival bacterial biodiversity in the periodontal pockets of patients with periodontitis in a Western Cape population.

Pooled subgingival plaque samples were collected from the deepest pocket/crevices of five periodontitis cases and five controls using sterile paper points. Illumina MiSeq paired-end sequencing and QIIME2 software were employed for sequence filtration and analysis. Several alpha and beta-diversity metrics assessed biodiversity within-sample and population structure between different microbiota datasets, respectively. Statistical significance for alpha diversity was tested using the Kruskal-Wallis H test (p < 0.05), and beta diversity differences were evaluated using PERMANOVA. Data visualization, including beta diversity plots, was conducted with the Phyloseq package in R.

Beta-diversity measures revealed significant differences between periodontitis cases and controls (p-value = 0.04), whereas alpha-diversity was higher in cases, though without statistical significance (p-value ≥ 0.05). Cases group showed high relative abundance of Fusobacterium (16%), Porphyromonas (10%), and Treponema (9%), while the periodontally healthy controls were dominated by Streptococcus (20%), Fusobacterium (15%), and Veillonella (10%), with g_Streptococcus showing a significant difference (p-value = 0.008). Differential abundance analysis revealed distinct bacterial genera enriched in cases (Bulleidia, Peptoanaerobacter, Phocaeiola, W5053) and controls (Abiotrophia, Haemophilus, Lautropia, Rothia, Streptococcus). Sample-specific variations included higher levels of Porphyromonas (15%) in grade B and Fusobacterium (20%) in grade C.

This exploratory study highlights distinct bacterial communities associated with periodontitis in a South African population. The findings emphasize the need for larger, population-based cohorts to validate these results and lay a foundation for future research into region-specific microbial profiles and their implications for personalized treatment strategies.

This study aimed to evaluate the effectiveness of the laser-assisted new attachment procedure (LANAP) and low-level laser therapy (LLLT) on clinical, biochemical, and radiographic parameters when applied alongside scaling and root planing (SRP).

The study was designed as a randomized controlled, single-blind, parallel trial involving 68 patients diagnosed with periodontitis. The participants were divided into three groups: Group 1: SRP (control), Group 2: LANAP, and Group 3: LLLT. Clinical measurements, gingival crevicular fluid (GCF) samples, and standard periapical radiographs were obtained pre-treatment and at one- and three-month follow-ups. In GCF, interleukin-1beta (IL-1β), interleukin-10 (IL-10), and vascular endothelial growth factor (VEGF) were analyzed.

In moderate (4-6 mm) and deep pockets (≥ 7 mm), laser-treated groups showed a significant reduction in pocket depth (PD) and clinical attachment level (CAL) compared to the control group. However, there were no statistically significant differences in biochemical markers between the groups. Group 2 demonstrated significant bone filling compared to the control group.

In deep pockets, laser-treated groups provide additional benefits to SRP. The application of LLLT positively affected recession (REC).

NCT04694222 Date of registration: 01/01/2021.

Background/Objectives: Gingivitis and dental caries are oral diseases resulting from bacterial accumulation in dental plaque, leading to inflammation, tissue destruction and the demineralization of tooth structures. Dioscorea communis, due to its anti-inflammatory and antimicrobial properties, could be a new treatment candidate. Methods: This study evaluated the preventive and therapeutic effect of a D. communis berry juice paste, formulated at 3% and 7% concentrations, on gingivitis and dental caries, in 55 male SKH-hr2 hairless mice. Gingivitis and dental caries were induced by ligation of the upper left incisor and the paste was applied topically three times daily, five days a week. Treatment efficacy was assessed through clinical examinations, photo-documentation, histopathological analysis and FT-IR spectroscopy. Results/Conclusions: Preventive administration of D. communis 7% significantly delayed disease onset, while therapeutic effects on established conditions were limited. Both concentrations were non-toxic to gingival tissues and dental structures.

Several studies have demonstrated an increased risk of periodontitis (PD) among patients diagnosed with systemic lupus erythematosus (SLE). However, the underlying common mechanism between them remains incompletely understood. Accordingly, the aim of this study is to examine diagnostic biomarkers and potential therapeutic targets for SLE and PD by leveraging publicly accessible microarray datasets and transcriptome analysis.

