Perceptions in Digital Smile Design: Assessing Laypeople and Dental Professionals' Preferences Using an Artificial-Intelligence-Based Application.

Digital Smile Design (DSD) is used in many fields of dentistry. This prospective observational study assessed laypeople's and dental professionals' perceptions of a DSD application. SmileCloud, an online DSD platform, was used to create two different designs for three patients; after that, the participants, in a 30-question online illustrated survey, were asked about the most attractive design and other features of the smile. Dentists' and laypeople's perceptions about specific DSD features were assessed. The Kolmogorov-Smirnov normality test was used. Descriptive and crosstab analyses compared the respondents' opinions for each statement. Chi-square tests were used to determine the relationship between the questions and any association with age, gender, and profession. The test results were rated as significant at a p-value < 0.05. A total of 520 participants (dental professionals, students, dental technicians, and laypeople) were enrolled. The statistically significant features were self-esteem related to appearance (p = 0.05), facial and smile symmetry (p = 0.42, p < 0.0001), tooth color (p = 0.012), and symmetry of gums (p < 0.001). For each patient, the design with dominant round upper incisors and perfect symmetry was preferred (p < 0.001). Digital pre-visualization benefits diagnosis and enriches treatment planning. The dentist-dental technician-patient team should be involved in the decision-making process of pre-visualization.

Botulinum Toxin Injection into the Digastric Muscle: Current Clinical Use and a Report of Five Cases.

The present research aimed to review the clinical applications of botulinum toxin-A (BTX-A) injection into the anterior belly of the digastric muscle (ABDM) and to highlight the potential role of the BTX-A injection into ABDM in preventing postsurgical relapse. Five Class II malocclusion patients who underwent orthognathic surgery received BTX-A injections into both ABDM for the prevention of postoperative relapse. The relapse was evaluated using lateral cephalometric radiographs by comparing the postoperative cephalometric analyses at two different time points, postoperatively at 2 weeks (T1), and long-term, at 9 months after the surgical intervention (T2). The results demonstrated no significant differences between T2 and T1 for the Selle-Nasion-point A (SNA) angle, Selle-Nasion-point B (SNB) angle, point A-Nasion-point B (ANB) angle, mandibular length, and sagittal mandibular position. The patients exhibited stable occlusion without any signs of relapse after the surgery. A single BTX-A injection into the ABDM can effectively prevent postoperative relapse in Class II malocclusion patients, following orthognathic surgery. From a clinical perspective, in case of optimal dosage and procedure, BTX-A injection could be considered as the primary option for the prevention of postsurgical relapse for Class II malocclusion patients.

The Impact of Benign Jawbone Tumors on the Temporomandibular Joint and Occlusion in Children: A Ten-Year Follow-Up Study.

This study aimed to provide a complex analysis of the modifications in craniofacial skeleton development that may arise following the diagnosis of pediatric benign jaw tumors. A prospective study was undertaken involving 53 patients younger than 18 years of age, who presented for treatment at the Department of Maxillo-Facial Surgery, University of Medicine and Pharmacy, Cluj-Napoca, with a primary benign jaw lesion between 2012 and 2022. A total of 28 odontogenic cysts (OCs), 14 odontogenic tumors (OTs), and 11 non-OTs were identified. At follow-up, dental anomalies were identified in 26 patients, and overjet changes were found in 33 children; lateral crossbite, midline shift, and edge-to-edge bite were found in 49 cases; deep or open bite were found in 23 patients. Temporomandibular disorders (TMDs) were found in 51 children, with unilateral TMJ changes identified in 7 cases and bilateral modifications found in 44 patients. Degenerative changes in the TMJ were also diagnosed in 22 pediatric patients. Although benign lesions could be associated with dental malocclusions, a direct etiological factor could be not identified. The presence of jaw tumors or their surgical treatment could, however, be linked to a change of the occlusal relationships or the onset of a TMD.

A New Detection Method of Oral and Oropharyngeal Squamous Cell Carcinoma Based on Multivariate Analysis of Surface Enhanced Raman Spectra of Salivary Exosomes.

