Synthesis, characterization and DNA cleavage activity of nickel(II) adducts with aromatic heterocyclic bases

Mixed ligand complexes of nickel(II) with 2,4-dihydroxyaceto-phenone oxime (DAPO) and 2,4-dihydroxybenzophenone oxime (DBPO) as primary ligands, and pyridine (Py) and imidazole (Im) as secondary ligands were synthesized and characterized by molar conductivity, magnetic moments measurements, as well as by electronic, IR, and 1H-NMR spectroscopy. Electrochemical studies were performed by cyclic voltammetry. The active signals are assignable to the NiIII/II and NiII/I redox couples. The binding interactions between the metal complexes and calf thymus DNA were investigated by absorption and thermal denaturation. The cleavage activity of the complexes was determined using double-stranded pBR322 circular plasmid DNA by gel electrophoresis. All complexes showed increased nuclease activity in the presence of the oxidant H2O2. The nuclease activities of mixed ligand complexes were compared with those of the parent copper(II) complexes

Artificial intelligence and personalized diagnostics in periodontology: A narrative review

Periodontal diseases pose a significant global health burden, requiring early detection and personalized treatment approaches. Traditional diagnostic approaches in periodontology often rely on a “one size fits all” approach, which may overlook the unique variations in disease progression and response to treatment among individuals. This narrative review explores the role of artificial intelligence (AI) and personalized diagnostics in periodontology, emphasizing the potential for tailored diagnostic strategies to enhance precision medicine in periodontal care. The review begins by elucidating the limitations of conventional diagnostic techniques. Subsequently, it delves into the application of AI models in analyzing diverse data sets, such as clinical records, imaging, and molecular information, and its role in periodontal training. Furthermore, the review also discusses the role of research community and policymakers in integrating personalized diagnostics in periodontal care. Challenges and ethical considerations associated with adopting AI-based personalized diagnostic tools are also explored, emphasizing the need for transparent algorithms, data safety and privacy, ongoing multidisciplinary collaboration, and patient involvement. In conclusion, this narrative review underscores the transformative potential of AI in advancing periodontal diagnostics toward a personalized paradigm, and their integration into clinical practice holds the promise of ushering in a new era of precision medicine for periodontal care

Impact of artificial intelligence assistance on diagnosing periapical radiolucencies: A randomized controlled trial

Objectives This randomized controlled trial aimed to evaluate the impact of artificial intelligence (AI) assistance on dentists’ diagnostic accuracy, confidence, and treatment decisions when detecting periapical radiolucencies (PRs) on panoramic radiographs. We specifically investigated whether AI support influenced diagnostic performance across different levels of clinical experience. Methods Thirty dentists with varying levels of experience evaluated 50 panoramic radiographs for the presence or absence of PRs, with and without the aid of AI, using a cross-over design. Diagnostic performance metrics, confidence scores, and clinical decision choices were analyzed. CBCT scans served as the reference standard. Outcomes included sensitivity, specificity, positive and negative predictive values, overall diagnostic accuracy, and area under the ROC and AFROC curves. Statistical analyses were conducted using mixed-effects regression models. Results AI assistance significantly improved overall diagnostic accuracy (91.6 % unaided vs. 93.3 % AI-aided; p < 0.001), mainly by reducing false positive diagnoses (false positive rate: 4.3 % unaided vs. 2.0 % AI-aided). Sensitivity remained stable (46.0 % unaided vs. 45.8 % AI-aided). Junior dentists showed the greatest improvements in performance and confidence. AI support shifted treatment decisions toward more conservative approaches. Conclusions AI assistance modestly enhanced dentists' diagnostic accuracy for detecting periapical radiolucencies, primarily by decreasing false positive diagnoses. Junior dentists benefited most from AI support. Integration of AI in diagnostic workflows may reduce overtreatment and enhance diagnostic consistency, especially among less experienced clinicians. Clinical Significance The integration of AI support in dental diagnostics reduced false positive diagnoses and supported more conservative treatment decisions, particularly benefiting less experienced clinicians. These findings suggest that AI assistance can enhance diagnostic consistency and reduce overtreatment in clinical dental practice

Machine Learning to Predict Apical Lesions: A Cross-Sectional and Model Development Study

(1) Background: We aimed to identify factors associated with the presence of apical lesions (AL) in panoramic radiographs and to evaluate the predictive value of the identified factors. (2) Methodology: Panoramic radiographs from 1071 patients (age: 11–93 a, mean: 50.6 a ± 19.7 a) with 27,532 teeth were included. Each radiograph was independently assessed by five experienced dentists for AL. A range of shallow machine learning algorithms (logistic regression, k-nearest neighbor, decision tree, random forest, support vector machine, adaptive and gradient boosting) were employed to identify factors at both the patient and tooth level associated with AL and to predict AL. (3) Results: AL were detected in 522 patients (48.7%) and 1133 teeth (4.1%), whereas males showed a significantly higher prevalence than females (52.5%/44.8%; p < 0.05). Logistic regression found that an existing root canal treatment was the most important risk factor (adjusted Odds Ratio 16.89; 95% CI: 13.98–20.41), followed by the tooth type ‘molar’ (2.54; 2.1–3.08) and the restoration with a crown (2.1; 1.67–2.63). Associations between factors and AL were stronger and accuracy higher when using fewer complex models like decision tree (F1 score: 0.9 (0.89–0.9)). (4) Conclusions: The presence of AL was higher in root-canal treated teeth, those with crowns and molars. More complex machine learning models did not outperform less-complex ones

