Chronic low-grade inflammation is a hallmark of aging and a major driver of metabolic and degenerative diseases. While systemic immune dysfunction has been widely investigated, the contribution of barrier tissues to persistent inflammatory signaling remains incompletely defined. The oral mucosa represents a uniquely exposed barrier, continuously challenged by microbial, mechanical, and metabolic stressors and characterized by a specialized immune architecture. Here, we synthesize current evidence supporting the oral barrier as an active immunometabolic interface linking local immune activation to systemic inflammatory tone. Spatially organized epithelial, neutrophil, and antigen-presenting cell (APC) compartments coordinate immune responses tightly coupled to metabolic reprogramming, including hypoxia-inducible factor-1α (HIF-1α)-dependent glycolysis and mitochondrial reactive oxygen species (mtROS) production. In parallel, the oral microbiota provides ligands and metabolites such as lipopolysaccharide (LPS), short-chain fatty acids (SCFAs), and succinate, which activate pattern-recognition receptors (PRRs), including toll-like receptors (TLRs) and the NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome, thereby sustaining nuclear factor kappa-light-chain-enhancer of activated B cell (NF-κB)-mediated inflammatory signaling. Barrier disruption and dysbiosis promote microbial translocation and persistent innate immune activation, while saliva and gingival crevicular fluid facilitate systemic dissemination of inflammatory mediators. Overall, sustained immunometabolic engagement at the oral barrier emerges as a key driver of chronic low-grade systemic inflammation and a potential therapeutic target in inflammaging.

TL1A and its receptor DR3 are key regulators of mucosal immune responses, but their role in periodontal disease is unknown. Herein, we investigated whether TL1A/DR3 signaling contributes to mucosal immune amplification and tissue-destructive inflammation in periodontitis using SAMP1/YitFc (SAMP) mice, which develop spontaneous ileitis and periodontal disease. DR3 deficiency markedly attenuated alveolar bone loss and improved periodontal architecture, restoring a phenotype comparable to healthy AKR (parental) controls. Gingival tissues from wild-type SAMP mice exhibited increased expression of both Tnfsf15 (encoding TL1A) and Tnfrsf25 (encoding DR3), with both positively correlating with disease severity. This was accompanied by elevated levels of IL-17, TNF-α, and IL-1β, and by increased numbers of CD4+ T helper cells and neutrophils. Conversely, SAMPxDR3-/- mice exhibited reduced inflammatory cytokine production and immune cell accumulation. These findings support a model in which the TL1A/DR3 axis is associated with amplification of mucosal immune responses in periodontal disease, linking effector T cell activation, increased cytokine production, and recruitment of innate immune cells. Altogether, our data identify the TL1A/DR3 cytokine-receptor pair as a potential regulator of inflammatory circuits that drive periodontal pathology. Blocking this pathway may provide a therapeutic modality for patients affected by chronic periodontitis.

Background and Aims The renin-angiotensin system (RAS) is known to modulate fibrosis, which is a common complication of ileal Crohn's disease. We tested the efficacy of losartan, an angiotensin receptor blocker, to treat intestinal fibrosis in relevant preclinical models of Crohn's-like disease.Methods Effector molecules of the RAS were mined in a large publicly available RNA-Seq dataset of intestinal biopsies from Crohn's patients and healthy individuals, and the presence of associated proteins was confirmed by immunohistochemistry in full-thickness intestinal tissues. Losartan's efficacy in altering mediators of the RAS and of fibrosis was tested in vitro using activated CCD-18Co fibroblasts, while its in vivo effects were investigated by administering losartan to SAMP1/YitFc (SAMP) mice, a well-described model of Crohn's-like disease that progressively develops both ileal-specific inflammation and fibrosis, using either therapeutic or maintenance of remission (treatment after dexamethasone) approaches.Results Angiotensinogen, an upstream regulator of the RAS, and the downstream effector, angiotensin II receptor type 1, expressed on target cells, are both increased in involved vs non-involved gut mucosa from Crohn's patients compared to healthy controls. In vitro, losartan suppresses the expression of molecules related to fibrosis, fibroblast-to-myofibroblast differentiation, collagen deposition, and cytoskeletal alterations. In vivo, losartan decreases both inflammation and fibrosis in SAMP mice with established disease, and prevents the reoccurrence of fibrosis following a novel relapse protocol.Conclusions Losartan, and other drugs targeting the RAS, may serve as an effective treatment to successfully dampen intestinal fibrosis during active inflammation, as well as prevent its progression after corticosteroid-induced remission in Crohn's patients.

