The selection of treatment choices for the decision to replace a single lost tooth is made by several chairside, dental-related, and patient-specific aspects. The objective of this study was to determine the individual factors that impact the decision-making process for selecting a treatment option to replace a single lost tooth. 440 patients (224 males and 216 females) above 18 years old, attending the College of Dentistry, University of Basrah, Iraq, with only a solitary missing tooth were considered in this descriptive-analytical study. Each participant was surveyed using a standardized questionnaire to gather information on their age, gender, and educational background. Following the questionnaire, a trained examiner conducted a thorough clinical examination to determine the number and position of any lost teeth. Data were collected through a particular proforma to assess patients' choices about three distinct types of prostheses considering various influencing factors. Analysis was carried out on those variables using a t-test. Pain and discomfort, damaging the adjacent tooth, treatment cost, dental phobia, and treatment duration were significant elements that influenced the selection of the prosthetic type. Most participants indicated that the primary factor for declining a replacement for a lost tooth was the presence of pain and discomfort. The highest percentage of subjects (37%) was within the implant prostheses category; most of them were under 40 years old. The most important factor affecting the selection of fixed partial dentures was damaging the neighboring teeth in about 40%. Removable partial dentures were selected by most non-graduated individuals 40.2% most of them above 50 years old. The relation between treatment options and tooth position was significant p-value = 0.04. Dental implants are the most popular way to restore a single tooth gap, followed by fixed and removable partial dentures. Pain and discomfort were the biggest considerations in patients' tooth replacement decisions. Education and location of lost teeth affect treatment options significantly.
This study aimed to evaluate salivary TNF‑α levels in patients with OLP compared to healthy controls and to assess correlations with clinical subtypes. A cross‑sectional study was conducted on 35 participants (20 OLP patients and 15 controls) recruited from Al‑Farabi University College of Dentistry. Saliva samples were collected and analyzed using ELISA to quantify TNF‑α concentrations. TNF‑α levels were significantly higher in OLP patients (48.9 ± 9.8 pg/mL) compared to controls (18.5 ± 8.1 pg/mL; p < 0.000001). Within the patient group, ulcerative lesions exhibited markedly elevated TNF‑α levels (59.9 ± 2.0 pg/mL) compared to reticular lesions (46.3 ± 7.8 pg/mL; p = 0.024). No significant differences in age or gender distribution were observed between groups. Elevated salivary TNF‑α levels in OLP patients, particularly in erosive forms, highlight the cytokine’s pivotal role in disease progression and severity. TNF‑α may serve as a potential biomarker for monitoring OLP activity and guiding therapeutic strategies.
To assess the association between body mass index for age (BMI-for-age, WHO 2007 reference) and the eruption status of the permanent premolars in children aged 8–10 years in Al-Najaf, Iraq, with attention to age and sex. In this cross-sectional study, 497 schoolchildren aged 8–10 years with complete weight and height measurements were examined for eruption of the right permanent premolars. BMI-for-age z-scores were derived from the WHO 2007 reference and used to classify each child as thinness, normal weight, overweight, or obesity. Associations with eruption status were tested using chi-square and Fisher exact tests, and multivariable logistic regression with BMI-for-age z-score, age, and sex as predictors. Thinness occurred in 5.4% of children, normal weight in 65.0%, overweight in 15.3%, and obesity in 14.3%. Higher BMI-for-age was associated with greater odds of eruption of the maxillary second premolar (adjusted OR per SD 1.18, 95% CI 1.01–1.37, p = 0.033) and the mandibular second premolar (1.18, 95% CI 1.0–1.39, p = 0.045). Age was the strongest predictor (maxillary 2.63, 95% CI 1.92–3.61, p < 0.001), and girls had higher odds than boys for the maxillary second premolar (1.7, 95% CI 1.08–2.68, p = 0.023) but not the mandibular one. Thin children did not differ from non-thin children, and the first premolars were not associated with BMI-for-age. Higher BMI-for-age was modestly associated with greater odds of second premolar eruption, with age the dominant correlate and thinness not associated with reduced eruption. These cross-sectional findings implicate adiposity rather than undernutrition and support the use of age-appropriate BMI standards.
