The interaction between gut microbiome and bone health.

PURPOSE OF REVIEW: This review critically examines interconnected health domains like gut microbiome, bone health, interleukins, chronic periodontitis, and coronavirus disease 2019 (COVID-19), offering insights into fundamental mechanisms and clinical implications, contributing significantly to healthcare and biomedical research. RECENT FINDINGS: This review explores the relationship between gut microbiome and bone health, a growing area of study. It provides insights into skeletal integrity and potential therapeutic avenues. The review also examines interleukins, chronic periodontitis, and COVID-19, highlighting the complexity of viral susceptibility and immune responses. It highlights the importance of understanding genetic predispositions and immune dynamics in the context of disease outcomes. The review emphasizes experimental evidence and therapeutic strategies, aligning with evidence-based medicine and personalized interventions. This approach offers actionable insights for healthcare practitioners and researchers, paving the way for targeted therapeutic approaches and improved patient outcomes. SUMMARY: The implications of these findings for clinical practice and research underscore the importance of a multidisciplinary approach to healthcare that considers the complex interactions between genetics, immune responses, oral health, and systemic diseases. By leveraging advances in biomedical research, clinicians can optimize patient care and improve health outcomes across diverse patient populations.

Celiac Disease-Related Enamel Defects: A Systematic Review.

INTRODUCTION: This systematic review aims to elucidate the intricate correlation between celiac disease (CD) and dental enamel defects (DED), exploring pathophysiological mechanisms, oral health implications, and a dentist's role in early diagnosis. MATERIALS AND METHODS: Following PRISMA guidelines, a comprehensive search from 1 January 2013 to 1 January 2024 across PubMed, Cochrane Library, Scopus, and Web of Science identified 153 publications. After exclusions, 18 studies met the inclusion criteria for qualitative analysis. Inclusion criteria involved study types (RCTs, RCCTs, case series), human participants, English language, and full-text available. RESULTS: The search yielded 153 publications, with 18 studies meeting the inclusion criteria for qualitative analysis. Notable findings include a high prevalence of DED in CD patients, ranging from 50 to 94.1%. Symmetrical and chronological defects, according to Aine's classification, were predominant, and significant associations were observed between CD severity and enamel defect extent. CONCLUSIONS: The early recognition of oral lesions, particularly through Aine's classification, may signal potential CD even in the absence of gastrointestinal symptoms. Correlations between CD and dental health conditions like molar incisor hypomineralization (MIH) emphasize the dentist's crucial role in early diagnosis. Collaboration between dentists and gastroenterologists is essential for effective monitoring and management. This review consolidates current knowledge, laying the groundwork for future research and promoting interdisciplinary collaboration for improved CD-related oral health outcomes. Further large-scale prospective research is recommended to deepen our understanding of these issues.

Diagnosis and Orthodontic Treatment of Obstructive Sleep Apnea Syndrome Children-A Systematic Review.

Obstructive sleep apnea syndrome (OSAS) is a respiratory illness that is associated with recurrent episodes of either partial or full obstruction of the upper airways, or apnea, among other sleep disorders. This study aims to analyze, through a literature review, whether orthodontic treatment can be a good treatment strategy for this type of disorder. We performed a database search on Scopus, Web of Science, and Pubmed with the keywords OSA(S) and orthodontics to select the papers under evaluation. The criteria for inclusion were articles related to OSA(S) children undergoing an orthodontic treatment and clinical studies or case series, excluding systematic reviews, narrative reviews, meta-analyses, adult studies, animal models, and in vitro studies. The screening phase ended with the selection of 16 publications for this work. RME, or rapid maxillary expansion, turned out to be the preferred orthodontic treatment in cases of pediatric OSAS. The goal of this orthodontic procedure is to increase the hard palate's transverse diameter by reopening the mid-palatal suture. Children with maxillary contraction and dental malocclusion typically undergo such a procedure and have excellent results. However, OSAS is a multifactorial disorder; it does not seem related to the morphology of the oral cavity, and therefore, it is not always possible to cope with this problem exclusively through orthodontic treatment.

