Rok Gašperšič

Background: Dental procedures generate dental spray that can transmit microorganisms. Substituting conventional coolants with antiseptics may mitigate this risk by preventing the transmission of infectious particles at the source. The aim of this in vitro study was to evaluate the efficacy of electrolyzed saline (EOS), a hypochlorous acid (HOCl) based antiseptic as a coolant for mitigating bacterial spray deposition during ultrasonic scaling (USS) in stimulated dental procedure. Methods: The bactericidal activity of EOS (pH 7.0, 200 ppm) and 0.2% chlorhexidine digluconate (CHX) was tested against Streptococcus mitis, Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae using a static antibacterial assay. Changes in bacterial morphology were visualized using transmission electron microscopy. A bacteria-laden dental spray model was used to simulate a patient undergoing plaque debridement procedure with ultrasonic scaler in standardized airborne transmission tunnel. Due to safety concerns, pathogen-free consortium of oral streptococci was used. Mitigation of bacterial deposition was quantified using a culture-based method. In addition, the biocompatibility of antiseptics was tested with exposure to human gingival fibroblasts (hGF) and human gingival keratinocytes (hOK). Results: In the static assay, CHX reduced all tested bacteria species to ≤10 CFU/mL within 10 s of exposure, irrespective of the presence of saliva. In contrast, EOS was generally less effective after 10 s but exhibited near-complete antibacterial activity after 30–60 s, with delayed efficacy in the presence of saliva. During USS procedures, no culturable bacteria were detected in splatter generated with either CHX or EOS. However, compared with saline EOS reduced bacteria-laden droplets/aerosol (CFU/cm ² ) deposition by 92% vs. 81% with CHX (both, p < 0.001), with no significant difference between the antiseptics ( p = 0.607). Both antiseptics effectively reduced bacterial deposition at short range. Nevertheless, only EOS maintained consistent mitigation efficacy over greater distances dominated by aerosol. EOS exhibited minimal cytotoxicity to hGF and moderate effects on hOK, while CHX substantially reduced viability of both cell types. Conclusions: EOS demonstrated rapid contact-bactericidal activity and comparable dental spray deposition reduction to CHX. As a reasonably biocompatible, broad-spectrum agent, EOS may represent a promising coolant candidate for infection prevention control, warranting further clinical evaluation.

Background/objectives: Zirconia dental implants are increasingly recognised as an alternative to titanium implants due to their biocompatibility and aesthetics. Initially developed as one-piece systems, zirconia implants have evolved into two-piece designs with different platform levels; however, comparative data on their primary and secondary stability– particularly as assessed by resonance frequency analysis (RFA)—and marginal bone dynamics remain limited. This case series aimed to evaluate the implant stability and marginal bone changes of two-piece zirconia implants with bone-level (BL) and tissue-level (TL) platforms in patients missing maxillary premolars. Methods: Thirteen zirconia implants (n = 13; 7 BL, 6 TL; Z5-TL/Z5-BL, Z-Systems, Switzerland) were placed in 11 patients with healed ridges. The implant stability quotient (ISQ) was measured immediately after insertion and before prosthetic loading. Lithium disilicate crowns were cemented after four months, and follow-ups were conducted for an average of 35 months (SD = 12). Results: Initial ISQ values ranged from 73 to 79, increasing to 76–84 at 3–4 months, indicating high implant stability for both BL and TL implants. The extent of marginal bone loss (MBL) after two years was greater around BL implants (mean 0.46 mm) compared to TL implants (mean 0.2 mm), although probing depths and bleeding on probing remained minimal in both groups, with only one TL implant showing gingival recession. Conclusions: Over a short observation period, two-piece zirconia implants with tissue-level platforms appeared to demonstrate superior marginal tissue stability. Further, larger-scale controlled studies are required to confirm these preliminary observations.

