Monica Monea

Background/Objectives: Complex endodontic lesions characterized by significant periapical bone loss, diverse anatomical variations in the root canal system and apical resorption represent a major therapeutic challenge. Biodentine, a calcium silicate-based bioactive dental restorative material, has gained considerable attention because of its potential to promote and sustain the regeneration of bone tissue. This review aims to evaluate current evidence on Biodentine’s regenerative abilities in treatments of diverse endodontic pathology and highlight the clinical and radiographic outcomes. Material and Methods: A systematic review was conducted in accordance with PRISMA guidelines by searching for articles in three electronic databases: Medline (PubMed), Scopus, and Cochrane Library. Studies describing the application of Biodentine in cases of complex endodontic pathology with destruction of apical bone and apical resorption of roots were considered for inclusion in the study. Quality assessment was carried out using the Cochrane risk of bias assessment tool RoB 2.0. Results: The included clinical and radiographic studies demonstrated positive treatment outcomes after using Biodentine in difficult endodontic lesions, including a reduction in lesion size, improvement in symptoms and progression of periapical bone regeneration after 12 months of follow-up. No significant adverse outcomes were reported in the studies included. Conclusions: Biodentine proved to be an efficient biocompatible material in terms of managing complex endodontic lesions. Due to its bioactive properties and high efficiency as an apical plug, Biodentine is capable of inducing bone regeneration within the affected periapical area.

Periodontitis is a chronic inflammatory condition defined by the destruction of the tooth-supporting structures, in which the oxidative stress arising from an imbalance between reactive oxygen species production and antioxidant defence mechanisms plays an important role in disease pathogenesis and progression. Our study aims to review the role of oxidative stress in periodontal health, focusing on the clinical correlations and the impact of oxidative stress biomarkers on the severity of periodontitis. Materials and methods: A comprehensive search of PubMed Central and other scientific databases identified studies published between January 2010 and April 2024 investigating the association between oxidative stress and periodontitis. Using keywords such as “oxidative stress,” “periodontitis,” and “biomarkers,” relevant outcomes including levels of reactive oxygen species (ROS), antioxidant biomarkers, and clinical parameters such as probing depth and attachment loss were assessed. Results The findings indicate that oxidative stress markers, including malondialdehyde (MDA), 8-hydroxydeoxyguanosine (8-OHdG), and superoxide dismutase, are significantly elevated in patients with periodontitis compared to healthy controls. These biomarkers correlate with clinical measures of periodontitis severity, such as increased pocket depth and alveolar bone loss. Antioxidant levels were generally lower in periodontitis patients, reflecting impaired oxidative defence mechanisms. Conclusions The studies reviewed confirm oxidative stress as a key factor in periodontitis. Biomarkers like MDA and 8-OHdG may help assess disease progression and treatment success. Future research should explore antioxidant therapies to reduce oxidative damage in periodontal tissues.

Background and Objectives: Severe early childhood caries (S-ECC) is a chronic infectious disease with a multifactorial etiology which has not been completely elucidated. Research on the role of oxidative stress in the etiopathogenesis of oral diseases suggests that the level of local antioxidants plays an important role in determining susceptibility to caries. This study aimed to demonstrate that the host’s redox imbalance, modified by genetic polymorphisms, may influence the onset and severity of S-ECC. Materials and Methods: A total of 110 patients were included in the study (59 diagnosed with S-ECC and 51 healthy controls). Upon initial appraisal, the DMFT (decayed-missing-filled teeth) index was determined, and epithelial cells were collected using oral swabs for genomic DNA extraction. Genotyping of SOD2 (rs4880) and GPX1 (rs1050450) was performed using TaqMan SNP genotyping assays and real-time polymerase chain reaction (PCR). Results: According to the results of the present study, there was a significant difference between the frequency of the reference genotype and variants for rs4880 (p = 0.0303). Subjects carrying the AG and GG variant genotype of rs4880 were significantly associated with a high DMFT value (p = 0.0005). However, no significant difference was found between the genotypes for rs1050450, nor was there an association with the severity of S-ECC. Conclusions: The AG and GG variant genotypes of the SOD2 polymorphism (rs4880) increase the severity of caries in preschoolers and predispose patients to develop carious lesions, especially when associated with certain feeding practices and infrequent toothbrushing. This observation emphasizes that host sensitivity to caries is a crucial factor in the onset and development of carious lesions in primary dentition, despite the main contributing factors to this pathology. The rs1050450 polymorphism was not associated with the severity of S-ECC.

Aim of the study The purpose of this study was to determine the prevalence of S-ECC in a group of preschool children from Romania and to evaluate the role of socio-behavioral factors in association with this condition. Material and methods 337 children aged between 3 and 5 years were included in this study after determining the sample size. This study was conducted as a questionnaire combined with a clinical examination which determined the DMFT index. After collecting the data from the questionnaire, the socio-behavioral factors were statistically analysed into determining which ones were associated with a high DMFT index. Results The prevalence of S-ECC in this group of preschool children was 31.80%. Some social and behavioral factors were significantly related to S-ECC and to a high DMFT index score such as bottle feeding (p=0.0001), frequently consumed sweet treats (p=0.0001), and irregular dentist visits (p=0.03). On the other hand, the type of toothbrush used (p=0.30), frequency of toothbrushing (p=0.68), and the usage of fluoride toothpaste (p=0.59) were not statistically associated with S-ECC. Conclusions The prevalence of S-ECC among Romanian preschool children is high, and its development and progression are strongly associated with different oral hygiene practices, dietary habits and preventive measures.

