Showing papers in "Current Oral Health Reports in 2017"

Periodontitis and Systemic Disease: Association or Causality?

Abstract: Purpose of Review The aim was to assess recent evidence that diabetes, metabolic syndrome (MetS) and obesity impact the progression of periodontitis.

Use of Probiotics and Oral Health

Abstract: The purpose of this study is to critically assess recent studies concerning the use of probiotics to control periodontal diseases, dental caries and halitosis (oral malodour). Clinical studies have shown that probiotics when allied to conventional periodontal treatment can ameliorate microbial dysbiosis and produce significant improvement in clinical indicators of disease. However, this effect is often not maintained by the host after the end of probiotic use. Current probiotics also show limited effects in treating caries and halitosis. Novel approaches based up on replacement therapy and using highly abundant health-associated oral species, including nitrate-reducing bacteria, have been proposed to improve persistence of probiotic strains and maintain oral health benefits. Probiotics have potential in the management of multifactorial diseases such as the periodontal diseases and caries, by more effectively addressing the host-microbial interface to restore homeostasis that may not be achieved with conventional treatments.

Additive Manufacturing Technologies Used for 3D Metal Printing in Dentistry

Abstract: Compared to conventional casting methods used for processing different alloys for dental applications, additive manufacturing technologies reduce manufacturing time and costs, minimize human errors and prevent possible defects in the cast objects. This review highlights working mechanisms, possible advantages and drawbacks of recent additive manufacturing technologies used for metal processing in dentistry. The literature reviewed indicated that powder-based fusion mainly based on selective laser sintering, selective laser melting and electro beam melting are the most commonly used technologies for 3D metal printing in dentistry for dental appliances made of CoCr and Ti6Al4V. Although mechanical properties of 3D printed alloys could be considered satisfactory, accuracy and reproducibility data do not present consistent results. There appears room for improvement between 3D printed metals and ceramic interfaces and precision before such technologies could be favoured over conventional cast methods.

Current Concepts of Epigenetics and Its Role in Periodontitis

Abstract: The focus of this review is to provide an overview of the recent findings on the role of epigenetic mechanisms in periodontal disease, including disease susceptibility, progression, and as potential treatment options. The findings on the influence of oral pathogens on epigenetic regulation of pathogen recognition receptors, such as Toll-like receptors, as well as pro-inflammatory cytokines suggest an important role for epigenetics in the regulation of the host immune response. Recent studies also show that the epigenetic pattern in periodontitis lesions differ from that of healthy and gingivitis tissue. In addition, these patterns differ between tissues in the same individual. Research is also indicating a role for both DNA methylation and histone acetylation on cells osteogenic differentiation and bone regeneration. Knowledge of epigenetic pattern in periodontal diseases may add not only to the knowledge of susceptibility of the disease but may also be a diagnostic tool to identify patients at risk to develop the severe form of periodontitis. In addition, recent research within gene therapy and tissue engineering indicate a role for epigenetics also to improve regeneration of periodontal tissues.

Definitions and Epidemiology of Endodontic Infections.

Abstract: This review describes the recent findings from epidemiological studies on endodontic infections. The recent literature was screened for studies on the prevalence of primary apical periodontitis and posttreatment apical periodontitis in various populations. Twenty-nine articles reporting data on the prevalence of primary or posttreatment apical periodontitis from all over the world were included. The prevalence of apical periodontitis varied between 7 and 86%, while that of posttreatment apical periodontitis varied between 10 and 62%. The quality of the coronal restoration and the root filling appears to be the major predictors of apical periodontitis. The recent findings from epidemiological studies on the prevalence of primary and posttreatment apical periodontitis in various populations are not substantially different from those from earlier years. It appears that the health of periapical tissues has not majorly improved in the general population.

