Aim: To evaluate the clinical outcomes of moderate intrabony defects treated with minimally invasive non‐surgical technique (MINST) with or without adjunctive delivery of cross‐linked hyaluronic acid (xHyA) gel.Materials and Methods: Forty‐two patients with 42 interdental intrabony defects were randomly assigned to test (MINST + xHyA) or control procedures (MINST alone). Probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and bleeding on probing (BOP) at the treated sites were assessed at baseline and at 3 and 6 months. Full‐mouth plaque score (FMPS) and full‐mouth bleeding score (FMBS) were recorded at baseline and after 6 months. Radiographic evaluation was performed at baseline and after 6 months, assessing the defect fill (DF) and radiographic defect angle (RDA). The primary outcome variable was PD change.Results: Thirty‐eight patients completed the trial without any adverse events. At 6 months, a statistically significant improvement (p < 0.05) was measured in all clinical parameters except GR (p > 0.05). However, no statistically significant differences were found between the experimental and control procedures (p > 0.05). Statistically significant differences between the test and control sites were observed at 3 months for PD and CAL changes (p < 0.05). The DF change was statistically significant when comparing experimental and control procedures at 6 months (p < 0.05). Both procedures failed to show statistically significant differences in terms of RDA changes at 6 months (p > 0.05).Conclusion: Within their limitations, the present results indicate that (a) treatment of intrabony defects with MINST, with or without application of xHyA gel, resulted in statistically significant improvements in the investigated clinical parameters at 3 and 6 months after therapy, and (b) although the adjunctive use of xHyA gel to MINST improved the clinical outcomes compared with MINST alone up to 3 months, statistically significant differences were not observed at 6 months. The study protocol was registered in ClinicalTrial.gov (NCT05188898).

Background: Periodontitis is a chronic inflammatory disease characterized by the destruction of periodontal tissues due to biofilm deposits and altered host immune response. Non-surgical periodontal therapy (NSPT) still represents the gold standard for treatment; however, its effectiveness in deep periodontal pockets is limited. Probiotics seem to modulate both oral microbiota and inflammatory response and have been proposed as an adjunctive therapy to NSPT. Methods: An electronic search was conducted on PubMed, Scopus, Medline, and Google Scholar to identify English randomized controlled trials (RCTs) evaluating probiotics as adjunctive treatments to NSPT. Studies were selected based on inclusion and exclusion criteria, and clinical outcomes such as probing depth (PD) and clinical attachment level (CAL) were extracted and analyzed. Results: Seven RCTs met the inclusion criteria. These studies showed significant improvements in PD and CAL when probiotics were used, specifically with Lactobacillus and Bifidobacterium species. However, outcomes ranged depending on the strain, dosage, and delivery method. Conclusions: Probiotics may be used as an adjunct treatment to NSPT; however, further studies are needed to define valid clinical guidelines.

Background: Third lower molar (TLM) extraction is one of the most common oral surgical procedures, often accompanied by postoperative pain and inflammation. In order to treat postoperative pain, different methods are used, mainly based on painkillers. PBMT may represent an adjunct to pain management. Objective: This narrative review aims to evaluate the efficacy of PBMT in reducing postoperative pain following TLM extraction. Methods: A comprehensive search was conducted to identify studies examining the use of PBMT for postoperative pain relief after TLM extraction. Four randomized controlled trials (RCTs) met the inclusion criteria and were analyzed qualitatively. Results: Two studies showed statistically significant reductions in pain with PBMT. Kahraman et al. reported lower pain scores in the intraoral PBMT (p = 0.001), with up to a 3.2-point reduction on the Visual Analog Scale (VAS). De Paula et al. found improved pain control using a dual-wavelength (808 + 660 nm) versus a single wavelength protocol (p = 0.031). The remaining studies showed non-significant results toward pain reduction. Conclusions: PBMT shows encouraging results in managing postoperative pain after TLM extraction, specifically with intraoral and multi-wavelength protocols. However, further studies are necessary to confirm its clinical utility.

Non-surgical periodontal therapy (NSPT) represents the gold standard in the treatment of periodontitis, but deep periodontal pockets and complex anatomies may reduce its efficacy. Therefore, in order to enhance NSPT outcomes and reduce the need for surgical intervention, several adjunctive therapies have been proposed. Propolis, a natural substance with antimicrobial, anti-inflammatory, and healing properties, has shown promising results in controlling supragingival biofilm. This narrative review aims to assess the clinical efficacy of propolis as an adjunct to NSPT. A comprehensive search on scientific databases was conducted for randomised clinical trials (RCTs) comparing NSPT with and without propolis, or with other adjuncts or placebos. Probing depth (PD) was the primary outcome. Seven RCTs met the inclusion criteria, using different propolis formulations and application protocols. Statistically significant improvements in clinical outcomes were recorded in all analysed studies compared with NSPT alone or placebo, while benefits were less substantial compared with laser therapy and conflicting when compared with chlorhexidine. Thus propolis may be considered a promising adjunctive agent to NSPT, with the potential to improve clinical outcomes of NSPT. Nonetheless, further long-term clinical trials with larger sample size are needed to validate its clinical efficacy and to determine its adverse effects.