The Impact of Cesarean Section Delivery on Intestinal Microbiota: Mechanisms, Consequences, and Perspectives-A Systematic Review.

The relationship between cesarean section (CS) delivery and intestinal microbiota is increasingly studied. CS-born infants display distinct gut microbial compositions due to the absence of maternal birth canal microorganisms. These alterations potentially link to long-term health implications like immune-related disorders and allergies. This correlation underscores the intricate connection between birth mode and the establishment of diverse intestinal microbiota. A systematic literature review was conducted on the PubMed, Scopus, and Web of Science databases by analyzing the articles and examining the intricate interactions between CS delivery and the infant's intestinal microbiota. The analysis, based on a wide-ranging selection of studies, elucidates the multifaceted dynamics involved in CS-associated shifts in the establishment of fetal microbiota. We also explore the potential ramifications of these microbial changes on neonatal health and development, providing a comprehensive overview for clinicians and researchers. By synthesizing current findings, this review contributes to a deeper understanding of the interplay between delivery mode and early microbial colonization, paving the way for informed clinical decisions and future investigations in the field of perinatal medicine.

Non-Thyroidal Illness in Chronic Renal Failure: Triiodothyronine Levels and Modulation of Extra-Cellular Superoxide Dismutase (ec-SOD).

Oxidative stress (OS) is implicated in several chronic diseases. Extra-cellular superoxide dismutase (ec-SOD) catalyses the dismutation of superoxide anions with a protective role in endothelial cells. In chronic kidney disease (CKD), OS and thyroid dysfunction (low fT3 syndrome) are frequently present, but their relationship has not yet been investigated. This cohort study evaluated ec-SOD activity in CKD patients during haemodialysis, divided into "acute haemodialytic patients" (AH, 1-3 months of treatment) and "chronic haemodialytic patients" (CH, treated for a longer period). We also evaluated plasmatic total antioxidant capacity (TAC) and its relationships with thyroid hormones. Two basal samples ("basal 1", obtained 3 days after the last dialysis; and "basal 2", obtained 2 days after the last dialysis) were collected. On the same day of basal 2, a sample was collected 5 and 10 min after the standard heparin dose and at the end of the procedure. The ec-SOD values were significantly higher in CH vs. AH in all determinations. Moreover, the same patients had lower TAC values. When the CH patients were divided into two subgroups according to fT3 levels (normal or low), we found significantly lower ec-SOD values in the group with low fT3 in the basal, 5, and 10 min samples. A significant correlation was also observed between fT3 and ec-SOD in the basal 1 samples. These data, confirming OS and low fT3 syndrome in patients with CKD, suggest that low fT3 concentrations can influence ec-SOD activity and could therefore potentially contribute to endothelial oxidative damage in these patients.

[Collapsing Glomerulopathy Secondary to Anabolic Steroids for Bodybuilding: A Case Series].

The abuse of anabolic androgenic steroids (AAS) for competitive (and non-competitive) purposes for bodybuilding practice is increasingly common. The consequences of these substances on the various organs are only partially known. Cases of FSGS following the use of AAS have been reported in the literature, even with evolution to ESKD. We describe three cases of bodybuilding athletes who presented alterations in renal function indices after taking AAS for a long time. Three renal biopsies were performed with histological diagnosis of FSGS collapsing variant. We examine the lesions observed on histological examination. Two athletes had rapid progression of renal disease requiring replacement therapy. The third one continues conservative treatment for chronic renal failure. We discuss the risks related to the intake of doping substances and how bodybuilders are exposed to different causes of kidney damage: anabolic steroids, supplements, and a high-protein diet.

The adult growth hormone multicentric retrospective observational study: a 24-month Italian experience of adherence monitoring via Easypod™ of recombinant growth hormone treatment in adult GH deficiency.