Recent Advances in Adhesive Bonding: The Role of Biomolecules, Nanocompounds, and Bonding Strategies in Enhancing Resin Bonding to Dental Substrates

Abstract: To present an overview on the main agents (i.e. biomolecules and nanocompounds) and/or strategies currently available to amplify or stabilize resin-dentin bonding. According to studies retrieved for full-text reading (2014–2017), there are currently six major strategies available to overcome resin-dentin bond degradation: (1) use of collagen crosslinking agents, which may form stable covalent bonds with collagen fibrils, thus strengthening the hybrid layer; (2) use of antioxidants, which may allow further polymerization reactions over time; (3) use of protease inhibitors, which may inhibit or inactivate metalloproteinases; (4) modification of the bonding procedure, which may be performed by using the ethanol-wet bonding (EWB) technique or by applying an additional adhesive (hydrophobic) coating, thereby strengthening the hybrid layer; (5) laser treatment of the substrate prior to bonding, which may cause specific topographic changes in the surface of dental substrates, increasing bonding efficacy; and (6) reinforcement of the resin matrix with inorganic fillers and/or remineralizing agents, which may positively enhance physicomechanical properties of the hybrid layer. With the present review, we contributed to the better understanding of adhesion concepts and mechanisms of resin-dentin bond degradation, showing the current prospects available to solve that problematic. In addition, adhesively-bonded restorations may be benefited by the use of some biomolecules, nanocompounds or alternative bonding strategies in order to minimize bond strength degradation.

How Stable is Dentin As a Substrate for Bonding

Abstract: This paper reviews the complexity of the composition of dentin, and the repercussions of this composition on the stability of dentin over time, particularly in relation to adhesive dental procedures. Dentin is a complex and dynamic structure that comprises the major part of the tooth. Most adhesive procedures in dentistry involve bonding to dentin. The hybrid layer (HL) created on the very variable and dynamic organic dentin phase may fail over time, leading to the failure of dental restorations. Literature showed that the collagen fibers in the HL are prone to hydrolysis and mechanical strain, as well as endogenous proteolytic activity (collagenolytic activity of matrix metalloproteinases and cysteine cathepsins). Hydrolysis of the resin phase of the HL also occurs over time. Advancements in the area of dental adhesion have been huge. Silencing of collagenolytic enzymes (protease inhibitors and cross-linking agents) is one of the main strategies to decrease the degradation of the HL. In the following years, new techniques will also probably be available, and efficacy of some of the available techniques will perhaps be further clarified.

Will Bioceramics be the Future Root Canal Filling Materials

Abstract: Filling the root canal is necessary when the dental pulp is lost as the dead space will be colonised by bacteria, leading to reinfection of the root canal and treatment failure. Treatment methodology depends on the extent of root formation and the choice of materials available. This review looks at the classical clinical methods and also queries if the newer materials change the treatment rationale. There is considerable confusion with nomenclature for some classes of dental materials. The newer materials have specific features that may not address the treatment needs. Nonetheless, the use of bioceramics and related materials definitely modifies and improves treatment outcome. The classical treatment methods for filling the root canals of both immature and mature teeth are quite well-established in clinical practice. Open apices are treated with calcium hydroxide paste for an extended period of time to stimulate barrier formation at the apex, and the roots are then obturated in a similar way to adult teeth using a solid cone and root canal sealer. With the introduction of bioceramics and related materials, treatment of the immature apex has been shortened to one to two visits. Bioceramic root canal sealers have changed the concept of root canal obturation from the concept of hermetic seal and inert materials to biological bonding and activity. The introduction of these materials has certainly changed the clinical outcomes of filling the root canals. Treatment time has been reduced, which is beneficial for the treatment of paediatric patients. The chemical bond and antimicrobial properties of the sealers in conjunction with hydraulic properties are promising and can potentially improve the clinical success of treatment. Further research is necessary to be able to define clinical protocols for the use of these materials in order to optimise their properties.

The Future of Periodontal-Systemic Associations: Raising the Standards.

Abstract: Periodontal medicine recognizes a “bidirectional” interaction between periodontitis and systemic conditions. Unfortunately, the facile ability to publish a periodontal-systemic association, regardless of biologic plausibility or rigorous scientific scrutiny, continues without abate. The increasing number of periodontal-systemic associations corrupts the ability of dentists to distinguish which of the associations are spurious and which are valid. The use of a Disease Association Checklist creates a register for rational assessment of current disease associations. However, to diminish the publication of spurious periodontal-systemic observational associations, editors must demand that authors follow Bradford-Hill criteria and the STROBE Statement to ensure a stringent pathway to publication.