Datasets pertaining to SLE and PD were retrieved from the Gene Expression Omnibus (GEO) database, and subsequently analyzed for differentially expressed genes (DEGs). Key gene modules were identified through weighted gene co-expression network analysis (WGCNA), and shared genes were obtained by overlapping key genes between DEGs and WGCNA. These shared genes were subsequently subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses, leading to the establishment of a Protein-Protein Interaction (PPI) network. Random forest (RF) and Least Absolute Shrinkage and Selection Operator (Lasso) regression were employed to identify key hub genes. Receiver operating characteristic (ROC) curves were generated using a new validation dataset to evaluate the performance of candidate genes. Finally, levels of immune cell infiltration in SLE and PD were assessed using CIBERSORTx.

A total of 50 core genes were identified between the genes screened by WGCNA and DEGs. Functional enrichment analysis revealed that these genes are primarily associated with the PI3K-Akt and B-cell receptor signaling pathways. Additionally, using machine learning algorithms and ROC curve analysis, a total of 8 key genes (PLEKHA1, CEACAM1, TNFAIP6, TCN2, GLDC, GNG7, LY96, VCAN) were identified Finally, immune infiltration analysis highlighted the significant roles of neutrophils, monocytes, plasma cells, and gammadelta T cells (γδ T cells) in the pathogenesis of both SLE and PD.

This study identifies 8 hub genes that could potentially serve as diagnostic markers for both SLE and PD, highlighting the importance of VCAN and LY96 in diagnosis. Moreover, the involvement of the PI3K-Akt signaling pathway in both diseases suggests its significant role. These identified key genes and signaling pathways lay the groundwork for deeper comprehension of the interplay between SLE and PD.

Background/Objectives: Previous research indicates that non-surgical periodontal therapy (NSPT) improves glycemic control in individuals with prediabetes and diabetes who have periodontitis. Few studies have demonstrated its effects on mouthrinse active-matrix metalloproteinase-8 (aMMP-8) levels as it relates to glycemic control. We assessed the periodontal treatment response of stage II-IV periodontitis patients with prediabetes, diabetes, and normoglycemia, regarding glycated hemoglobin (HbA1c) and mouthrinse aMMP-8 levels using point-of-care kits (PoC). Materials and Methods: Eighty-eight adults (11 normoglycemic, 32 prediabetic, 45 with type 2 diabetes), aged 25-78, with stage II-IV periodontitis were included. Full-mouth clinical examinations were used to evaluate their periodontal parameters. HbA1c and mouthrinse aMMP-8 levels were assessed using PoC kits before and approximately three months after scaling and root planing. Results: There were positive treatment effects of non-surgical periodontal therapy on periodontal clinical parameters, aMMP-8 and HbA1c levels in the prediabetes and diabetes groups. The aMMP-8 reduction was significant (p < 0.001) in the prediabetes and prediabetes + diabetes groups, while HbA1c decreased significantly in the diabetes and prediabetes + diabetes (p < 0.001) groups. In contrast, a non-significant increase in mean aMMP-8 levels, HbA1c, and CAL was observed in normoglycemia (p > 0.05). Stage III + IV periodontitis showed significant treatment effects for aMMP-8 (p < 0.001) and HbA1c (p < 0.01) compared to stage II, regardless of glycemic status. Conclusions: Non-surgical periodontal therapy significantly improves periodontal health as well as HbA1c and aMMP-8 levels in people living with prediabetes and diabetes.

More than two years of the Russian-Ukrainian war have resulted in widespread human and economic tragedy. This crisis also affects health status, including oral health.

To carry out an exploratory analysis on the extent of caries in Ukrainian war refugee children and adolescents, and in addition to determine whether there was a statistically significant association between caries and age, gender, periodontal health status (using the Periodontal Screening and Recording (PSR) index), self-reported socioeconomic status and Italian language speaking skills.