Introduction: Non-compliance to recombinant human growth hormone (rhGH) treatment is universally recognized as a key detrimental factor to achieve the expected clinical outcomes in adult GH deficiency (aGHD). The Easypod™ electronic device allows objective measurement of adherence. Adherence to treatment has been reported to be related with IGF-1 levels and consequently with clinical satisfactory results. The aim of this multicentric, observational, retrospective, 24- month study, is to objectively assess aGHD patients' compliance to rhGH, using the Easypod™ device. Additionally, the study aims to compare the biochemical responses of adherent vs non-adherent patients. Methods: Forty-three patients (28 females and 15 males) affected by aGHD and equipped with Easypod™ from 3 Italian centers were included in the study. Adherence to treatment was defined as the proportion of injections correctly administered during the observational period, out of the expected total number of injections. All patients were evaluated for IGF-1, glucose, insulin, HOMA and QUICKI index, total/LDL/HDL cholesterol and triglycerides. Results: Mean adherence rate was consistently under 85% across the 2-year observation period (73% at year 2). A trend toward significant difference in adherence was shown when comparing female and male patients (respectively 76% and 61%) after a 2-year period. Among the anamnestic features, the prescribed frequency of administration of rhGH and the number of administered therapies appeared to be the most relevant adherence-influencing factors. A strong direct correlation between IGF-1 z-score and adherence to rhGH therapy was detected in the whole population. Discussion: Compliance to rhGH therapy is still a major issue in aGHD treatment. Adherence relates to therapy efficacy in aGHD. The use of Easypod™ could be beneficial for physicians to better manage aGHD patients and to achieve improved better biochemical and clinical responses.

Total Antioxidant Capacity: Biochemical Aspects and Clinical Significance.

Despite the physiological role of oxidant molecules, oxidative stress (OS) could underlie several human diseases. When the levels of antioxidants are too low or too high, OS occurs, leading to damage at the molecular, tissue and cellular levels. Therefore, antioxidant compounds could represent a way to modulate OS and/or to maintain proper redox balance. This review provides an overview of the methods available to assess total antioxidant capacity (TAC) in biological systems to elucidate the correct terminology and the pathophysiological roles. The clinical context is fundamental to obtain a correct interpretation of TAC. Hence, we discuss metabolic syndrome and infertility, two clinical conditions that involve OS, including the potential prognostic role of TAC evaluation in monitoring antioxidant supplementation. This approach would provide more personalised and precise therapy.

Bruxism and Botulinum Injection: Challenges and Insights.

Botulinum toxin (BTA) is a bacterial-derived extract that can inhibit muscle contraction, acting directly on the absorption of acetylcholine. Thanks to this property, botulinum has been used in aesthetic and general medicine for several years. Nowadays, the use of botulinum toxin is being deepened to address the problem of bruxism. In this scoping review, the results of the studies in the literature of the last 10 years were analyzed. Indeed, 12 reports (found on PubMed, Web of Science, and Scopus, entering the keywords "BRUXISM" and "BOTULINUM TOXIN") were deemed eligible for inclusion in this review. In the studies reviewed, BTA was injected into different muscle groups: masseters, masseter and temporalis or masseter, temporalis, and medial pterygoid. Botulinum toxin injection is a viable therapeutic solution, especially in patients with poor compliance or without improvement in conventional treatment.

Precision Medicine on the Effects of Microbiota on Head-Neck Diseases and Biomarkers Diagnosis.

Precision medicine using highly precise technologies and big data has produced personalised medicine with rapid and reliable diagnoses and targeted therapies. The most recent studies have directed precision medicine into the study of tumours. The application of precision medicine in the oral microbiota can be used both in the field of prevention and treatment in the strictly dental field. This article aims to evaluate the interaction between microbiota and oral cancer and the presence of biomarkers as risk predictors. MATERIALS AND METHODS: A literature search of PubMed, Scopus, and Web of Science was performed analysing the various interactions between microorganisms, biomarkers, and oral cancer. RESULTS: After screening processes, 21 articles were selected for qualitative analysis. CONCLUSION: The correlation between oral diseases/cancers and changes in the microbiota explains the increasing utility of precision medicine in enhancing diagnosis and adapting treatment on the individual components of the microbiota. Diagnosing and treating oral diseases and cancers through precision medicine gives, as well as economic advantages to the health care system, predictable and rapid management of the patient.