Raman spectroscopy recently proved a tremendous capacity to identify disease-specific markers in various (bio)samples being a non-invasive, rapid, and reliable method for cancer detection. In this study, we first aimed to record vibrational spectra of salivary exosomes isolated from oral and oropharyngeal squamous cell carcinoma patients and healthy controls using surface enhancement Raman spectroscopy (SERS). Then, we assessed this method's capacity to discriminate between malignant and non-malignant samples by means of principal component-linear discriminant analysis (PC-LDA) and we used area under the receiver operating characteristics with illustration as the area under the curve to measure the power of salivary exosomes SERS spectra analysis to identify cancer presence. The vibrational spectra were collected on a solid plasmonic substrate developed in our group, synthesized using tangential flow filtered and concentrated silver nanoparticles, capable of generating very reproducible spectra for a whole range of bioanalytes. SERS examination identified interesting variations in the vibrational bands assigned to thiocyanate, proteins, and nucleic acids between the saliva of cancer and control groups. Chemometric analysis indicated discrimination sensitivity between the two groups up to 79.3%. The sensitivity is influenced by the spectral interval used for the multivariate analysis, being lower (75.9%) when the full-range spectra were used.

Temporomandibular Joint Osteoarthritis Diagnosis Employing Artificial Intelligence: Systematic Review and Meta-Analysis.

The aim was to systematically synthesize the current research and influence of artificial intelligence (AI) models on temporomandibular joint (TMJ) osteoarthritis (OA) diagnosis using cone-beam computed tomography (CBCT) or panoramic radiography. Seven databases (PubMed, Embase, Scopus, Web of Science, LILACS, ProQuest, and SpringerLink) were searched for TMJ OA and AI articles. We used QUADAS-2 to assess the risk of bias, while with MI-CLAIM we checked the minimum information about clinical artificial intelligence modeling. Two hundred and three records were identified, out of which seven were included, amounting to 10,077 TMJ images. Three studies focused on the diagnosis of TMJ OA using panoramic radiography with various transfer learning models (ResNet model) on which the meta-analysis was performed. The pooled sensitivity was 0.76 (95% CI 0.35-0.95) and the specificity was 0.79 (95% CI 0.75-0.83). The other studies investigated the 3D shape of the condyle and disease classification observed on CBCT images, as well as the numerous radiomics features that can be combined with clinical and proteomic data to investigate the most effective models and promising features for the diagnosis of TMJ OA. The accuracy of the methods was nearly equivalent; it was higher when the indeterminate diagnosis was excluded or when fine-tuning was used.

Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study.

This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.

Psoriatic arthritis of the temporomandibular joint: A systematic review.

OBJECTIVES: Psoriasis is an inflammatory condition brought on by the immune system. This study aimed to perform a systematic review related to psoriatic arthritis (PsA) of the temporomandibular joint (TMJ). METHODS: The search strategy was developed by a radiologist expert with more than 20 years of experience. The search was performed without time restrictions in five electronic databases: PubMed, Web of Science, Embase, Scopus and Ovid. The search strategy was based on MeSH and Emtree terms. The methodological quality of the studies was rated using the quality assessment tools from the National Heart Lung and Blood Institute (NHLBI). RESULTS: Twenty-three publications were included, 10 being case reports. One hundred-fifty-one patients with TMJ PsA were reported. Psoriasis evolution ranged from 1.5 years to 24 years. Clinical symptoms of TMJ involvement included: TMJ pain and sounds, limited range of jaw movements, preauricular swelling, malocclusion, headache, tinnitus, neck stiffness and altered dietary function. TMJ was evaluated by magnetic resonance imaging (six studies), computed tomography (eight articles) and by ultrasonography findings (two articles). For TMJ treatment, topical and systemic medication was reported in 11 studies. Five studies included patients needing surgical procedures for TMJ ankylosis. CONCLUSIONS: A relationship between TMD and psoriasis has been revealed. TMJ PsA has been investigated and debated, although the radiographic findings or clinical symptoms of PsA are not noticeably different from other forms of TMJ arthritis. Conservative therapy can lead to significant improvement of TMJ function.

Artificial intelligence models for clinical usage in dentistry with a focus on dentomaxillofacial CBCT: a systematic review.

