Objectives. The aim of this in vitro study was to observe through scanning electron microscopy (SEM) the surface morphology of root samples treated with different mechanical instrumentation methods and the additional application of a nano-colloidal silver-based antiseptic solution. Material and methods. Root samples were prepared from extracted molars and divided in four groups: group 1 of samples was instrumented with Gracey curette (7/8), group 2 of samples was instrumented with ultrasonic tip 1S, group 3 of samples was instrumented with ultrasonic tips 1S plus H4R/L, group 4 of samples was treated with ultrasonic tips 1S plus H4R/L and application of the silver-based antiseptic solution. All samples were then subjected to SEM examination. Outcomes. Group 1 of samples presented a smoother surface compared to the samples in the other groups. Group 2, 3 and 4 displayed superficial grooves parallel to the direction of action of the ultrasonic tip. In group 3 and 4, root planning with tip H4R/L did not ameliorate the smoothness of the surface. The smear layer was present, regardless the instrumentation method. In group 4, the additional application of the antiseptic solution did not influence the surface morphology or the amount of smear layer. Conclusions. Gracey curettes created a smoother radicular surface compared to ultrasonic tips. Smear layer was obvious on the radicular surfaces, no matter the instrumentation method. The application of the silver-based antiseptic solution had no additional impact on surface morphology.

Objectives. The aim of the present study was to evaluate the potential additional clinical benefit of a commercial nano colloidal silver-based local antiseptic used as irrigation solution after subgingival mechanical instrumentation. Material and methods. Periodontitis patients were treated following the current guidelines. Two randomly assigned hemiarches of each patient received subgingival mechanical instrumentation plus irrigations with the commercial product (experimental group); the other two hemiarches received mechanical instrumentation plus saline irrigations (control group). A clinical periodontal examination at baseline moment and after 3 months was performed. The parameters considered for analysis were oral hygiene index (IHI), bleeding on probing score (BoP), periodontal pocket probing depth (PD), gingival recession (GR) and clinical attachment level (CAL). 72 sites were included in the analysis, the site with the highest PD/quadrant for each patient. Data were analyzed using GraphPad Prism version 8.0.1 (GraphPad Software Inc., La Jolla, CA, USA). p<0.05 was set as statistical significance level. Outcomes. Eighteen periodontitis patients were treated. All clinical parameters improved at re-evaluation, compared to baseline, both in experimental and control group. The differences were statistically significant in terms of IHI, BoP and PD reduction. At re-evaluation, there were no statistically significant differences between periodontal parameters registered in the experimental and control sites. Conclusions. The present study failed to prove an adjunctive clinical benefit of the antiseptic product in the nonsurgical treatment of periodontitis. These results support the gold standard role of subgingival mechanical instrumentation in the periodontitis’ therapeutic protocol.

Lactoferrin is a cationic glycoprotein found in different compartments of the body and secreted mostly by glandular epithelia and neutrophils. Although initially considered that its functions derive solely from its iron-binding capacity, further research demonstrated the pleiotropic nature of the glycoprotein. Thereby, lactoferrin fulfills various essential physiological functions based on its anti-infectious, immunomodulatory and antioxidative properties. In the oral cavity, lactoferrin is an central component of the local defense mechanisms, and based on its versatility, it can prevent the occurrence and progression of different local pathologies, including periodontitis. Microbiological and inflammatory periodontitis-induced modifications influence the local levels of secreted lactoferrin, the protein becoming a potential diagnosis biomarker of periodontal disease. Moreover, lactoferrin has a potential adjunctive therapeutic benefit in periodontal treatment, based on the interference of the biomolecule with local microorganisms, its anti-inflammatory and antioxidative activity. Additionally, the adverse effects of lactoferrin administration seem less evident as compared to other adjunctive agents. Thus, the present study aims to review the most important characteristics of lactoferrin in different oral pathologies, particularly in periodontitis.