Effectiveness of fissure sealants in 8- to 10-year-olds with and without molar–incisor hypomineralization (MIH) – results from a cross-sectional epidemiological study

Objective This cross-sectional study aimed to investigate the use, quality, and caries-preventive effects of fissure sealants (FSs) in 8- to 10-year-olds with and without molar–incisor hypomineralization (MIH). Materials and methods A total of 5,418 children (2,692 males, 2,726 females) were examined via standard instruments (dental mirrors, CPI probes, adequate lighting, mobile examination tables, and air syringes) and methods for the recording of caries (DMFT index, WHO method) and FSs. The classification of MIH followed the recommendations of the European Academy of Pediatric Dentistry (EAPD). Statistical analysis included descriptive analysis and mixed-effects logistic regression models. Results 59.0% of all children had at least one FS; this percentage was 57.8% in the MIH group. The proportions of fully intact sealants and minimal, moderate, or nearly complete loss of retention were 31.7%, 48.3%, 16.8%, and 3.2%, respectively. The mean caries experience was low, at 0.2 DMFT in the whole population. Lower DMFT means were registered in individuals with FSs without MIH (0.1) and with MIH (0.1). The regression analysis revealed a significant caries-protective effect of FSs and MIH in relation to the overall caries burden. In addition, the caries-protective effect was greater in individuals with fully retained sealants (aOR 0.269) than in those with minimal (aOR 0.346), moderate (aOR 0.567) or nearly complete loss of retention (aOR 0.721). Conclusion This study documented the comparable use, quality, and caries-preventive effects of FSs in individuals and permanent molar with and without MIH. Clinical relevance FSs are caries protective in children with and without MIH

Efficiency of biofilm removal by combination of water jet and cold plasma: an in-vitro study

Background: Peri-implantitis therapy is a major problem in implantology. Because of challenging rough implant surface and implant geometry, microorganisms can hide and survive in implant microstructures and impede debridement. We developed a new water jet (WJ) device and a new cold atmospheric pressure plasma (CAP) device to overcome these problems and investigated aspects of efficacy in vitro and safety with the aim to create the prerequisites for a clinical pilot study with these medical devices. Methods: We compared the efficiency of a single treatment with a WJ or curette and cotton swab (CC) without or with adjunctive use of CAP (WJ + CAP, CC + CAP) to remove biofilm in vitro from rough titanium discs. Treatment efficacy was evaluated by measuring turbidity up to 72 h for bacterial re-growth or spreading of osteoblast-like cells (MG-63) after 5 days with scanning electron microscopy. With respect to application safety, the WJ and CAP instruments were examined according to basic regulations for medical devices. Results: After 96 h of incubation all WJ and CC treated disks were turbid but 67% of WJ + CAP and 46% CC + CAP treated specimens were still clear. The increase in turbidity after WJ treatment was delayed by about 20 h compared to CC treatment. In combination with CAP the cell coverage significantly increased to 82% (WJ + CAP) or 72% (CC + CAP), compared to single treatment 11% (WJ) or 10% (CC). Conclusion: The newly developed water jet device effectively removes biofilm from rough titanium surfaces in vitro and, in combination with the new CAP device, biologically acceptable surfaces allow osteoblasts to grow. WJ in combination with CAP leads to cleaner surfaces than the usage of curette and cotton swabs with or without subsequent plasma treatment. Our next step will be a clinical pilot study with these new devices to assess the clinical healing process

A Study Into Systemic and Oral Levels of Proinflammatory Biomarkers Associated With Endpoints After Active Non‐Surgical Periodontal Therapy