Background/Objectives: Periodontitis is an inflammatory disease induced by bacteria in dental plaque that can activate the host’s immune-inflammatory response and invade the bloodstream. We hypothesized that a higher periodontal inflamed surface area (PISA) is associated with higher levels of inflammatory biomarkers, lower levels of antioxidants, and mitochondrial DNA copy number (mtDNAcn). Methods: Using periodontal parameters, we calculated the PISA score, measured the levels of inflammatory biomarkers and antioxidants in the serum, and took buccal swabs for mtDNA and nuclear DNA (nDNA) extraction. Results: Higher PISA was associated with higher CRP levels, higher leukocyte, neutrophil, and erythrocyte counts, and lower magnesium-to-calcium ratio, but not with mtDNAcn. A higher number of deep pockets was associated with higher leukocytes and neutrophil counts and higher uric acid levels. Conclusions: The PISA score might be an appropriate parameter to assess the inflammatory burden of periodontitis, but not to assess mitochondrial dysfunction after mtDNA isolation from buccal swabs.

Objective: The present systematic review and meta-analysis aimed to evaluate the periodontal health of systemic sclerosis patients compared with non-systemic sclerosis controls. Materials and methods: Online databases were searched for eligible studies on February 24, 2023. The primary outcomes of interest in systemic sclerosis patients and controls included the clinical attachment level, periodontal probing depth, recession depth, plaque index, bleeding on probing score, gingival index, number of teeth with periodontitis, prevalence of periodontitis and gingivitis, and extent and severity of periodontitis. Results: Fourteen studies met inclusion criteria and were incorporated in the qualitative and quantitative analysis. In comparison with the controls, systemic sclerosis patients had a higher prevalence of periodontitis (OR = 7.63 (1.74–33.50), p = 0.04, I² = 69%), including more severe forms of periodontitis (OR = 6.68 (3.39–13.15), p = 0.85, I² = 0%), as well as higher periodontal probing depth ((0.88 (0.45–1.31), p = 0.02, I² = 99%)), clinical attachment level (1.22 (0.8–1.64), p = 0.003, I² = 98%), and plaque presence (0.83 (0.13–1.53), p = 0.03, I² = 96%). There was no statistically significant difference in gingival inflammation (1.14 (0.07–2.21), p = 0.04, I² = 98%). Conclusions: The systematic review and the meta-analysis showed that systemic sclerosis patients suffer from worse periodontal health than non-systemic sclerosis individuals.

Purpose: To evaluate the 3-year success and survival rates of fixed prostheses supported by 4-mm extra-short implants splinted to 10-mm implants in patients with shortened maxillary arches and low maxillary sinus floors. Methods: A total of 11 patients with reduced alveolar bone heights ...

The report describes the rehabilitation of a maxillary arch with limited bone volume in a 67‐year‐old female taking antiresorptives due to osteopenia. One 10‐mm and two extra‐short 4‐mm implants were inserted, and implant‐supported splinted crowns were fabricated. The 5‐year follow‐up showed stable bone levels, despite poor initial stability (ISQ: 14–51).

Objectives: To determine if minimally invasive non-surgical therapy (MINST) outperforms classical non-surgical periodontal therapy for stage III periodontitis with primarily suprabony (horizontal) type defects. Materials and methods: In a split-mouth randomised controlled trial, 20 patients’ dental quadrants were randomly assigned to MINST or classical non-surgical treatment. The primary outcome variable was the number of sites with probing pocket depth ≥ 5 mm and BOP. Treatment method, tooth type, smoking status, and gender were evaluated using a multivariate multilevel logistic regression model. Results: After 6 months, the percentage of sites with PD ≥ 5 mm and BOP that healed (MINST = 75.5%; control group = 74.1%; p = 0.98), and the median number of persisting sites (MINST: 6.5, control group: 7.0; p = 0.925) were similar in both groups. In the test and control groups, respectively, median probing pocket depths (2.0 mm vs. 2.1 mm) and clinical attachment level (1.7 mm vs. 2.0 mm) changed significantly (p < 0.05) but similarly. Significantly less gingival recession occurred in the MINST group’s deep molar pockets compared to the control group (p = 0.037). Men (OR = 0.52, p = 0.014) and non-molars (OR = 3.84, p 0.001) had altered odds for healing of sites with PD ≥ 5 mm and BOP. Conclusions: MINST reduces gingival recession associated with molar teeth, although it performs similarly to traditional non-surgical therapy in treating stage III periodontitis with predominately horizontal-type defects. Clinical relevance: MINST performs similarly to non-surgical periodontal therapy in stage III periodontitis with predominantly suprabony defects. Trial registration: Clinicaltrials.gov (NCT04036513) on June 29, 2019.