Periodontitis (P) is a highly prevalent inflammatory disease of the oral cavity. The objective of the study was to evaluate the stages of pro-inflammatory cytokine IL-1β in initial, moderate and severe periodontitis. One hundred and twenty two patients were included in the study. Periodontitis subjects had at least 20 natural teeth and ≥8 sites with pocket depths of >4 mm and clinical attachment loss (CAL). A questionnaire was used with respect to the socio demographic parameters which included age, gender, ethnicity, education, marital, residence and occupation. To categorize the severity of the disease, teeth were assessed for, Plaque index (PI), Bleeding on probing (BOP), CAL, missing tooth, tooth mobility and bone loss. Unstimulated whole saliva (UWS) was collected and Interleukin-1β (IL-1β) cytokine levels were analyzed using enzyme linked immunosorbent assay with microplate reader at 450 nm. Clinical parameters and salivary cytokine concentrations were assessed using one-way analysis of variance, whereas a correlation of cases with gender and severity of periodontitis was evaluated using chi-square test. Fifty-nine patients were healthy controls and 63 were periodontitis patients Thirty two percent (n = 20) had initial periodontitis, 40% (n = 25) suffered from moderate and 29% (n = 18) had severe periodontitis. Periodontitis subgroups were significantly different with regards to age and gender (p < 0.001). The mean PPD and CAL among the periodontitis patients (PPD, 3.52 ± 1.25 mm; CAL, 4.04 ± 1.64 mm) were significantly compromised (p < 0.05) compared to healthy controls (PPD, 1.52 ± 0.73 mm; CAL, 0.08 ± 0.28 mm). Increased levels of IL-1β were associated with high CAL and PPD findings. UWS IL-1β levels were higher in periodontitis patients compared to healthy individuals. In addition, cases of severe periodontitis showed significantly higher UWS IL-1β levels compared to initial and moderate periodontitis patients. Comparative levels of salivary IL-1β can be potentially used as a diagnostic tool for periodontitis identification and disease progression along with clinical parameters.

Idiopathic condylar resorption (ICR) can be described as a dysfunctional remodeling of the temporomandibular joint (TMJ). It is clinically characterized by morphological changes in TMJ including reduced ramus height, accelerated mandibular retrusion and reduced growth in juveniles. With a strong predilection towards females (90 %) within an age group of 10 to 40 years, diagnosis and management of ICR is a critical clinical challenge. The aim of this study is to present a comprehensive review of diagnosis and management strategies for ICR. Literature search based on keywords relating to ICR was conducted on PubMed (Medline) database. Studies fulfilling the inclusion criteria (reports based on clinical diagnosis and management of ICR) were selected for comprehensive review. 253 articles were identified through literature search. After abstract screening and full-text review, 54 studies were selected for qualitative synthesis. Diagnosis of ICR is established by combination of clinical and radiographic findings, patient history, and exclusion of all known local/systemic factors contributing to condylar resorption. Management of ICR depends on condylar activity and surgeon’s ability to preserve the articular disc and mandibular condyle, and could either be surgical or non-surgical. Surgical treatment can be either by orthognathic surgery alone or through a combination of orthognathic and TMJ surgeries. Based on the present review, it may be concluded that diagnosis and management of ICR requires adequate clinical understanding of the condition. Identifying the stage of ICR is important in deciding optimum treatment plan. While early-stage ICR could be managed non-surgically by orthodontic and splint therapies, advanced stage disease require simultaneous TMJ Surgery with orthognathic correction for skeletal stability. Future research should focus on elucidating underlying mechanisms of ICR, refining diagnostic criteria, and optimizing treatment protocols to enhance patient outcomes.

Extended temporomandibular joint reconstruction (eTMJR) can be described as a refined approach to conventional temporomandibular joint reconstruction (TMJR) designed to address both the articulating components of the TMJ and associated mandibular segmental defects or defects in the skull base. Extended temporomandibular joint reconstruction (eTMJR) combined with the advancement in VSP not only offers improved functional and esthetic outcomes but also signifies a significant leap forward in the realm of TMJR interventions. In comparison to autogenous grafts, alloplastic pro$stheses exhibit superior outcomes concerning MIO, pain management, and dietary functionality, underscoring their potential as the preferred treatment modality. This review article showcases an in-depth exploration of eTMJR, covering its classifications, indications, contraindications, advantages, disadvantages, complications, virtual surgical planning (VSP), criteria for successful alloplastic devices, and the surgical approach.