This study used a cross-sectional design, was conducted in Perugia, Italy at the University Dental Clinic (COU) between November 2023 and April 2024 and included 50 children and adolescents between 3 and 18 years old (mean age 9.2 SD 4.6) with Ukrainian citizenship who had left their home country due to the war. The visits were conducted in the presence of a cultural mediator. The visits consisted of two parts: the administration of questionnaires on socio-economic status and communication skills, followed by a dental examination. A logistic regression model was used to identify the factors independently associated (age, sex, PSR, socio-economic status and level of communication) with high DMFT/dmft values.

The refugees' mean DMFT/dmft was 3.5 SD 2.5. The multivariate logistic regression model showed that increased PSR (OR 7.71, 95% CI 1.38-22.94, p = 0.020) and low communication (OR 6.09, 95% CI 1.34-27.69, p = 0.019) were independently associated with the risk of having a DMFT/dmft > 4.

The study findings were worrying in terms of the prevalence and severity of caries, especially in refugee children with a poor level of integration in the host country. This study with its preliminary data provides a starting point to reflect on the need for specific health policies adapted to a complex type of social vulnerability such as refugee children status.

Esophageal cancer, primarily comprising the squamous cell carcinoma (ESCC) and adenocarcinoma (EAC) subtypes, is the sixth leading cause of cancer deaths globally. In addition to many well-established endogenous and exogenous risk factors, there is emerging evidence for the etiologic role of infectious agents in esophageal cancer, although these associations are incompletely understood. Here, we review the currently available literature on the relationship between infectious agents and esophageal cancer. By far, human papilloma virus (HPV), particularly HPV 16 and 18, have the strongest etiologic association with ESCC. Less robust is the association of high-risk HPV (hr-HPV) with EAC. Although H. pylori has been implicated in the development of EAC via increased acid reflux, decreased lower esophageal sphincter tone, and the resultant Barrett's metaplasia-dysplasia-adenocarcinoma pathway, some hypothesize based on epidemiological trends that H. pylori may in fact be a protective factor. In rare cases, EBV can cause esophageal lymphoepithelial carcinoma. Several other agents including HSV, polyomaviruses, and Candida are associated with esophageal cancer to varying degrees. In summary, while several studies, including those conflicting with each other, implicate several infectious agents, the evidence is weak, at best. Clearly, further work is needed to help solidify clear etiologies that will help facilitate prevention and treatment.

Patent foramen ovale (PFO) is the most common congenital heart abnormality of foetal origin and has been associated with cryptogenic ischemic stroke (CIS) through several mechanisms, with most theories supporting paradoxical embolism. Other possible but unknown contributing factors, such as the role of the microbiome in PFO-associated strokes, remain unclear. We analysed saliva metagenomes to study the differences in the oral microbiome between young-onset CIS patients with clinically relevant high-risk PFO (n = 52) and those without PFO (n = 52). Age- and sex-matched stroke-free controls (n = 16) with high-risk PFO were included for the comparison. Beta diversity was significantly different between patients and controls with high-risk PFO, but not between patients with and without high-risk PFO. The phylum Ascomycota and class Saccharomycetes were significantly more abundant in patients with high-risk PFO than in those without high-risk PFO. Additionally, the abundance of Lactococcus, including Lactococcus raffinolactis and L. cremoris, was higher in controls with high-risk PFO than in patients with high-risk PFO. These findings highlight that oral dysbiosis and high-risk PFO may form a critical but under-recognized combination in the aetiology of CIS. Future research should focus on elucidating the precise mechanisms of these interactions and developing targeted interventions.

The present study aimed to elucidate the prognostic factors affecting the probing depth (PD) reduction following the non-surgical periodontal treatment of patients with periodontitis using a linear mixed-effects model. A retrospective analysis was performed on 455 patients who met the specific inclusion criteria. Data were gathered from 3-month re-evaluation records in the electronic periodontal charting system at the Department of Periodontology, School and Hospital of Stomatology at Tianjin Medical University between December 2021 and January 2022. Descriptive statistics were used to assess the changes in PD and certain baseline characteristics of the patients. A three-level nested random-effects mixed-effect model (patient/tooth/site) was used to evaluate the prognostic factors for PD reduction. Variance decomposition was conducted to analyze PD reduction across different nested levels. P<0.05 was considered to indicate a statistically significant difference. The overall mean PD reductions at the patient level for all sites were 0.88 mm. Patients diagnosed with Grade C periodontitis exhibited a greater PD reduction compared with those with Grade B periodontitis (0.96 vs. 0.76 mm; P<0.001). The multivariable coefficient for patients with Grade C periodontitis was 0.20 (95% confidence interval, 0.08-0.33; P<0.001). Random-effects analysis demonstrated that the variability in PD reduction was 59.4, 39.1 and 73.8% at the patient, tooth and site levels, respectively. Grade C periodontitis had the most substantial importance on the effect of PD reduction following NSPT. This reduction in PD could primarily be explained at both the site and patient levels.

