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Topic Review
CBCT for Sinus Floor Elevation Procedures
Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The research is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. 
  • 493
  • 26 May 2023
Topic Review
CAD/CAM Abutments versus Stock Abutments
CAD/CAM abutments allow individualization of abutment parameters with respect to soft tissue, allow increased fracture toughness, predict the failure mode, show no change in the fracture toughness over time, reduce the prosthetic steps, and reduce the functional implant prosthesis score and pain perceived by patients in the early stages. The advantages associated with the use of stock abutments mainly concern the risk of corrosion, time spent, cost, and fit, evaluated in vitro, in the implant–abutment connection. Equal conditions are present regarding the mechanical characteristics during dynamic cycles, screw loss, radiographic fit, and degree of micromotion.
  • 489
  • 31 Aug 2022
Topic Review
Local and Systemic Effects of Porphyromonas gingivalis Infection
Porphyromonas gingivalis, a gram-negative anaerobe, is a leading etiological agent in periodontitis. This infectious pathogen can induce a dysbiotic, proinflammatory state within the oral cavity by disrupting commensal interactions between the host and oral microbiota. It is advantageous for P. gingivalis to avoid complete host immunosuppression, as inflammation-induced tissue damage provides essential nutrients necessary for robust bacterial proliferation. When it gains access to circulation, P. gingivalis is able to infect a variety of cells, further triggering a variety of inflammatory and hemostatic responses. Among these is the activation of platelets and neutrophils. Neutrophil responses to P. gingivalis, particularly in the presence of activated platelets, include the release of strongly thrombogenic extracellular DNA traps (NETs). Consequently, this pathogen has the capacity not only to promote localized tissue destructiion of the gums but may also trigger some thromboinflammatory processes.
  • 488
  • 24 Mar 2023
Topic Review
Oral Health Status in Inflammatory Bowel Diseases Patients
Inflammatory bowel diseases (IBD) are chronic disorders that affect the gastrointestinal tract, including the oral cavity. Both Crohn’s disease (CD) and ulcerative colitis (UC) patients have an increased odds of periodontitis coincidence compared to the controls. Moreover, in most studies, patients with IBD are characterized by higher values of caries indices. In conclusion, the risk of oral diseases in IBD patients cannot be clearly established due to the possible association of other factors, e.g., sociodemographic or environmental factors.
  • 484
  • 24 Nov 2021
Topic Review
Effects of Wearing Bite-Aligning Mouthguards
The purpose of the present entry was to determine the acute effects of wearing bite-aligning mouthguards on muscle strength, power, agility and quickness in athletes. A search of the current literature was performed using the electronic databases (until 1 May 2021) Web of Science, Scopus and Medline. The inclusion criteria were: (1) descriptive design studies; (2) with randomized clinical trials; (3) examining the within-subject acute effects of wearing mouthguards on functional and neuromuscular performance parameters; (4) in physical active, recreational or highstandard athletes. Twenty-seven studies met the inclusion criteria. Sixteen reported positive effects in some of the variables assessed, two reported negative effects and the rest found no significant differences. Overall, the main findings described in the literature are inconclusive concerning the neuromuscular advantages of using mouthguards in muscle strength, power, agility and quickness. These discrepancies might be related to several factors such as differences in testing protocols, poor control of the jaw magnitude and improper mouthguard designs. Despite these differences, after conducting the present systematic review, the authors speculate that jaw clenching while wearing custom-made, bite-aligning oral devices might promote beneficial effects in lower limb power actions, especially in jump ability and knee extension movements. Thus, athletes might consider the use of mouthguards, not only for their protective role but also for the potential ergogenic effects in specific actions, mainly those for which lower limb muscular power are required.
  • 479
  • 21 Jul 2021
Topic Review
Periodontitis in Systemic Sclerosis
Systemic sclerosis (SSc) is a chronic, autoimmune, multisystemic disease characterized by aberrant extracellular matrix protein deposition and extreme progressive microvasculopathy. These processes lead to damage within the skin, lungs, or gastrointestinal tract, but also to facial changes with physiognomic and functional alterations, and dental and periodontal lesions. Orofacial manifestations are common in SSc but are frequently overshadowed by systemic complications. In clinical practice, oral manifestations of SSc are suboptimally addressed, while their management is not included in the general treatment recommendations. Periodontitis is associated with autoimmune-mediated systemic diseases, including systemic sclerosis. In periodontitis, the microbial subgingival biofilm induces host-mediated inflammation with subsequent tissue damage, periodontal attachment, and bone loss. When these diseases coexist, patients experience additive damage, increasing malnutrition, and morbidity. 