Periodontitis: from Infection to Inflammation

Abstract: The purpose of this study is to discuss the current understanding of periodontitis causation. The understanding of periodontitis as a monocausal infection has hindered the investigation of other potential causes that influence periodontitis morbidity and does not reflect the complexity of periodontitis etiology. Still today, the periodontal literature frequently defines periodontitis as an infection, whereas other potential causes of periodontitis, like smoking, which seems to be causally related to periodontitis, are typically called modifying or susceptibility factors. Instead of addressing the complexity of periodontitis, the field has narrowed its focus trying to find the most important bacteria or gene. Distal causes of periodontitis and interaction between constellations of causes at multiple levels have been commonly neglected. Understanding periodontitis as a group of signs and symptoms characterized by inflammatory destruction of the periodontium would provide a better frame for future etiological research.

Clinical Performance of All-Ceramic Dental Restorations

Abstract: The study aims to assess the current scientific evidence on the clinical performance of all-ceramic dental restorations. Silica-based and oxide-based ceramics provide esthetic treatment alternatives but rely on proper case selection and handling. Clinical long-term success rates are generally high for both tooth-supported and implant-supported restorations. Due to limited flexural strength and high brittleness, silica-based ceramics are limited in respect to clinical indications and their success greatly depends on resin bonding for final insertion. High-strength oxide-based ceramics can be inserted with conventional cements and reveal high success rates. More recently developed materials, such as resin matrix ceramics, zirconia-reinforced silicate ceramics, and monolithic translucent zirconia, reveal promising properties in the laboratory. However, they lack scientific validation through long-term clinical trials. Established silica-based and oxide-based ceramic materials demonstrate high long-term clinical survival rates; however, recently developed ceramics need further assessment.

Malnutrition and Oral Health in Children

Abstract: The purpose of this paper is to review the effects of malnutrition on children’s oral health. Malnutrition negatively affects the development of craniofacial structures and teeth. Nutrient deficiencies during amelogenesis and dentinogenesis lead to defective tooth structures, which tend to harbor cariogenic bacteria. The role of vitamin D in prevention of dental caries is inconclusive. Some researchers believe dental caries is not multifactorial nor transmissible because caries cannot develop without sugars. There is conflicting information in relation to the effects of malnutrition in tooth eruption and exfoliation, but its deleterious influence is clear in the integrity of the oral mucosa and salivary function. An improper nutrition deprives the child from important nutrients for growth and development, including that of oral structures. More research is needed to elucidate the role of malnutrition in tooth development, exfoliation, and eruption.

Association between Sugar Intake, Oral Health, and the Impact on Overall Health: Raising Public Awareness

Abstract: The role of sugar consumption and oral health refocused largely due to associations between systemic diseases and conditions (type 2 diabetes, obesity) and oral health. This review examines the evidence supporting the impact of sugars on oral diseases and the role of sugars in oral-systemic complications. The increased consumption of dietary sugars, including sugar-sweetened beverages, and the increasing percentage of sugars as a component of the US diet affect oral health in the population. It is important for dental professionals to know public health implications and strategies to effectively communicate this risk to patients’ oral health. Local and state governments experienced success with the regulation of sodas and sugar-sweetened beverages and studies demonstrated that these regulations are largely successful in decreasing consumption among adolescents. It is the role of the dental professional to support these activities to promote healthy dietary choices for patients.

The Impact of Oral Health on General Health: Educating Professionals and Patients

Abstract: This review provides a brief summary of what science has postulated about the oral cavity and its relationship to the rest of the body. This article then looks at the emerging body of evidence for a definitive statement on the impact of oral health and disease on overall health and disease. It concludes by examining ways to educate oral healthcare providers (OHCPs) (i.e., dentists and dental hygienists) and their role in educating patients and the public about the interrelationships of oral and overall health and challenges associated with this. Since 1989, there have been major advances in understanding the role of periodontal infection and inflammation in contributing to the risk for systemic diseases. As the evidence emerges for an oral-systemic link, new strategies for educating dentistry, medicine, other non-dental healthcare professions, and the public about this link are also emerging. Hopefully, a new awareness and understanding of the significance of oral health in sustaining general health lead to a new emphasis for prevention and treatment of periodontal disease.