Background and aim Remarkable evidence supports the hypothesis that vitamin D influences and prevents the sequelae of periodontal disease. Its deficiency has also been found among patients with polycystic ovary syndrome (PCOS), and it could be attributed to the polymorphisms in the vitamin D receptor (VDR) gene. Hence, the goal of this study is to assess the periodontal health of PCOS participants and investigate the serum vitamin D levels in patients with PCOS and periodontitis. Methods and material A cross-sectional study was conducted on 100 female participants between the ages of 18 to 40 years and were equally divided into four groups: Group 1: participants with periodontitis only; Group 2: participants with PCOS only; Group 3: participants with periodontitis and PCOS; and Group 4: participants without periodontitis and PCOS. Results Serum vitamin D levels in Group 1 (35.40±3.862), Group 2 (31.20±5.888), Group 3 (32.12±3.811), and Group 4 (33.24±5.885) presented no statistically significant differences among the groups. Many people in all study groups had lower levels of serum vitamin D. In PCOS individuals, there is no discernible decline in periodontal health. Conclusions In this study, it was concluded that serum vitamin D levels do not significantly correlate with the prevalence of PCOS or periodontitis.

This cross-sectional study aimed to evaluate the interplay between volatile sulfur compounds (VSC), biofilm, salivary parameters, and periodontal status in patients with and without periodontal disease. Sixty-four subjects diagnosed with periodontitis and 60 periodontally healthy individuals were included. Probing depth, clinical attachment level, bleeding on probing, tongue coating index, plaque index, number of teeth, spinnability of unstimulated whole saliva, and salivary flow rate were evaluated. The concentrations of VSC were quantified using a portable gas chromatograph. The mean differences in hydrogen sulfide, methyl mercaptan, salivary flow, spinnability, and plaque index did not exhibit statistically significant variances between the two groups. However, a pronounced tongue coating index and a diminished tooth count showed statistical significance in the periodontitis group (p = 0.039; p < 0.001). Unstimulated salivary flow rate less than 0.25 mL/min was statistically significant in the periodontitis group (p = 0.032). After controlling for confounding factors, bleeding on probing remained significant. A positive correlation between periodontal parameters and VSC concentration was found. An inverse correlation was also noted between the spinnability of saliva and tongue coating index (-0.34; p < 0.001). Salivary parameters may contribute to the formation of tongue coating and are correlated with periodontal status. Bleeding on probing, clinical attachment level, and probing depth were identified as potential contributors to VSC formation.

The periodontium is one of the most complex tissues in the body, consisting of a hierarchical blend of soft and hard tissues. Its complex architecture makes treating and regenerating disease-damaged periodontal tissues a persistent challenge in biomedicine. Three-dimensional (3D) bioprinting represents a transformative approach to tissue engineering, offering promising advancements in treating and regenerating periodontal disease. This innovative technology enables the precise fabrication of complex, patient-specific tissue structures, facilitating the repair and restoration of damaged periodontal tissues, including the gingiva, bone, and periodontal ligament (PDL). By utilizing biocompatible materials such as living cells, hydrogels, and growth factors, 3D bioprinting has the potential to create functional, biologically integrated constructs that can mimic the natural architecture of periodontal tissues. However, translating these advancements into clinical applications remains a challenge. Emerging technologies like bioprinting have been developed to address some limitations of traditional tissue engineering methods. This review explores the current state of 3D bioprinting technology, its application in periodontal disease treatment, and the challenges associated with scaling up this technology for clinical use. Additionally, it discusses the future implications of bioprinting for personalized medicine, offering a new frontier for regenerating periodontal tissues and improving patient outcomes in oral health. Integrating 3D bioprinting into periodontal regenerative therapies could revolutionize clinical practices, offering more effective, tailored, and sustainable solutions to address the challenges of periodontal disease.

