Periodontitis is a chronic non-communicable inflammatory disease in which oxidative stress plays an important role in tissue destruction and alveolar bone loss. Excessive production of reactive oxygen species disrupts redox homeostasis, activates inflammatory signaling pathways, and promotes regulated cell death processes such as pyroptosis and ferroptosis. The Nrf2/Keap1 pathway is a key regulator of antioxidant defense and cellular adaptation to redox imbalance. Impaired Nrf2 signaling has been associated with enhanced oxidative injury, NF-κB and NLRP3 inflammasome activation, osteoclast-driven bone resorption, and reduced regenerative capacity in periodontal tissues. Experimental studies suggest that Nrf2 activation can restore the redox balance and attenuate inflammation and bone destructive responses in a periodontal model. Moreover, therapeutic approaches involving phytochemicals, microbial-derived metabolites, and redox-responsive biomaterials have been reported to influence Nrf2-related signaling in experimental settings. However, the majority of the available evidence is derived from in vitro or animal studies, and the relevance of these findings to clinical periodontitis remains to be established. This review summarizes the current advances linking oxidative stress, redox signaling, cell death pathways, and bone remodeling with Nrf2 dysfunction in periodontitis and outlines the key mechanistic insights while highlighting the existing knowledge gaps.

Additive manufacturing techniques are being used in the medical field. Orthopedic hip prostheses and denture bases are designed and fabricated based on the patient’s computer-aided design (CAD) data. We attempted to incorporate this technique into dental implant bone augmentation. Surgical simulation was performed using patient data. Fourteen patients underwent bone augmentation using a selective laser melting (SLM) titanium mesh plate. The results showed no evidence of infection in any of the 14 patients. In 12 patients, only one fixation screw was used, and good results were obtained. The SLM titanium mesh plate was good adaptation in all cases, with bone occupancy greater than 90%. The average bone resorption of the marginal alveolar bone from the time of dental implant placement to the time of the superstructure placement was 0.69 ± 0.25 mm. Implant superstructures were placed in all cases, and bone augmentation with SLM titanium mesh plates was considered a useful technique.

Oral mucositis frequently develops during radiotherapy or chemotherapy for head and neck cancer and is characterized by severe pain and impaired eating and speech. It was previously demonstrated that freeze-dried hyaluronic acid (HA) sheets effectively promote the healing of oral mucosal ulcers. This study aimed to optimize the HA sheet formulation by evaluating the effects of HA molecular weight and nicotinamide mononucleotide (NMN) loading on therapeutic efficacy. HA sheets were prepared using HA with four different molecular weights (50, 350, 800, and 2000 kDa), and their therapeutic effects were evaluated in an animal oral ulcer model using 6-week-old male Syrian hamsters. Among the formulations tested, the 800 kDa HA sheet exhibited the greatest healing efficacy, and it showed an excellent balance between buccal retention and the sustained release of NMN for the treatment of oral mucositis. In vitro cytotoxicity assays confirmed that HA, with or without NMN, was non-toxic and suitable for local applications. These findings indicate that HA sheets, particularly those composed of 800 kDa HA, may represent a promising and biocompatible mucoadhesive material for the delivery of NMN and the local treatment of oral mucositis associated with head and neck cancer.

Titanium implants are subjected to various surface treatments to improve their in vivo function. In this study, we evaluated the usefulness of titanium implants treated with acid, NaOH, CaCl₂, heat, and ICl₃ (Ac-NaCaThIo) in terms of in vivo bone-bonding strength, bone formation, and histological anti-inflammatory properties. Iodine-loaded experimental dental implants and commercial control dental implants were placed in rabbit femurs, and bone-bonding strength was evaluated by measuring the implant stability quotient (ISQ), bone formation using tissue specimens, and the effect of iodine using thyroid-stimulating hormone (TSH) levels. Iodine-loaded titanium plates and untreated titanium plates were placed on rat skulls and inoculated with Streptococcus mitis (S. mitis) solution to evaluate anti-inflammatory properties. Consequently, the experimental implants did not demonstrate non-inferiority in bone-bonding strength (ISQ) compared with the controls; however, histological specimens revealed dense bone contact and favorable bone formation. TSH levels showed no differences at 13 weeks, indicating no long-term adverse effects of iodine. The experimental tissue specimens of the soft tissue had fewer inflammatory cells than the control at 2 weeks after placement, demonstrating an anti-inflammatory effect. These results suggest that, although non-inferiority in ISQ was not demonstrated, Ac-NaCaThIo-treated implants showed favorable bone formation, dense bone contact, anti-inflammatory properties, and biosafety, indicating potential for future applications.

Oral mucositis is a frequent adverse effect of cancer therapy and is often complicated by pain, oral dryness, and secondary infection. Freeze-dried hyaluronic acid (HA) sheets can protect and moisturize the oral mucosa, but their intrinsic antibacterial activity is limited. We developed freeze-dried HA sheets containing the commercial persimmon tannin product PANCIL^® PS-M and evaluated their release behavior, pH profile, antimicrobial activity, and in vitro cytocompatibility. Persimmon tannin release into phosphate-buffered saline was quantified over 8 h using the Folin–Ciocalteu method. Antimicrobial activity against Streptococcus mitis, Prevotella intermedia, and Candida albicans was assessed by colony counting, and cytocompatibility was evaluated using the human oral cell line T3M-1. Approximately 95% of the incorporated persimmon tannin was released within 8 h, while the surrounding pH remained near neutral to mildly alkaline. The antibacterial HA sheets markedly reduced viable counts of S. mitis and P. intermedia, whereas no inhibitory effect was observed against C. albicans. Neither HA sheet nor antibacterial HA sheet solutions significantly reduced T3M-1 cell viability at concentrations up to 100 µg/mL after 24 h. These findings suggest that persimmon tannin-containing HA sheets may provide sustained antibacterial activity without detectable cytotoxicity under the tested conditions and may serve as a topical adjunct for cancer treatment-related oral mucositis.