1,721,125 research outputs found
The role of probiotics in preventing dental caries: a systematic review of clinical evidence
No full textBackground: Probiotics have emerged as a promising adjunctive strategy for oral health, particularly in the prevention of dental caries, a multifactorial disease driven by ecological imbalances in the oral microbiome.
Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between January 2014 and January 2025, focusing on the use of probiotics for caries prevention in children and young adults. Clinical trials and observational studies were included, and a qualitative synthesis was performed based on the extracted outcomes.
Results: Twenty-one studies met the inclusion criteria. Most clinical trials reported a significant reduction in Streptococcus mutans levels following administration of probiotic strains, particularly Lactobacillus paracasei, Lactobacillus rhamnosus, and Bifidobacterium lactis. Several studies also demonstrated a decreased incidence of new carious lesions and an improvement in salivary immune markers. However, a minority of studies found no significant effect, highlighting potential variability due to strain type, dosage, delivery method, and population characteristics.
Conclusion: The current evidence supports the potential of specific probiotic strains to reduce cariogenic bacterial loads and contribute to caries prevention. Further standardized, long-term trials are needed to clarify the most effective formulations and regimens for clinical application
The interaction between gut microbiome and bone health
Full text linkPurpose of review: This review critically examines interconnected health domains like gut microbiome, bone health, interleukins, chronic periodontitis, and coronavirus disease 2019 (COVID-19), offering insights into fundamental mechanisms and clinical implications, contributing significantly to healthcare and biomedical research. Recent findings: This review explores the relationship between gut microbiome and bone health, a growing area of study. It provides insights into skeletal integrity and potential therapeutic avenues. The review also examines interleukins, chronic periodontitis, and COVID-19, highlighting the complexity of viral susceptibility and immune responses. It highlights the importance of understanding genetic predispositions and immune dynamics in the context of disease outcomes. The review emphasizes experimental evidence and therapeutic strategies, aligning with evidence-based medicine and personalized interventions. This approach offers actionable insights for healthcare practitioners and researchers, paving the way for targeted therapeutic approaches and improved patient outcomes. Summary: The implications of these findings for clinical practice and research underscore the importance of a multidisciplinary approach to healthcare that considers the complex interactions between genetics, immune responses, oral health, and systemic diseases. By leveraging advances in biomedical research, clinicians can optimize patient care and improve health outcomes across diverse patient populations
Concentrated Growth Factors and Bone Grafting in Maxillary Sinus Lift: A Systematic Review
No full textAim
This review evaluates the latest studies on the effectiveness of growth factor concentrates and bone grafts (BGs) in maxillary sinus lift (MSL) procedures, emphasizing their role in bone regeneration and healing. The aim is to determine their impact on enhancing clinical outcomes by improving bone quality and accelerating the healing process.
Materials and Methods
A comprehensive literature search was conducted using the Scopus, Web of Science, and PubMed databases. The following keywords were employed: “PRP,” “L-PRF,” “CGF,” “oral surgery,” and “sinus lift,” combined with the Boolean operators “AND” and “OR.” A total of 727 studies were initially identified, of which 18 met the inclusion criteria for this review.
Results
The included studies demonstrate that the use of growth factors in conjunction with alloplastic and xenogeneic BGs significantly promotes early vascularization and has potent proangiogenic effects in vivo. Furthermore, these combinations reduce postoperative inflammation and discomfort, accelerating the healing process and enhancing tissue regeneration.
Conclusions
Although further research is necessary, current evidence suggests that autologous platelet concentrates hold promise for improving clinical outcomes in MSL procedures. They may enhance bone height and thickness, improve vascularization, and expedite postoperative healing, offering a valuable adjunct to traditional bone grafting techniques in oral surgery
Gestione di apici larghi con tecnica ‘GC homemade’: case report con follow-up a 7 anni
No full textOBIETTIVI: L’endodonzia ha subito grandi cambiamenti grazie all’introduzione di strumentazioni sempre più precise con meccaniche all’avanguardia, che l’hanno resa più affidabile e prevedibile. Tuttavia, la gestione dei canali con apici di grosse dimensioni rimane una sfida.
Questo studio si propone di presentare una tecnica per la preparazione e l’otturazione dei canali radicolari con apici di dimensioni superiori a 60 centesimi di millimetro, utilizzando strumenti canalari specifici.
