Background: Subantimicrobial‐dose doxycycline (SDD) is widely used as an adjunctive treatment to scaling and root planing (SRP), but its long‐term effectiveness remains controversial. The purpose of this systematic review was to assess the actual evidence of the effectiveness of SRP + SDD compared to SRP + placebo in the treatment of chronic periodontitis.Methods: A literature search of electronic databases was performed for articles published through November 1, 2010. Several dental journals were screened during the manual search, and authors were contacted for missing information. The systematic review and meta‐analysis were conducted according to the Quality of Reporting of Meta‐Analyses statement and recommendations of the Cochrane Collaboration. The methodologic quality of the studies was determined via a Consolidated Standards of Reporting Trials–based assessment. Clinical attachment levels, probing depths, plaque and gingival indices, and gingival crevicular fluid levels were compared between baseline and the end of follow‐up. Data were extracted and pooled using a random‐effect model. The weighted mean difference was reported with the 95% confidence interval. Heterogeneity was assessed using the χ²‐based Q‐statistic method and I² measurement. P <0.05 was considered statistically significant.Results: After applying inclusion and exclusion criteria, three randomized placebo‐controlled clinical trials were entered into the meta‐analysis. These studies had similar treatment designs, SDD dosage regimens (20 mg twice daily for 3 months), and post‐treatment follow‐up lengths (9 months). Significant differences were observed for all investigated clinical parameters in favor of the SRP + SDD group.Conclusion: The meta‐analysis results seemed to support the long‐term effectiveness of adjunctive SDD therapy; however, future studies are needed to confirm these findings.

In the analysis of the characteristics of a pleasant smile, a gummy smile has negative components, which most affect the esthetics of non-verbal communication. For this purpose a proposed classification based upon etiopathogenetic criteria as useful indications for a therapeutical approach is given.The nature of a high smile line can be: dento-gingival, connected to an abnormal dental eruption, which is revealed by a short clinic crown; muscular, caused by an hyperactivity of the elevator muscle of the upper lip; dento-alveolar (skeletal), due to an excessive protuberance or vertical growth of the jawbone (maxillary); lastly, a mixed nature, in the presence of more than one of the above described factors.The diagnosis of gummy smile must be precocious and based, with reference to specific parameters, upon a careful analysis of the etiopathogenetic factors and the degree of seriousness of the alteration. A correct treatment plan must contemplate the possibility of an orthognatodontic, orthopedic and/or surgical therapeutic resolution considering the seriousness and complexity of the gums exposures (high smile line) in connection with the age of the subject.

The physiology of swallowing is characterized by a complex and coordinated activation of many stomatognathic, pharyngeal, and laryngeal muscles. Kinetics and electromyographic studies have widely investigated the pharyngeal and laryngeal pattern of deglutition in order to point out the differences between normal and dysphagic people. In the dental field, muscular activation during swallowing is believed to be the cause of malocclusion.