Esthetic Crown Lengthening: Contemporary Guidelines for Achieving Ideal Gingival Architecture and Stability

Abstract: The achievement and maintenance of ideal gingival margin levels and architecture constitute essential requirements for esthetic crown lengthening procedures. The use of a scalpel blade and ancillary mechanical armamentarium to sculpt the gingival margins may not be the most efficient or accurate surgical method available, and this review will consider the use of contemporary alternatives. Additionally, the fact that gingival margin levels are often not stable following esthetic crown lengthening surgery is a phenomenon that has perplexed clinicians. The purpose of this article is to review the pertinent literature in search of predictable clinical protocols for esthetic crown lengthening. There has been increasing interest in the use of lasers for dental applications, and their potential benefits for gingival sculpting procedures must be considered. Diode lasers may offer an advantageous compromise between surgical efficacy and practicality. Additionally, coronal gingival re-growth is often an undesired sequela of traditional crown lengthening procedures. Recent literature helps to identify potential contributing factors. The establishment of ideal gingival margin architecture requires precise sculpting of the soft tissues. This is often easier to achieve with lasers, particularly diode lasers. Coronal gingival proliferation following esthetic crown lengthening may be prevented by incorporating more current concepts regarding the need for sufficient bone removal and flap management that emphasizes the preservation of gingival complex dimensions.

Fit of CAD/CAM Tooth-supported Single Crowns and Fixed Dental Prostheses

Abstract: Dentistry follows the generational change towards digital technology, and traditional techniques for dental restorative procedures are being influenced. An increasingly large number of CAD/CAM systems are currently used for fabrication of single crowns and fixed dental prostheses in the dental practice. The fit of a full coverage restoration is considered as criterion for long-term success. A review and comparison of the available digital workflows, CAD/CAM systems, and related biomaterial were conducted. Despite the variability of the different systems and evaluation methods, the majority of current literature attributes clinically acceptable marginal and internal gap measurements to the full digital workflow. While the contemporary digital systems appear to provide many advantages along with high-quality prostheses, the existing limitations and the continuous technological advancements fuel intensive research and improvement.

CAD/CAM Removable Dental Prostheses: a Review of Digital Impression Techniques for Edentulous Arches and Advancements on Design and Manufacturing Systems

Abstract: The aim of this article is to provide an overview of CAD/CAM removable dental prostheses in the treatment of completely edentulous patients. Computer-aided design/computer-aided manufacturing protocols continue to evolve in many areas in dentistry including removable complete dentures. Current protocols are advantageous in decreasing the number of clinical appointments needed, which may reduce the distress in elderly with limited access to care. In addition, CAD/CAM complete dentures are fabricated using standardized techniques using high-value quality controlled materials. Laboratory tabletop scanners are being used predominantly for the digitization of conventional impressions or dental casts. Further research is needed to further advance existing intra-oral scanners in digital impressioning of the completely edentulous jaws. Use of digital technology in complete denture manufacturing provides prostheses with improved quality such as reduced porosity, polymerization shrinkage, and improved retention. Presence of digital depository data allows replacement dentures to be fabricated in case they are lost or damaged.

Current Status of Regenerative Periodontal Treatment

Abstract: Periodontal regenerative therapy aims to completely restore the tooth’s supporting tissues (e.g., periodontal ligament, root cementum, alveolar bone, and gingiva) which have been lost following periodontal disease or trauma. The histologic outcomes should translate in substantial clinical improvements evidenced by probing depth reduction, gain in clinical attachment level, and bone fill. The present review provides a brief overview of the current status of periodontal regenerative therapy. There is plenty of evidence to support the use of guided tissue regeneration (GTR) techniques and the application of enamel matrix proteins (EMD) onto the exposed root result in true periodontal regenerative. The use of various growth factors and autologous blood concentrates for periodontal regeneration also have produced positive results, but more studies are needed. In general, both GTR and EMD, alone or in combination with bone grafts or substitutes, result in larger clinical improvements compared to conventional periodontal treatment for deep intrabony and furcation Class II defects. Important factors that negatively impact on the clinical outcomes of periodontal regeneration procedures are smoking, large number of remaining sites with bleeding on probing, bad oral hygiene, and increased tooth mobility. The magnitude of improvement arising from periodontal regenerative techniques and procedures depends largely on operator skills, not only in terms of dexterity but also on the ability to choose the best approach regarding the surgical technique and the regenerative technology depending on patient- and site-specific criteria. The clinical improvements after regenerative treatment can be preserved on a long-term basis on the majority of treated sites, provided that patients do not smoke, keep high oral hygiene standards, and attend regularly SPT.

