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ObjectivesThe aim of the present randomized controlled split-mouth clinical trial is to evaluate the effectiveness of the adjunctive use of photodynamic low-level laser therapy (670 nm), applying methylene blue as photosensitizer, and the effectiveness of a diode laser (940 nm) compared with conventional non-surgical mechanical treatment in a group of patients with chronic periodontal disease.Materials and methodsTwenty-one patients with moderate to severe periodontal disease with presence of 3 or more quadrants, each containing at least three sites with periodontal pocket depth (PPD) of ≥ 5 mm, were included in the study. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (control group), SRP with diode laser (diode group), and SRP with photodynamic therapy (photodynamic group).ResultsAll treatment modalities in this study lead to statistically significant improvements in the evaluated clinical parameters at 3 months and 6 months compared with baseline. There was no statistically significant difference regarding PD and BOP between groups. There was only a tendency for greater reduction of PD in the diode group for deep pockets at 3 months, but not statistically significant.ConclusionsAfter 6 months of evaluation, the high intensity diode laser and the antimicrobial photodynamic therapy have not shown any additional benefits to the conventional periodontal treatment.Clinical relevanceThe diode or photodynamic laser therapy in conjunction with conventional SRP does not seem to be superior in reducing probing depth and bleeding on probing than SRP alone 6 months after treatment. More studies are necessary to prove the actual need of these types of lasers in the periodontal clinical practice.

The concept of gingival phenotype and width of keratinized gingiva influencing the diagnosis and treatment in the periodontal scenario is relatively new. Soft and hard tissue dimensions of oral tissues are considered essential parameters in daily clinical practice. Factors such as the biotype category and the width of the keratinized gingiva help dentists seek the perfect therapy plan for each patient to achieve long-term stability of periodontal health. Several methods have been proposed to categorize phenotypes and each phenotype is characterized by various clinical characteristics. This review aims to discuss the possible association between the gingival phenotype and the width of keratinized gingiva along with the results appeared. After a rigorous search in major electronic databases, the results of the included studies indicated that the width of keratinized gingiva seems to be associated with the periodontal phenotype, with thick biotypes being characterized by a more pronounced keratinized gingival width. However, the heterogeneity of the included studies did not allow to make a conclusion about a direct relationship.

Objectives: This systematic review and meta-analysis aimed to evaluate histological outcomes of alveolar ridge preservation (ARP) compared to spontaneous healing after tooth extraction, focusing on the percentage of new bone formation and residual graft material. Materials and Methods: Randomized controlled trials (RCTs) assessing histomorphometric outcomes in humans were included. Eligible studies compared ARP using various graft materials to unassisted socket healing. Primary outcome was new bone formation (%); secondary outcome was residual graft material (%). Random-effects meta-analyses and subgroup analyses were conducted based on graft material type, membrane application, and healing duration. Risk of bias and certainty of evidence were assessed using the Cochrane RoB 2.0 tool and GRADE, respectively. Results: Twenty-two RCTs (816 patients) met inclusion criteria. Overall, ARP did not result in significantly greater new bone formation compared to spontaneous healing (mean difference −5.86%, 95% CI: −13.84% to 2.11%, p = 0.15; I2 = 98%), revealing a paradoxical trend: while ARP maintains ridge volume, histologically it may yield slightly lower proportions of vital bone compared to unassisted healing. However, autologous biomaterials (e.g., PRF/CGF) and xenografts with collagen membranes showed significantly new bone formation (mean differences +16.28% and −22.47%; p< 0.001 and p = 0.003, respectively). Residual graft content was highest in relation to xenografts and allografts, particularly without membranes. Long-term studies demonstrated a statistically significant benefit for ARP following excluding high-risk trials. Conclusions: Histological advantage of ARP is biomaterial-dependent. Autologous platelet concentrates and xenografts with membranes yielded the most consistent bone regeneration outcomes. Clinical Relevance: Although ARP preserves socket volume, its histological superiority over natural healing is not universal. Therefore, the selection of biomaterials and determination of and appropriate healing period are critical parameters.