This study aimed to compare two laboratory methods, enzyle-linked immunosorbent assay (ELISA) and the latex agglutination test, for the detection of serum C-reactive protein in individuals with different periodontal health statuses. Inn addition, the study evaluated the association between CRP levels, periodontal disease severity, age, and gender. A case-control study including 90 participants (30 healthy, 30 with gingivitis, and 30 with periodontitis was performed. Clinical periodontal examinations were done, and serum samples were collected for CRP analysis by latex agglutionation rtest and ELISA. Chi-square, one-way ANOVA, and Tukey post hoc analyses were performed to compare CRP levels among the study groups and to determine correlations between CRP levels, disease severity, age, and gender. Serum CRP levels increased significantly with periodontal disease severity (P < 0.001). ELISA detected higher CRP concentrations from healthy controls than from individuals with periodontitis, while the latex agglutination test showed high specificity (96.2%) but low sensitivity (27%) for CRP detection. The elevation was associated with increasing disease severity, indicating its potential use as a biomarker of periodontal inflammation. Age showed a significant association with disease severity, whereas geneder was not significantly associated. Serum CRP levels increased significantly with periodontal disease severity. Although the latex agglutination test demonstated high specificity abd ay serve as a rapid screenkng method, ELISA provided superior sensitivity and quantitative accuracy, making it the preferred method for clinical and research applications.
Dental caries is the most prevalent biofilm-mediated disease worldwide, and Streptococcus mutans is its principal etiological agent. Because broad-spectrum antiseptics disturb the commensal flora and may drive resistance, anti-virulence strategies based on safe natural products are increasingly sought. Sulforaphane (SFN), a cruciferous isothiocyanate, has documented bacteriostatic activity, but its effect on clinical S. mutans isolates and on the molecular determinants of cariogenicity is poorly defined. Twenty-five clinical S. mutans isolates from carious lesions and dental plaque were challenged with SFN (Sigma-Aldrich) in 0.5% DMSO. Antibacterial activity was assessed by agar-well diffusion and broth microdilution (MIC/MBC) with chlorhexidine as positive control and triphenyltetrazolium chloride as viability indicator. Biofilm formation and the anti-biofilm effect were quantified by the crystal-violet microtiter assay. Expression of gtfC (EPS synthesis), ldh (acidogenicity) and sodA (oxidative-stress defense) was measured by qRT-PCR at sub-MIC (625 µg/mL) using 16S rRNA as reference gene (2-ΔΔCt method). SFN showed dose-dependent activity (zone of inhibition 17.8 ± 0.55 mm at 5%). The MIC was 1250 µg/mL for all isolates; no killing occurred up to 2500 µg/mL (MBC > 2500 µg/mL; MBC/MIC > 2), indicating a bacteriostatic, anti-virulence action. Eighteen isolates were strong, 3 moderate and 4 weak biofilm producers; SFN suppressed biofilm formation dose-dependently (p < 0.0001). At sub-MIC, SFN down-regulated gtfC by ≈99.5% (≈195-fold), sodA by ≈97.2% (≈35-fold) and ldh by ≈97.0% (≈34-fold) (all p < 0.01). gtfC/sodA expression was strongly correlated (r = 0.72), and PCA cleanly separated treated from untreated profiles (PC1 = 70.8%). SFN is a bacteriostatic, multi-target anti-virulence agent against clinical S. mutans, simultaneously disabling biofilm scaffolding, acidogenesis and oxidative-stress defense without killing the cell — a profile favorable for caries control with low resistance-selection pressure.
