Objectives: This case series reports on alveolar osteitis (AO) treatment outcomes after standard AO therapy combined with cross-linked hyaluronic acid (xHyA) and a collagen sponge. Material and Methods: Nine patients fulfilling the AO criteria after permanent tooth extraction were included. After standard AO treatment, that is, irrigation and curettage, a xHyA gel combined with an absorbable collagen sponge was applied into the socket and stabilized with a suture. Pain perception (visual analogue scale [VAS], pain killer consumption), soft tissue healing index (STHI), alveolar bone exposure, necessity of re-treatment, occurrence of complications, and patients' opinion were assessed up to 14 days post-treatment. Results: Eight patients completed the 14-day follow-up, while one patient dropped out after 1 day due to persisting pain. Initial mean pain perception (VAS) was 7.5 (1.4), which decreased after a single treatment to 4.4 (2.2) within 6 h and by 50% (3.8 [2.4]) within 24 h. In 5 out of 8 patients, complete pain resolution was achieved after 14 days, while 3 patients still experienced moderate pain. Pain reduction was accompanied by an improvement of STHI, reaching 4.0 (0.8) within 14 days; complete coverage of exposed alveolar bone walls was already observed within 3 days in all 8 patients. Only one patient required re-treatment; 5 out of 8 patients expressed willingness to pay on top between 50 and 300€ for the material costs (xHyA+collagen sponge). Conclusions: A single application of xHyA combined with a collagen sponge offered effective and fast pain relief combined with a favorable healing process in patients suffering from AO. Furthermore, the need for re-treatment was infrequent, and favorable patient feedback was observed. However, randomized controlled trials with a sufficient sample size and a control group are essential to validate these findings.

Objective: To provide an overview on the effect of hyaluronic acid (HyA) on hard tissue healing in alveolar bone augmentation procedures in humans (PROSPERO registration: CRD42023464863). Methods: Three databases were searched until April 2025. Studies using HyA in any form and in any alveolar bone augmentation procedure were included, if a control group allowing to assess the effect of HyA was available; studies addressing periodontal regeneration or using HyA coated implants were not included. Primary outcome parameters, summarized descriptively, were histologic/radiographic new bone formation (NBF), alveolar ridge width (ARW) and height (ARH). The Cochrane Collaborations RoB 2.0 and ROBINS-I tool were used to assess the risk of bias. Results: Fourteen studies with a follow-up of 3–12 months were included, which contributed with 229 patients and 317 sites allowing to assess the effect of HyA. HyA was assessed as adjunct to maxillary sinus floor augmentation (MSFA), guided bone regeneration (GBR), and alveolar ridge preservation (ARP). The addition of HyA significantly improved NBF in 50 and 66% of the MSFA and ARP studies, respectively; however, a significant clinical improvement was not consistently observed. Advantages for NBF as well as ARW or ARH gain have been reported in GBR procedures, but the available data are limited and mostly descriptive. No differences were observed regarding reported post-operative complication rates. Due to the heterogeneity in treatments and outcome measures, as well as the limited number of studies, a meta-analysis was not feasible for any of the outcomes. Conclusions: In the original studies, positive and occasionally significant results have been reported for the adjunct use of HyA in alveolar bone augmentation; however, the effect size and clinical relevance is unclear, and further clinical research is needed. Clinical relevance: HyA in alveolar bone augmentation is safe, but it remains unclear in which indication and in which application form it may enhance quality and/or quantity of NBF and at what extent.

AIM: To assess the effect of a hyaluronic acid (HyA) containing gel on patient-related outcomes (PRO) and wound healing after palatal punch-biopsy representing a free gingival graft.

MATERIAL AND METHODS: A punch-biopsy (6 mm diameter, 2 mm thickness) was harvested from one side of the palate at Day 0 and from the contralateral side at Day 21. Sites were randomly allocated to either 0.3% HyA containing gel (test) or sterile saline solution (control), professionally applied after harvesting and then self-applied three times/day for 7 days. Up to 21 days PRO-related questionnaires were answered and intraoral scans and photographs recorded to assess wound re-epithelialization, tissue refill, and color match.