MATERIALI E METODI: Lo studio è focalizzato sull’uso degli strumenti rotanti in nichel-titanio (Ni-Ti) per preparare e otturare canali radicolari con apici di dimensioni considerevoli (oltre i 60 centesimidi millimetro). La lega Ni-Ti, nota per caratteristiche come memoria di forma e superelasticità, ha rivoluzionato l’endodonzia, rendendola più certa e ripetibile. L’intervento endodontico è stato eseguito con successo utilizzando gli strumenti rotanti in nichel-titanio (Ni-Ti) e la tecnica Microseal per la preparazione e l’otturazione dei canali radicolari con apici di dimensioni considerevoli. Il blocco del nervo alveolare inferiore è stato ottenuto con mepivacaina con adrenalina 1:100000, e l’isolamento del campo operatorio è stato realizzato con l’uso della diga di gomma. La procedura di apertura della camera pulpare è stata eseguita tramite frese diamantate rotanti ad alta velocità, seguita dall’accesso ai canali radicolari. Durante la strumentazione canalare con il sistema Mtwo®, è stata utilizzata un’irrigazione alternata con ipoclorito di sodio al 5% e acido etilenodiamminotetraacetico al 17%. Per la preparazione dei canali, è stata impiegata una sequenza di strumenti Mtwo® con diversi diametri e conicità. Per raggiungere gli apici di grosse dimensioni, è stata sviluppata una tecnica innovativa chiamata “GC home made”, che prevede il taglio progressivo della punta di uno strumento Mtwo®. Dopo la preparazione, l’otturazione è stata eseguita utilizzando la tecnica Microseal con guttaperca e coni di guttaperca. Lo studio è stato applicato a un caso clinico di ritrattamento endodontico su un molare inferiore e ha dimostrato l’efficacia della tecnica “GC home made” nella preparazione e nell’otturazione dei canali con apici di grosse dimensioni. Questo approccio offre un’alternativa innovativa e promettente nella pratica endodontica.
RISULTATI: La tecnica è stata efficace nel raggiungere e sigillare l’apice dei canali. Complessivamente, l’approccio ha garantito un trattamento endodontico accurato e avanzato, dimostrando l’efficacia della combinazione di strumenti canalari scelti e della tecnica “GC home made” nella gestione di apici di grosse dimensioni.
CONCLUSIONI: La tecnica descritta si è dimostrata efficace nel trattamento di canali con apici di grosse dimensioni, consentendo una preparazione e un’otturazione adeguate. Tale approccio potrebbe migliorare il successo clinico nei casi con anatomia radicolare complessa.
SIGNIFICATO CLINICO: Il materiale degli strumenti canalari utilizzati offre flessibilità, efficienza e capacità di taglio durante la strumentazione canalare grazie alla sua memoria di forma e superelasticità. Tuttavia, ci sono alcuni rischi come la frattura degli strumenti stessi sotto carichi maggiori e l’accumulo di fatica. Sono importanti una tecnica operativa corretta e il controllo del carico applicato. L’otturazione canalare è cruciale per il successo endodontico, con enfasi sul sigillo tridimensionale e la scelta accurata del limite apicale.OBJECTIVES Endodontics has undergone great changes with the introduc tion of increasingly precise in strumentation with state-of-the art mechanics, making it more reliable and predictable. Howev er, the management of canals with large apices remains a chal lenge. This study aims to present a technique for the preparation and obturation of root canals with apices larger than 60 hundredths of a millimeter, using Mtwo® in struments. MATERIALS AND METHODS This study focuses on the use of nickel-titanium (Ni-Ti) rotary in struments to prepare and obtu rate root canals with apices of considerable size (over 60 hun dredths of a millimeter). The Ni-Ti alloy, known for characteristics such as shape memory and su perelasticity, has revolutionized endodontics, making it more cer tain and repeatable. Endodontic surgery was successfully per formed using the Microseal tech nique with gutta-percha and Ni Ti cones. The study was applied to a clinical case of endodontic retreatment on a lower molar and demonstrated the effectiveness of the “GC home made” tech nique in the preparation and ob turation of canals with large api ces. This approach offers an in novative and promising alterna tive in endodontic practice. RESULTS formed using nickel-titanium (Ni Ti) rotary instruments and the Microseal technique for prepara tion and obturation of root canals with sizable apices. Blockage of the inferior alveolar nerve was achieved with mepivacaine with adrenaline 1:100000, and isola tion of the operative field was achieved with the use of rubber dam. The pulp chamber opening procedure was performed using high-speed rotary diamond burs, followed by root canal access. During root canal instrumenta tion with the Mtwo® system, al ternating irrigation with 5% sodi um hypochlorite and 17% eth ylene diamine tetraacetic acid was used. For canal preparation, a sequence of Mtwo® instru ments with different diameters and taper was used. To reach large apices, an innovative tech nique called “GC home made” was developed, which involves progressive cutting of the tip of an Mtwo® instrument. After preparation, obturation was per The technique was effective in reaching and sealing the apex of the canals. Overall, the compre hensive approach ensured accu rate and advanced endodontic