Periodontitis is among the most common health conditions and represents a major public health issue related to increasing prevalence and seriously negative socioeconomic impacts. Periodontitis-associated low-grade systemic inflammation and its pathological interplay with systemic conditions additionally raises awareness on the necessity for highly performant strategies for the prevention and management of periodontitis. Periodontal diagnosis is the backbone of a successful periodontal strategy, since prevention and treatment plans depend on the accuracy and precision of the respective diagnostics. Periodontal diagnostics is still founded on clinical and radiological parameters that provide limited therapeutic guidance due to the multifactorial complexity of periodontal pathology, which is why biomarkers have been introduced for the first time in the new classification of periodontal and peri-implant conditions as a first step towards precision periodontics. Since the driving forces of precision medicine are represented by biomarkers and machine learning algorithms, with the lack of periodontal markers validated for diagnostic use, the implementation of a precision medicine approach in periodontology remains in the very initial stage. This narrative review elaborates the unmet diagnostic needs in periodontal diagnostics, the concept of precision periodontics, periodontal biomarkers, and a roadmap toward the implementation of a precision medicine approach in periodontal practice.

Peri-implant diseases are an emerging public health problem, and it’s considered that limitations of standard diagnostics play the role herein. The study objective was the estimation of pathological bone resorption at clinical and biological level in patients with peri-implant mucositis (PIM) and peri-implantitis (PI) before and 6 months after standard treatment and to compare them with healthy controls (HC). The split-mouth interventional study included 60 patients affected with PIM or PI. Patients that also presented at least one more HC were enrolled in the study and underwent standard non-surgical and surgical treatment, respectively. Standard clinical parameters and soluble levels of RANKL were measured in peri-implant crevicular fluid baseline and 6 months following treatment. Clinical parameters and RANKL significantly decreased following treatment in PIM and PI. However, bleeding on probing and probing depth remained significantly increased when compared to HC. RANKL answered requests for biomarker of peri-implant diseases, its baseline levels were significantly increased in PIM and PI, they decreased following treatment and reached HC in peri-implantitis, while in PIM RANKL remained significantly increased. Presence of pathological bone resorption in patients lacked its clinical signs, and respective persistence following treatment suggest the need for biomarker-supported diagnosis for timely diagnosis of peri-implantitis and appropriate orientation of respective management strategies.

Preterm birth is defined as a delivery prior to the completed 37th week of gestation. Literature data suggested that periodontal processes may influence to the feto-placental unit and induce preterm delivery. The degree of the periodontal disease is influenced by secretor status. Pro-inflammatory cytokines are involved in periodontitis as well as in delivery. The combined influence of these factors on the risk of preterm birth has not been explored. The aim of our study was to investigate the associations between periodontal diseases, secretor status, and IL1-ß and PGE2 levels in women delivered preterm. Material and methods. The study included 56 preterm delivery women and 56 women delivered at term as a control group, aged between 17 and 41 years. Periodontal examination, blood and saliva sampling were performed within 48 hours following delivery. Secretor phenotype was determined by Hemagglutination Inhibition method. The concentrations of IL1-ß and PGE2 were measured by High Sensitivity enzyme-linked immunosorbent assay. Results. In the pre-term birth group we had 66.1% of women with periodontitis, while in the control there were 12.5% (p<0.01). Concentrations of IL1-ß and PGE2 in plasma were significantly higher in the non-secretor group of women who gave birth pre-term and had periodontitis comparing to other groups. There was a significant correlation between salivary levels of PGE2 and IL1-ß (R=0.416, p=0.017) and between the plasma concentrations of IL1 ß and PGE2 (R= -0.592, p<0.001) in preterm birth group. In women who delivered at term these correlations were failed to be found. Conclusion. Our results support the hypothesis that non-secretor phenotype and periodontitis are at least in part responsible for pathogenesis of preterm birth. This probability of negative impact of non-secretor status cannot be ignored. These findings support the need for additional research into the biology of human parturition.

Background and Objectives: Individuals with heroin-related opioid use disorder are at high risk of poor oral health and impaired oral health-related quality of life (OHRQoL). However, data on the determinants of OHRQoL in this population remain limited. This study aimed to assess oral health status and OHRQoL and to identify key predictors of OHRQoL among hospitalized patients with heroin-related opioid use disorder. Materials and Methods: A cross-sectional study was conducted among 97 hospitalized patients with heroin-related opioid use disorder. Data were collected through structured interviews and clinical oral examinations, including the Decayed, Missing, and Filled Teeth (DMFT) index and the Simplified Oral Hygiene Index (OHI-S). OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14). Spearman correlation and multiple linear regression analyses were performed to examine associations and identify predictors of OHRQoL. Results: Participants had poor oral health, with high DMFT (19.1 ± 6.1) and OHI-S (2.0 ± 1.2) scores. OHRQoL was markedly impaired, with a mean OHIP-14 score of 29.6 ± 7.0, particularly in the psychological and social domains. OHIP-14 scores were strongly correlated with DMFT (r = 0.754, p < 0.001) and OHI-S (r = 0.552, p < 0.001). Longer duration of heroin use was associated with higher DMFT scores, poorer oral hygiene, and greater OHRQoL impairment. Multiple linear regression analysis identified unstable housing/homelessness (β = 0.166, p = 0.012), DMFT (β = 0.624, p < 0.001), and OHI-S (β = 0.272, p = 0.007) as significant predictors of poorer OHRQoL. Conclusions: Individuals with heroin-related opioid use disorder experienced substantial oral health burden and impaired OHRQoL, strongly associated with caries experience, poor oral hygiene, and housing instability. These findings highlight the need to integrate prevention-oriented dental care into addiction treatment services and to address the broader social determinants of oral health.

Introduction/Objective. Antibiotics are essential drugs for treating bacterial infections; however, inappropriate use contributes to antibiotic resistance. This study aimed to assess the knowledge and attitudes of biomedical science students regarding risks associated with antibiotic use and the emergence of antibiotic resistance. Methods. This cross-sectional study was conducted using a questionnaire-based survey. A total of 195 biomedical science students participated, including 65 students each from medicine, pharmacy, and dentistry at the Faculty of Medical Sciences, University of Kragujevac. Participants anonymously completed a 15-item questionnaire covering sociodemographic characteristics and knowledge and attitudes related to antibiotic use and resistance. Data were analyzed using SPSS software, version 22. Results. The mean age of participants was 24.06 ± 1.1 years, and most respondents were female (80.5%). Nearly all students were familiar with the definition of antibiotics (98.5%), types of antibiotics (89.2%), and the concept of antimicrobial resistance (99.5%). The majority (75.9%) recognized antibiotic resistance as a major global health problem. Statistically significant differences were observed between medical and dental students, as well as between pharmacy and dental students. Concern about the impact of antibiotic resistance on personal health varied significantly among groups; 55.4% reported concern, while 33.3% were not concerned. Most respondents (96.4%) strongly agreed that responsible antibiotic use is a collective responsibility. Conclusion. Students across all study programs demonstrated good knowledge of antibiotic use and resistance but expressed a need for additional education. Curriculum revision during clinical training may improve application of knowledge in future clinical practice.