Abstract Background: Poor oral health is a major consequence of substance misuse, mainly smoking, which plays a leading role in the development of various oral health problems such as periodontal disease, tooth loss, peri-implant complications, and oral potentially malignant disorders. Objective: The objective of this study was to comprehensively evaluate the clinical outcomes and intervention methods for oral health among substance-using populations, in particular focusing on the effects of tobacco, alcohol, and other substances. Methods: A systematic literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in PubMed, Scopus, Web of Science, and Cochrane Library for the period 1989–2026. This search yielded 687 records. Screening the records and assessing their eligibility resulted in a final inclusion of 31 studies. Randomized controlled trials were evaluated using the Cochrane risk of bias 2.0 tool, and observational studies were assessed by the Newcastle–Ottawa Scale. Data were synthesized narratively, and meta-analysis was undertaken in cases where data were sufficiently homogenous. Results: Substance use has been very often linked to negative periodontal consequences, worsened response to treatment, and increased levels of inflammatory markers. Some additional treatments (low-dose doxycycline, photodynamic therapy resveratrol synbiotics, simvastatin) were shown to cause significant changes in probing pocket depth and clinical attachment level. Besides that, smoking cessation interventions such as dental-office counseling, quitline programs, and digital platforms have raised quit rates and helped keep periodontal stability. Observational studies show that crack cocaine use is connected to more tooth loss and that combined tobacco and alcohol exposure increases the risk of erythroplakia. Conclusion: Quitting smoking as well as the use of adjunctive therapies can enhance the periodontal outcomes in the populations using substances. Continued exposure though results in worse outcomes, and that means it is vital that concerted clinical and public health interventions be carried out.
Abstract Aim: This study aimed to evaluate the feasibility and explore the clinical outcomes of integrating artificial intelligence (AI)-assisted diagnostic assessment with transcutaneous auricular vagus nerve stimulation (taVNS) in adults with temporomandibular disorders (TMDs). Methods: This prospective, single-arm exploratory pilot study included 30 adults with clinically diagnosed TMD. Participants received a standardized 4-week taVNS intervention using the VagusStim® device (VagusStim Technologies). AI models were used to assess symptom patterns and explore predictors of response (not for diagnosis). Primary outcomes included pain (Visual Analog Scale) and jaw function (Jaw Functional Limitation Scale). Secondary outcomes included maximum mouth opening (MMO), heart rate variability (HRV) (root mean square of successive differences [RMSSDs] and low-frequency/high-frequency ratio [LF/HF]), and quality of life. Results: Statistically significant improvements were observed in pain, jaw function, MMO, HRV indices (RMSSD and LF/HF ratio), and quality of life ( P < 0.05). Conclusion: In this exploratory single-arm study, AI-assisted assessment combined with taVNS was associated with improvements in clinical and physiological outcomes. Due to the absence of a control group, no causal inferences can be made. These findings support feasibility and justify future randomized controlled trials.
Abstract Background: Extracting teeth in the anterior esthetic zone triggers rapid horizontal and vertical bone resorption. This tissue loss is particularly severe in the thin buccal plate, frequently jeopardizing final implant alignment and clinical esthetics. Combining socket preservation with early implant placement protocols is a clinical strategy designed to limit this post-extraction collapse and maintain peri-implant tissue stability. Objective: This study systematically reviews how socket preservation combined with early or immediate implant placement performs clinically in the anterior maxilla. The analysis focuses primarily on implant survival, marginal bone loss (MBL), esthetic scores, and complication rates. Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses 2020 guidelines. Electronic searches were performed in PubMed/MEDLINE, Scopus, and Web of Science for studies published between January 2020 and December 2025. Eligible studies included randomized controlled trials (RCTs), cohort studies, and systematic reviews involving human participants who received socket preservation with early or immediate implant placement in the anterior esthetic region. Primary outcomes included implant survival, MBL, and esthetic outcomes measured using validated indices such as the Pink Esthetic Score (PES). Risk of bias was assessed using the Cochrane RoB 2.0 and the Newcastle–Ottawa Scale. Because of heterogeneity among studies, qualitative synthesis was performed. Results: Twenty-seven studies met the inclusion criteria, including eight RCTs, eleven cohort studies, and eight systematic reviews. Implant survival ranged from 95.0% to 98.5%, while MBL remained within 0.5–1.5 mm. Grafted sites demonstrated lower bone loss than nongrafted sites. Protocols incorporating socket preservation, guided bone regeneration, connective tissue augmentation, immediate provisionalization, and the socket shield technique showed improved tissue stability and higher PES values. Complication rates were low and generally manageable. Conclusion: The integration of socket preservation with early implant placement provides a predictable clinical pathway in the esthetic zone. The approach yields stable bone levels, high implant survival, and strong esthetic outcomes. Standardizing these workflows still requires larger, long-term randomized clinical trials.