This study aimed at performing a systematic review of the literature on the application of artificial intelligence (AI) in dental and maxillofacial cone beam computed tomography (CBCT) and providing comprehensive descriptions of current technical innovations to assist future researchers and dental professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) Statement was followed. The study's protocol was prospectively registered. Following databases were searched, based on MeSH and Emtree terms: PubMed/MEDLINE, Embase and Web of Science. The search strategy enrolled 1473 articles. 59 publications were included, which assessed the use of AI on CBCT images in dentistry. According to the PROBAST guidelines for study design, seven papers reported only external validation and 11 reported both model building and validation on an external dataset. 40 studies focused exclusively on model development. The AI models employed mainly used deep learning models (42 studies), while other 17 papers used conventional approaches, such as statistical-shape and active shape models, and traditional machine learning methods, such as thresholding-based methods, support vector machines, k-nearest neighbors, decision trees, and random forests. Supervised or semi-supervised learning was utilized in the majority (96.62%) of studies, and unsupervised learning was used in two (3.38%). 52 publications included studies had a high risk of bias (ROB), two papers had a low ROB, and four papers had an unclear rating. Applications based on AI have the potential to improve oral healthcare quality, promote personalized, predictive, preventative, and participatory dentistry, and expedite dental procedures.

Post-Traumatic-Related Technical Errors in Orthopantomographic Imaging.

Background: This study aimed at identifying errors encountered in orthopantomography (OPG) in post-traumatic patients caused by limitations in performing a correct technique. Methods: A retrospective observational study was performed. Diagnosis, exposure/processing mistakes, positioning-related errors, and bimaxillary immobilization were evaluated. Results: Thirty panoramic radiographs with mandible fractures were examined. Twelve error types were encountered: errors in exposure or processing, air radiolucency in the palatoglossal space, errors in the alignment of the Frankfort horizontal plane: head in flexion, with a joyful expression or head extended, with a somber appearance, errors towards the mid-sagittal plane (lateral head inclination, deviation, or rotation), errors caused by the non-use of the bite-block or inappropriate position on the device, errors caused by positioning outside the focal plane, artifacts/shadow images produced by post-operative metal plates, and bimaxillary immobilization errors. The number of errors per radiograph ranged from two to a maximum of five. The most dominant ones were inappropriate alignment in the focal plane and lateral rotation of the head in over 70% of cases. Lateral deviation and palatoglossal air were present in more than 50% of images. Conclusions: In trauma cases, technical difficulties in obtaining a proper OPG image are common and often insurmountable, limiting the diagnosis.

Recovery following Orthognathic Surgery Procedures-A Pilot Study.

This study aims at evaluating and categorizing patients' objective and subjective postoperative recovery symptoms after bimaxillary orthognathic surgery assigning the healing process. The patients were monitored throughout the recovery process, and their symptoms were managed. A prospective, observational study was performed. Patients with Class II and III malocclusion (aged 18 to 35) were evaluated and monitored preoperatively, and postoperatively at 48 h, 2 weeks, 1 month, and 3 months postsurgery. A questionnaire was used to assess pain and anesthesia/hypoesthesia. The most common objective and subjective signs that were correlated with the healing process were edema, hematoma, trismus, pain, and anesthesia/hypoesthesia. Edema peaked at 48−72 h postoperatively (distance between eye's external canthus and gonion, mean difference = 4.53, between tragus and cheilion, mean difference = 7, between tragus and gnathion, mean difference = 4.65, p < 0.001); mouth opening amplitude was significantly decreased during the first two weeks postsurgery (class II, mean difference = 32.42, p = 0.006, class III, mean difference = 44.57, p < 0.001), but it steadily and considerably improved over three months. The nose tended to widen postsurgery. The most severe pain experienced by patients was of medium intensity in the mandibular body, described as pressure, and usually did not spread. Patients were most severely and persistently impacted by anesthesia/hypoesthesia.

Point-of-Care Virtual Surgical Planning and 3D Printing in Oral and Cranio-Maxillofacial Surgery: A Narrative Review.

