The purpose of this study is to analyze the microbiota of patients undergoing orthodontic treatment with multibrackets and transparent aligners. The second goal is to evaluate the effectiveness of the oral irrigator on the oral hygiene and periodontal health of orthodontic patients. Fifty patients (27 F, 23 M; mean age 21.5 years) were recruited for the study, then divided into two groups. Group A underwent fixed orthodontic therapy with multibracket, and a home protocol that included manual orthodontic toothbrush, interdental brushes, and one-tuft brushes. Group B used transparent aligners for 22 h a day and a home protocol that included a manual brush with soft bristles and dental floss. After 3 months, all patients of the two groups, A and B, underwent plaque evaluation with a phase-contrast microscope. If the test result showed non-pathogenic bacterial flora, the subject continued with the traditional home oral-hygiene protocol. If the test detected pathogenic flora, the subject changed the home protocol, with a sonic toothbrush and oral irrigator, while the microbiological analysis continued to be performed after 3 months. After 3 months, 10 out of 25 patients treated with multibrackets (group A) and only 3 out of 25 patients with aligners (group B) passed from non-pathogenic flora to pathogenic flora. After 6 months, using the oral irrigator and a sonic toothbrush for 3 months, all subjects returned to non-pathogenic flora. This study confirms that in patients treated with multibrackets, the risk of developing unfavorable microbiota increases compared to those treated with clear aligners. The use of an oral irrigator combined with the sonic toothbrush seems to be able to restore good oral hygiene in subjects with pathogenic flora and therefore to be effective at reducing the risk of caries and gingivitis in orthodontic patients.

In periodontology, lasers have been suggested for the nonsurgical treatment of chronic periodontitis. Many wavelengths were tested, but unfortunately, most parts were not efficient. An Nd:YAG laser was applied in a specific protocol named the laser-assisted new attachment procedure (LANAP). LANAP seems to facilitate the refurbishment of new tissues from supporting structures of the periodontium, wherein the unhealthy surface of the roots exhibits pristine attachments in human beings. Photodynamic therapy (PDT) was investigated too. The aim of our study is to show the effects of oxygen high-level laser therapy (OHLLT) in removing all bacterial deposits on the root or implant surface by means of mechanical instrumentation and laser irradiation compared to LANAP and to nonsurgical debridement of periodontal pockets. At 7 days post-treatment, a real-time PCR test had similar results on the OHLLT and LANAP groups. After 9 months, all periodontal pockets were treated successfully, not showing significant differences in the clinical results between OHLLT and LANAP and with a decrease in the plaque index, bleeding on probing and probing depth compared with the nonsurgical debridement group.

Background: Impaction of maxillary canines is a frequent clinical challenge in orthodontics. Early diagnosis is key to effective management. Methods: This narrative review included studies published from 2004 to 2024. An electronic search was conducted in PubMed, Scopus, and Google Scholar (September–November 2024), using predefined eligibility criteria. The selection and drafting were completed in the following months. Studies involving orthopedic, orthodontic, or surgical-orthodontic management of impacted maxillary canines were included. Case reports and procedures limited to avulsion or transplantation were excluded. Results: A total of 10 studies were analyzed, comprising 5529 patients, of whom 2530 met the criteria for treatment-specific analysis. Surgical exposure with orthodontic traction was the most frequent treatment (72%), followed by monitoring (12%), maxillary expansion (6%), and extractions (10%). Interceptive approaches were mainly applied in patients aged 7–18 years, with favorable outcomes especially before age 12. In adults, more invasive treatments were required, often with reduced success rates. Conclusions: Early diagnosis and interceptive extraction of deciduous canines reduce treatment complexity and improve success. Therapeutic outcomes are strongly influenced by patient age, tooth position, and angulation. A structured, radiographically guided approach, supported by the proposed decision-making flowchart, may optimize clinical outcomes. However, heterogeneity of included studies and lack of long-term follow-up limit the strength of available evidence.