Background and Objectives: Dysbiosis of the oral–gut axis is related to several extraintestinal inflammatory diseases, including endometriosis. This study aims to assess the microbial landscape and pathogenic potential of distinct biological niches during endometriosis. Materials and Methods: A microbiome meta-analysis was conducted on 182 metagenomic sequences (79 of fecal and 103 of vaginal origin) from women with and without endometriosis. Fecal and vaginal microbial diversity, differential abundance, and functional analysis based on disease status were assessed. Random forest, gradient boosting, and generalized linear modeling were used to predict endometriosis based on differentially enriched bacteria. Results: Only intestinal microbes displayed distinctive taxonomic and functional characteristics in women with endometriosis compared to control women. Taxonomic differences were quantified using the microbial endometriosis index (MEI), which effectively distinguished between individuals with and without the disease. The observed functional enrichment pointed to proinflammatory pathways previously related to endometriosis development. Conclusions: Dysbiosis in the oral–gut microbial community appears to play a prevalent role in endometriosis. Our findings pave the ground for future studies exploring the potential mechanistic involvement of the oral–gut axis in disease pathogenesis.

A growing number of in vitro and in vivo studies suggest the application of probiotics as a natural approach to maintaining oral health. This double-blind, randomized controlled trial aimed to evaluate the efficacy of Levilactobacillus brevis CD2 (CNCM I-5566), a multifunctional probiotic frequently used in oral medicine, in preserving or improving several recognized oral health indicators. Thirty consenting healthy adults were randomized to receive four lozenges per day of L. brevis CD2 probiotic (n = 15) or placebo (n = 15) over four weeks. Clinical parameters (full-mouth bleeding on probing (BoP) and plaque index (PI) scores) were recorded. Unstimulated saliva was collected to measure salivation rate, pH, and buffer capacity. Salivary biomarkers were analyzed, including glucose, D-lactate, and secretory immunoglobulins A (sIgA). Clinical and salivary parameters were assessed at baseline, after four weeks of intervention, and two weeks post-intervention. Wilcoxon rank-sum test and robust regression analysis were used for statistical comparisons. The possible mediating effect of PI on BoP changes was assessed. After four weeks, the probiotic group showed significant improvements in BoP and PI compared to baseline and placebo. The probiotic group had a higher salivation rate than baseline and placebo after four weeks of treatment and washout. While changes in salivary pH were not significant, buffering capacity increased in the probiotic group after four weeks of treatment and washout. Salivary glucose and D-lactate levels were lower in the probiotic group post-treatment and after washout. sIgA values increased and remained stable after washout in the probiotic group. No adverse effects were reported. The treatment with L. brevis CD2 significantly improved clinical and salivary parameters, supporting its efficacy as a probiotic for oral health. ClinicalTrials.gov , NCT06457724; Registered 7 June 2024 - Retrospectively registered; https://clinicaltrials.gov/study/NCT06457724?viewType=Table page=452 rank=4512#study-overview .

ABSTRACT Objectives The market offers many plaque‐controlling mouthrinse options, but recent research reveals fatty acids' antimicrobial potential. Despite limited evidence on their antiplaque effects, fatty acids are intriguing for oral care innovation. Material and Methods This noninferiority randomized clinical trial assessed the antiplaque efficacy of a fatty acids–based (FAG) compared to stannous fluoride (SF) mouthrinse in experimental gingivitis induced by 14 days of oral hygiene cessation. Participants used assigned treatments twice daily for 14 days. Full Mouth Plaque and Bleeding Scores (FMPS/FMBS) served as primary outcomes. Statistical analyses encompassed parametric and nonparametric methods, as well as logistic regression models. Results Thirty‐one volunteers (22.9 ± 1.6 years, 58.1 female) completed the trial, split between FAG (n = 15) and SF (n = 16) groups. Experimental gingivitis increased in both groups, with rates of 60.0% and 50.0% for FAG and SF, respectively. After the 14‐day intervention, FMPS and FMBS were reduced in both groups compared to the post‐induction phase, confirming the noninferiority of FAG. Specifically, FAG's FMPS was 39.7% ± 13.8% with FMBS at 28.9% ± 16.9%, while SF's FMPS was 43.2% ± 14.9% with FMBS at 21.4% ± 11.9%. No significant FMPS/FMBS differences were observed overtime, and there were also no significant differences in gingivitis rates throughout the trial. Crude and adjusted models, accounting for baseline FMPS, age and gender, reiterated the lack of significant association between outcomes and treatments. The adjusted odds ratio was 0.71 (p = 0.662). Conclusion This study establishes the noninferiority of fatty acids–based relative to SF mouthrinse in an experimental gingivitis model. Fatty acids offer promising avenues for oral care enhancement, necessitating further investigation and validation in broader real‐life scenarios.