  • 476
  • 09 Mar 2023
Topic Review
Novel Antibacterial Approaches for Eradicating Dental Biofilm
Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. Studies suggest efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.
  • 474
  • 20 Jan 2022
Topic Review
In Vivo Ectopic/Semiorthotopic Models for Dental Pulp Regeneration
Efforts to heal damaged pulp tissue through tissue engineering have produced positive results in pilot trials. However, the differentiation between real regeneration and mere repair is not possible through clinical measures. Therefore, preclinical study models are still of great importance, both to gain insights into treatment outcomes on tissue and cell levels and to develop further concepts for dental pulp regeneration.
  • 472
  • 06 Dec 2022
Topic Review
Improving Consistency of Photobiomodulation Therapy
One of the molecular mechanisms for this treatment implicates the mitochondrial enzyme, cytochrome C oxidase. However, the efficacy and consistency of clinical outcomes with photobiomodulation treatments has been fiercely debated. This work was motivated by this need to improve photobiomodulation devices and delivery approaches.
  • 471
  • 06 Aug 2021
Topic Review
Stem Cell Transplantation/Cell-Free Treatment for Periodontal Regeneration
Many in vivo and in vitro studies have demonstrated the efficacy of stem cell transplantation for the regeneration of periodontal tissues over the past 20 years. Although positive evidence has accumulated regarding periodontal regeneration using stem cells, the exact mechanism of tissue regeneration is still largely unknown. 
  • 471
  • 29 Jan 2022
Topic Review
Clinical Applications of the Microbiome in Oral Mucositis
Oral mucositis (OM) is a common and impactful toxicity of standard cancer therapy, affecting up to 80% of patients. Its aetiology centres on the initial destruction of epithelial cells and the increase in inflammatory signals. These changes in the oral mucosa create a hostile environment for resident microbes, with oral infections co-occurring with OM, especially at sites of ulceration. However, increasing evidence suggests that oral microbiome changes occur beyond opportunistic infection, with a growing appreciation for the potential role of the microbiome in OM development and severity.
  • 470
  • 19 May 2023
Topic Review
Role of Oral Microbiome on Oral Cancer
Oral cancer (OC) is the most common neoplasm in the head and neck region. OCs are defined as cancers of the tongue, the floor of the oral cavity, the lining of the cheeks, the roof of the oral cavity, the gums, and the lips but do not include laryngeal and pharyngeal cancers. The majority of OCs comprise oral squamous cell carcinomas (OSCCs). The oral microbiome hosts more than 750 common oral species. A healthy microbiome usually consists of Streptococci, Staphylococci, Neisseria species, and about 50 other aerobes. The consensus is that a normal mouth microbiome consists mainly of aerobes, while the percentage of anaerobes increases with OC (and other pathological oral conditions). The connection that exists between microbes and carcinoma is complex and influenced by a number of factors, such as the vulnerability and genetic makeup of the host, as well as environmental conditions, including the host’s dietary regime, oral hygiene, and tobacco and alcohol use.
  • 465
  • 19 May 2023
Topic Review
Oral Microbiota in Patients with Peri-Implant Disease
Peri-implant infections are the most common complications related to the placement of dental implants. There are many microbial similarities between peri-implantitis and periodontitis but due to current laboratory techniques there are just as many differences. The peri-implant microbiota presents a lower microbial quality than the periodontal microbiota, becoming increasingly complex as it progresses from peri-implant mucositis to peri-implantitis. The microbial difference detected between the peri-implant and periodontal microbiota is primarily related to whole bacterial populations, rather than specific bacterial taxa. The use of probiotics could support the reduction of peri-implant pockets, in association with mechanical debridement, due to their mechanism of action of competitive inhibition for adhesion sites. The peri-implant microbiota represents a qualitatively inferior but quantitatively superior bacterial ecosystem for some bacterial genera compared to the periodontal microbiota, showing that a progression from healthy state to peri-implantitis causes changes in microbiota composition in the absence of specific disease-causing bacteria.
