Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review.

The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.

Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature.

Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.

Assessment of Psychopatologic Traits in a Group of Patients with Adult Chronic Periodontitis: Study on 108 Cases and Analysis of Compliance during and after Periodontal Treatment.

OBJECTIVES: Although there is nowadays wide agreement on bacteria being the main etiologic agents of periodontal disease, their sole presence cannot damage periodontal tissues in all subjects. This suggests that an individual response and an adaptation to a certain quantity of bacterial biofilm can occur without the disease progressing and vice versa. Depression, stress and anxiety have not been confirmed yet as risk conditions but, in some observational studies, they have been identified as potential risk factors of periodontal disease. The current study aims at investigating the role which these psychological disorder have in the onset and progression of advanced stage periodontitis. MATERIALS AND METHODS: The case selection was carried out by means of clinical and radiological periodontal assessment involving a total of 108 subjects, both male and female, aged between 24 and 67. Patients were then divided in two groups of 54 patients each: the first group included patients with severe periodontal disease, the second group was formed by periodontally healthy subjects. Clinical assessment was performed by a sole examiner who selected and divided periodontopathic patients from non-periodontopathic ones. From the current study were excluded: patients with systemic pathologies; smokers; patients taking antidepressant drugs; pregnant women. RESULTS: For what concerns depression, in the group of periodontopathic patients it was found that the 62.5% of them were depressed, against the 38.86% in the group of periodontally healthy subjects. For the other two psychological conditions taken into consideration, anxiety and stress, it emerged a different percentage of subjects with anxiety in the periodontal group (31.48%) against healthy controls (20.37%). CONCLUSIONS: For each of the psychological variables considered (depression, anxiety, stress), a significant correlation could be observed with periodontal disease, it can be therefore be suggested that the importance these disturbs have in the onset and progress of the dental disease which supports the existing available data in literature. The innovative aspect of this research was the focus on the assessment of compliance, monitoring the ability of periodontal patients to follow oral hygiene instructions aiming at the improving and keeping their own periodontal condition, even though this takes more time than the control group.

Calcification of the Atlanto-Occipital Ligament (Ponticulus Posticus) in Orthodontic Patients: A Retrospective Study.

BACKGROUND: Ponticlus Posticus (PP) is a rare anomaly of the first cervical vertebra easily identifiable in lateral cephalometric radiograph and typically required for orthodontic diagnosis. The aim of this study is to evaluate the PP prevalence in lateral Cephalograms in a cohort of orthodontic patients treated at the Dental School of the University of Bari 'Aldo Moro', Italy, and to find possible connection between PP and other dental anomalies, as well as the patient's cephalometric characteristics. METHODS: A total of 150 panoramic radiographs and 150 lateral Cephalograms, obtained for orthodontic use only, were evaluated. No patients were referred to for congenital syndromes or disease, or a history of previously occurred maxillofacial trauma. A detailed cephalometric study was performed for each patient, and the whole cohort was divided according to the common three dental malocclusion classes. The values obtained were analyzed using the Chi-Square Test. RESULTS: PP prevalence was 8% (12 of 150 cases), where the complete and partial forms observed 4.7% and 3.3%, respectively. Although females were more affected (9.6%), no statistically significant sex-related difference was found. Furthermore, no statistically significant relationship regarding age or dental anomalies (dental agenesis/palatal impacted canines) among the groups was observed either. Cephalometric analyses revealed that half of the subjects with PP were sagittal skeletal class I and had vertical hyper-divergence. CONCLUSIONS: PP is a frequent anatomical variation of the cervical vertebra, apparently unrelated to the skeletal malocclusion type or dental anomalies. The current study needs to further confirm the congenital hypothesis of PP's origin already reported in literature.

Maxillary Overdenture Retained with an Implant Support CAD-CAM Bar: A 4 Years Follow Up Case.

INTRODUCTION: Oral rehabilitation with overdenture on implants of upper jaw must be taken into consideration a variety of anatomical and biomechanical issues. It is possible to provide for rehabilitation with two or more implants, in different positions, solidarizing them with a bar. MATERIALS & METHODS: The present study involved a patient rehabilitated with 4 Xive implants (Friadent GmbH, Mannheim, Germany) solidarized with a titanium bar crafted with CAD-CAM technology for maximal comfort, precision and structural lightness. RESULTS & DISCUSSION: The follow-up was 54 months, with an implant survival of 100%. Based on our clinical evidence, bars engineered with CAD-CAM technology are promising in terms of precision and comfort despite higher costs.