Evolution of the Oral Microbiome and Dental Caries

Abstract: Our paper reviews how dietary changes during human evolution have contributed to the increased incidence and prevalence of dental caries in modern populations by shifting the oral microbiome from a “healthy” to “carious” state. We addressed two questions: (1) what is the microbial difference between the states of health and caries, and (2) how has the development of an agricultural diet impacted the oral microbiome? The application of next-generation sequencing has revealed the complexity of the oral microbiome and lack of a simple compositional difference between health and caries. Genetic analysis of the oral microbiome from contemporary and ancient humans has shown that the introduction of agriculture was associated with increased frequency of caries-related bacteria and the evolution of the key carious pathogen, Streptococcus mutans. The adoption of an agricultural diet has contributed to a modern rise in caries by changing the oral microbiome ecology. Identification of evolutionary factors that have influenced the oral microbiome in health and caries, and how the two states differ functionally, as opposed to compositionally, may help to reduce the current burden of caries.

Advances and Challenges in Oral Biofilm Control

Abstract: The paper aims to critically study the literature published over the past 3 years as relevant to oral biofilm control. The emphasis of this review is the interests and importance of new findings, seeking the following answers: (i) what is the major challenge in oral biofilm control?, (ii) what are the new anti-biofilm approaches?, and (iii) what are the further researches? In addition to mechanical plaque removal and the use of chemical agents against pathogenic biofilm, there is a need for development of new anti-biofilm approaches. The majority of the new studies aiming to control oral biofilm have been performed with the characterization of the extracellular matrix components. Exopolysaccharides (EPS), proteins, lipids, nucleic acids (eDNA), lipoteichoic acids (LTA), and lipopolysaccharides have been identified in the matrices of bacterial biofilms and are considered the current targets to oral biofilm control. The extracellular matrix is essential for the existence of the biofilm and by its virulence both in bacterial and fungal pathogens. The better understanding of the biomechanical properties of the EPS matrix is the main advance and is leading to new chemical and/or biological approaches to remove or disorganize cariogenic biofilms. Recently, researches are focusing on the extracellular matrix for oral biofilm control with further clinical applicability.

Beyond Cell Division: the Ecological Roles of Autolysins in Oral Biofilm Communities

Abstract: The goal of this review is to address the complicated nature of autolysins found among oral bacteria and the roles they play within the oral biofilm. The various functions of autolysins are discussed, as well as the regulation of autolysins and overall contribution to biofilms and the oral environment. With their many functions, bacterial autolysins can be understood as contributing to both cell physiology and population dynamics within the oral environment. Cell division, peptidoglycan turnover/remodeling, fratricide, and programmed cell death are all influenced, if not controlled, by autolysins. The release of nutrients and DNA as functional byproducts of lysins can alter the biofilm by affecting the growth and overall genetic makeup of the diverse bacteria. Autolysins and their various functions contribute to biofilm formation, horizontal gene transfer, and the overall health of the oral cavity.

Accuracy and Reliability of Intraoral Scanners: Are They the Better Option?

Abstract: The aim was to compare the accuracy of digital intraoral impressions with conventional impressions on the fabrication of different types of restorations. This study also compared the accuracy, reliability, and ease of use of different types of intraoral scanners available and correlated the results with the different scanning technologies. Digital impressions offer the same level of accuracy as conventional impressions regarding fabrication of crowns, fixed dental prostheses (FDPs), implant-supported crowns, and short-span FDPs with marginal gap values within the clinically acceptable range (<120 μm). However, for full-arch restorations, conventional impressions result in better accuracy. Further enhancements needs to be undertaken regarding intraoral scanners to improve its accuracy regarding fabrication of full-arch restorations. Further in vivo studies evaluating the accuracy of intraoral digital impressions on the fabrication of a wider range of restorations such as inlays, veneers, and full-arch restoration need to be conducted.