This paper provides an overview on the use of virtual surgical planning (VSP) and point-of-care 3D printing (POC 3DP) in oral and cranio-maxillofacial (CMF) surgery based on a literature review. The authors searched PubMed, Web of Science, and Embase to find papers published between January 2015 and February 2022 in English, which describe human applications of POC 3DP in CMF surgery, resulting in 63 articles being included. The main review findings were as follows: most used clinical applications were anatomical models and cutting guides; production took place in-house or as "in-house-outsourced" workflows; the surgeon alone was involved in POC 3DP in 36 papers; the use of free versus paid planning software was balanced (50.72% vs. 49.27%); average planning time was 4.44 h; overall operating time decreased and outcomes were favorable, though evidence-based studies were limited; and finally, the heterogenous cost reports made a comprehensive financial analysis difficult. Overall, the development of in-house 3D printed devices supports CMF surgery, and encouraging results indicate that the technology has matured considerably.

The usefulness of cone beam computed tomography according to age in cleft lip and palate.

The current study aimed to evaluate the usefulness of cone beam computed tomography (CBCT) examination in cleft children and adolescents, the age of the first CBCT exposure, and the criteria that justified the first CBCT exposure. A number of 229 non-syndromic cleft subjects aged between 0-22 years receiving treatment in the same specialized surgical center in orofacial cleft treatment were studied. A cleft group of 64 cleft lip and palate (CLP) children with at least one CBCT exposure was identified based on CBCT records. Parameters related to diagnosis and treatment planning in cleft deformity were considered dental anomalies and bone morphology changes. The examiners assessed whether the treatment option was necessary, not necessary, or could not be evaluated at the age of CBCT exposure. A number of thirty-nine unilateral clefts and fifteen bilateral clefts were identified. Posterior palatal cleft was present in six children (mean age: 15.03±5.55 years; male/female ratio: 1/0.8). Alveolar bone morphology changes were found in 90.58% of cases; jaw relationship changes in 71.82%; nasal fossa morphology changes in 74.99%; airway obstruction in 49.98% and maxillary asymmetry in 87.48%. Orthodontic planning was necessary for 85.93% of CLP patients, and orthognathic surgery in 39.05%. The usefulness of CBCT in patients with CLP varied with age, with reduced value for the evaluation of impaction and root resorption under the age of ten.

Salivary Exosomal MicroRNA-486-5p and MicroRNA-10b-5p in Oral and Oropharyngeal Squamous Cell Carcinoma.

Background and Objectives: The research aimed at evaluating the capacity of salivary exosomal miR-10b-5p and miR-486-5p for oral and oropharyngeal cancer detection. Materials and Methods: The saliva samples were harvested from histopathological diagnosed oral and oropharyngeal squamous cell carcinoma patients and healthy volunteer subjects. The exosomes were isolated by differential ultracentrifugation and quantified by Nano Track Analysis. The microRNAs were extracted and quantified from salivary exosomes by quantitative Real-Time Polymerase Chain Reaction. Results: This research comprised fifty participants. When compared to healthy controls, salivary exosomal miR-486-5p was elevated and miR-10b-5p was reduced in oral and oropharyngeal squamous cell carcinoma. Moreover, miR-486-5p had a high expression level in stage II of cancer in comparison to the other cancer stages. The cancer samples presented an increased exosome dimension compared to the control samples. Conclusions: Salivary exosomal miR-10b-5p and miR-486-5p have an altered expression in oral and oropharyngeal cancer.

Petrotympanic Fissure Architecture and Malleus Location in Temporomandibular Joint Disorders.

The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint disorders (TMD). A retrospective study was performed, including patients with TMD. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) examination were used to evaluate temporomandibular joint (TMJ) disc position and condylar bone changes. Fifty-eight TMJs from twenty-nine patients (23:6 females: males) were assessed. Erosive changes (DDR-disc displacement with a reduction of 6 (24%), DDwR-disc displacement without a reduction of 8 (61.5%) vs. normal disc position 3 (15%), p = 0.012) and condyle osteophytes production (DDR 6 (24%), DDwR 9 (69.2%) vs. normal condyle 7 (35%), p = 0.012) were more frequent in subjects with disc displacement compared to normal disc position; malleus was closer to PTF in cases with erosive changes (median 2.15 interquartile range: (1.85-2.75) vs. 2.75 (2.25-3.15), p = 0.029) as well as those with condylar osteophytosis (2.25 (1.91-2.75) vs. 2.75 (2.33-3.32), p = 0.015); the PTF length was higher in cases with condylar osteophytosis compared to those without (4.45 (3.50-4.77) vs. 3.67 (3.34-4.28), p = 0.039). The disc position and disc shape were not related to PTF or malleus position. Malleus position and PTF dimensions were not associated with the PTF type. In cases with erosive changes and condylar osteophytosis, malleus was closer to PTF.

