Background/Objectives: With the increasing use of dental implants in edentulous patients and the high prevalence of peri-implantitis, understanding its microbial and risk factors is crucial. This study investigated Romanian patients from two private dental clinics in Cluj-Napoca, Romania, diagnosed with peri-implantitis, focusing on identifying the predominant bacterial species at affected sites compared with healthy implant sites. Additionally, we examined the impact of factors such as smoking, gender, age, and prosthetic restoration type on disease prevalence. Methods: This cross-sectional study, conducted between January 2023 and December 2024, included randomly selected patients who met the predefined inclusion and exclusion criteria. We enrolled 22 patients and 50 implants in the study. Data collected from medical records, clinical evaluations, and microbiological assessments were subsequently entered into a computerized database. Clinical data were analyzed using Social Science Statistics software(Jeremy Staangroom 2018). Bacterial samples were assessed, incubated, and subsequently identified using the Vitek 2 Compact System (BioMérieux, Marcy—l’ Étoile, France). Results: Peri-implantitis incidence was found to be independent of gender, more prevalent in the mandible, and equally affected smokers and non-smokers. The disease involves a complex polymicrobial infection, with pathogenic bacteria triggering the condition and opportunistic bacteria sustaining it. Conclusions: Peri-implantitis is a complex polymicrobial infection that arises from the interaction of strict pathogenic bacteria and opportunistic bacteria. Peri-implantitis results from intricate interactions of local, systemic, and microbial factors. Identifying its causes is essential for developing effective treatments, with future research emphasizing the role of opportunistic bacteria in disease progression.

The aim of this research was to validate the use of a gentamicin (GEN) and nano-hydroxiapatite (nHAP)-loaded polycaprolactone nanostructured membrane (NM) as an innovative, highly efficient, low-cost treatment for periodontitis. We conducted an in vivo study on Wistar rats, in which we induced periodontitis by placing silk ligatures around the first right and left upper molars. The subjects were divided into three groups; the first group received no periodontal treatment, the second group received open flap debridement, and the third group received open flap debridement, together with the positioning of the GEN and nHAP-loaded nanostructured membrane as a treatment. The extent of periodontal regeneration was assessed by the periodontal pocket depth, bleeding on probing, tooth mobility, dental plaque, microbiological analysis, concentration of MMP-8 in saliva, plasma levels of CRP, and histological analysis. The results showed that using open flap debridement with the NM is more efficient, and it significantly reduces the probing depth, extent of bleeding on probing, dental mobility, bacterial plaque, and pathogenic flora. The concentrations of MMP-8 and CRP decrease. The histological analysis demonstrated that NM leads to bone regeneration. Our study indicates that gentamicin and nano-hydroxyapatite embedded in the fiber of the biodegradable membranes might be a promising therapeutic option for periodontitis treatment.

Background and Objectives: Reduced bone quality due to osteoporosis significantly complicates oral rehabilitation and bone regeneration therapies. While Vitamin D (Vit. D3) is crucial for osteogenesis, systemic administration often lacks local efficacy. This study aimed to evaluate the osteoregenerative potential of a novel Chitosan-based nanostructured scaffold (NS) loaded with Vit. D3, underlining its efficacy in vitro and in an ovariectomized (OVX) rat model of osteoporosis. Materials and Methods: Chitosan NSs were fabricated with varying Vit. D3 concentrations. In vitro assessments included cytotoxicity (MTT assay), cell viability (Alamar Blue), and mineralization (Alizarin Red) using human dental follicle stem cells. In vivo, 30 Wistar rats were ovariectomized to induce osteoporosis (confirmed by biomarkers Osteocalcin and β-CTX) and were divided into three groups (n = 10). Bilateral maxillary bone defects were treated with (1) a Control (clot only), (2) a Hemostatic Sponge with Vit. D3 (HS/Vit. D3), or (3) an NS loaded with Vit. D3 (NS/Vit. D3-6.25 ng/mL). Histological and morphometric analyses were performed at 4 and 8 weeks. Results: In vitro, the NS loaded with 6.25 ng/mL Vit. D3 demonstrated superior cytocompatibility, achieving a cell viability of 117.77% at 72 h and significantly enhanced calcium nodule deposition compared to controls. In vivo, a total of 44 defect sites were analyzed following the exclusion of compromised samples (Control: 16 sites; HS/Vit. D3: 16 sites; NS/Vit. D3: 12 sites). The NS/Vit. D3-6.25 ng/mL group exhibited the highest degree of mature bone formation and vascularization (p < 0.05) compared to the Control and HS/Vit. D3 groups. While cellular activity (osteoblasts/osteocytes) was initially higher in the HS/Vit. D3 group, the NS/Vit. D3-6.25 ng/mL group achieved superior structural integration and scaffold replacement by mature bone tissue over time. Conclusions: The novel Vit. D3-loaded Chitosan NS effectively promotes bone regeneration in osteoporotic conditions. It supports osteogenic differentiation in vitro and enhances bone matrix maturation in vivo, suggesting its potential as a bioactive scaffold for regenerative dentistry.

Background /Objectives: In clinical surgery, bone regeneration has proven to be a significant challenge. Autografts, allografts and xenografts can be used in bone tissue regeneration, but these approaches are linked with the following disadvantages: limited availability, increased surgical time, increased costs. In the case of autograft, morbidity of the donor site and a lower probability of success are also noteworthy, and in the case of allografts the probability of disease transmission and the probability of immunological reaction should be considered. Due to these disadvantages, better solutions have been sought to achieve the regeneration of deficient bone tissue. Thus, for a biomaterial to be suitable for bone regeneration, it must have certain properties, namely: biocompatibility, osteoinduction, osteoconduction and mechanical strength. The aim of this study was to evaluate the benefits of a novel nanostructured chitosan membrane loaded with vitamin D, in bone tissue regeneration therapy. The membrane was applied in an osteoporotic bone defect model, to simulate a post-extraction alveolus. Materials and Methods: We conducted an in vivo study on 30 female Wistar rats, to whom we induced osteoporosis. A bone defect was created artificially by milling. The 30 female rats were divided into three groups, depending on the material used in filling the defect: control group I was treated with no filler for the bone defect, group II was treated with vitamin D loaded on a hemostatic sponge, and group III was treated with vitamin D loaded on a novel nanostructured membrane. The bone regeneration obtained in the three study groups was assessed by descriptive histological analysis and histological scoring. Results: The results show that the Vitamin D-loaded chitosan nanostructured membranes have positive effects in bone tissue regeneration, with better efficiency than other studied therapeutic strategies. Conclusions: Our study indicates that Vitamin D-loaded chitosan nanostructured membrane might be a promising therapeutic option for bone regeneration.