Growing evidence supports the use of nitrate-reducing bacterial strains as probiotics to enhance the benefits of nitrate metabolism for both oral and systemic health. This study aimed to test the nitrate reductase activity of Levilactobacillus brevis CD2 (DSM-27961/CNCM I-5566), a strain widely used as a starter culture in fermented foods and recognized for its multifaceted health-promoting probiotic properties. We also sought to determine whether the probiotic lysate enhances nitrate reduction ex vivo using six salivary samples from healthy subjects while evaluating its potential influence on pH and buffering capacity. Considering the established link between lactate metabolism and nitrite production, we assessed the salivary levels of D-lactate after a 3-hour incubation with or without Lv. brevis. The results indicate that Lv. brevis CD2 exhibits significant intrinsic and concentration-dependent nitrate reductase activity. Additionally, treatment with Lv. brevis for 3 h significantly increased nitrite generation across all saliva samples, with further enhancement observed after the addition of exogenous nitrates. Lv. brevis also significantly improved salivary pH and buffering capacity, particularly when combined with nitrate. Furthermore, the probiotic treatment resulted in reduced levels of salivary D-lactate. To further support and validate our in vitro and ex vivo findings, we evaluated the oral nitrate-reducing activity in saliva samples from healthy individuals treated for four weeks with Lv. brevis CD2 lozenges. Of note, the results indicated that the probiotic group showed a significant increase in oral nitrate-reducing capacity compared to baseline and placebo after four weeks of treatment. Overall, our study suggests that Lv. brevis CD2 acts as a nitrate-reducing probiotic, providing new insights into its health benefits and complementing findings from previous studies.

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings.

Introduction:Chronic periodontitis is linked to systemic inflammation and cardiovascular risk, yet the temporal trajectory and magnitude of systemic cytokine reduction following nonsurgical-periodontal-therapy (NSPT) remain underexplored. We conducted a meta-analysis and spline-based meta-regression to assess whether intensive NSPT, compared to standard therapy, produces sustained reductions in circulating TNF-α, IL-1β, IL-6 and high-sensitivity C-reactive protein (hs-CRP). Methods:We systematically searched major databases for interventional studies published until January 2024 comparing intensive vs. standard NSPT on inflammatory markers. Using a custom R pipeline, standardized mean differences (SMDs), 95% confidence intervals (Cis) heterogeneity (I²) and stratified analyses by phenotype (e.g., smoking, diabetes) and time were performed. A spline-based mixed-effects meta-regression explored temporal dynamics of inflammatory reduction in the intensive group. Results:From 216 observations (14,374 paired values), intensive NSPT led to significantly greater reductions in TNF-α (SMD -0.59, 95% CI -1.02 to -0.16; P=0.008), IL-6 (SMD -0.20, 95% CI -0.39 to -0.00; P=0.046) and hs-CRP (SMD -1.17, 95% CI -2.18 to -0.16; P=0.024) compared to standard therapy. IL-1β showed a near-significant reduction (SMD -4.14, P=0.052). Standard therapy was paradoxically associated with greater CRP reduction (SMD -0.30, P=0.001). Age, tooth count and year of publication moderated effects. Early benefits emerged within 3 months for TNF-α and 6 months for IL-1β. Although no strong nonlinear time-response was confirmed (QM = 4.23, P=0.2372),a potential rebound in cytokine suppression was suggested. The overall anti-inflammatory effect remained significant. Discussion:Intensive NSPT reduces systemic inflammation particularly in younger, non-smoking individuals. The potential rebound in inflammatory markers underscores the need for longitudinal studies but, supports the systemic immunoregulatory effect of periodontal therapy. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO, identifier CDR42024503063.