Polymethyl methacrylate (PMMA) is the most widely used denture base material in prosthodontics due to its favorable mechanical properties, esthetic appearance, and cost-effectiveness. This study aimed to evaluate the effect of three different media insulating material (distilled water) as control, linseed oil (flaxseed oil), and lemon oil Heat-polymerized acrylic resin's surface-level hardness by comparing hardness values before and after immersion .Twenty-one rectangular acrylic resin samples (65mm × 10mm × 2.5mm) were fabricated using heat-cured PMMA and divided into three groups (n=7 each): Group A (control group) immersed in distilled water, group B (linseed oil), and group C (lemon oil). Surface hardness was measured using a Shore D durometer before and after two months of immersion at 37°C in an incubator. Data were statistically analyzed using one-way ANOVA and LSD post-hoc tests (p<0.05). Before immersion, group C (lemon oil) exhibited the highest mean hardness (83.829), followed by Group A (82.886) and Group B (82.386), with significant differences among groups (p=0.01). After two months, group B (linseed oil) showed the highest mean hardness (85.314), while no significant difference was found between linseed and lemon oil groups (p=0.236). The control group exhibited a slight decrease in hardness, whereas both oil-treated groups showed increased hardness after immersion. Immersion in natural oils, particularly linseed and lemon oils, effectively preserved or enhanced the hardness of polymerized resin compared to distilled water. Lemon oil improved initial hardness due to its terpene and limonene content, while linseed oil maintained superior long-term hardness due to its high concentration of unsaturated fatty acids and hydrophobic nature. These findings suggest that natural oils can protect acrylic resin from water-related softening and improve its durability. Future studies are recommended to optimize oil type, concentration, and clinical application methods.
Bond failure at the wire–composite interface remains the most frequent mode of fixed lingual retainer breakdown. The influence of wire surface treatment on adhesion across different alloys and intraoral aging conditions is incompletely characterized. This study evaluated the effect of sandblasting, MDP-containing metal primer (Assure Plus), and their combination on the shear bond strength (SBS), pull-out strength, and adhesive remnant index (ARI) of dead-soft stainless-steel (SS) and dead-soft titanium (Ti) retainer wires bonded with Transbond XT composite resin. A total of 480 bovine incisor specimens were allocated across 24 experimental subgroups defined by four surface-treatment protocols (control, sandblasting, primer, combination), two wire types, and three aging conditions (thermocycling, distilled water storage, acid challenge), with n = 10 per subgroup. SBS and pull-out force were measured using a universal testing machine. ARI scores were recorded post-debonding. Data were analyzed by one-way ANOVA, independent t-test, two-way and three-way ANOVA with Tukey HSD post-hoc testing (p < 0.05). Surface treatment significantly affected both outcomes (SBS: F = 8.544, p < 0.001; pull-out: F = 96.684, p < 0.001). The combination protocol produced the highest mean SBS (20.44 ± 8.51 MPa) and pull-out strength (176.77 ± 61.09 N). Titanium wire exceeded stainless steel in SBS (14.96 vs. 13.88 MPa, p < 0.001), whereas stainless steel exceeded titanium in pull-out strength (133.88 vs. 106.97 N, p < 0.001). Aging significantly affected pull-out strength (p < 0.001) but not SBS (p = 0.459). Significant three-way Wire × Treatment × Aging interactions were detected for both outcomes. The combination group recorded the highest ARI scores (mean = 2.8 ± 0.4). Dual mechanical–chemical surface conditioning significantly enhances adhesion of fixed lingual retainer wires to composite resin, with effects that are wire-alloy-dependent and modulated by the aging environment. These findings support the systematic adoption of combined sandblasting and primer application in clinical retention protocols.