treatment, demonstrating the ef fectiveness of the combination of selected root canal instruments and the “GC home made” tech nique in managing large apexes. CONCLUSIONS The described technique proved effective in the treatment of ca nals with large apices, allowing febbraio/2025 DENTAL CADMOS for adequate preparation and ob turation. This approach could im prove clinical success in cases with complex root anatomy. CLINICAL SIGNIFICANCE The material of the root canal in struments used offers flexibility, efficiency, and cutting ability during root canal instrumentation due to its shape memory and su perelasticity. However, there are some risks such as the instru ments fracture under lower loads and fatigue accumulation. Proper operative technique and control of the applied load is important. Root canal obturation is crucial to endodontic success, with em phasis on three-dimensional sealing and careful selection of the apical limit
Effectiveness of Herbal Medicines with Anti-Inflammatory, Antimicrobial, and Antioxidant Properties in Improving Oral Health and Treating Gingivitis and Periodontitis: A Systematic Review
Full text linkObjectives: This systematic review investigates the effectiveness of natural extracts with anti-inflammatory properties for improving oral health, particularly in managing gingivitis and periodontal disease (PD). With PD being a major global health issue, exacerbated by microbial dysbiosis and oxidative stress, the integration of phytochemicals and herbal formulations into periodontal therapy offers a promising avenue for adjunctive treatments. Methods: A systematic review was conducted following PRISMA guidelines and registered under the International Prospective Register of Systematic Reviews (ID: 641944). Databases, including PubMed, Scopus, and Web of Science, were searched between 18–24 December 2024, using Boolean keywords combining terms such as “herbal medicine”, “plant extracts”, “anti-inflammatory”, and “periodontal therapy”. Studies involving animal models, in vitro data, or non-peer-reviewed articles were excluded. Results: Seventeen studies met inclusion criteria. Polyherbal formulations and single-component extracts (e.g., Camellia sinensis, Punica granatum, Zingiber officinale, and Rosmarinus officinalis) demonstrated comparable efficacy to conventional agents like chlorhexidine (CHX). Polyherbal rinses, camellia sinensis gels, and extracts like Punica granatum reduced inflammation, improved gingival health, and showed antimicrobial properties, offering effective natural alternatives. Conclusions: Natural products, including single extracts and polyherbal formulations, provide effective and safe alternatives for managing gingivitis and PD. Their anti-inflammatory, antimicrobial, and antioxidant properties support their adjunctive role alongside with scaling and root planning therapy (SRP) in periodontal therapy. However, further large-scale, long-term studies are needed to standardize formulations and establish optimal protocols
Accuracy of the surgical template used in the placement of implants and orthodontic miniscrews
No full textBackground
For the best clinical results, accuracy is essential in orthodontics and oral surgery. Surgical guides, also known as templates, are now indispensable instruments for improving precision in operations like orthodontic treatments and dental implant installation. Cone-beam computed tomography (CBCT), intraoral scanning, and 3D printing are just a few of the cutting-edge imaging and manufacturing technologies used in these guides to produce patient-specific devices that complement predetermined treatment plans. Their application improves treatment predictability and lowers errors while minimizing hazards like harm to anatomical structures or improper placement. Materials and Methods: The technique was directed by the PRISMA protocol, which involved searching PubMed, Scopus, and Web of Science for research articles published from 2014 to 2024. English-language human studies evaluating the accuracy of surgical guides were given priority in the inclusion criteria. Results: Results underscore the transformative role of surgical guides in reducing complications, enhancing interdisciplinary collaboration, and optimizing outcomes. However, challenges remain, including dependence on imaging quality, guide stability, and cost. Conclusions: Notwithstanding its drawbacks, surgical guides are a major development in dentistry that helps close the gap between clinical execution and virtual planning while opening the door to safer, more predictable, and patient-centered care
Advancing Postoperative Pain Management in Oral Cancer Patients: A Systematic Review