Aim: To analyse whether some selected inflammatory biomarkers collected from venous blood and gingival crevicular fluid (GCF) were associated with the outcome of non-surgical periodontal therapy. Materials and Methods: Two-hundred and nine patients affected by periodontitis were enrolled in the study, who had undergone steps I and II therapy as well as a non-surgical re-instrumentation (NSRI) of periodontal pockets after 6 months. Serum (SE), plasma (PL) and GCF samples were quantitatively analysed for the following inflammatory biomarkers: active matrix metalloproteinase-8 (aMMP-8), prostaglandin E2 (PGE2) and surfactant protein D (SP-D). Therapy outcomes were evaluated using a ‘treat-to-target’ endpoint (T2T) at the patient level, defined as ≤ 4 sites with pocket depth ≥ 5 mm. Results: Patients presented with 23 ± 6 teeth (mean ± SD) at baseline. After steps I and II therapy, 41.6% of the patients reached T2T and after NSRI 47.4%. Univariate analysis identified a potential association between high levels of PL-SP-D and more favourable treatment outcomes. Multivariate binary logistic regression adjusted for sex, mean baseline probing depth, diabetes and current smoking status confirmed an independent relationship between baseline PL-SP-D and the T2T after steps I and II therapy (aOR 0.432, p = 0.011), implying that a higher level PL-SP-D at baseline is associated with a > 50% reduced risk of failing T2T. However, no such association was found for PL-SP-D and NSRI. Conclusion: Higher baseline PL-SP-D levels might be associated with more favourable treatment outcomes after steps I and II therapy. This may be due to its role in the regulation of neutrophil function. However, further investigation is required to confirm this hypothesis. If proven, PL-SP-D could play a role as a biomarker for identifying individuals who respond differentially to primary therapy

A retrospective study on the impact of different antibiotic regimens in non-surgical periodontal therapy on microbial loads and therapy outcomes

IntroductionThis study aimed to analyse the impact of different antibiotic regimens during non-surgical periodontal therapy on the microbial load of selected periodontitis-associated bacteria (PAB) and the primary therapy outcomes.MethodsFor this aim, 259 patients received steps I and II of periodontal therapy and were included in this clinical trial. 202 patients were treated without the adjunctive use of systemic antibiotics, 18 received amoxicillin (AMOX) as well as metronidazole (MET) and 39 only MET. Subgingival biofilm samples were quantitatively analysed for selected PAB using DNA-DNA-hybridisation-based detection assays for microbial loads of PAB before and 6 months after treatment. Changes in the microbial load of PAB and achievement of a “treat-to-target” endpoint (T2T) (≤4 sites with probing depth ≥5 mm) were analysed. Patients' subgingival microbial load was significantly reduced following therapy.Results38.2% of the patients achieved T2T. Binary logistic regression adjusted for confounders indicated a relationship between residual PAB levels and not achieving T2T. In patients not receiving systemic antibiotics a 2.4-fold increased risk of not reaching T2T after steps I and II therapy was observed (none vs. MET aOR = 2.38 p = 0.44). Linear regression analysis adjusted for T0 PAB concentration and confounders revealed an increased reduction of PAB levels in patients with systemic antibiotics. No difference in PAB reduction or chance of achieving T2T was observed between MET and MET + AMOX.DiscussionMicrobial loads of PAB were found directly associated with periodontal status. As antibiotic treatment with both MET and MET + AMOX similarly reduced microbial loads of PAB, treatment with MET alone may be sufficiently effective as adjunctive to non-surgical periodontal treatment. To confirm this, further prospective studies with bigger sample size are needed

Dental practitioners' thresholds for restorative intervention in carious lesions: a survey based systematic review update

Introduction: Despite evidence supporting the clinical and cost-effectiveness of minimally invasive dentistry (MID), its adoption by the dental profession has been slow. A systematic review in 2016 found the majority of dentists intervene invasively earlier than necessary. The aim was to update this review of the assessment of dental practitioners’ thresholds for providing restorative treatment for carious lesions given changes in evidence, teaching, and guidelines since 2016. The primary outcome was dental practitioners’ restorative thresholds (the extent of the lesion when they would decide to intervene restoratively). Secondary outcomes were changes over time, caries risk, regional differences, and primary/permanent dentition. Methods: This updated review replicated the methodology for the initial review, following the PRISMA 2020 guidelines (PROSPERO; CRD42023431906). Embase, MEDLINE (via PubMed), and Web of Science databases were searched (2016–2023) for observational studies reporting on dental clinicians’ thresholds for restorative interventions in adults and children without language, time, or quality restrictions. Screening, data extraction, and risk of bias assessment (Modified Newcastle-Ottawa Scale) were carried out independently and in duplicate. Meta-analyses were performed using a random-effects model. No funding sought. Results: Overall, 47 publications (30 from original publication and 17 from updated search) met the inclusion criteria and 65 datasets were included in the meta-analyses: 19 for occlusal lesions (16 pre-2016 and 3 post-2016; n = 11,946) and 46 for proximal lesions (38 pre-2016 and 8 post 2016; n = 20,428). The meta-analyses found that for occlusal lesions confined to enamel, there were fewer practitioners intervening invasively: 5% (95% confidence interval [CI]; 1–20%) post-2016, compared with 15% (95% CI; 9–23%) pre-2016. The opposite was found for proximal lesions with increased intervention levels, 27% (95% CI; 18–40%) for lesions confined to enamel post-2016, compared with 19% (95% CI; 12–29%) pre-2016, and for lesions extending up to the enamel-dentine junction 61% (95% CI; 36–81%) post-2016, compared with 39% (95% CI; 29–51%) pre-2016. There was variance between regions but too few studies to draw conclusions on individual regions. Conclusion: There was a suggestion of less invasive treatment of occlusal lesions over time; however, this was not evident for proximal lesions