To evaluate the effect of systemically administered lavender essential oil on circulating inflammatory cell counts in a ligature-induced rat model of periodontitis. Periodontitis was induced in 18 rats using a 3-0 silk ligature placed around the maxillary right second molar the first use of this model in Iraq. Animals were randomly divided into three groups (n = 6 each): control (no ligation), ligated-only, and ligated plus daily oral systemic lavender essential oil (600 mg/kg). After 11 days, blood samples were collected via cardiac puncture and analyzed using an automated blood analyzer to quantify white blood cells, lymphocytes, monocytes, and granulocytes. Data were analyzed using one-way ANOVA with Tukey's HSD post-hoc test (SPSS v19). The control group showed no evidence of inflammation, while both ligated groups showed significant increases across all inflammatory cell types (p < 0.001). No statistically significant difference was found between the ligated-only and ligated-plus-lavender groups for WBC, granulocytes, or monocytes, indicating that lavender oil did not attenuate the systemic inflammatory response beyond ligation alone. Systemic administration of lavender essential oil (600 mg/kg) had no significant effect on inflammatory cell counts in ligature-induced periodontitis in rats. Future studies should investigate topical, rather than systemic, application.
To evaluate the prevalence and severity of dental caries and to observe the variables associated with dental caries among Iraqi adolescents aged 12 years. A cross-sectional study was conducted with 504 adolescents aged 12 years in Kut city, Iraq, from November 2025 to April 2026. Background about the adolescents was captured using a questionnaire that covered demographic characteristics and oral health-related behaviours. Additionally, a clinical dental examination incorporated assessment of decayed, missing, and filled teeth and surfaces (DMFT, DMFS) and the simplified oral hygiene index (OHI-S) based on the criteria of the World Health Organization (WHO). The statistical analysis comprised the Chi-square test, ANOVA test, an independent sample t test, and simple and multiple logistic regressions. The caries prevalence and the mean of DMFT among the adolescents were 74% and 1.92 (±1.74), respectively. Multiple logistic regression indicated that lower maternal education level (OR=3.83, 95% CI: 2.21 to 5.65), never toothbrushing practice (OR=2.98, 95% CI: 1.67 to 5.14), and fair oral hygiene (OR=3.23, 95% CI: 1.45 to 7.20) were positively associated with the prevalence of dental caries among the adolescents. Dental caries was highly prevalent, whereas good levels of oral health behaviors were low in adolescents in this investigation. Maternal educational level, toothbrushing frequency, and oral hygiene conditions were associated with dental caries.
The present study aimed to evaluate the diagnostic value of salivary IL-6 and IL-40 levels in patients with periodontitis and to investigate their association with clinical periodontal parameters. This case–control study included 60 participants comprising 30 patients diagnosed with Stage III or Stage IV periodontitis and 30 periodontally healthy controls. Unstimulated whole saliva samples were collected under standardized conditions. Salivary IL-6 and IL-40 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Clinical periodontal parameters, including plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL), were recorded. Receiver operating characteristic (ROC) curve analysis, correlation analysis, and logistic regression were performed to evaluate the diagnostic value of the investigated biomarkers. Clinical periodontal parameters were significantly higher in periodontitis patients than in healthy controls (p < 0.001). Salivary IL-6 and IL-40 levels were significantly elevated in the periodontitis group. ROC analysis demonstrated good diagnostic performance for both biomarkers. IL-6 showed the highest diagnostic accuracy (AUC = 0.868), whereas IL-40 demonstrated acceptable diagnostic performance (AUC = 0.797). Both biomarkers showed significant positive correlations with periodontal parameters, particularly probing pocket depth. Logistic regression analysis identified IL-6 and IL-40 as significant predictors of periodontitis. Salivary IL-6 and IL-40 are significantly associated with periodontitis and demonstrate promising diagnostic potential as non-invasive biomarkers. These findings support their possible application in periodontal disease assessment and monitoring. Further longitudinal studies are recommended to validate their clinical utility and investigate their prognostic value.