Full text linkThe goal of this review is to shed light on the management of orofacial discomfort after a cancer diagnosis in the head and neck region. A search was conducted on PubMed, Scopus, and Web of Science to identify studies on postoperative pain control in oral cancer. The review included open-access research, investigations into pain management, randomized clinical trials, retrospective studies, case-control studies, prospective studies, English-written studies, and full-text publications. Exclusion criteria included animal studies; in vitro studies; off-topic studies; reviews, case reports, letters, or comments; and non-English language. Three reviewers independently accessed databases and assigned a quality rating to the chosen articles. The review explores postoperative pain management in oral cancer patients; highlighting persistent opioid use; the efficacy of adjuvant drugs, such as gabapentin; and a multimodal approach. It emphasizes the need for personalized pain management, recognizing individual pain perception and tailoring interventions. Integrating pharmacological and non-pharmacological strategies is crucial for comprehensive pain management. The review also serves as a guide for future research, emphasizing the need for standardized methodologies and diverse participant populations
Six-Year Implants Follow-Up After Guided Bone Regeneration Using Autologous Tooth Graft: Innovative Biomaterial for Bone Regeneration Tooth Transformer®
Full text linkObjectives: Recently, there has been great interest in teeth and their derivatives as suitable substrates for the treatment of alveolar bone defects. This retrospective study evaluates the clinical and radiographic outcomes of implants inserted in a site that underwent GBR procedure using a tooth derivate material. Materials and methods: A total of 21 patients received a GBR using an autologous extracted tooth. Four months after the GBR techniques, the implants were inserted and were followed for an average of 5.28 + −1.10 years after loading. The X-ray was analyzed after a period of 63.36 + −13.2 months for a total follow-up period. Results: A total of 28 implants were inserted. All the implants were clinically functional after the follow-up period. The average bone loss from the X-ray images was 0.1208 + −0.1307. Conclusion: Within the limitations of this study, the use of a tooth as a graft using a tooth transformer device guarantees the production of bone and maintenance over time
Dentin, Dentin Graft, and Bone Graft: Microscopic and Spectroscopic Analysis
Full text linkBackground: The use of the human dentin matrix could serve as an alternative to autologous, allogenic, and xenogeneic bone grafts. Since 1967, when the osteoinductive characteristics of autogenous demineralized dentin matrix were revealed, autologous tooth grafts have been advocated. The tooth is very similar to the bone and contains many growth factors. The purpose of the present study is to evaluate the similarities and differences between the three samples (dentin, demineralized dentin, and alveolar cortical bone) with the aim of demonstrating that the demineralized dentin can be considered in regenerative surgery as an alternative to the autologous bone.
Methods: This in vitro study analyzed the biochemical characterizations of 11 dentin granules (Group A), 11 demineralized using the Tooth Transformer (Group B), and dentin granules and 11 cortical bone granules (Group C) using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) to evaluate mineral content. Atomic percentages of C (carbon), O (oxygen), Ca (calcium), and P (phosphorus) were individually analyzed and compared by the statistical t-test.
Results: The significant p-value (p < 0.05) between group A and group C indicated that these two groups were not significantly similar, while the non-significant result (p > 0.05) obtained between group B and group C indicated that these two groups are similar.
Conclusions: The findings support that the hypothesis that the demineralization process can lead to the dentin being remarkably similar to the natural bone in terms of their surface chemical composition. The demineralized dentin can therefore be considered an alternative to the autologous bone in regenerative surgery
Tecniche e materiali in un intervento chirurgico di riabilitazione implantare mediante rialzo del seno e GBR [Techniques and materials in implant rehabilitation surgery using sinus lift and GBR]
No full textOBIETTIVI: L’obiettivo principale dell’articolo è sottolineare l’importanza della risoluzione di casi riabilitativi complessi, valutando gli esiti clinici e radiografici con attenzione alla riduzione delle perforazioni, utilizzando tecniche chirurgiche avanzate come la chirurgia piezoelettrica e la rigenerazione ossea guidata, GBR (Guided Bone Regeneration).
Queste procedure consentono di affrontare le sfide legate al posizionamento di impianti endossei nei casi di aumento di volume del seno mascellare e di perdita ossea con successo e affidabilità.
MATERIALI E METODI: Viene descritto il caso di una paziente che ha subito un aumento del seno mascellare tramite l’approccio vestibolare, combinato con la GBR e la piezo surgery. I farmaci utilizzati in fase pre-operatoria sono stati: Clenil 0,8 mg/2 ml e Libenar 22 g/l per areosol, amoxicillina 1 g ogni 12 orex6 gg, 7 gg prima dell’intervento.
L’intervento ha previsto l’utilizzo di sostituto osseo bovino Re-Bone e membrana Shelter in pericardio bovino, sutura in seta 4/0. Dopo la chirurgia la paziente ha seguito un regime di cura postoperatoria con terapia antinfiammatoria, paracetamolo, al bisogno, e Bentelan da 1 mg per i successivi 4 gg. L’inserimento di impianti dentali nelle zone trattate può stimolare la maturazione e il rimodellamento osseo. Viene anche discussa la scelta tra l’inserimento simultaneo di innesti e impianti o un approccio in due fasi.