Objectives:Evaluate the changes in oral microbiota linked to orthodontic treatment by analyzing the 16S rRNA gene. Materials and Methods:A total of 22 articles was included in the systematic review. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Risk of Bias tool for randomized studies. Results:Orthodontic appliances significantly influenced the composition of oral microbiota. Specifically, fixed orthodontic appliances were linked to an increase in periodontopathogenic bacteria associated with various systemic diseases. In contrast, transparent aligners correlated with an increase in Streptococcus species. Conclusions:In this study, we evaluated the changes in oral microbiota associated with orthodontic treatment by analyzing the 16S rRNA gene. Results revealed significant alterations in oral microbiota following orthodontic treatment; however, significant variability among studies prevents firm conclusions. Additional research is essential to clarify the effects on oral health.

Purpose: This study systematically analyzed the published literature to evaluate the reliability of the caries experience index detection conducted in children (younger than 18 years of age) through teledental systems, comparing it with data obtained through traditional dental consultations. The question to be explored was whether dentists could use teledentistry to assess the caries risk index by calculating the DMFT (decayed, missing, and filled permanent teeth) score, thereby potentially reducing consultation time. Methods: A systematic English-language literature review was conducted, including the period from 2014 to 2024, that included the MeSH terms (("telemedicine"[Mesh]) AND "dental caries"[Mesh]) AND "DMF index"[Mesh]). Inclusion and exclusion criteria were defined according to the PICO methodology. A total of 11 manuscripts met the inclusion criteria. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale (NOS) with specific tools for cross-over studies. Results: From the 11 studies reviewed, it was suggested that teledentistry, through the use of intraoral photographs or video recordings, may represent a reliable, noninvasive, and efficient alternative for the detection of the caries experience index, compared to clinical examinations performed according to the traditional method. In most cases, the results were comparable between the two approaches. Conclusion: Incorporating teledentistry in combination with regular dental appointments could streamline clinical processes, enable effective treatment planning, and facilitate remote monitoring of the oral health status of patients, making it a timely and contemporary solution for a connected and health-conscious society-which is particularly valuable during public health crises such as the COVID-19 pandemic.

Background: This study investigates the diagnostic reliability of an artificial intelligence (AI)-based software (Diagnocat) in caries, dental restorations, missing teeth, and periodontal bone loss on panoramic radiographs (PRs), comparing its performance with evaluations from three independent dental experts serving as ground truth. Methods: A total of 104 PRs were analyzed using Diagnocat, which assigned a likelihood score (0–100%) for each condition. The same images were independently evaluated by three experts. The diagnostic performance of Diagnocat was evaluated using sensitivity, specificity, and receiver operating characteristic (ROC) curve analysis, while inter-rater agreement was assessed through Cohen’s kappa (κ). Results: Diagnocat showed high overall sensitivity (99.2%), identifying nearly all conditions marked as present by human evaluators. Specificity was low (8.7%), indicating a tendency to overdiagnose. Overall accuracy was 96%, likely influenced by the coexistence of multiple conditions. Sensitivity ranged from 77% to 96%, while specificity varied: dental restorations (66%), missing teeth (68%), periodontal bone loss (71%), and caries signs (47%). The agreement was fair for dental restorations (κ = 0.39) and missing teeth (κ = 0.37), but poor for caries signs (κ = −0.15) and periodontal bone loss (κ = −0.62). Conclusions: Diagnocat shows promise as a screening tool due to its high sensitivity, but low specificity and poor agreement for certain conditions warrant cautious interpretation alongside clinical evaluation.

