The cellular metabolic processes ensure the physiological integrity of the dentine-pulp complex. Odontoblasts and odontoblast-like cells are responsible for the defence mechanisms in the form of tertiary dentine formation. In turn, the main defence reaction of the pulp is the development of inflammation, during which the metabolic and signalling pathways of the cells are significantly altered. The selected dental procedures, such as orthodontic treatment, resin infiltration, resin restorations or dental bleaching, can impact the cellular metabolism in the dental pulp. Among systemic metabolic diseases, diabetes mellitus causes the most consequences for the cellular metabolism of the dentine-pulp complex. Similarly, ageing processes present a proven effect on the metabolic functioning of the odontoblasts and the pulp cells. In the literature, several potential metabolic mediators demonstrating anti-inflammatory properties on inflamed dental pulp are mentioned. Moreover, the pulp stem cells exhibit the regenerative potential essential for maintaining the function of the dentine-pulp complex.
Autoimmune thyroid disease (AITD) is a dysregulation of the immune system that causes an attack on the thyroid gland. Two major clinical manifestations are Hashimoto’s thyroiditis and Graves’ disease. Saliva performs many functions and, importantly, has the potential for easy, non-invasive diagnostics of several systemic disorders. This systematic review was designed to answer the question whether salivary alterations are reliable for the diagnosis of autoimmune thyroid diseases. Following the inclusion and exclusion criteria, fifteen studies were included. Due to their heterogeneity, saliva analysis was divided into two subgroups: quantitative assessment analysing salivation and qualitative assessment concerning potential salivary biomarkers for AITD. In addition to detecting altered levels of thyroid hormones and antibodies, salivary changes were also observed in the concentrations of total protein, cytokines and chemokines, as well as markers of oxidative status. According to the saliva flow rate values, significantly reduced saliva secretion was observed in patients with HT. In conclusion, it is not possible to unequivocally state if salivary biomarkers can potentially be used in autoimmune thyroid disease diagnosis. Therefore, further investigations, including salivation disorders, are necessary to validate these findings.
The imbalance of thyroid hormones affects the metabolic activity of various tissues, including periodontium. Also, autoimmune diseases present an increased tendency to suffer from periodontal disease. Therefore, our systematic review was designed to answer the question "Is there a relationship between thyroid diseases and periodontal disease?". Following the inclusion and exclusion criteria, 10 studies were included in this systematic review using the databases PubMed, Scopus and Web of Science (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines). Based on the meta-analysis, patients with thyroid diseases (especially with hypothyroidism) demonstrated significantly worse periodontal status than systemically healthy controls. Moreover, according to the cross-sectional studies, 5.74 % of periodontitis patients reported the concomitance of thyroid diseases. In summary, the included studies suggest a potential relationship between thyroid diseases and periodontal disease. However, further research is necessary to reliably assess the oral health in patients with hypothyroidism and hyperthyroidism.
The COVID-19 pandemic has significantly impacted healthcare systems, including dentistry. This retrospective analysis aims to evaluate long-term changes in the spectrum of performed dental procedures due to the COVID-19 pandemic based on the example of the university specialized centre in Poznan. We explored the patient dataset from the University Center of Dentistry and Specialized Medicine (Poznan, Poland) covering the period from 1 January 2017 to 31 December 2023. Services performed during the prepandemic (2017-2019), pandemic (2020), and postpandemic (2021-2023) periods were compared. Selected procedures in restorative dentistry, endodontics, dental surgery, and dental radiology were analyzed in detail, including data for both children and adults. Our study analyzed a total of 342,112 patient medical records, including 158,882 conservative procedures and 101,556 surgical procedures. During the pandemic, there was a significant reduction in conservative procedures, particularly commercial services. In the postpandemic period, the number of refunded restorations and endodontic treatments for anterior teeth increased significantly, which was not observed for commercial procedures. A notable disruption between surgical and conservative procedures occurred during the first wave of the pandemic. The prepandemic period and the first quarter of the year were more conducive to conservative and endodontic treatments. The COVID-19 pandemic has led to a significant long-term shift from preventive and conservative dentistry into surgical interventions. Although the overall number of services provided has increased, more patients are opting for procedures that do not require out-of-pocket expenses. The pandemic has a lasting impact on the clinical decisions made by dental patients, with a greater preference for reimbursed and surgical services.
Bruxism is occlusal behaviour that often leads to stomatognathic system overload. Inflammatory markers in the periodontium are detectable in the gingival crevicular fluid (GCF). GCF production fluctuates due to various factors. Our study aimed to assess the effect of tooth clenching or grinding on GCF volume and proinflammatory IL-1β concentration in GCF. This pilot study was carried out on 20 participants aged 21 to 28 with good general health (per 10 people studied and control groups). GCF volume was measured with Periotron 8010 after absorbing for 30 s with PerioPaper strips. Twelve samples were collected from each patient—the buccal and lingual surfaces of teeth 16, 11, 24, 36, 31, and 44 were included. Laboratory examination of IL-1β concentration was performed. In patients with pathological tooth wear, a tendency to increase GCF secretion and IL-1β concentration in GCF was found. GCF volumes were higher in posterior teeth, while IL-1β levels were higher in anterior teeth. Crevices at the molars seem to have a potential predictive value in diagnosing periodontal microinflammation in patients with probable bruxism. Due to occlusal overload, these bruxists are more prone to microinflammatory processes in the periodontium. Further studies in a broader group are required to confirm this correlation.
An integral part of daily dental practice is preparing and polishing placed composite restorations. When these procedures are performed, significant amounts of composite dust are released from the grinding material. This systematic review aims to enhance the existing body of knowledge, encourage further dialogue, and expand the understanding of composite dust and its related risks. Following inclusion and exclusion criteria, twelve studies were included. Several studies highlight that composite dust contains nanoparticles capable of deep lung penetration, posing significant health risks to both dental staff and patients. Inhalation of composite dust can lead to respiratory diseases such as pneumoconiosis. Studies have shown that water cooling during composite grinding reduces dust emissions but does not eliminate them completely. Researchers suggest that thermal degradation of the composite material, not just filler particles, may be the source of the nanoparticles. In vitro studies have shown the toxicity of composite dust to bronchial and gingival epithelial cells, especially at high concentrations. Further research is needed on the health effects of composite dust and the development of effective methods to protect staff and patients.