Periodontal diseases generally correspond to a disturbance in the balance between the host’s defense and the micro-organisms colonizing the periodontal environment. The exact mechanisms underlying the destruction of the periodontium remain to be fully elucidated. Our study aims to quantify the main bacteria pool involved in periodontal pathology and associate it with other factors involved in the onset of periodontal disease so that an accurate diagnosis with profound implications for the therapeutic algorithm can be developed. Micro-Ident tests, based on the polymerase chain reaction (PCR) technique, were used for the study group, chosen for their high specificity in identifying periodontopathogenic bacteria and determining their relative numbers. The results of our study indicate an increased concentration of 4.50 (number of strains) for Capnocytophaga, followed by Tannerella forsythia, in a concentration of 3.50; the next highest concentration percentages are for Treponemei denticola, and Prevotela intermedia, low concentrations were found for Fusobacterium nucleatum and Porphyromonas. The concentration of each type of bacteria is reflected in the clinical picture and constitutes the starting point for a targeted antibiotic therapy. Following the effects of antibiotic-targeted therapy obtained from the evaluation of the micro-IDent B test results on the periodontium of the supporting teeth, we observed that the values of the periodontal indices change slightly at 3-month intervals with a predominance of plaque, bleeding, and gingival indices, and less in the indices concerning the depth of the probing pocket and the loss of attachment on the buccal and oral surfaces. In conclusion, our study emphasizes a direct relationship between the subgingival tartar presence and the patients age, gingival recession, presence of periodontal pockets, dental mobility, as well as the periodontal indexes: plaque index, bleeding index, and gingival index. The correlation of negative values of periodontal indices with the nature of the involved bacteria materializes in relevant starting points in the elaboration of the periodontal diagnosis of the therapeutic plan and predictability of the prognosis of oral rehabilitation.

GLP-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes and obesity and are increasingly relevant in periodontal and implant practice. This review covers mechanisms, preclinical and early human evidence, and practical periodontal considerations; the structured database search is conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) and the International Committee of Medical Journal Editors (ICMJE) principles. Two pathways explain GLP-1RAs’ relevance: indirect effects from better glycemic control, weight loss, and reduced inflammation; and direct tissue effects involving GLP-1R signaling and the GLP-1/dipeptidyl peptidase-4 (DPP-4) axis. Preclinical studies show reduced inflammation, osteoclast activity, and alveolar bone loss, along with improved periodontal stem cell function under hyperglycemia or inflammation via Nuclear Factor-kappaB (NF-kappaB), Wingless-related integration site (Wnt)/beta-catenin, and Mitogen-Activated Protein Kinase (MAPK) pathways. Animal studies on implants and local delivery, including exendin-4 platforms, suggest osteometabolic benefits. Human data are limited and mostly observational, and confounders include metabolic status, smoking, medication, and nutrition. Oral side effects such as xerostomia and dehydration are also noted. At present, GLP-1RA therapy should be regarded as a contextual modifier of periodontal risk and healing capacity rather than as a stand-alone periodontal therapy.

Background: Early detection of dental caries is essential for effective oral health management. Current diagnostic workflows rely heavily on radiographic imaging, which involves infrastructure requirements, workflow coordination, and resource considerations that may limit frequent use in high-throughput or resource-constrained settings. These contextual factors motivate exploration of adjunct screening concepts that could support front-end triage decisions within existing care pathways. This study evaluates, in simulation, whether modeled tooth-percussion response signals contain sufficient discriminative information to justify further translational and managerial investigation. Implementation costs, workflow optimization, and economic outcomes are not evaluated directly; rather, the objective is to assess whether the technical preconditions for a potentially scalable screening concept are satisfied under controlled in silico conditions. Methods: An in silico model of tooth percussion was developed in which enamel, dentin, and pulp/root structures were represented as a simplified layered mechanical system. Impulse responses generated from simulated tapping were used to compute the modeled surface-vibration response (enamel-layer displacement), which served as a proxy for a measurable percussion-related signal (e.g., contact vibration), rather than a recorded acoustic waveform. Carious conditions were simulated through depth-dependent reductions in stiffness and effective mass and increases in damping to represent enamel and dentin demineralization. A synthetic dataset of labeled simulated signals was generated under varying structural parameters and measurement-noise assumptions. Machine-learning models using Mel-frequency cepstral coefficient (MFCC) features were trained to classify healthy teeth, enamel caries, and dentin caries at a screening (triage) level. Results: Under baseline simulation conditions, the classifier achieved an overall accuracy of 0.97 with balanced macro-averaged F1-score (0.97). Misclassifications occurred primarily between healthy and enamel-caries categories, whereas dentin-caries cases were most consistently identified. When measurement noise and structural variability were increased, performance declined gradually, reaching approximately 0.90 accuracy under the most challenging simulated scenario. These results indicate that discriminative information is present within the modeled signals at a screening (triage) level, meaning that higher-risk categories can be distinguished probabilistically rather than with definitive diagnostic certainty. Sensitivity and specificity trade-offs were not optimized in this study, as the objective was to assess separability rather than to define clinical decision thresholds. Conclusions: Within the constraints of the in silico model, simulated tooth-percussion response signals demonstrated discriminative patterns between healthy, enamel caries, and dentin caries categories at a screening (triage) level. These findings establish technical plausibility under controlled simulation conditions and support further investigation of percussion-based screening as a potential adjunct to clinical assessment. From a healthcare management perspective, the present results address a prerequisite question—whether such signals contain sufficient information to justify translational research, rather than demonstrating workflow optimization, cost reduction, or system-level impact. Clinical validation, threshold optimization, and implementation studies are required before managerial or operational benefits can be evaluated.