Disc Displacement of the Temporomandibular Joint and Facial Asymmetry in Children and Adolescents: A Systematic Review and Meta-Analysis.

Subjects with facial skeletal asymmetries have a higher incidence of anterior temporomandibular joint disc displacement. The objective of the study was to consolidate existing evidence on the connection between temporomandibular joint disc displacement and mandibular asymmetry in youngsters and adolescents. A thorough examination was undertaken in the following databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane. To judge the publications' methodological quality Newcastle Ottawa Scale was used. From the 1011 identified records, eight were selected for the qualitative synthesis and five for the quantitative synthesis, amounting to 692 subjects. Fifteen cephalometric variables were meta-analyzed. The distance from menton (Me) to midline (lateral mandibular asymmetry) was significantly shorter [-1.75 (95% CI -2.43--1.07), p ≤ 0.001] in subjects with disc displacement compared to those without disc displacement. The distance from articulare (Ar) to gonion (Go) was significantly longer [3.74 (95% CI 1.04-6.44), p = 0.007] in subjects with disc displacement compared to those without disc displacement. The relationship between distance from articulare (Ar) to gonion (Go) or sella (S) to gonion (Go) and disc displacement was shown to be close to statistical significance level, but not for other cephalometric data. Disc displacement was associated with several cephalometric measurement variations in children and adolescents.

Evaluation of the Mandibular Condyle Morphologic Relation before and after Orthognathic Surgery in Class II and III Malocclusion Patients Using Cone Beam Computed Tomography.

This study aimed at evaluating the mandibular condyle position changes before and after bimaxillary orthognathic surgery in class II and III malocclusion patients. CBCT scans from patients who underwent bimaxillary orthognathic surgery were analyzed: Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). Both condyles were independently assessed for their largest anterior and posterior joint spaces, smallest medial joint spaces, and condyle angles concerning the transverse line. In the sagittal plane, the minimum size of the anterior and posterior joint spaces was measured. In the coronal plane, the smallest medial joint space was measured. The position of the condyle within the glenoid fossa was determined before and after surgery. A total of 56 TMJs from 28 patients were studied. Following orthognathic surgery, the anterior and posterior space in class II increased. Postoperatively, the anterior joint space in class III decreased. In 42.85% of malocclusion class II patients and 57.14% of malocclusion class III patients, the pre-and post-surgical position of the condyle changed, the condyle was anteriorly positioned (42.85%) in class II patients and centrically positioned (71.4%) in class III patients. Significant changes in the joint space, condylar position, and condyle angle were found in the class II and class III subjects.

Bruxism's Implications on Fixed Orthodontic Retainer Adhesion.

BACKGROUND: Fixed retainers assist in maintaining the outcomes of orthodontic treatment. Fixed retention may be affected by bruxism. OBJECTIVE: Evaluate two adhesives (an ormocer and a flowable composite) used for fixed orthodontic retention in simulated bruxism settings, compared to regular mastication, using a dual axis chewing simulator. METHODS: Eighty human teeth were used. Periodontal tissues were simulated and exposed to 120,000 mechanical cycles, corresponding to 6 months of clinical service. Each set of two teeth was supplied with a pre-shaped, fixed, multi-braided, stainless steel wire retainer, in 1.5 cm portions, to establish passive contact with the lingual surface of the teeth. The Adhesive Remnant Index (ARI) was used to evaluate the shear bond strength. A stereomicroscope was used to assess the micro-infiltration. RESULTS: There was no significant difference in the mean value of micro-infiltration between adhesives in the mastication group but in the bruxism group. During testing, one composite sample (ARI score 1) was broken in the mastication group, while three ormocer samples (ARI score 2) and one composite sample (ARI score 1) were broken in the bruxism group. CONCLUSIONS: The mean value for micro-infiltration in composite (0.31) was more than double that in ormocer (0.13).