Background: A transverse discrepancy refers to a dimensional difference in the transverse component of the upper and lower dental arches with functional and esthetic implications. The main purpose of this study is to compare the effectiveness of transverse expansion movement of dentoalveolar nature performed by two innovative orthodontic appliances: elastodontic devices and clear aligners. Specifically, it is intended to determine which of the two methods is more effective in terms of dentoalveolar expansion in a sample of children with mixed dentition. Methods: In total, 29 patients aged 8 to 13 years with mixed dentition were included in the present study and divided into two groups according to a case–control scheme. Of the subjects, 15 (8 females and 7 males) represented the test group and were treated with Eptamed elastodontic devices, while the control group, consisting of 14 patients (12 females and 2 males), received a Spark aligner. The efficacy of the devices was evaluated by comparing cross-sectional measurements of the arch scans at time T0 (before the start of treatment), T1 (6 months after the start of treatment) and T2 (one year after the start of treatment) by measurement in mm of the distance between the palatal cusps of the first upper premolar (if missing, of the corresponding deciduous molar). Statistical analysis was conducted using a nonparametric approach with the Wilcoxon signed-rank test. Statistical significance was set at p < 0.05. The data resulting from the measurements were expressed as the mean (standard deviation). Results: No statistically significant difference was observed between the two groups at either T0 (p = 0.3), T1 (p = 0.78), or T2 (p = 0.66), thus allowing the conclusion that both treatment modalities are comparable. Conclusions: Both elastodontics and clear aligners proved to be effective devices in the treatment of transverse discrepancies of a dentoalveolar nature. Elastodontics also plays a crucial role in the rebalancing of stomatognathic and extrastomatognathic functions.

BACKGROUND:Trigeminal neurostimulation of the dorsal anterior mucosal surface of the tongue has been proposed to treat a variety of pathologies and to promote neuro-muscular coordination and rehabilitation. Dental ULFTENS can also be considered a form of trigeminal neurostimulation applied to the skin surface bilaterally at the level of the tragus. It has been used for years in dentistry for practical and diagnostic purposes. Previous work has combined the two stimulation techniques showing an efficacy in improving HRV in healthy young women of dental ULFTENS applied to the mucosal surface of the tongue. This work sought to assess whether there is a difference in HRV in relation to the site of application of dental ULFTENS (tragus vs. tongue). If effective in reducing the activity of arousal circuits, this tongue-level stimulation technique could have new clinical applications. MATERIAL AND METHOD:A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 80 healthy young women divided into two groups: TUD group (ULFTENS stimulation on the mucosa of the tongue) and Tragus group (stimulation with ULFTENS bilaterally in the area of the tragus). The effects on HRV were monitored by photoplethysmographic wave (PPG). The HRV parameters studied were RMSSD, HF, LF, LF/HF. RESULTS:Only the TUD group showed a significant change in selected HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and an increased of HRV parameter. The Tragus group did not show significant change in the direction of increased HRV but showed an opposite trend. There were no undesirable or annoying effects of stimulation. CONCLUSION:Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV while the same stimulation on tragus area, according to traditional dental ULFTENS procedure, did not show the same effects. CLINICAL IMPLICATIONS:This stimulation technique could be an aid in the diagnosis and treatment of disorders characterized by autonomic disequilibrium such as, in the dental field, TMDs. TRIAL REGISTRATION:"Effects of Trigeminal Neurostimulation on Heart Rate Variability: Comparing Tragus and Tongue Stimulation". ID number: NCT06549205. Date of first registration: August 1st 2024. https://clinicaltrials.gov/study/NCT06549205?id=%09NCT06549205&rank=1 .

AIM:This paper aims to verify the effectiveness of using elastodontic devices in the treatment of malocclusions in growing patients. An English-language literature search was conducted. The following electronic databases were selected for searching from 2020 to June 2023: PubMed, Web of Science, and Scopus. Eight articles were included based on the inclusion and exclusion criteria. The articles examined highlight the ability of elastodontic devices to act in cases of malocclusion in a safe, simple and more comfortable way for the young patient. However, there is a lack of knowledge about this technique, so this study aims to review the most recent literature to provide the scientific community with new knowledge.