Background/Objectives: Hospital performance is a multidimensional construct that cannot be adequately assessed using isolated financial, clinical, organizational, or patient-reported indicators. This study aimed to develop and evaluate an Integrated Multidimensional Hospital Performance Assessment Framework combining organizational management, healthcare quality, patient satisfaction, and cost efficiency. Methods: An observational, descriptive, comparative study was conducted using data collected during 2018–2019 from two Romanian public hospitals with different organizational profiles: a multidisciplinary general hospital and a monospecialty hospital. Organizational, operational, financial, and clinical indicators were analyzed comparatively. Patient satisfaction was assessed in 184 hospitalized patients, including 130 from the general hospital and 54 from the monospecialty hospital, using a structured questionnaire with excellent internal consistency (Cronbach’s α = 0.92). Cost efficiency was estimated using Stochastic Frontier Analysis based on hospital expenditure, activity, resource utilization, case complexity, and quality-related variables. Results: Significant differences were identified between the hospitals in staff composition, bed occupancy, outpatient activity, case-mix complexity, surgical activity, healthcare quality, and financial performance. Patient satisfaction was generally high in both institutions, although several dimensions differed significantly, particularly overall satisfaction, waiting time, physician consultation, treatment received, and adherence to the prescribed medication schedule. The general hospital had a lower mean cost-inefficiency score than the monospecialty hospital (0.253 vs. 0.395), corresponding to higher estimated cost efficiency (0.747 vs. 0.605; p < 0.001). Conclusions: The proposed framework offers a comprehensive and practical approach to hospital performance assessment, and its application in two public hospitals provides a proof-of-concept demonstration of feasibility. Further multicenter studies are required for external validation and assessment of its generalizability across different hospital settings.

Indirect posterior restorations combining complete occlusal coverage with extension onto an axial surface are described inconsistently, and their biomechanical advantage remains uncertain. This review compared failure load and a review-defined severe-failure category of morphology-defined axial-extension restorations with occlusal-only restorations and full-coverage crowns. PubMed, Scopus, Embase, and Web of Science Core Collection were searched from inception and last checked on 22 July 2026; citation searching supplemented the database searches. Eligible studies tested restorations meeting the morphological definition in extracted human posterior teeth. Two reviewers independently selected studies, extracted data, and appraised risk of bias using RoBDEMAT with QUIN as a supplementary appraisal. Multiple eligible intervention arms were combined, and shared comparators were counted once. Exploratory random-effects models estimated average effects across heterogeneous laboratory systems using ratios of means (RoMs) and mean differences (MDs) for failure load and risk ratios (RRs) for review-defined severe failure. Eight studies were included. Five independent studies contributed to the main comparison, restricted to single-surface axial-extension versus occlusal-only restorations. Failure-load estimates were inconclusive (RoM 0.98, 95% CI 0.88 to 1.09; MD −23 N, 95% CI −195 to 149). Severe-failure events were sparse and inconsistently defined across the source studies; exact counts were therefore primary, and the pooled RR was exploratory (RR 1.10, 95% CI 0.65 to 1.86). Three studies compared axial-extension restorations with crowns, but these heterogeneous comparisons were not pooled and remained inconclusive. Current in vitro evidence is insufficient to determine whether the evaluated axial-extension designs affect failure load or the occurrence of review-defined severe failure. Imprecision, methodological heterogeneity, and indirectness for clinical performance preclude claims of clinical superiority. A routine strength benefit of the evaluated axial-extension designs cannot be inferred. Standardized preparation definitions, testing protocols, and failure reporting are required. Registration: OSF, DOI 10.17605/OSF.IO/9PXE5 (retrospective).