Intrusion of Maxillary Posterior Teeth by Skeletal Anchorage: A Systematic Review and Case Report with Thin Alveolar Biotype.

This study aimed to review the literature related to the intrusion of maxillary posterior teeth in subjects needing pre-prosthetic restoration or orthodontic treatment due to anterior open bite, and to report a thin alveolar biotype case needing a pre-prosthetic intrusion of maxillary teeth by introducing a novel, personalized method of intrusion measurement. An electronic search was conducted between February 2022 and March 2022 in the following databases: PubMed, Scopus, Embase, Web of Science, and Lilacs; the terms "tooth movement techniques", "orthodontic anchorage procedures", "tooth intrusion", "intrusion", "molar", "premolar", and "human" were surveyed. Eighteen articles were included in this review; the mean amount of intrusion ranged from between 2.1 ± 0.9 mm and 4.57 ± 0.98 mm (being mostly 2-3 mm). The intrusion force varied between 100 and 500 g; 10 articles reported miniscrews (MS), 7 reported zygomatic plates (ZP), and 1 publication reported both anchorage types. The average treatment time was 6.9 months for MS and 7.9 months for ZP. Levelling the occlusal plane by intrusion of the upper posterior teeth can be achieved by skeletal anchorage. The stability of the obtained results, shortening treatment time, and controlling treatment outcome are the main goals for a complex surgical and orthodontic treatment approach.

Is Teledentistry a Method for Optimizing Dental Practice, Even in the Post-Pandemic Period? An Integrative Review.

BACKGROUND: For the past two and half years, dentists all across the world, along with their patients, have faced numerous challenges. In this context, the aim of this integrative review was to assess if dentists' and patients' attitudes regarding teledentistry (TD) have changed since the COVID-19 outbreak, and if the use of TD will continue to rise, even in the post-pandemic period; (2) Methods: A literature search was performed between August 2021 and January 2022. The PubMed, Scopus, and Science Direct databases were searched for articles published between 2012 and 2022 using a combination of the following Mesh terms: "COVID-19", "pandemic", "oral telemedicine", "teledentistry"; (3) Results: Among the 52 included papers, nine papers were published between 2011 and 2019, and 43 articles were published after 2020 (12 were published in 2020, 29 papers were published in 2021, and two in 2022). Among the articles published before 2020, seven out of nine included papers were reviews, and two were original research. Among the 43 papers published after 2020, 18 were reviews and 25 original research. (4) Conclusions: Based on the results of this integrative review, there is clear evidence that the interest in teledentistry and teleassistance in the dental field has increased rapidly, especially in the context of the COVID-19 pandemic. Therefore, while dental practitioners should be encouraged to keep themselves updated about new technologies, patients should also be constantly informed about their options for receiving special oral health care.

Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis.

(1) Background: Our study aimed to assess the association between the neutrophil to lymphocyte ratio (NLR), platelet to leukocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), red cell distribution width (RDW), and systemic immune inflammation index (SII) and periodontitis. (2) Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS databases, identifying observational studies. The Newcastle Ottawa scale was used to evaluate the quality of the included studies. The principal summary outcome measure in our random effects meta-analysis was the mean difference (MD). (3) Results: After screening 682 search results, a total of 10 studies including 3164 subjects were selected for quantitative assessment. We found a higher mean NLR, PLR, and LMR in the periodontitis group compared to the control group (0.41 (95% CI 0.12-0.7), p = 0.006; 7.43 (95% CI 0.31-14.54), p = 0.04; 2.05 (95% CI 0.27-3.83), p = 0.024). No differences were observed for RDW. (4) Conclusions: We found an association between NLR, LMR, and PLR and periodontitis, which might be thought of as emerging blood cell count inflammatory biomarkers that could shed light on the link between periodontitis and systemic disbalances, as well as for periodontitis prognosis and grading.