The present review examined the current literature on the topic of adult oral Candida colonization and then briefly discusses how Candida can cause dental caries from a perspective of biofilm action, microbial interaction, and host-related conditions. Several aspects are covered in the analysis including the biofilm aspect, microbial interaction, and the role of host-related conditions. According to recent studies, Candida albicans is usually regarded as an oral commensal, but its possible to see a certain shift towards pathogenesis once conditions have changed. Additionally, there is experimental evidence as well as clinical evidence that Candida and cariogenic bacteria might form a collaboration, enhance mixed biofilms, tolerate low pH, and survive in mouths where there is reduced saliva protection. For adults, there is some evidence suggesting that presence of Candida is related to caries experience in certain populations, although not every case proves this relationship. Differences can result from sampling procedures, methods used in the laboratory, different ages, and saliva status. The oral candida colonization may be viewed as some form of ecological factor in adult cariology. It is improbable that the oral candida colonization is the sole agent responsible for caries. However, it may contribute to pushing dysbiosis to the point where the disease progresses further.
This study evaluated the effect of occlusal surface design (anatomic vs. non-anatomic) on the fracture resistance of monolithic zirconia full crowns fabricated using CAD/CAM technology. A mandibular first molar was prepared with 1.5 mm occlusal and 1.0 mm axial reduction (90° shoulder finish line) to serve as a master die. The die was duplicated using a heavy-body silicone index to produce 40 type IV stone dies, randomly divided into two groups (n=20): Group A (full anatomic occlusal design) and Group B (modified non-anatomic/flat occlusal design). Crowns were milled via CAD/CAM, sintered, and seated on their respective dies. Axial loading was applied using a rounded indenter in a Universal Testing Machine at a crosshead speed of 1 mm/min) until fracture, and the maximum load (N) was recorded. Group A exhibited a mean fracture resistance of 2063 N (range 1903-2173 N). Group B demonstrated a highly comparable mean fracture resistance of 2059 N (range 1987-2125 N). Statistical analysis showed no significant difference between the two groups (p = 0.905). Modifying the occlusal design from anatomic to flat does not significantly affect the fracture resistance of monolithic zirconia crowns. Both designs demonstrated exceptional load-bearing capacities that comfortably exceeded maximum clinical masticatory forces.
The long-term success of dental implants is not solely dependent on osseointegration but also critically relies on the formation of a stable, bacteria-resistant soft tissue barrier known as the perimucosal seal. This seal, formed by the gingival tissues around the bio-inert implant's transmucosal component, prevents microbial invasion and subsequent inflammation that can lead to peri-implantitis and implant failure. Nanotechnology offers a paradigm shift, enabling the design of "bio-instructive" surfaces that can actively guide the behavior of gingival fibroblasts and epithelial cells to establish a superior biological barrier. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science for studies published between 2010 and 2025. The PRISMA-ScR guidelines were followed. The search strategy employed keywords. Studies were included if they investigated nanotechnological modifications of implant surfaces (primarily titanium) and evaluated biological outcomes related to gingival cell adhesion, proliferation, orientation, and barrier function. The literature mapping revealed three primary nanotechnological strategies aimed at enhancing soft tissue integration: (1) Nanotopographical Modification, utilizing features like nanogrooves, nanopits, and nanotubes to provide physical cues for "contact guidance," which directs the alignment and elongation of gingival fibroblasts, mimicking the natural collagen fiber orientation. (2) Surface Biofunctionalization, involving the nanocoating of surfaces with biomimetic molecules such as fibronectin, laminin, or specific cell-adhesive peptides (e.g., RGD, YIGSR) to accelerate and strengthen cell attachment via specific integrin-mediated binding. (3) Creation of Multifunctional Surfaces, which combine pro-integrative topographies or chemistries with antibacterial agents (e.g., silver or zinc oxide nanoparticles) to create a surface that exhibits "selective bioactivity" simultaneously promoting host tissue healing while preventing bacterial colonization at the critical implant-gingiva interface. Nanotechnology provides a powerful and precise platform for engineering the next generation of dental implant collars with enhanced biological functionality. By creating surfaces that actively direct soft tissue healing, it is possible to accelerate the formation of a robust and resilient perimucosal seal. While in-vitro evidence is strong, significant research gaps remain, particularly the need for in-vivo models that can accurately assess the long-term stability and function of this engineered seal. Future research should focus on developing multifunctional, gradient surfaces and translating these promising laboratory findings into clinical solutions for preventing peri-implant disease.
