In Vivo Validation of a Nanostructured Electrospun Polycaprolactone Membrane Loaded with Gentamicin and Nano-Hydroxyapatite for the Treatment of Periodontitis.

The aim of this research was to validate the use of a gentamicin (GEN) and nano-hydroxiapatite (nHAP)-loaded polycaprolactone nanostructured membrane (NM) as an innovative, highly efficient, low-cost treatment for periodontitis. We conducted an in vivo study on Wistar rats, in which we induced periodontitis by placing silk ligatures around the first right and left upper molars. The subjects were divided into three groups; the first group received no periodontal treatment, the second group received open flap debridement, and the third group received open flap debridement, together with the positioning of the GEN and nHAP-loaded nanostructured membrane as a treatment. The extent of periodontal regeneration was assessed by the periodontal pocket depth, bleeding on probing, tooth mobility, dental plaque, microbiological analysis, concentration of MMP-8 in saliva, plasma levels of CRP, and histological analysis. The results showed that using open flap debridement with the NM is more efficient, and it significantly reduces the probing depth, extent of bleeding on probing, dental mobility, bacterial plaque, and pathogenic flora. The concentrations of MMP-8 and CRP decrease. The histological analysis demonstrated that NM leads to bone regeneration. Our study indicates that gentamicin and nano-hydroxyapatite embedded in the fiber of the biodegradable membranes might be a promising therapeutic option for periodontitis treatment.

Correlations between Dental Implant Infectious Pathologies and Maxillary Sinusitis: A Review Article.

(1) Background: The demands of patients for aesthetic and functional rehabilitation of edentulous areas led to the use of dental implants as therapeutic means on an increasingly large scale. This aspect determined the appearance of some infectious pathologies with a peri-implant starting point that can be complicated by various sinus diseases. The purpose of this review article is to synthesize the existing information in the specialized literature regarding the existing correlations between peri-implant and maxillary sinusitis. (2) Methods: The articles published in five databases were researched using different combinations of search terms. We selected 12 articles from the 250 found, by applying the inclusion and exclusion criteria and removing duplicates. (3) Results: We analyzed the included studies and we found that all of them reported a positive correlation between maxillary sinusitis and peri-implant infectious diseases. There are also reported other pathologies with a peri-implant infectious disease as a starting point such as abscesses, oro-antral communications, or foreign body reactions due to implant or bone graft materials migration. (4) Conclusions: This scoping review highlighted the existence of correlations between peri-implant and sinus pathology and the importance of preventing peri-implant diseases of an infectious nature to avoid the occurrence of these complications.

Platelet rich fibrin as a gingival tissue regeneration enhancer.

Tissue regenerative procedures aim to enhance regeneration of altered tissue. Extensive research has been carried out in this area and all proposed procedures present limitations. In this context the area of platelet-rich fibrin (PRF) research has gained tremendous awareness in the latest years. PRF is a low-cost regenerative modality that facilitates soft tissue regeneration derived from 100% autologous sources. It forms a fibrin mesh that liberates growth factors in a slow and prolonged manner and also contains supra-physiological concentrations of leukocytes. Reports from the literature have suggested that these leukocyte-rich blood-preparations are capable of improving wound healing, diminishing post-operative pain, and additionally minimizing the risk of infection. In our article we present the first clinical case where PRF was used as a wound healing accelerator of gingival lesions in a chemical soft tissue burn after teeth whitening.

Diagnostic and therapeutic approaches in oral cavity granulomas based on new data concerning their origin and pathogenesis.

Giant cell granulomas in the oral cavity are reactive hyperplastic lesions that arise either peripherally in the mucoperiosteum or centrally in the bone. The peripheral giant cell granuloma (PGCG) is a benign lesion induced by local chronic irritation. It may develop at any age, and tends to be more frequent in females. Central giant cell granuloma (CGCG) is a reactive lesion of unknown etiology. It commonly occurs in children and young adults. It is also predominant in females and frequently located in the anterior part of the mandible. Histologically, PGCG and CGCG have similar features. The lesions are non-encapsulated proliferations of oval and spindle-shaped mononuclear cells (MCs) and multiple multinucleated giant cells (MGCs) in a vascular supporting stromal tissue, associated with foci of hemorrhage. Despite the similar microscopic features, PGCG and CGCG have different clinical behavior. PGCG is usually reduced in size and asymptomatic. It grows locally, as an exophytic lesion on the alveolar mucosa, but may become slightly infiltrative in the underlying periosteum and bone. After complete excision and curettage, it has a low recurrence rate. Contrarily, CGCG has an aggressive behavior, with rapid growth and intense osteolytic activity causing perforation of the cortical plate, teeth malposition and pain. Moreover, it is characterized by a high recurrence rate. This review focuses on the origin and activating pathways of MCs and MGCs, discusses the mechanisms underlying their biological activity, tries to explain the variable clinical behavior and proposes therapeutic approaches for the granulomas associated with the jaw bones.