RISULTATI E CONCLUSIONI: Gli esiti radiografici e clinici dell’intervento indicano il successo del riempimento dell’area atrofica del seno mascellare con il
materiale di innesto, granuli di osso bovino. La zona trattata, dopo 6 mesi, ha presentato un aumento significativo dello spessore e dell’altezza ossei. La conclusione riassume l’efficacia della tecnica GBR a fini implantari. Questa procedura clinica si è rivelata altamente affidabile in caso di riabilitazione di pazienti con gravi deficit ossei mascellari posteriori.
Complessivamente, il testo sottolinea l’importanza delle tecniche chirurgiche avanzate e della rigenerazione ossea guidata per affrontare con successo le sfide cliniche legate al posizionamento degli impianti dentali in situazioni di aumento di volume del seno mascellare e perdita ossea. L’utilizzo della piezo surgery rende la procedura più precisa e meno invasiva, garantendo peraltro una migliore esperienza post-operatoria rispetto ai tradizionali strumenti rotanti.
Le informazioni contenute nel testo possono essere utili per i professionisti odontoiatrici che si occupano di tali casi complessi.
SIGNIFICATO CLINICO: Le implicazioni cliniche riguardano principalmente:
– trattamenti implantari nei casi di aumento del volume del seno mascellare e perdita ossea. Il testo evidenzia la crescente domanda di trattamenti implantari e le sfide legate al riassorbimento osseo e all’atrofia nell’area del seno mascellare. Questo fornisce una comprensione più approfondita delle sfide che possono sorgere in tali situazioni e delle tecniche avanzate che possono essere utilizzate per affrontarle;
– strumenti piezoelettrici e tecnica GBR per il rialzo del seno mascellare possono essere utilizzati con successo per affrontare casi riabilitativi chirurgici complessi.OBJECTIVES
The main purpose of the article is to highlight the importance of resolving complex rehabilitation cases, evaluating clinical and radiographic outcomes, with attention to perforation reduction, using advanced surgical techniques, such as piezoelectric surgery and bone regeneration guided, GBR (Guided Bone Regeneration). These procedures allow you to face the challenges related to the positioning of endosseous implants in cases of increased volume of the maxillary sinus and bone loss, successfully and reliably.
MATERIALS AND METHODS
The case of a patient who underwent maxillary sinus augmentation via the vestibular approach, combined with GBR and piezo surgery, is described. The drugs used in the pre-operative phase were: Clenil 0.8 mg/2 ml and Libenar 22 g/l by aerosol, moxicillin 1 g every 12 hours for 6 days, 7 days before the operation. The operation involved the use of Re-Bone bovine bone substitute and Shelter membrane in bovine pericardium, 4/0 silk suture. After surgery, the patient followed a post-operative care regimen with anti-inflammatory therapy, paracetamol as needed and Bentelan 1 mg for the following 4 days. The insertion of dental implants in the treated areas can stimulate bone maturation and remodeling. The choice between placing grafts and implants simultaneously or a two-stage approach is also discussed.
RESULTS AND CONCLUSIONS
The radiographic and clinical results of the operation indicate the success of filling the atrophic area of the maxillary sinus with the graft material, bovine bone granules. The treated area, after 6 months, showed a significant increase in bone thickness and height. The conclusion summarizes the effectiveness of the GBR technique for implant purposes. This clinical procedure has proven to be highly reliable in the case of rehabilitation of patients with severe posterior maxillary bone deficits. Overall, the text highlights the importance of advanced surgical techniques and guided bone regeneration to successfully address the clinical challenges related to the placement of dental implants in situations of maxillary sinus volume increase and bone loss. The use of piezo surgery makes the procedure more precise and less invasive, also guaranteeing a better post-operative experience compared to traditional rotary instruments. The information contained in the text can be useful for dental professionals dealing with such complex cases.
CLINICAL SIGNIFICANCE
The clinical implications mainly concern:
- implant treatments in cases of increased volume of the maxillary sinus and bone loss. The text highlights the growing demand for implant treatments and the challenges related to bone resorption and atrophy in the maxillary sinus area. This provides a deeper understanding of the challenges that can arise in such situations and the advanced techniques that can be used to address them;
- piezoelectric instruments and GBR technique for maxillary sinus lift can be used successfully to address complex surgical rehabilitation cases
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