The objective of this study was to determine salivary IL-8, sIgA, and CRP levels in relation to E. faecalis among patients with a refractory root canal infection. This prospective case-control study was conducted between January and March 2026 and included 150 participants with 100 individuals having symptoms of continued root canal infection, and 50 healthy controls. During retreatment, root canals were sampled aseptically, and microbiological assessment was performed using the VITEK 2 Compact system. We analyzed salivary samples for IL-8 and sIgA and measured serum levels of CRP by standardized immunoassays. Enterococcus faecalis was the most frequent bacterial isolate and was present in 42% of chronic infections. Clinical and radiographic changes of patients with E. faecalis were more severe than that of patients negative for E. faecalis [greater pain (74.2% vs. 39.8%), and greater radiographic lesion size (57.6% vs. 31.7%)]. Moreover, the E. faecalis-positive group had significant higher salivary levels of IL-8, sIgA, and CRP in serum, which also correlated with radiographic disease severity, especially IL-8 and CRP. The best independent predictors of E. faecalis positivity were identified using multivariate logistic regression analysis and included salivary IL-8 and serum CRP, while sIgA and periapical index scores predicted E. faecalis positivity as well. Overall, non-healing root canal infections were characterized by local immune activation and greater salivary IL-8, sIgA, and increased serum CRP.
The goal of this study was to evaluate the efficacy of autogenous bone grafts with and without recombinant human bone morphogenetic protein-2 for rehabilitation of narrow alveolar ridge width by dental implants. Twelve patients (2 males and 10 females), ranging from 36 to 60 years and a mean age of 47.08 years, were divided into two study groups. One received autogenous bone graft (A1) and the other group autogenous bone graft with rhBMP-2 using a collagen membrane (A2). All patients were clinically evaluated and received a CBCT for an accurate measurement of the alveolar ridge width, height, and after six months postoperatively. The mean difference in primary and secondary alveolar bone width (after 6 months) in group A1 was 4.14 mm, with a statistically significant difference (p < 0.05). Also, the mean difference in primary and secondary (after 6 months) alveolar bone width in group A2 was 5.14 mm, with a significant difference between them (P-value 0.00). The addition of rhBMP-2 increased the extent of bone width regeneration compared with the autogenous bone graft used alone. Both study groups showed a statistically significant increase in bone width at 6 months, with the highest increase observed in group A2 (ABG + rhBMP-2).
The objectives of the study were to assess the effect of enzymatic and microbial biofilm exposure on the surface roughness and corrosion resistance of dental crown materials commonly used in dentistry in oral environment. Three modern dental crown materials were used: yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), lithium disilicate glass-ceramic, and cobalt–chromium metal-ceramic alloy. Ninety disc-shaped specimens were manufactured and randomized to three experimental groups: control (artificial saliva), enzymatic exposure and combined enzyme–biofilm exposure. Enzymatic degradation was simulated using matrix metalloproteinase-8 (MMP-8), esterase, and proteinase K. Biofilm formation was induced using Streptococcus mutans (ATCC 25175) and Lactobacillus acidophilus under anaerobic incubation. The surface roughness was measured by atomic force microscopy (AFM), and the corrosion resistance was measured by electrochemical impedance spectroscopy (EIS). The measurements were taken at 7, 14 and 28 days. Two-way ANOVA and repeated-measures ANOVA with Bonferroni post hoc testing were used for statistical analysis. All materials investigated showed an increase in surface roughness and loss of corrosion resistance after both the enzymatic and combined enzyme–biofilm treatments. The synergic effect had a greater degradation than the enzymatic effect (p < 0.05). The surface roughness values remained as low as zirconia and the impedance values remained as high as zirconia throughout the experimental period. The specimens of metal-ceramic exhibited the lowest corrosion resistance and the highest increase in roughness with time. The surface degradation and corrosion experiments of dental crown materials indicated that both enzymatic and microbial biofilm exposure had great effects on the surface degradation and corrosion behavior of the materials under simulated oral conditions. Bacterially mediated degradation was found to be more resistant for zirconia than for lithium disilicate and metal-ceramic materials.