Interconnection between Microbiota-Gut-Brain Axis and Autism Spectrum Disorder Comparing Therapeutic Options: A Scoping Review.

BACKGROUND: Autism spectrum disorder (ASD) is a group of neurodevelopmental illnesses characterized by difficulty in social communication, social interaction, and repetitive behaviors. These clinical diagnostic criteria can be seen in children as early as one year old and are commonly associated with long-term difficulties. ASD is connected with a higher frequency of various medical diseases such as gastrointestinal complaints, seizures, anxiety, interrupted sleep, and immunological dysfunction, in addition to the range of developmental abnormalities listed. METHODS: From 1 January 2013 to 28 February 2023, we searched PubMed, Scopus and Web of Science for English-language papers that matched our topic. The following Boolean keywords were utilized in the search approach: "autism" AND "microbiota". After deleting duplicates, a total of 2370 publications were found from the databases, yielding 1222 articles. (1148). Nine hundred and eighty-eight items were excluded after their titles and abstracts were scrutinized. The method resulted in the removal of 174 items for being off-topic. The final 18 articles for qualitative analysis are included in the evaluation. CONCLUSION: The findings of this extensive study revealed that probiotics, prebiotics, their combination as synbiotics, fecal microbiota transplantation, and microbiota transfer therapy may benefit ASD patients suffering from both gastrointestinal and central nervous system symptoms.

Conservative Treatment of Dental Non-Carious Cervical Lesions: A Scoping Review.

This scoping review aims to evaluate methods of conservative reconstruction of dental enamel lesions resulting from abrasions and evaluate the effect of diode laser in reducing the symptoms of tooth sensitivity. The cementoenamel junction is more prone to substance loss because the enamel thickness is substantially decreased, resulting in a much weaker enamel-dentin bond. METHODS: Dental abrasion was examined in the mechanical cause alone. Pubmed, Scopus, and Web of Science were used to discover publications that matched our topic from 1 January 2018 to 20 March 2023. A comparison of various non-carious cervical lesion (NCCL) restoration treatments was generated mostly by mechanical considerations. RESULTS: A final number of 11 clinical trials and randomized controlled trials were included in the review for qualitative analysis. Composite resins performed well in clinical trials for the restoration of NCCLs. CONCLUSIONS: Composite, in its different forms of filling and consistency, preceded by the use of adhesives, is an efficient and effective material for the treatment of NCCLs. Diode laser use prior to NCCL restoration of teeth does not diminish restoration retention rate, may lessen hypersensitivity, and may affect restoration success.

Cannabidiol for Oral Health: A New Promising Therapeutical Tool in Dentistry.

The medical use of cannabis has a very long history. Although many substances called cannabinoids are present in cannabis, Δ9tetrahydrocannabinol (Δ9-THC), cannabidiol (CBD) and cannabinol (CBN) are the three main cannabinoids that are most present and described. CBD itself is not responsible for the psychotropic effects of cannabis, since it does not produce the typical behavioral effects associated with the consumption of this drug. CBD has recently gained growing attention in modern society and seems to be increasingly explored in dentistry. Several subjective findings suggest some therapeutic effects of CBD that are strongly supported by research evidence. However, there is a plethora of data regarding CBD's mechanism of action and therapeutic potential, which are in many cases contradictory. We will first provide an overview of the scientific evidence on the molecular mechanism of CBD's action. Furthermore, we will map the recent developments regarding the possible oral benefits of CBD. In summary, we will highlight CBD's promising biological features for its application in dentistry, despite exiting patents that suggest the current compositions for oral care as the main interest of the industry.

Oral Piercing: A Pretty Risk-A Scoping Review of Local and Systemic Complications of This Current Widespread Fashion.