Digital Workflow in Implant Dentistry

Abstract: Implant dentistry is going through a digital revolution. Through the development of new equipment and their corresponding workflows, the diagnosis and treatment of our patients are becoming simpler and more efficient. This review examines the workflows and techniques that apply digital technology to the pre-operative planning stages, the surgical placement, and the prosthetic phases of implant treatment. With the current influx of new hardware and software into the market, dental technology has the potential to infiltrate every area of clinical implant dentistry. Its use generally begins with the diagnostic scanning by means of an intra-oral scanner and cone beam computed tomography. These modalities, in conjunction with implant planning software, allow for the planning and the guided surgical execution of dental implants. Technology can further be used with the prosthetic design and manufacturing of the interim and final restorations of the implants allowing all areas of clinical diagnosis and care to have the opportunity to apply digital dentistry. These tools can allow for more predictable, profitable, and pleasant treatment for our patients. As our clinical landscape changes with the influx of digital tools, the uses, workflows, and clinical protocols associated with implant dentistry can be learned and applied in our daily clinical practice allowing for the streamlining and simplification of patient care.

Engineering Dental Implants

Abstract: Implant dentistry is traditionally viewed as a clinical subject. However, the integration of a foreign metallic structure into a living bone involves several engineering considerations. This paper aims at reviewing and discussing recent basic issues and developments pertaining to the engineering aspects of dental implant development. We consider the three components of the system, namely the implant itself, the bone, and their interaction. We start with the implant material and its geometrical and surface condition parameters. Next, we discuss the long-term mechanical survivability of the implant, namely its resistance to fatigue cracking, outlining the uncertainty on the applied loads, and surrounding atmosphere. Following a summary of the jawbone from a mechanical standpoint, we discuss the dental implant-bone interaction, as modeled analytically or numerically, with emphasis on the bone damage and evolution. The contribution of high resolution observations to enriched numerical simulations is discussed. Progress in both experimental characterization techniques and numerical simulation methods brings engineering and dentistry closer, allowing for more focused clinical work that will ultimately lead to personalized implant dentistry.

Digital Impressions for Implant-Supported Fixed Dental Prostheses

Abstract: With the advent of CAD/CAM systems in dentistry, digital impressions have become an integral part of the treatment workflow in implant dentistry. The purpose of this article is to review the current status of digital impression systems, their applications within the digital workflow in implant dentistry, and the literature related to clinical viability in terms of its efficiency, accuracy, and patient-centered factors. The accuracy of intraoral scanners is similar to that of conventional impression techniques for single-crown and short-span fixed dental prosthesis (FDP) implant restorations. Clinical adjustment times were found to be shorter for dental implant crowns that were fabricated through a digital workflow than through a conventional one. Patients overwhelmingly prefer digital impressions over conventional methods in clinical studies. Intraoral scanner systems are clinically viable tools for the taking of implant impressions, demonstrating comparable accuracy and improved efficiency as compared to conventional methods, when provided appropriate case selection. Conventional methods demonstrate better accuracy for full-arch cases and long-span FDPs. Due to the relative lack of clinical studies in this area, future investigative efforts should focus on in vivo investigation into the accuracy of digital implant impressions in a variety of clinical situations.

Functional Salivary Gland Regenerative Therapy for Oral Health

Abstract: Salivary glands maintain oral health and homeostasis via functional interactions with many organs, including the teeth and the tongue. Dysfunction of salivary glands causes many problems, such as dental caries, bacterial infection, and swallowing dysfunction. Current regenerative therapy for salivary gland tissue repair and whole salivary gland replacement is currently a novel therapeutic concept that may result in full recovery of salivary gland function. The salivary glands arise from reciprocal epithelial and mesenchymal interactions. We developed a novel three-dimensional cell manipulation method that can reproduce organogenesis via the epithelial-mesenchymal interaction. The bioengineered salivary glands develop correct structure and successfully secrete saliva into the oral cavity via reestablishment of the afferent-efferent neural network. The bioengineered salivary glands also improve dry mouth symptoms, such as bacterial infections and swallowing dysfunction. This review summarizes recent findings and technological advances in salivary gland regenerative therapy.