Background and Objectives: Among nutritional factors implicated in periodontal health, the vitamin B complex-particularly folate (vitamin B9), cobalamin (B12), thiamine (B1), and riboflavin (B2)-has gained attention for its role in immunomodulation and tissue repair. This systematic review aims to synthesize current evidence on whether adequate vitamin B complex intake or status is associated with improved periodontal outcomes. Methods: A systematic search was performed in PubMed, Scopus, and Web of Science for observational studies investigating vitamin B complex intake or status in relation to periodontal disease indicators. Articles were screened according to PRISMA guidelines, and five studies met inclusion criteria. Results: Five observational studies were included. In older adults, each standard deviation increase in serum folate was associated with an approximate 26% reduction in periodontal disease odds ratio (OR = 0.74, 95% confidence interval (CI) 0.58-0.93). Among young adult women, inadequate riboflavin (B2) and pyridoxine (B6) intake correlated with higher community periodontal index (CPI) scores (p < 0.05). In a large NHANES-based cohort, insufficient thiamine (B1) intake yielded a 33% higher likelihood of severe periodontitis (p < 0.05), while adequate riboflavin was protective (OR = 0.90). Another dose-response analysis (n = 8959) indicated up to a 30% risk reduction for moderate folate or B1 intake, but no extra benefit with excessive intake. Finally, a UK Biobank analysis (n = 9476) showed that those in the highest quartile of a "high micronutrient" dietary pattern-including vitamins B6 and folate-had a 24% lower risk of self-reported periodontal disease (OR = 0.76, 95% CI 0.65-0.90) compared to the lowest quartile. Conclusions: Across diverse populations, inadequate vitamin B complex intake-especially folate-was consistently linked to worse periodontal outcomes.

Evidence has shown that both smoking and periodontitis were linked to cognitive impairment. This study examines whether periodontitis mediates the effects of smoking status on cognitive function in older adults.

Using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, the study included 1728 older participants who have data on smoking, serum cotinine, periodontal examination, and cognitive function. Mediation analysis was performed to test whether extent of periodontitis mediated associations between smoking status and cognitive function, adjusted for sociodemographic and basic health factors.

Compared to never-smokers, daily smokers exhibited significantly worse global cognitive function, with periodontitis mediating this effect (effect= -0.16; 95% CI= -0.29, -0.05). Similarly, periodontitis mediated the association between serum cotinine levels and cognitive function in the total sample (effect= -0.02; 95% CI= -0.03, -0.00).

Periodontitis significantly mediates the impact of smoking on cognitive function. The findings highlight the potential roles of maintaining oral health and smoking cessation in mitigating cognitive decline.

Trimethylamine N-oxide (TMAO) has been implicated in systemic inflammatory pathways, emphasizing its potential as a biomarker. Elevated plasma TMAO levels have been associated with increased oxidative stress, leading to higher plasma concentrations of TNF-α, a key pro-inflammatory cytokine. Given this systemic inflammatory linkage, saliva-a non-invasive diagnostic medium-offers a unique opportunity to reflect both local and systemic inflammatory changes. This study aimed to evaluate the alterations in salivary and serum TMAO levels in periodontitis and assess the diagnostic potential of salivary TMAO as an indicator of periodontal inflammation.

Twenty-four patients with periodontitis (Stage III Grade B) and 24 healthy controls were included. Clinical parameters (probing depth (PD), plaque index (PI), bleeding on probing (BOP), and clinical attachment loss (CAL)) were recorded. TMAO levels in saliva and serum were measured using liquid chromatography-mass spectrometry (LC-MS/MS), and TNF-α levels were assessed using Enzyme-Linked ImmunoSorbent Assay (ELISA).