Primary cutaneous melanoma (PCM) is the most aggressive skin malignancy, with an increasing incidence and significant mortality. Tumoral invasion, expressed as Breslow thickness, is routinely assessed on hematoxylin and eosin (HE), although this stain may sometimes underestimate the tumoral depth. The aim of this study was to compare the efficiency of the immunohistochemical (IHC) markers S-100, SOX10, Melan-A, and HMB-45 with HE for the evaluation of the Breslow thickness and staging of PCM. This retrospective study included 46 cases of PCM diagnosed between 2015 and 2022; for each case, the Breslow thickness using HE, S-100, SOX10, Melan-A, and HMB-45 was measured and the appropriate T category was recorded. The highest values of the Breslow thickness were observed for S-100. However, S-100, SOX10, and Melan-A provided statistically significant higher values of the Breslow thickness compared to HE, but no difference was noted between HMB-45 and HE. S-100 was most frequently involved in increasing the T category (26.1%), the majority of cases being upstaged from T1a to T1b. The IHC markers S-100, SOX10, and Melan-A contributed to better evaluation of the melanoma invasion, especially in thin melanomas, but their impact on staging and consecutive treatment remains to be confirmed by future studies.

Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with increased mortality, in which the early diagnosis is the most important step in increasing patients’ survival rate. Extensive research has evaluated the role of saliva as a source of diagnostic biomarkers, among which matrix metalloproteinases (MMPs) have shown a valuable potential for detecting even early stages of OSCC. The aim of this review was to present recent clinical data regarding the significance of salivary MMPs in the detection of early malignant transformation of the oral mucosa. A narrative review was conducted on articles published in PubMed, Cochrane Library, Web of Science, EBSCO and SciELO databases, using specific terms. Our search revealed that MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-10, MMP-12 and MMP-13 had significantly higher levels in saliva from patients with OSCC compared to controls. However, the strength of evidence is limited, as most information regarding their use as adjuvant diagnostic tools for OSCC comes from studies with a low number of participants, variable methodologies for saliva sampling and diagnostic assays, and insufficient adjustment for all covariates. MMP-1, MMP-3 and MMP-9 were considered the most promising candidates for salivary diagnosis of OSCC, but larger studies are needed in order to validate their clinical application.

Institutionalized children, regardless of their age, are prone to psychiatric disorders, compared to those who live in two-parent families, due to the unfavorable physical and psychological conditions in which they develop. Unpropitious psychological conditions affect the child’s general health and induce local manifestations that can be found in the oral cavity, affecting both soft tissues and teeth. Therefore, the purpose of our study was to assess and diagnose a series of pathological manifestations of the oral mucosa associated with poor living conditions or closely related to psychological stress. The clinical examination was performed by 4 specialist dentists, who consulted 150 children representing the study group and 52 children representing the control group, all having ages between 14 and 18 years old and meeting the same inclusion criteria. From the control group, 62.5% presented plaque-induced gingivitis (26.6% girls, 35.8% boys), 26.6% presented mucosal lesions produced by lip and cheek biting (23.3% girls, 35.8% boys), and 11.7% presented geographic tongue (6.6% girls, 5% boys), herpes simplex eruptions (3.3% girls, 4.2% boys) and oral ulcerations (12.5% girls, 10.8% boys). Morsicatio buccarul is a chronic, self-mutilating habit, currently becoming one of the most common tics encountered among institutionalized children. Furthermore, these children do not benefit from constant support and guidance to perform their dental hygiene, so the incidence of gingivitis induced by bacterial plaque and calculus is very high.

The presence of micronuclei in oral epithelial cells is considered a marker of genotoxicity, which can be identified using exfoliative cytology. The aim of this study was to investigate cytotoxic damage through the evaluation of micronuclei in the oral mucosa of smokers and e-cigarette users compared to nonsmokers. We obtained smears from the buccal mucosa of 68 participants divided in 3 groups (smokers, e-cigarette users and nonsmokers), which were further processed with Papanicolaou stain. The frequencies of micronuclei and micronucleated cells were recorded and statistically analyzed at a level of significance of p < 0.05. The mean micronuclei values per 1000 cells were 3.6 ± 1.08 for smokers, 3.21 ± 1.12 for e-cigarette users and 1.95 ± 1.05 for nonsmokers. The mean values of micronucleated cells per 1000 cells were 2.48 ± 0.91 for smokers, 2.39 ± 1.07 for e-cigarette users and 1.4 ± 0.68 for nonsmokers. Smokers and e-cigarette users had significantly higher values of micronuclei and micronucleated cells compared to nonsmokers, but there were no significant differences between smokers and e-cigarette users. We concluded that the micronuclei count can be used as an early indicator for alterations of oral mucosa and exfoliative cytology represents an accessible tool which could be applied for mass screening.

General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. The evaluation of 237 occlusal surfaces and caries risk assessment were performed in 96 children aged 7 to 15 years. The presence of pit-and-fissure noncavitated lesions was recorded using ICDAS-II scoring system and laser fluorescence. Statistical analysis was performed using McNemar test, with a level of significance of P < .05. The caries risk was measured for all participants. In 109 occlusal surfaces both methods identified enamel changes (46%) and in 62 cases both methods excluded the carious lesion (26.2%). The statistical analysis showed a significant moderate agreement between ICDAS-II code and DiagnoDent pen measurements (McNemar chi-squared statistic 9.5, P = .002 and Cohen kappa coefficient = 0.427). The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.