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The human body consists of its own cells, but also of microorganisms that are found both inside and outside the human body [...].The human body consists of its own cells, but also of microorganisms that are found both inside and outside the human body [...].

Background: The human being is defined as a ‘superorganism’ since it is made up of its own cells and microorganisms that reside inside and outside the human body. Commensal microorganisms, which are even ten times more numerous than the cells present in the body, perform very important functions for the host, as they contribute to the health of the host, resist pathogens, maintain homeostasis, and modulate the immune system. In the mouth, there are different types of microorganisms, such as viruses, mycoplasmas, bacteria, archaea, fungi, and protozoa, often organized in communities. The aim of this umbrella review is to evaluate if there is a connection between the oral microbiome and systematic diseases. Methodology: A literature search was conducted through PubMed/MEDLINE, the COCHRANE library, Scopus, and Web of Science databases without any restrictions. Because of the large number of articles included and the wide range of methods and results among the studies found, it was not possible to report the results in the form of a systematic review or meta-analysis. Therefore, a narrative review was conducted. We obtained 73.931 results, of which 3593 passed the English language filter. After the screening of the titles and abstracts, non-topic entries were excluded, but most articles obtained concerned interactions between the oral microbiome and systemic diseases. Discussion: A description of the normal microbial flora was present in the oral cavity both in physiological conditions and in local pathological conditions and in the most widespread systemic pathologies. Furthermore, the therapeutic precautions that the clinician can follow in order to intervene on the change in the microbiome have been described. Conclusions: This review highlights what are the intercorrelations of the oral microbiota in healthy subjects and in subjects in pathological conditions. According to several recent studies, there is a clear correlation between dysbiosis of the oral microbiota and diseases such as diabetes, cardiovascular diseases, chronic inflammatory diseases, and neurodegenerative diseases.

The aim of the present systematic review was to evaluate and possibly differentiate the effects of traditional cigarettes, heat-not-burn tobacco, and electronic cigarettes on periodontal and peri-implant health status. Electronic cigarettes and heat-not-burn tobacco have become very popular in recent years and have been proposed to consumers as a safer alternative to conventional tobacco smoke, although their effect on periodontal and peri-implant health remains unclear. The study protocol was developed according to PRISMA guidelines, and the focus question was formulated according to the PICO strategy. A literature search was conducted across PubMed/MEDLINE and the COCHRANE library from 2003 to April 2022. From the 1935 titles initially identified, 18 articles were finally included in the study and extracted data were qualitatively synthesized. It may be carefully concluded that e-cigarettes may cause attenuated clinical inflammatory signs of periodontitis and, hypothetically, of peri-implantitis when compared to conventional tobacco smoke. Both alternative smoking products, containing nicotine, may likewise exert negative effects on periodontal and peri-implant health, as demonstrated by in vitro studies. Further investigations are needed to assess the impact of electronic cigarettes and heat-not-burn tobacco products on periodontal and peri-implant health status.

Oral Candidiasis (OC) is an opportunistic fungal infection of the oral cavity, frequently reported under local and systemic predisposing circumstances. While the recurrence of OC HIV-infected subjects has been well described and reported, the association between oral candidiasis and the SARS-CoV-2 infection is a recent finding that still is worthy of further study. The present paper focuses on this novel association, reporting the incidence and prevalence of OC occurring during and after COVID-19 and the possible etiopathogenic mechanisms underlying the onset of OC in COVID-19 subjects. The work found that the immune inflammatory hypo reactions and immunosuppression found in children and adults with COVID-19 could favor the proliferation colonization of Candida species and the following infection. At the same time, poor oral hygiene and iatrogenic causes seem to be the main risk factors.

Background and Objectives: To achieve success in endodontic treatment, it is essential to properly perform the steps of shaping, cleansing and obturation. Determining the working length of the canal is, therefore, a process that must be precise and accurate. Electronic apex locators are a useful tool for the clinician to best perform this step of endodontic treatment. Materials and Methods: The purpose of the following umbrella review is to evaluate, through data in the literature, the degree of accuracy of apex locators. Results: Seven systematic reviews were included in the following umbrella review. Five compare the accuracy of apex locators versus radiographic techniques, two compare different types of electronic apex locators, and two analyze the determination of working length in primary teeth. Conclusions: From the results obtained from the following umbrella review, albeit at low levels of evidence, the methods for determining working length using electronic apex locators and other methods, particularly using radiographic evaluation, are equally valid.

Introduction: Modern endodontics aims to decrease the bacterial load from the complex endodontic space. Over the years, improvements in the operative phases have led to a considerable increase in the success rate of endodontic treatments. The shaping phase has seen the development of new techniques supported by technological innovations that have led to higher treatment predictability. Endodontic instruments have experienced a series of changes that have led to modifications in their design, surface treatments, and heat treatments. The clinical use of rotating nickel–titanium instruments has become widespread and consolidated, a success due primarily to the alloy’s mechanical characteristics, which are superior to steel ones, but also to innovations in instrument design. The advent of the Ni-Ti alloy has kept the concepts and requirements of shaping the same but has modified its implementation in endodontics. Aim: The following review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol. The research question focused on Ni-Ti endodontic instruments whose cyclic fatigue was evaluated by analyzing cyclic fatigue strength and the incidence of fracture. Results: At the end of the research, 10 systematic reviews and 1 randomized controlled trial were included in this comprehensive review. The most frequently analysed alloys were M-wire, conventional Ni-Ti, and CM-wire. In seven articles, instruments made of M-wire alloy were used; in eight articles, instruments made of conventional Ni-Ti; and in seven articles, instruments made of CM-wire alloy. Conclusions: The technological evolution of Ni-Ti alloys has led to the development of increasingly high-performance endodontic files that are resistant to cyclic fatigue during clinical practice and have greater resistance to sterilisation practices, making treatment easier and more predictable over time. In particular, heat-treated nickel-titanium root canal instruments present greater resistance to cyclic fatigue than untreated ones and those used with reciprocating kinematics concerning continuous rotation.