Salivary and serum TMAO levels and salivary TNF-α levels were significantly higher in the periodontitis group (p = 0.003, p = 0.004, and p = 0.031, respectively). Salivary TMAO showed positive correlations with periodontal parameters (p < 0.05) and salivary TNF-α levels. A significant positive correlation was also observed between salivary and serum TMAO levels (p < 0.001). Salivary TMAO was the accurate biomarker in differentiating between periodontitis and controls (sensitivity = 0.583, specificity = 0.833, AUC = 0.747).

Salivary TMAO demonstrates potential as a non-invasive marker for periodontitis, showing correlations with clinical parameters and inflammatory markers. These findings suggest that TMAO may reflect both local and systemic inflammatory states associated with periodontal disease.

Salivary TMAO may serve as a potential non-invasive indicator of periodontitis, as it reflects aspects of both local and systemic inflammation, offering insights into periodontal disease status.

This register-based follow-up study investigated periodontal status after periodontal treatment (PT) based on need following oral health examination (OHE).

A total of 42,533 adults aged 18-89 years receiving OHE in the public oral health clinics of the City of Helsinki in 2009 were included. Dentists recorded periodontal status by the Community Periodontal Index (CPI), and determined the individual recall interval (IRI). Follow-up OHE between 2010 and 2015 was performed for 16,040 adults based on IRI or later. Outcome of interest was change of CPI during follow-up and was modelled with proportional odds model for each sextant separately. Results were reported as odds ratios (ORs).

Signs of periodontal disease were present in 95% of the study population. Symptoms of periodontitis (CPI score 3 or 4) were observed in 24% of patients. In models, PT indicated better outcome in all six sextants and in sextant 5 after one treatment (OR 5.05, 95% confidence interval [CI] 4.53-5.63). A poorer outcome was observed in patients with diabetes or severe mental disorders and in men.

The study population had a high prevalence of periodontal diseases. Men and patients with diabetes or severe mental disorders should be specifically targeted by dentists.

Gingivitis and periodontitis are microbially associated diseases, with some features characteristic of pediatric age and others linked to systemic diseases. While the role of periodontal pathogenic bacteria is well recognized, the contribution of fungi and viruses, particularly Herpesviridae, remains controversial. Studies in adults have highlighted the presence of Herpesviridae, but evidence in pediatric subjects, especially systemically compromised, is limited. This systematic review aimed to assess periodontal status (e.g., health, gingivitis, periodontitis, necrotizing gingivitis, and/or periodontitis) and the subgingival and/or salivary microbial (bacterial, viral, and fungal) profile in systemically compromised pediatric (≤18 years) subjects with gingivitis and/or periodontitis compared to clinical periodontal health.

The review protocol was registered on PROSPERO (CRD42024597695) and followed the PRISMA statement. Data from eight studies were descriptively analyzed and qualitatively assessed through ROBINS-I and JBI tools.

CMV was frequently detected, particularly in necrotizing gingivitis (19.40%). EBV was found in necrotizing gingivitis (20.69%) and periodontitis (10.34%); HSV was mainly associated with gingivitis and necrotizing gingivitis. Bacteria species in periodontitis included Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium, and Campylobacter species. Candida albicans was detected in periodontitis, suggesting a fungal involvement in the disease's pathogenesis. Although the bacterial and fungal profile was not investigated, limited viral presence was noted in subjects with healthy periodontium, indicating a stable microbiome.

These findings underscore the dynamics of microbial interactions in the progression of periodontal disease in systemically compromised pediatric subjects.