The study was undertaken to assess the effect of addition of a silver–zinc–potassium polyacrylate (Ag–Zn–KPA) composite filler to PMMA denture base materials on their mechanical properties, antimicrobial activity and water sorption behavior. Specimens of PMMA were modified with different concentrations (0%, 1%, 2.5% and 5 wt%) of Ag–Zn–KPA composite. Flexural strength, impact resistance, surface hardness and water sorption tests according to ISO 20795-1 standards were performed for mechanical performance characterization. Antimicrobial activity was assessed by colony-forming unit (CFU) counts and inhibition zone against Candida albicans and Streptococcus mutans. Statistical comparisons were conducted with one-way ANOVA and Tukey post-hoc tests (α = 0.05). The incorporation of Ag–Zn–KPA exhibited significantly higher flexural strength and surface.hardness and higher antibacterial activity than PMMA resin (p < 0.05). The 2.5 wt% formulation provided the best combination of enhanced mechanical performance with controlled water sorption. The Ag–Zn–KPA-modi fi ed PMMA revealed a promising multifunctionality, showing mechanical durability, antimicrobial resistance and functional water retention. This composite system could represent an interesting and potentially clinically relevant improvement of denture base materials.
The purpose of the study was to assess the impact of pregnancy on the healing of oral wounds and the early implant osseointegration in a rabbit model. Rabbits were randomly allocated into pregnant and non-pregnant control, extraction, and immediate implant placement groups. Clinical healing was measured at days 3, 7, 14 and 28. Epithelialization, collagen deposition, angiogenesis and inflammatory response were assessed through histological analysis. The resonance frequency analysis (RFA) was used to measure the stability of implants and the histomorphometric bone-to-implant contact (BIC) was measured. The level of oxidative stress was measured by spectrophotometric methods such as malondialdehyde (MDA) and glutathione peroxidase (GPx). Throughout all groups, progressive healing of wounds was observed over time, and full mucosal cover was noted in all groups at day 14. Implant stability and BIC values increased significantly during the healing period (p < 0.001). The highest MDA levels were observed on day 3 and gradually declined over time, whereas GPx activity peaked on day 14 before returning toward baseline values. Significant differences were observed between pregnant and non-pregnant groups in most evaluated parameters (p < 0.05), indicating that pregnancy influenced healing dynamics and early implant osseointegration. Within the limitations of this experimental rabbit model, pregnancy appeared to influence oral wound healing and early implant osseointegration through modulation of angiogenesis, immune response, and oxidative stress regulation. These findings highlight the importance of systemic physiological conditions in peri-implant healing dynamics.