  • 464
  • 28 Mar 2022
Topic Review
Endodontic Regenerative Procedures in Necrotic Adult Teeth
Regenerative endodontic procedures (from now on REPs) have been defined as ‘biologically based procedures that intend to physiologically replace damaged tooth structures, including dentine and root, as well as cells of the pulp–dentin complex’. REPs were first exclusively developed for the treatment of immature teeth, with the purpose of achieving a complete root development. Nevertheless, these procedures can also restore tooth vitality and pulp functions thanks to the pulp tissue regeneration. Thus, sensibility, immunity, healing, and restorative properties of dental pulp would also be recovered, in turn reducing the chances of reinfection. For that reason, the feasibility of this treatment in mature teeth should be further studied, as until now, conservative treatment for irreversible necrosis or pulpitis has been limited to conventional endodontic therapy. 
  • 461
  • 16 May 2022
Topic Review
Medication-Induced Dry Mouth
Dry mouth is common among older people, affecting between 20% and 30% of those over 65. There are two aspects to the condition. Salivary gland hypofunction (SGH) is the state of having low salivary flow, while xerostomia refers to the subjective sensation of dry mouth.
  • 460
  • 21 Oct 2021
Topic Review
Sedatives in Dental Implant Surgery
Implant surgery is a lengthy dental procedure, and sedation is often used to reduce discomfort. The effectiveness of sedation has traditionally been evaluated in terms of patient and surgeon satisfaction, but the most important goal is not to induce a deep sleep in the patient, but rather to ensure that the surgery is performed safely and as planned. Additionally, adequate pain control is a necessary requirement for patient and surgeon satisfaction. Most patients undergoing implant surgery are middle-aged or older, and a relatively large number of them have cardiovascular disease. Infiltration anesthesia using articaine or lidocaine in combination with adrenaline is widely used, but its use in patients with cardiovascular disease is limited because of adrenaline’s effects on the cardiovascular system. The use of long-acting local anesthetics and the potential efficacy of ultrasound-guided jaw nerve block have been investigated to enhance analgesia without resorting to adrenaline. Midazolam and propofol are usually used for sedation, but dexmedetomidine, which causes less respiratory depression, and the ultrashort-acting benzodiazepine remimazolam are emerging as potential alternatives. Monitoring of anesthetic depth using electroencephalography is effective in maintaining a constant level of sedation. In addition, sedation promotes the stabilization of heart rate and blood pressure, reducing the risks associated with adrenaline and allowing for safer management.
  • 457
  • 31 Mar 2023
Topic Review
Intraoral Sialadenoma Papilliferum
Sialadenoma papilliferum (SP) is a rare benign epithelial tumour of salivary gland origin, its diagnosis being potentially challenging. It was first described by Abrams and Finck in 1969 as an analog of the cutaneous syringocystadenoma papilliferum.
  • 455
  • 30 Sep 2022
Topic Review
Association between Periodontitis and Peri-Implantitis
Dental implants to replace lost teeth are a common dentistry practice nowadays. Titanium dental implants display a high success rate and improved safety profile. Nevertheless, there is an increasing peri-implantitis (PI), an inflammatory disease associated with polymicrobial infection that adversely affects the hard and soft tissues around the implant. Studies have demonstrated that oral microbiota (microorganisms residing in the oral cavity collectively known as oral microbiota) associated with periodontitis (PE) is involved in the infections related to PI, indicating a common link between PE and PI.
  • 455
  • 16 Jan 2023
Topic Review
Velopharyngeal Insufficiency Treatment in Cleft Palate Patients
Cleft lip and palate (CLP) are one of the most common congenital anomalies with a global prevalence of 1:700. Velopharyngeal insufficiency may occur as a result of an anatomical or structural defect and may be present in patients with cleft lip and palate. The treatment options presented in the literature are varied, covering invasive and non-invasive methods.
  • 453
  • 09 Sep 2022
Topic Review
Desquamative Gingivitis
Desquamative gingivitis is a clinical condition with a chronic course, not specific to a particular disease, characterized by intense erythema, scaling, vesicles, and/or blisters that may involve both the marginal free gingiva (MG) and the neighboring adherent gingiva (AG). 
  • 452
  • 07 Oct 2023
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