Abstract Objective: The aim of this study was to investigate the association between defensin beta 1 ( DEFB1 ) rs11362 polymorphism and susceptibility to periodontitis and to evaluate its influence on clinical outcomes following nonsurgical periodontal therapy. Methods: The prospective case-control study included 95 participants (65 patients with periodontitis and 30 healthy controls). Rs11362 polymorphism was genotyped using Tetra-amplification refractory mutation system polymerase chain reaction. Hardy-Weinberg equilibrium was confirmed in controls ( P = 0.674). Genotype distribution were compared using Pearson’s chi-square or Fisher’s exact test. Multivariable logistic regression under the dominant model (heterozygous genotype [CT] + homozygous genotypes [TT] vs. [CC]), adjusted for body mass index, hypertension, type 2 diabetes mellitus, and smoking and followed by false discovery rate correction, was performed to evaluate periodontitis susceptibility. Clinical attachment loss (CAL), probing pocket depth (PPD), gingival index, and plaque index were evaluated at baseline and after 3 months; treatment-related changes and differences among genotypes were assessed using the Wilcoxon signed-rank test and one-way analysis of variance or Kruskal-Wallis test. Results: No significant differences in genotype or allele distributions were observed between groups. Logistic regression showed no significant association between rs11362 and periodontitis susceptibility (odds ratio = 0.781, 95% confidence interval [CI]: 0.313-1.951). Following treatment, CAL and PPD decreased by 1.11 mm (95% CI: 0.91-1.31) and 1.91 mm (95% CI: 1.66-2.15). Although the CC genotype showed greater mean improvements than the CT and TT genotypes, the between genotype differences were not statistically significant. The absence of a significant association may partly reflect the limited statistical power of this study. Conclusion: DEFB1 rs11362 polymorphism was not significantly associated with periodontitis susceptibility in this cohort. Nonsurgical periodontal therapy significantly improved periodontal outcomes. Larger longitudinal studies are warranted to determine whether DEFB1 rs11362 influences periodontal treatment.
Abstract Objective: To critically analyze the biological basis of enamel biomineralization and evaluate contemporary and emerging strategies for enamel remineralization and regeneration. Methods: A comprehensive narrative review was conducted using literature from major electronic databases, focusing on studies related to amelogenesis, enamel matrix proteins, biomimetic remineralization, and advanced material-based strategies. Relevant articles from the past decade were prioritized, alongside foundational studies. Results: Enamel biomineralization is a highly regulated process involving coordinated protein–mineral interactions. Conventional ion-based remineralization strategies effectively arrest early lesions but fail to replicate the enamel microarchitecture. Advanced approaches, including protein-guided systems, hydrogels, and hybrid biomimetic platforms, demonstrate improved control over crystal orientation and structural integration, though clinical translation remains limited. Conclusion: Current remineralization strategies are predominantly reparative rather than regenerative. Biomimetic approaches show promise in replicating enamel structure; however, significant translational challenges persist. Future clinical success depends on integrating biological principles with material science to achieve functional enamel regeneration.