To compare the accuracy of surgical guides manufactured with two different 3D printers, two resins, two different occlusal designs (OS: original shape, and GS: groove sealing), and interactions of these factors were used. Forty surgical guides were printed on a digital light processing (DLP) printer and a Liquid Crystal Display (LCD) printer, with two resin types (SG guide and V-guide) and two occlusal designs. The region where the implant was planned was digitally removed from the cast, allowing passive positioning of the implant through the guide. A scan body was inserted in the implant, and the cast was scanned with an intraoral scanner. The planned implant compared with the actual implant position. Six measurements representing the accuracy of implant placement: (depth, angular, global apical, horizontal apical, global coronal, and horizontal coronal) deviations. Descriptive statistics and a multivariate analysis of variance (MANOVA) were conducted. Printer type had a statistically significant multivariate effect (Wilks’ Lambda = 0.015, p< 0.001, Partial η² = 0.985). The resin type had no multivariate effect on the combined dependent variables, as indicated by Wilks’ Λ = 0.727, p = 0.161. Occlusal shape showed a significant multivariate effect (Wilks’ Lambda = 0.015, p<0.001). The univariate tests revealed that printer type and the shape of the occlusal surface had a statistically significant effect on all six deviation parameters (p < 0.001 for all); however, resin type had a significant effect only on horizontal coronal deviation (p = 0.018). The multivariate analysis using Wilks’ Lambda revealed a significant interaction effect between printer and resin (Wilks’ Λ = 0.593, F (6,27) = 3.094, p = 0.019, Partial η² = 0.407), A significant interaction was also observed between printer and occlusal design (Wilks’ Λ = 0.445, F (6,27) = 5.606, p = 0.001, Partial η² = 0.555) and between printer, resin, and occlusal surface (Wilks’ Λ = 0.414, F (6,27) = 6.380, p < 0.001, Partial η² = 0.586). The DLP printer group and groove sealing group were more accurate than the LCD printer, and occlusal surface group. The accuracy of both SG and V-guide resins was the same.
This study aimed to evaluate salivary sodium, potassium, cobalt, and iron as a multi-element biomarker profile for non-invasive stratification of periodontal disease and to investigate electrolyte–trace element interactions in relation to periodontal inflammatory and structural parameters. This comparative cross-sectional study included 90 adults equally classified into periodontally healthy, gingivitis, and periodontitis groups. Unstimulated whole saliva samples were collected using the passive drool method, and salivary sodium, potassium, cobalt, and iron concentrations were measured by atomic absorption spectrophotometry. Clinical periodontal parameters included bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL). Group comparisons, post-hoc testing, correlation analysis, inter-element correlation analysis, and receiver operating characteristic (ROC) curve analysis were performed. Salivary sodium increased progressively from periodontal health to gingivitis and periodontitis (16.64 ± 2.33, 20.50 ± 2.55, and 22.39 ± 3.23 mmol/L, respectively; p < 0.001), whereas potassium decreased across the corresponding groups (12.36 ± 1.32, 10.65 ± 1.77, and 10.38 ± 2.30 mmol/L, respectively; p < 0.001). Cobalt and iron were also reduced in disease groups compared with healthy controls, decreasing from 0.28 ± 0.09 to 0.21 ± 0.09 and 0.18 ± 0.09 µg/dL for cobalt, and from 47.63 ± 11.03 to 34.40 ± 8.89 and 30.77 ± 11.35 µg/dL for iron, respectively (both p < 0.001). Sodium showed the clearest progressive discriminatory pattern across the three periodontal groups, while potassium, cobalt, and iron mainly distinguished periodontal health from disease. Sodium was positively correlated with BOP (r = 0.565, p < 0.001), whereas potassium (r = -0.316, p = 0.002), cobalt (r = -0.314, p = 0.003), and iron (r = -0.468, p < 0.001) were negatively correlated with BOP. None of the salivary elements showed significant correlations with PPD or CAL within the periodontitis group. Inter-element analysis showed that sodium and potassium, cobalt, and iron were all negatively correlated whereas potassium, cobalt, and iron were positively correlated with each other. ROC analysis showed the best diagnostic performance for sodium, with the most significant difference between healthy controls and periodontitis noted (AUC = 0.932, sensitivity = 83.3%, specificity = 86.7%). Periodontal disease was correlated with a coordinated multi-element salivary profile characterized by elevated sodium levels and concurrent reductions in potassium, cobalt, and iron. This elemental remodeling pattern was more related to periodontal inflammatory burden rather than structural periodontal destruction. Multi-element salivary biomarker profiling may serve as a promising non-invasive adjunct for periodontal disease stratification, although further validation in larger and demographically balanced cohorts is required.