Periodontitis is a highly prevalent condition leading to a continuous destruction of tooth-supporting tissues. It increases the risk for various systemic diseases and adverse pregnancy outcomes. Therefore, screening for periodontitis is important. Screening measures can range from self-reported symptoms to clinical full-mouth periodontal examination. The hypothesis of our study was that self-reported parameters and clinical definition perform equally well in identifying periodontitis patients. The aim of this study was to develop, validate its internal consistency, and evaluate a self-reported instrument against periodontal clinical evaluation for diagnosis of periodontitis in a group of postpartum women, as well as to describe their periodontal status and the risk factors associated with periodontal disease. A cross-sectional study on postpartum women was conducted in a tertiary university hospital, from April 2018 to March 2019. Sociodemographic and behavioral data, periodontal clinical parameters, and self-reported periodontal perception were collected. A 16-item questionnaire was developed to obtain information about perceived periodontal alterations and oral hygiene habits. The utility of the questionnaire was tested against a periodontal diagnosis based on a full-mouth periodontal examination. The questionnaire was applied in 215 postpartum women aged 29.16±5.54 years (mean age (y) ± standard deviation) having the following periodontal status: 16 individuals without periodontal disease (7.44%), 32 individuals with gingivitis (14.88%), 19 individuals with mild periodontitis (8.84%), 132 individuals with moderate periodontitis (61.39%), and 16 individuals with severe periodontitis (7.44%). A significant association was observed between oral hygiene score, smoking status, and periodontal conditions (p<0.05). A significant association between the self-reported items related to “gum swelling”, “halitosis”, “previous periodontal diagnosis” and “previous periodontal treatment” with clinical periodontitis have been identified (p<0.05). Using self-reported questionnaires for detection of periodontal disease was ineffective in our studied population, since self-reported parameters and clinical definition do not appear to perform equally in identifying periodontitis cases. Clinical periodontal examination remains the gold standard for screening. Periodontitis was frequent in our group and the severity was significantly associated with the oral hygiene score and smoking. These results underline the necessity for periodontal clinical examination during pregnancy.

In this study, we examined the effects of injectable platelet-rich fibrin (iPRF) on proliferation and osteodifferentiation in mesenchymal stem cells (MSCs) isolated from human gingiva.Gingival MSCs (gMSCs) were grown in experimental culture media with different concentrations of iPRF [5%, 10%, and replacement of fetal calf serum (FCS) in the standard media with 10% iPRF-10% iPRF-FCS].Immunophenotyping of gMSCs was performed after seven days by flow cytometry, and their proliferation was examined after three and seven days using the Cell Counting Kit-8 method.After 14 days in culture, spontaneous osteogenic differentiation of gMSCs was evaluated via real-time polymerase chain reaction.All gMSCs were positive for cluster of differentiation (CD) 105, CD73, CD90, and CD44, and negative for CD34/45, CD14, CD79a, and human leukocyte antigen, DR isotype (HLA-DR).Reduced expression of some surface antigens was observed in the gMSCs grown in 10% iPRF-FCS medium compared to the other groups.After three days, gMSCs grown in 10% iPRF had proliferated significantly less than the other groups.After seven days, proliferation was significantly higher in the 5% iPRF cells compared to the control, while proliferation in the 10% iPRF and 10% iPRF-FCS groups was significantly lower.No spontaneous osteogenic differentiation was observed in the presence of iPRF, as observed by low runt-related transcription factor 2 (RUNX2) expression.Some expression of secreted protein acidic and cysteine rich (SPARC) and collagen 1 alpha (COL1A) was observed for all the gMSCs regardless of the culture medium composition.gMSCs grown in 10% iPRF had significantly lower SPARC expression.In conclusion, 5% iPRF stimulated gMSC proliferation, and an excessively high concentration of iPRF can impair osteogenic induction.

The main goal of periodontal regenerative techiques is to recreate the soft and hard lost tissues for functional and aesthetic reasons. Because of the complexity of this proccess (multiple celular types that need to be stimultated in a particular time sequence for recreation of all four periodontal tissues), periodontal regenerative techniques are still inconsistant and unpredictable. In the last decades, the tendency in surgical periodontal approaches is to use autologous products like platelet concentrates, because of their high content in growth factors that improve the healing proccess and promote tissue regeneration. The existing scientific proofs on this matter are yet insufficient for reliable clinical conclusions upon the use of platelet concentrates in periodontal surgical therapy.