Malnutrition and Oral Disease in the Elderly––Is There Any Bidirectional Relationship?

Abstract: The purpose of the review is to find recent evidence for a bidirectional relationship between oral diseases and malnutrition. Electronic search of MEDLINE using PubMed and a manual search of key journals for literature published in English between January 2013 and June 2016, was conducted and resulted in the selection of 25 papers. These selected studies comprised 19 observational studies, which included 17 cross-sectional and 2 longitudinal designs, and 6 interventional studies. A majority of the studies demonstrated a significant association between the following conditions in older adults: older adults with oral diseases are at risk for malnutrition and malnourished older adults are at risk for oral diseases. Treatment with dental prosthesis may have positive effects on the nutritional status of older adults. The current review revealed that research findings support a potential bidirectional relationship between oral diseases and malnutrition; however, there is insufficient evidence to draw definitive conclusions. Additional high-quality studies are necessary to accumulate more evidence.

Proteomics of Periodontal Pocket

Abstract: This study aims to present and evaluate the findings of the literature referring to proteomic analysis of the periodontal pocket aimed to identify potential biomarkers for periodontal disease. A comprehensive examination of data from “shotgun” proteomic analysis has shown that a number of human proteins, previously not extensively investigated in the literature, have emerged as new candidates. Proteins relevant to various biological functions such as actin, profilin, hemoglobin, plastins, alpha-amylase, matrix metalloproteinases, keratins, histones, annexins, antimicrobial peptides including histatins, S-100A9, cathelicidin-related peptide-37 (LL-37), human neutrophil peptides (HNP)-1, -2, and -3, statherin, and cystatins are commonly identified in gingival crevicular fluid (GCF) by proteomic analysis and are upregulated in periodontal disease and therefore could serve as biomarkers. Proteomic analysis has provided a new insight into the search for biomarkers of periodontal disease presence, progression, prognosis, and endpoints of treatment. Data derived should be validated by larger scale studies, including significant subject samples. These second-stage studies should focus on evaluating the importance of these proposed new biomarkers using standardized procedures.

Taste Sensing Systems Influencing Metabolic Consequences

Abstract: The taste information contributes to evaluate the quality and nutritional value of food before it is ingested, and thus, is essential for maintaining nutritive homeostasis within the body. Recent studies revealed that taste sensitivity is modulated by humoral factors such as hormones. Angiotensin II is a key hormone regulating sodium and water balance. Investigations of its involvement in the taste system revealed that angiotensin II suppresses the gustatory NaCl responses (amiloride-sensitive component) and enhances sweet taste sensitivity without affecting umami, sour, and bitter responses in mice. These results suggest that taste modulation by angiotensin II may play important roles in maintaining electrolyte and glucose homeostasis. This review focuses on the molecular mechanisms of salty taste perception and its modulation through the angiotensin II signaling to work out novel strategies to control food intake influencing metabolic consequences.

Root Coverage Procedures for Multiple Recession Defects

Abstract: The demand for root coverage in multiple gingival recession defects has increased in recent years. Compared to isolated recession, multiple gingival recession defects are much more challenging due to various limiting factors and require more sophisticated surgical techniques. This review aims to address recent progress in the management of multiple recession defects. The subepithelial connective tissue graft (SCTG) procedure, while effective, is limited due to tissue availability and patient preference to avoid a donor harvest site. Different surgical techniques and biological materials have been studied in an attempt to find ideal alternatives. Based on the studies reviewed, the SCTG procedure still remains the gold standard in terms of percent root coverage. Acellular dermal matrix allograft in conjunction with different flap designs has shown comparable, satisfactory results up to 1 year postoperatively. Other materials such as porcine collagen matrix and enamel matrix derivative also show some promise. Well-designed studies with long-term outcomes are still needed.