Background: Protein carbonylation is an irreversible post-translational modification that is considered indicative of oxidative damage. Objective: The purpose of the study was to examine by an immunohistochemical method for the first time the extent and localization of protein carbonylation in biopsies of gingiva from periodontitis patients with or without diabetes mellitus (DM). Methods: These were processed for immunohistochemical staining of the carbonylated proteins, using the ENVISIOM FLEX Mini Kit, high pH, and anti-dinitrophenyl (DNP) antibody, a marker of oxidative damage to a given protein. The extent of protein carbonylation was semi-quantitatively estimated and evaluated by calculation of the Allred score (percentage of stained cells × intensity of staining). Results: The biopsies from periodontitis patients with diabetes mellitus (DM) exhibited higher staining scores as per the percentage of positively stained cells than the biopsies from patients with only periodontitis (means of 49.2 and 16.7, respectively), the difference being statistically significant (p = 0.036). The same trend was observed in the case of the combination of the above with the intensity of staining (score parameter) as well (means of 59.6 and 20.8, p = 0.036, respectively). Conclusions: An immunohistochemical method with the novelty of utilization for the first time of the anti-dinitrophenyl (DNP) antibody in gingival tissues was introduced and showed efficacy in detecting protein carbonylation indicative of oxidative stress and its impact in the pathogenesis of these two prevalent diseases of periodontitis and diabetes mellitus.

Objective: This review article aims to analyze the existing relevant literature comparing the clinical outcomes and underlining the most common complications associated with immediate, early, and delayed dental implant placement in order to determine the most favorable timing for achieving optimal functional and esthetic results for the patient. Methods: A comprehensive review of the literature was conducted using PubMed-MEDLINE and Cochrane Library and a number of keywords, including “dental implant placement timing”, “immediate implant”, “early implant”, “delayed implant”, “clinical outcomes”, “complications”, and “implant success”, focusing on studies comparing immediate, early, and delayed implant placement. The primary outcome variable was implant survival rate, while secondary outcome variables included implant success rate, complications, and patient-reported outcomes. Results: A total of 9774 articles were identified. The articles included a variety of studies, including randomized controlled trials, prospective cohort studies, and retrospective studies. Immediate implant placement was associated with a high survival rate (93.8–100%), but also with an increased risk of complications, such as gingival recession and implant exposure. Early implant placement (4–8 weeks or 12–16 weeks after extraction) showed similar survival rates (95–100%) and fewer complications compared with immediate placement. Delayed implant placement (more than 4 months after extraction) was the most commonly used protocol and demonstrated high survival rates (92–100%) with predictable outcomes. Implant success rates varied depending on the criteria used, but all types of placements showed acceptable success rates (83.3–100%). The choice of loading protocol (immediate, early, or conventional) also influences treatment outcomes. Conclusions: The timing of dental implant placement and loading should be individualized based on patient-specific factors, such as bone and soft tissue conditions, medical history, esthetic considerations, and patient preferences. Immediate placement can be successful in ideal conditions but requires careful patient selection and surgical expertise. Early and delayed placement offer more predictable outcomes and are suitable for a wider range of patients.

Intrabony defects occur frequently in periodontitis and represent sites that, if left untreated, are at increased risk for disease progression. Although resective or repair procedures have been used to treat intrabony defects, aiming at their elimination, the treatment of choice is surgical periodontal regeneration. The development of periodontal regeneration in the last 30 years has followed two distinctive, though totally different, paths. The interest of researchers has so far focused on regenerative materials and products on one side, and on novel surgical approaches on the other side. In the area of materials and products, three different regenerative concepts have been explored namely, barrier membranes, bone grafts, and wound healing modifiers/biologics, plus many combinations of the aforementioned. In the area of surgical approaches, clinical innovation in flap design and handling, as well as minimally invasive approaches, has radically changed regenerative surgery. Recently, a minimally invasive non-surgical technique (MINST) for the treatment of intrabony defects was proposed. Initial clinical trials indicated comparable results to the surgical minimally invasive techniques in both clinical and radiographic outcomes. These results support the efficacy of this treatment approach. The aim of this review is to present the evidence on the application of minimally invasive non-surgical techniques and their efficacy in the treatment of intrabony defects.