Piercing insertion is a common practice among people of all ages for different reasons (e.g., esthetics, culture, religion). In the oral cavity, the jewel can be placed in the lips, cheeks, tongue, and frenulum. The presence of an oral piercing could cause local and systemic complications in the short term. In the long term, irreversible damage may occur to the hard and soft tissues of the oral cavity. Different authors in the past have produced publications focusing on this issue. This study analyzes 10 published articles sourced from online databases according to the PRISMA flowchart. These articles were chosen from the 501 suitable papers initially found. PubMed, Web of Science, and Scopus were used as the online databases for searching for papers that matched the topic, using the keywords "complication" and "oral piercing". The purpose of this review is to describe and analyze all possible complications related to the presence of a piercing in the mouth. Local and systemic complications are related to the presence of plaque and localized pathogenic micro-organisms that can spread via the bloodstream, although they rarely occur in patients without predisposing conditions. Maintaining proper oral hygiene and frequent check-ups are essential to avoid the onset of complications.

Predictability and Effectiveness of Nuvola® Aligners in Dentoalveolar Transverse Changes: A Retrospective Study.

Nowadays, many people use clear aligners to address their dental issues. The efficacy of transparent dental aligners must be investigated even though they are more aesthetically pleasing, easy to use, and tidy than permanent tools. Thirty-five patients in this study's sample group who used Nuvola® clear aligners for their orthodontic therapy were prospectively observed. Initial, simulated, and final digital scans were analysed with a digital calliper. The actual results were compared with the prescribed ending position to evaluate the efficacy of transversal dentoalveolar expansion. Aligner treatments in Groups A (12) and B (24), particularly in the dental tip measures, demonstrated high adherence to the prescription. On the other hand, the gingival measures exhibited a greater level of bias, and the differences were statistically significant. However, there was no difference in the outcomes between the two groups (12 vs. 24). Within specific parameters, the evaluated aligners were shown to be helpful in predicting movements in the transverse plane, particularly when considering movements linked to the vestibular-palatal inclination of the dental elements. This article compares the expansion effectiveness of Nuvola® aligners compared with other work in the literature using competitor companies.

Dentin, Dentin Graft, and Bone Graft: Microscopic and Spectroscopic Analysis.

BACKGROUND: The use of the human dentin matrix could serve as an alternative to autologous, allogenic, and xenogeneic bone grafts. Since 1967, when the osteoinductive characteristics of autogenous demineralized dentin matrix were revealed, autologous tooth grafts have been advocated. The tooth is very similar to the bone and contains many growth factors. The purpose of the present study is to evaluate the similarities and differences between the three samples (dentin, demineralized dentin, and alveolar cortical bone) with the aim of demonstrating that the demineralized dentin can be considered in regenerative surgery as an alternative to the autologous bone. METHODS: This in vitro study analyzed the biochemical characterizations of 11 dentin granules (Group A), 11 demineralized using the Tooth Transformer (Group B), and dentin granules and 11 cortical bone granules (Group C) using scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) to evaluate mineral content. Atomic percentages of C (carbon), O (oxygen), Ca (calcium), and P (phosphorus) were individually analyzed and compared by the statistical t-test. RESULTS: The significant p-value (p < 0.05) between group A and group C indicated that these two groups were not significantly similar, while the non-significant result (p > 0.05) obtained between group B and group C indicated that these two groups are similar. CONCLUSIONS: The findings support that the hypothesis that the demineralization process can lead to the dentin being remarkably similar to the natural bone in terms of their surface chemical composition. The demineralized dentin can therefore be considered an alternative to the autologous bone in regenerative surgery.

Surface Coatings of Dental Implants: A Review.