Background/Objectives: Le Fort I maxillary osteotomy (LF1-MO) is associated with a risk of infraorbital nerve neurosensory deficiency (NSD). This study aimed to evaluate post-operative subjective numbness and objective NSD after LF1-MO and assess the impact of these outcomes on overall patient satisfaction. Methods: A retrospective cross-sectional study was conducted among adult LF1-MO patients, who were evaluated for treatment satisfaction using a 10-item patient satisfaction questionnaire. In addition, subjective and objective NSDs were assessed post-operatively for six months. Overall patient satisfaction was compared against different variables (patient age, sex, and type of LF1-MO) and NSD. The proportion of subjective and objective NSDs were statistically correlated and compared against these variables, assuming a 95% significance level (p < 0.05). Results: A total of 58 LF1-MO patients in the age range of 20–38 years (mean–29.79 ± 4.62 years) were included in this study. Most patients were females (n = 48; 82.8%) and aged 30 years and older (n = 32; 55.2%). The overall mean patient satisfaction score was 27.38 ± 3.94 (range 12–30), which did not significantly differ based on patient age or sex. Patients who had advanced LF1-MO had significantly higher satisfaction scores (28.27 ± 1.85) compared to those who had impaction (24.61 ± 7.34) (p < 0.05). Subjective numbness and an abnormal “Level A” response to objective neurosensory testing were associated with poor patient satisfaction. There was significant statistical correlation between subjective and objective NSDs (Spearman’s rho–0.441; p < 0.01). Based on a chi-squared test, patients undergoing maxillary setback (subjective–88.9%; objective–44.5%) had significantly higher NSDs (p < 0.05). Conclusions: Most patients reported satisfaction after LF1-MO, particularly among females, those aged 30 and older, and those without NSD. However, residual infraorbital NSDs persisted, with about two-thirds experiencing subjective numbness and 25% showing abnormal responses in “Level A” objective neurosensory tests six months post-operatively. Moreover, subjective numbness correlated with abnormal objective testing results, leading to lower patient satisfaction.

Background and Objectives: To compare the clinical, radiographic, and inflammatory peri-implant parameters around narrow diameter implants (NDI) supported single and splinted crowns in non-diabetics and prediabetes. Materials and Methods: The clinical and radiographic parameters and the levels of IL-6 and TNF-α in the peri-implant crevicular fluid (PICF) of narrow diameter single (NDISCs) and splinted (NDISPs) crown implants were assessed both in non-diabetics and participants with prediabetes. The glycemic state of the patient was assessed using glycated hemoglobin (HbA1c) levels. The peri-implant soft tissue indices (Plaque index (PI), bleeding on probing (BoP), probing depth (PD)) and marginal bone loss were recorded and compared between the groups. Success of the prosthesis was assessed by the frequency of technical complications and patient satisfaction. Inter-group comparison was performed using ANOVA (one-way analysis of variance) while the normal distribution of dependent variables was calculated using Shapiro–Wilk. A p-value of less than 0.05 was considered to be statistically significant. Results: Sixty participants (30 non-diabetics and 30 with prediabetes) with a total of 178 (118 NDISCs and 60 NDISPs) platform-switched NDIs were a part of the study. Of the 118 NDISCs, 56 were placed in the non-diabetic individuals and 62 were placed in the prediabetes group whereas 30 NDISPs each were placed in both the study groups. The clinical parameters of PI, BoP and PD in the single crown and splinted crown groups showed comparable results. However, a statistically significant difference (p-value of less than 0.05) in PI, BoP and PD and in the values of IL-6 and TNF-α was found when a comparison was made between the non-diabetes and prediabetes group. A total of 91% of the patients were satisfied with the esthetics of the implants while 79% of the patients showed satisfaction with function. Conclusions: All the clinical and radiographic parameters were statistically similar in both single and splinted types of narrow diameter implants. However, the bone loss, probing depth, plaque index, and levels of inflammatory markers were statistically higher in prediabetes as compared to non-diabetes implying that a slight hyperglycemic state impacts peri-implant health.