Objective The current cross‐sectional study aimed to investigate the prevalence of gingival recession (REC) in a sample of young individuals. In addition, the association with several risk factors was examined. Materials & methods A 104 subjects, aged 18–30 years old, were randomly enrolled in the study. Participants were requested to fill in a simple structured questionnaire in order to provide information on dental hygiene habits, educational level, smoking and history of orthodontic treatment. Afterwards, all the included individuals were subjected to a thorough clinical periodontal examination including gingival recession (REC), gingival biotype, plaque levels and gingival bleeding index (GBI) assessment. Results The mean prevalence of REC in the studied population surpassed 50% with an equal distribution among females and males. The most common teeth associated with REC were the lower left canine and left 1st premolar. Among the examined variables, only the bleeding index was found to be associated with the presence of REC. Conclusions Gingival recession was a prevalent condition among young individuals. Gingival inflammation was found to be the most significant factor affecting the incidence of REC.

Charalampous et al. conducted a PRISMA systematic review to evaluate postoperative outcomes after surgery for BPE-Related BOO in men with CNS diseases and NLUTD. [...]this review only included retrospective studies with a high risk of bias, as well as significant heterogeneity in patient characteristics, diagnosis of BOO, surgery technique, and reported outcomes. [...]well-designed prospective studies with standardized inclusion criteria, surgical techniques, and longer follow-up are still needed to determine the real advantage of this intervention in distinct neuro-urological groups. Surgical Management of Anatomic Bladder Outlet Obstruction in Males with Neurogenic Bladder Dysfunction: A Systematic Review.

The current study aimed to investigate the effect of the combined Nd-Er: YAG laser on the surgical treatment of peri-implantitis by evaluating clinical markers and biomarkers of bone loss (RANKL/OPG). Twenty (20) patients having at least 1 implant diagnosed with peri-implantitis were randomly assigned to two groups for surgical treatment. In the test group (n = 10), Er: YAG laser was used for granulation tissue removal and implant surface decontamination, while Nd: YAG laser was employed for deep tissue decontamination and biomodulation. In the control group (n = 10), an access flap was applied, and mechanical instrumentation of the implant surface was performed by using titanium curettes. The following clinical parameters were evaluated at baseline and six months after treatment: Full-mouth Plaque Score (FMPS), Probing Pocket Depth (PPD), Probing Attachment Levels (PAL), recession (REC), and Bleeding on probing (BoP). Peri-implant crevicular fluid (PICF) was collected at baseline and six months for the evaluation of soluble RANKL and OPG utilizing enzyme-linked immunosorbent assay (ELISA). Baseline clinical values were similar for both groups, with no statistical differences between them. The study results indicated statistically significant improvements in the clinical parameters during the 6-month observation period in both groups. More specifically, PPD, PAL, and REC were improved in the test and control groups with no differences in the between-groups comparisons. However, a greater reduction in the BoP-positive sites was noted for the laser group (Mean change 22.05 ± 33.92 vs. 55.00 ± 30.48, p = 0.037). The baseline and six-month comparisons of sRANKL and OPG revealed no statistically significant differences between the two groups. The combined Nd: YAG—Er: YAG laser surgical therapy of peri-implantitis seemed to lead to more favorable improvements in regard to bleeding on probing six months after treatment compared to the conventional mechanical decontamination of the implant surface. None of the methods was found superior in the modification of bone loss biomarkers (RANKL, OPG) six months after treatment.

The objective of the study was to evaluate the long-term esthetic and radiographic results of implants placed in the anterior maxilla after ridge preservation, combining bovine xenograft with collagen matrix. Fifteen patients who required a single tooth extraction because of fracture, root resorption, or extended caries were included in the study. After extraction, all sites were grafted using Deproteinized Bovine Bone Mineral (DBBM) with collagen and covered by a resorbable collagen matrix (CM). Five months after socket grafting, implants were successfully installed. The implant diameter range was between 3.8 and 4.2 mm. All patients were monitored for over 7 years, both clinically and radiographically. Three independent observers evaluated the long-term esthetic outcome, employing the Pink Esthetic Score (PES) technique. Over a period exceeding seven years, a 100% survival rate was observed for all 15 implants, with minimal marginal bone loss. The mean PES was 11.40 (±1.44) at the first assessment and 11.38 (±1.63) at the second assessment. The difference was not statistically significant (p = 0.978), and the scores of PES measurements indicated excellent esthetic results even after seven years. Based on these preliminary results, it seems that placing collagen bovine bone in a fresh extraction socket, covered with a collagen matrix, can preserve the alveolar ridge and provide long-term stable esthetic results.