A structural and organizational redesign of the dental care system is necessary today due to current trends in the demographic process and the accompanying changes in the population’s healthcare needs. The purpose of this article is to review the literature, analyzing those trends that today represent useful tools for the oral health of pediatric patients, with particular reference to teledentistry and all the supports it uses to reach remote territories or patients who, for various reasons, cannot have access to dental care. An independent literature search was conducted in three electronic databases: PubMed/MEDLINE, Google Scholar, and the COCHRANE library. Thirty-one articles were considered. Reported findings highlight that teledentistry has been used in pediatrics to educate and promote oral health and to provide remote diagnosis and monitoring through mobile health applications, smartphone cameras and apps, intraoral cameras, websites and search engines, and telephonic communications. Specifically, teledentistry has been beneficial in providing dental care in remote locations with difficult access to pediatric dentists, conducting remote diagnostic and screening programs, monitoring patients between appointments, promoting children’s oral health through dental education, and providing behavioral counseling prior to office visits. Future research should further investigate the long-term use, additional applications, and cost-effectiveness of teledentistry in children.

Since smoking is considered among the main risk factors for the onset and progression of periodontitis and peri-implantitis, the present systematic review aimed to evaluate the effect of smoking cessation on clinical, radiographic, and gingival crevicular periodontal parameters around natural teeth and dental implants in ex-smokers compared to current and non-smokers. The study protocol was developed based on the PRISMA guidelines, the research question was formulated according to the PICO model, and the literature search was conducted through PubMed/MEDLINE, Cochrane library, and BioMed Central databases. From the 916 title/abstracts initially identified, seven articles were included in the present systematic review and assessed for quality through the ROBINS-I tool. Reported findings on clinical and crevicular periodontal parameters around natural teeth were contrasting when comparing ex-smokers to current and non-smokers; thus, individualized recommendations for previous smoker periodontal patients are currently lacking. No data on radiographic parameters were retrieved. Similarly, data on periodontal parameters around dental implants were not available, highlighting the need for focused investigations assessing the role of both smoking habit and cessation on peri-implant health status and responsiveness to treatment.

Background and Objectives: The endodontic space is a complex area on both micro and macro levels; therefore, traditional irrigation techniques may not guarantee a complete cleaning of such a complicated tridimensional system. The presented ex vivo study aimed to evaluate root canal cleanliness, obtained through an equal volume of traditionally applied sodium hypochlorite (NaOCl), compared to ultrasonically activated NaOCl and ultrasonically activated NaOCl that had undergone intracanal heating NaOCl. Materials and Methods: A total of 60 freshly extracted human mandibular premolars underwent root sample length standardization (18 mm), root canal preparation and, based on the irrigation method employed, were randomly and equally assigned to three study groups, composed of root samples treated with ultrasonically activated NaOCl, ultrasonically activated NaOCl that had undergone intracanal heating and traditionally applied NaOCl. The root specimens were subsequently fixated with 4% buffered formalin solution and decalcified in Morse liquid. A total often 6-micron-thick serial cross-sections were obtained, dyed using hematoxylin and eosin and examined through an optical microscope at 40×, 100×, and 200×. Results: Ultrasonically activated NaOCl that had undergone intracanal heating showed a significantly smaller amount of debris compared to ultrasonically activated and traditionally applied NaOCl groups (p value < 0.05). Conclusions: Root canal cleanliness saw significant enhancements by ultrasonically activated NaOCl that had undergone intracanal heating.

Aim: Modern endodontics has advanced radically in the recent years, and recently, it has been focused on the concept of mini-invasive treatments. This study aimed to evaluate the sections of the root apices at 1 mm from the radiographic apex using a high-resolution CBCT. Materials and Methods: The current study was performed in three different dental centers. One hundred maxillary permanent premolars (50 first and 50 s premolars) were analyzed using measurement software of the CBCT radiographic pictures. The mesio-distal (M-D) and bucco–palatal (B-P) sections were measured at 1 mm from the radiographic apex of each root. The section of 0.3 mm or less, 1 mm from the anatomical apex of the upper premolars, was decided as the limit value. All values were statistically analyzed. Results: The mean value in the 304 sections analyzed was 1.03 (±0.37). Only 19 sections (6.3%) had measurements less than or equal to 0.3 mm. All these 19 sections were from first premolars (p = 0.002). Conclusions: Based on the data obtained, the authors recommend performing conservative shaping when endodontically treating first maxillary premolars, especially when a pre-operative CBCT to evaluate the actual apical dimensions cannot be acquired.