In peri-implantitis, treatment lasers are effectively used to enhance implant surfaces’ decontamination of bacteria. The type of lasers commonly used and tested in dentistry are Nd:YAG, Er:YAG and diodes. The Er:YAG laser is considered to be effective in removing biofilm from implant surfaces. Photodynamic therapy (PDT), realized with low-level laser therapy (LLLT) and a photosensitizer, seems to have limited efficacy in peri-implantitis management, while diode lasers used with high frequency and power (Wiser, Doctor Smile), performed with hydrogen peroxide 10 vol. 3% (OHLLT), seems to lead to a deep sanitization of implant surfaces, without any thermal effect. The aim of our retrospective controlled study is to compare an oxygen high-level laser therapy (OHLLT) protocol with OHLLT with an Er:YAG laser (Pluser, Doctor Smile) in order to maximize bacterial removal and to evaluate if an Er:YAG laser could improve hard tissue regeneration with respect to OHLLT alone. Two hundred and ten implants affected by peri-implantitis were divided into two groups: 88 implants were treated with OHLLT alone (control group) while 122 underwent OHLLT and Er:YAG treatment (test group). Mean bone loss before (T₀) and after treatment (T₁) (with a follow-up of 5 years) was registered for all implants. The collected data were analyzed with the Statistical Package for Social Sciences (SPSS) version 11.5. No statistically significant differences were found. In the OHLLT group, we noticed a mean bone loss after treatment of 2.1 mm in the upper arch and 2.4 mm in the mandible. In the OHLLT + Er:YAG group, the results indicate a mean bone loss of 2.0 mm in the upper arch and 2.5 mm in the mandible. Both groups showed a mean bone loss after treatment of 2.3 mm. According to the Kolmogorov–Smirnov test, overall, data followed a normal distribution (value of the K-S test statistic = 0.0912; p = 0.36112). OHLLT plays a central role in enhancing clinical results in peri-implantitis treatment, leading to an effective bacterial decontamination. Our results showed no statistically significant differences between OHLLT and OHLLT + Er:YAG laser; thus, the potential advantageous role of Er:YAG has been downgraded with the analysis of our study.

Background: Alzheimer’s disease is a slowly progressing neurodegenerative illness and the most common form of dementia. This pathology leads to an increase in cognitive decline and is responsible, in patients, for several difficulties in performing various activities of daily living, such as oral hygiene. Several experimental studies have shown that oral health in patients with Alzheimer’s disease worsens in direct proportion to the progression of the disease due to the appearance of gingivitis and periodontitis. Methods: This clinical literature review aims to evaluate a possible correlation between periodontal disease and Alzheimer’s disease, trying to understand if the periopathogens can contribute to the onset or the progression of Alzheimer’s disease (AD). The study was conducted on the database PubMed (MEDLINE) of full-text systematic reviews in English on humans and animals that were published in the last five years, from 2018 to 2023. This returned 50 publications, which, once the eligibility criteria were applied, resulted in the 10 publications examined in this review. The selected articles were organized through the construction of tables, analyzed, and compared through Judith Garrard’s Matrix method to arrive at the review results. Results: Infection by periopathogens can increase the risk of developing Alzheimer’s disease, but also the onset of the latter can make it more difficult to maintain proper oral hygiene, favoring the onset of periodontal disease: it is possible to affirm the existence of a correlation between periodontitis and AD. It was found that patients exposed to chronic periodontitis have a greater risk of developing a cognitive decline or AD and that oral pathogens can be responsible for neuropathologies and increasing systemic inflammation. Conclusions: Periodontitis and periodontal pathogens represent a real risk factor for the onset or worsening of AD; however, the pathogenetic mechanism is still not completely clear.

Background: Traumatic dental injuries (TDIs) are a common complication in sports, with an overall prevalence ranging from 0.71% to 60%. Kickboxing is a high-risk combat sport for trauma to the facial region. Methods: A total of 142 5-to-65-year-old amateur athletes participated in the survey with a questionnaire that was released during their regular practice days. The questionnaire was structured into three parts: (1) questions about age, gender, type, and time of sports practice; (2) questions about dental injuries, personal experience, and awareness of emergency management, particularly about tooth avulsion; (3) questions about wearing a mouthguard for TDI prevention. Results: A total of 13 percent of athletes suffered a TDI while training or fighting. Regarding first aid, 61% of the participants in this survey are aware of the possibility of replanting a tooth after its avulsion; 10% believe that the tooth should be replanted within 15 min, and 37% of athletes believe that it should be kept wet. The mouthguard is known to the majority of athletes (94%), and 66% were informed by the coach; 68% of the athletes use it. Seventy-four percent of the mouthguards were purchased in a sports shop. Conclusions: A relatively low prevalence of TDIs was observed in players in the sample. A lack of information about the emergency management of tooth avulsion and about the type of mouthguard to wear emphasizes the importance of educational training by dentists to athletes and coaches.