Periodontitis has been linked to systemic inflammation, however research on its role in causing systemic diseases remains limited. Recent studies explore probiotics for microbiome modulation and enhancing natural compound bioavailability. This study investigated periodontitis-related systemic disease mechanisms, and evaluated the mitigation effects of bioconversion product using Lactiplantibacillus plantarum SMFM2016-RK and Artemisia herba-alba extracts. Four types of bioconverted milk [BM1 (L. plantarum SMFM2016-RK), BM2 (BM1 + A. herba-alba ethanol extract), BM3 (BM1 + A. herba-alba hot-water extract), and BM4 (BM1+ both A. herba-alba extracts)] were studied in a periodontitis-induced rat model. Rats were divided into six groups: normal control, skim milk with ligature, and four BM groups with ligature.   Periodontitis induction elevated trabecular resorption (0.325 ± 0.057 mm³) and histopathological symptoms. Serum ALT (55.6 ± 6.6 U/L), glucose (261.7 ± 64.3 mg/dL), insulin (1.90 ± 0.87 ng/mL), inflammation in the liver and colon, and gluconeogenesis-related enzyme expression increased. Periodontitis-induced rats showed gut dysbiosis, with decreased Lactobacillaceae level and increased Oscillospiraceae level. BM3 administration significantly reduced the serum glucose (190.9 ± 27.8 mg/dL), ALT (40.5 ± 5.0 U/L), inflammation, and gluconeogenesis-related enzymes, while increasing tight junction proteins expression and phylum Actinobacteria levels in the gut microbiome. The findings highlight the systemic impact of periodontitis on inflammation, glycemic control, and gut microbiome balance. BM3 effectively alleviated these effects suggesting therapeutic potential.

According to an ADA report, approximately 15% of the US population requires dental care annually but does not receive it. Access to dental care, particularly for periodontal examinations, is challenging for many individuals, leading to uncontrolled periodontitis progression and systemic health complications. Periodontitis, an inflammatory gum disease, affects nearly half of American adults over 30. Current diagnostic approaches rely on periodontal exams and radiographs, requiring clinical settings and experienced dental care providers. However, many individuals lack access to dental care, making it difficult to obtain up-to-date clinical probing depth, dental X-rays or CT scans. To address this gap, we developed a machine learning (ML) tool for at-home preliminary periodontitis assessments. This tool would benefit individuals unaware of their undiagnosed periodontal conditions and those with limited access to dental care, empowering them to prioritize dental care and seek timely treatment within their constraints. Our tool leverages the NHANES database to train an ML model on multimodal features relevant to periodontitis that are radiographic-independent. We labeled the individuals with different periodontitis severity based on their periodontal charting records and performed feature engineering on the dataset. We first developed a baseline model and subsequently trained additional classifiers, conducting a comprehensive hyperparameter search that resulted in consistent performance. The best-performing model was evaluated on the test set, achieving an overall precision of 0.80 and AUC of 0.81, demonstrating robust classification performance without overfitting. Feature importance analysis provided guidance for the questionnaire design for the real-world application of this tool. Additionally, our novel approach of analyzing misclassified populations offered insights for data interpretation, supported model improvement, and revealed deeper correlations between periodontitis and its risk factors. Our model exemplifies the capacity to leverage extensive public health databases for periodontitis evaluations. Ultimately, our ML-driven tool aims to overcome existing dental care barriers by providing users with periodontitis predictions and personalized dental care suggestions, all easily accessible from their smartphones or laptops at home.

Objectives: The aim of this study was to describe the structure and assess the efficacy of a patient-centered framework for managing periodontitis, utilizing the Bioperio® protocol, a standardized treatment approach incorporating both clinical and extra-clinical phases. Methods: Patients diagnosed with periodontitis were included in this multicenter, single-arm, clinical observational study with a 3-month follow-up. All patients were treated following the Bioperio® protocol, involving professional supra-gingival scaling, oral hygiene instructions, and scaling and root planing following a full-mouth approach. In Stage III/IV periodontitis cases, enamel matrix derivatives (EMD) were applied in periodontal pockets > 5 mm. Monthly recalls were performed until the 3-month follow-up. Results: In total, 663 patients were enrolled, with 76.4% being diagnosed with Stage II/III periodontitis. At 3 months, all clinical periodontal parameters improved regardless of the initial stage of periodontitis, achieving pocket closure in 75.4% of cases and patient resolution in 91.3% of the sample. Stages I/II showed significantly improved outcomes compared to Stage IV. The adjunct of EMDproved beneficial, especially in stage III patients, increasing pocket closure by 15% and doubling the odds of patient resolution. No adverse effects of the treatment protocol were observed throughout the study. Conclusions: The Bioperio® protocol appears to be a safe and effective therapeutic approach for the management of patients affected by periodontitis. Combining a stepwise approach for clinical phases with tailored oral hygiene instructions and motivational sessions offers a comprehensive strategy that may enhance outcomes for patients with periodontitis.