Background: This study aimed to compare the clinical outcomes of using two different devices to treat upper palatal discrepancies evaluated with a digital intraoral scanner. Methods: A total of 64 patients were enrolled and treated with either an elastodontic expansion device (32 patient test group, 16 females and 16 males, mean age 7.08 ± 0.44) or Haas expander (32 patient control group, 16 females and 16 males, mean age 7.32 ± 0.50). The two groups exhibited similar orthodontic features. The orthodontic criteria were: skeletal class I relationship; molar class I relationship; complete eruption of upper sixths; presence of unilateral or bilateral cross bite. All dental casts were examined and subsequently scanned with an intraoral scanner (I-Tero) pre-treatment (T0) and 12 months after the onset of therapy (T1) to assess the distance between the decidous upper canines (ICW, intercanine width) and the distance between the mesiopalatal cusps of the upper first molars (IMW, intermolar width). For statistical analysis, the t-test for continous variables and the chi-square test for categorical variables were used, respectively. Results: There were no statistically significant differences between the mean and SD of the expansions that resulted from the Haas expander and the elastodontic devices (Haas expander vs. Eptamed: ICW_T1 (Haas) = 42.34 (3.09), ICW_T1 (Eptamed) = 42.69 (2.77); p = 0.743; IMW_T1 (Haas) = 34.22 (2.29), IMW_T1 (Eptamed) = 34.00 (2.56); p = 0.800). The two devices were similarly effective. Conclusions: Elastodontic devices and the Haas expander can successfully help the orthodontist to conduct upper arch expansion treatment. However, elastodontic devices are more comfortable during the resolution of palatal discrepancies compared to palatal expander devices.

Background: The main objective of this study was to compare the clinical efficacy of two different devices, the Eptamed elastodontic device and a common bite sold in pharmacies, by assessing a computer aid evaluation of patients' surface electromyography (sEMG) and kinesiography activity of four pairs of masticatory and postural muscles (anterior temporalis, digastricus, masseters and sternocleidomastoids muscles) before and after 6 months of treatment. Materials and Methods: Twelve adult patients with temporomandibular disorders and in need of orthodontic treatment were enrolled in the study and divided into cases and controls. Cases underwent orthodontic treatment with the Eptamed elastodontic device, while controls were treated with a bite sold in pharmacies. Both groups underwent electromyographic and kinesiographic examinations before and after 6 months from the start of treatment. Results: The Eptamed device was found to guarantee an improvement in the electrical activity of the muscles examined. The subjects in the control group, on the other hand, had a general worsening of electrical activity after wearing a splint purchased in a pharmacy. As for the kinesiographic examination, there was no significant improvement in both groups. Conclusions: the use of the Eptamed device in subjects with TMD ensured a greater relaxation of the chewing muscles than a standard bite, effectively reducing the risk of worsening the symptomatology of temporomandibular disorders.

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality worldwide with a high socioeconomic burden. Increasing evidence supports a convincing connection with increased cardiovascular risk of periodontal diseases (PD), a group of widespread, debilitating, and costly dysbiotic relapsing-remitting inflammatory diseases of the tissues supporting the teeth. Herein, we ensembled the best available evidence on the connection between CVDs and PD to review the recently emerging concept of the latter as a non-traditional risk factor for CVDs. We focused on oral dysbiosis, inflammation-associated molecular and cellular mechanisms, and epigenetic changes as potential causative links between PD and CVDs. The available evidence on the effects of periodontal treatment on cardiovascular risk factors and diseases was also described.

Background. Enamel plays an essential role in protecting the underlying layers of the human tooth; therefore, preserving it is vital. This experimental study aimed to evaluate the potential ability of L. brevis to counteract the action of a demineralizing agent on dental enamel morphology and mineral composition in vitro. Methods. The sample consisted of 12 healthy human posterior teeth. The coronal portion of each tooth was subdivided into two equal parts longitudinally. The specimens were randomly divided into four groups: artificial saliva, L. brevis suspension, demineralizing agent (DA), and DA plus L. brevis. Scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were used to evaluate the surface micromorphology and the mineral content, respectively. The statistical analysis was conducted using a one-way ANOVA, followed by Tukey’s post hoc test. Results. SEM analysis did not highlight significant changes in the enamel microstructure of L. brevis-treated specimens compared to the control. DA-induced damage to the enamel structure was drastically reduced when the specimens were contextually exposed to the probiotic. The treatment with DA substantially reduced the weight % of crucial enamel minerals, i.e., Ca and P. Notably, the probiotic was able to reverse the demineralization process, bringing Ca and P weight % back to basal levels, including the Ca/P ratio. Conclusions. The findings indicate that L. brevis is able to efficiently protect the dental enamel surface from the damage caused by DA and increase the enamel resistance to demineralization. Overall, L. brevis confirms its efficacy in preventing or counteracting the action of carious lesions through a novel mechanism that protects the tooth surface under a chemical challenge that mimics the caries process.