Replacement of missing teeth is possible using biocompatible devices such as endosseous implants. This study aims to analyze and recognize the best characteristics of different implant surfaces that ensure good peri-implant tissue healing and thus clinical success over time. The present review was performed on the recent literature concerning endosseous implants made of titanium, a material most frequently used because of its mechanical, physical, and chemical characteristics. Thanks to its low bioactivity, titanium exhibits slow osseointegration. Implant surfaces are treated so that cells do not reject the surface as a foreign material and accept it as fully biocompatible. Analysis of different types of implant surface coatings was performed in order to identify ideal surfaces that improve osseointegration, epithelial attachment to the implant site, and overall peri-implant health. This study shows that the implant surface, with different adhesion, proliferation, and spreading capabilities of osteoblastic and epithelial cells, influences the cells involved in anchorage. Implant surfaces must have antibacterial capabilities to prevent peri-implant disease. Research still needs to improve implant material to minimize clinical failure.

[Anti-MBG crescentic glomerulonephritis with negative immunofluorescence: case report and literature review].

Anti-glomerular basement membrane (anti-GBM) antibody disease is a rapidly progressive glomerulonephritis characterized by (i) positivity to anti-GBM in serum reacting with a specific antigen present in type IV collagen at both the glomerular and alveolar levels (ii) presence of crescent on light microscopy and positivity to linear deposits of IgG and C3 on immunofluorescence. In the classic variant, the clinic is that of a nephro-pneumological syndrome but there are variants. Rarely, the glomerular damage is pauci-immune. We describe a case of a variant in which there is anti-MBG positivity in serum but negative immunofluorescence and offer a review of the literature and potential treatments.

Precision Medicine in Oral Health and Diseases: A Systematic Review.

Precision medicine (PM) is personalized medicine that can develop targeted medical therapies for the individual patient, in which "omics" sciences lead to an integration of data that leads to highly predictive models of the functioning of the individual biological system. They enable rapid diagnosis, assessment of disease dynamics, identification of targeted treatment protocols, and reduction of costs and psychological stress. "Precision dentistry" (DP) is one promising application that need further investigation; the purpose of this paper is therefore to give physicians an overview of the knowledge they need to enhance treatment planning and patient response to therapy. A systematic literature review was conducted on the PubMed, Scopus, and Web of Science databases by analyzing the articles examining the role of precision medicine in dentistry. PM aims to shed light on cancer prevention strategies, by identifying risk factors, and on malformations such as orofacial cleft. Another application is pain management by repurposing drugs created for other diseases to target biochemical mechanisms. The significant heritability of traits regulating bacterial colonization and local inflammatory responses is another result of genomic research, and is useful for DP in the field of caries and periodontitis. This approach may also be useful in the field of orthodontics and regenerative dentistry. The possibility of creating an international network of databases will lead to the diagnosis, prediction, and prevention of disease outbreaks, providing significant economic savings for the world's health care systems.

Mandibular Crowding: Diagnosis and Management-A Scoping Review.

BACKGROUND: Crowding is the most frequent malocclusion in orthodontics, with a strong hereditary tendency. It already occurs in pediatric age and is mainly hereditary. It is a sign of a lack of space in the arches, and is not self-correcting, but can worsen over time. The main cause of the worsening of this malocclusion is a progressive and physiological decrease in the arch perimeter. METHODS: To identify relevant studies investigating the most common possible treatments for mandibular dental crowding, a comprehensive search of PubMed, Scopus and Web of Science was conducted encompassing the last 5 years (2018-2023) using the following MeSH: "mandibular crowding AND treatment" and "mandibular crowding AND therapy ". RESULTS: A total of 12 studies were finally included. An orthodontic treatment cannot ignore the concept of "guide arch", which concerns the lower arch, because of the objective difficulty in increasing its perimeter; the bone structure of the lower jaw is more compact than that of the upper one. Its expansion, in fact, is limited to a slight vestibularization of the incisors and lateral sectors that may be associated with a limited distalization of the molars. CONCLUSIONS: There are various therapeutic solutions available to the orthodontist, and a correct diagnosis through clinical examination, radiographs and model analysis are essential. The decision of how to deal with crowding cannot be separated from an overall assessment of the malocclusion to be treated.