Periodontal Medicine: Impact of Periodontal Status on Pregnancy Outcomes and Carcinogenesis

Periodontal medicine is a broad term commonly used to define the relationship between periodontitis and systemic health. Periodontitis is a highly prevalent, chronic multifactorial infectious disease, induced by the dysbiotic biofilm that triggers a persistent systemic inflammation and recurrent bacteremia. There is a growing body of scientific evidence that suggests the potential implication of periodontitis in the causation and progression of various systemic disease and conditions, such as diabetes, cardiovascular disease, pulmonary disease, adverse pregnancy outcomes and cancer. Some studies consider periodontitis as an independent risk factor for preterm birth, growth restriction, low birth-weight and pre-eclampsia. However not all studies support the association. Despite sparse scientific data, some studies indicate that individuals with periodontitis are at increased risk for cancer development, due to the increased inflammatory burden sustained by the presence of periodontal pathogens. This chapter emphasis the relationship between periodontitis and adverse pregnancy outcomes and the underlying mechanisms that link peridontitis to oral carcinogenesis

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)

The Impact of Simulated Bruxism Forces and Surface Aging Treatments on Two Dental Nano-Biocomposites—A Radiographic and Tomographic Analysis

Background and Objectives: Nowadays, indication of composite materials for various clinical situations has increased significantly. However, in the oral environment, these biomaterials are subjected (abnormal occlusal forces, external bleaching, consumption of carbonated beverages, etc.) to changes in their functional and mechanical behavior when indicated primarily for patients with masticatory habits. The study aimed to recreate in our lab one of the most common situations nowadays—in-office activity of a young patient suffering from specific parafunctional occlusal stress (bruxism) who consumes acidic beverages and is using at-home dental bleaching. Materials and Methods: Sixty standardized class II cavities were restored with two nanohybrid biocomposite materials (Filtek Z550, 3M ESPE, and Evetric, Ivoclar Vivadent); the restored teeth were immersed in sports drinks and carbonated beverages and exposed to an at-home teeth bleaching agent. The samples were subjected to parafunctional mechanical loads using a dual-axis chewing simulator. A grading evaluation system was conducted to assess the defects of the restorations using different examination devices: a CBCT, a high-resolution digital camera, and periapical X-rays. Results: Before mechanical loading, the CBCT analysis revealed substantially fewer interfacial defects between the two resin-based composites (p > 0.05), whereas, after bruxism forces simulation, significantly more defects were identified (p Conclusions: There were different behaviors observed regarding the studied nanocomposites when simulation of parafunctional masticatory forces was associated with aging treatments

CORRELATION BETWEEN BRUXISM, OCCLUSAL DYSFUNCTION AND MUSCULO-ARTICULAR STATUS

Aim of the study. The objective of the current study is to determine if a correlation exists between bruxism and occlusal dysfunction. It was also investigated whether bruxism is influenced by musclo-articular status and/or is associated with dental-periodontal pathologies including dental wear, dental fissures, gingival retraction or abnormal dental mobility. Materials and method. The study was carried out in two stages. In the first phase an original bruxism questionnaire was distributed to the 180 subjects included in the study. Based on the answers two groups were formed: subjects with self-reported bruxism (n=60) and the second group without bruxism (n=120). In the second phase an intraoral examination was performed, including static and dynamic occlusion, masticatory muscles and temporomandibular joint (TMJ) evaluation. Dental signs of bruxism were also identified and registered (dental wear, gingival retraction or dental mobility). Results. Occlusal dysfunction and TMJ pain (83,3% vs 16,7%) or disc displacement (80% vs. 20%) were more frequently diagnosed in patients with bruxism. A significant correlation (p<0,005) was observed between the presence of bruxism and muscle pain, hypertonia and/or hypertrophy (63%). Conclusion. Bruxism is more frequent in patients presenting occlusal imbalance. Dental signs in patients with bruxism are represented by pathological wear, dental fissures or fractures, mobility and gingival retraction. Jaw muscle symptoms (such as pain, hypertonia or hypertrophy) and temporomandibular joint signs (pain or/and disc displacement) often coexist with bruxism

A Systematic Analysis of the Available Human Clinical Studies of Dental Implant Failure in Patients with Inflammatory Bowel Disease

Background and objectives: The aim was to evaluate the current literature on the influence of inflammatory bowel disease (ulcerative colitis/Crohn&rsquo;s disease) in dental implant osseointegration in human clinical studies. Materials and methods: This review was conducted under the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. PubMed, Scopus, and Web of Science databases were electronic screened to find relevant articles published until October 2021. The inclusion criteria consisted of human clinical studies that reported the use of dental implant in patients diagnosed with inflammatory bowel disease. Risk of bias was assessed according to The Strengthening the Reporting of Observational studies in Epidemiology criteria. Results: A total of 786 studies were identified from databases. Of these, six studies were included in the review and reported the use of implants in patients with Crohn&rsquo;s disease. No articles were available for ulcerative colitis. Included articles indicated that Crohn&rsquo;s disease may determine early and late implant failure. Besides Crohn&rsquo;s disease, several patients presented associated risk factors and systemic disease that determined implant failure. Conclusions: The presence of clinical studies on the influence of IBD in implant therapy is low. When recommending an implant therapy to IBD patients, the multidisciplinary team should be aware of side effects and a close collaboration between members of this team is necessary. More data are needed to sustain the effect of IBD on implant therapy