RESULTS: Eighteen of 25 recruited participants were analyzed. Pain perception, difficulties with eating/drinking, and taste alterations significantly decreased over time and were hardly experienced after Day 7 in both groups (p > 0.05). Participants reported significantly more often a positive experience after applying HyA compared to placebo, that is, in 8 versus 1 out of 18 cases. The residual wound area was significantly smaller in the test compared to control group at Day 7, and cases with a thicker palatal tissue showed tendency for faster re-epithelialization.

CONCLUSION: Despite the potential limitations of the present study (i.e., possibility of a carryover effect, questionable blinding of the participants), repeated local application of a 0.3% HyA containing gel appears to only accelerate re-epithelialization in an open palatal wound and provide a positive experience after application, but it did not improve any PRO in such small-sized wounds compared to sterile saline application.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05099718.

OBJECTIVE: This cross-sectional survey aimed to assess oral health in patients with inflammatory bowel diseases (IBD) living in Austria.

METHODS: Data collection was conducted with an online questionnaire, including when possible validated tools, covering general medical history, socioeconomic factors, IBD-related parameters, and various oral health parameters, that is, tooth loss rate, prevalence of severe periodontitis, oral health-related quality of life (OHRQoL), and presence of oral lesions. The questionnaire was disseminated to the members of the Austrian Crohn's Disease/Ulcerative Colitis Association.

RESULTS: The analysis included the responses of 327 patients (68% female; average age 46 years), 134 with ulcerative colitis (UC) or IBD unclassified, and 193 with Crohn's disease (CD). Based on self-reported data, about 85% of the patients reported intake of an IBD-related medication and about two thirds of the responders reported some IBD activity in the past 12 months. Approximately 24% of the patients had < 20 remaining teeth, 34% had severe periodontitis, and 7% reported poor OHRQoL. IBD diagnosis did not affect the odds for having < 20 teeth or self-reported severe periodontitis, but patients with CD presented more frequently with poor OHRQoL. In addition, patients with CD received more frequently information from their physician on the possibility of oral lesions due to IBD; however, > 50% of all patients indicated not having any problems with oral lesions.

CONCLUSIONS: Oral health remains inadequately addressed in patients with IBD despite the significant need for dental care. Hence, treating physicians should motivate patients with IBD to inform their dentist about their diagnosis and to maintain regular dental checkups.

BACKGROUND: Rapidly evolving evidence, from preclinical and clinical studies, indicates a possible connection between inflammatory bowel disease and periodontitis. This study aimed to summarize the evidence from preclinical in vivo studies regarding the possible link between periodontitis and colitis.

METHODS: A systematic literature search was performed and resulting studies were screened against predefined eligibility criteria; data from included studies were extracted, and meta-analyses were performed whenever possible.

RESULTS: Thirty-four publications using mice or rats were included; 26 experiments evaluated the effect of inoculation with oral bacteria on experimental colitis, 3 the effect of experimental periodontitis on experimental colitis, and 7 the effect of experimental colitis on periodontal status; 45% (9), 78% (14), 57% (12), and 89% (16) of the studies found a significantly higher body weight loss, shorter colon length, higher disease activity index (DAI), and higher intestinal histopathological assessment scores (IHA), respectively, in animals exposed to inoculation with oral bacteria and experimental colitis compared with animals with only colitis. Meta-analyses confirmed that inoculation with oral bacteria significantly aggravated colitis, that is, significant negative overall effect on body weight, colon length, DAI, and IHA. Among the tested bacteria, Fusobacterium nucleatum had the strongest effect followed by Porphyromonas gingivalis. The results of the remaining interactions and comparisons are inconclusive due to a limited number of studies and differences in study design.

CONCLUSIONS: Inoculation with the periodontitis-associated bacteria F. nucleatum and probably also P. gingivalis exacerbates experimental colitis in mice. It is yet unclear whether colitis can affect periodontal health and/or disease.

OBJECTIVE: To evaluate the impact of implant surface and instrumentation time on the efficacy of two air powder water-jet (APWJ) devices in cleaning the implant surface in a simulation of non-surgical peri-implantitis treatment.

MATERIALS AND METHODS: Turned and modified surface implants (28 each) were coated with a biofilm imitation and mounted on resin models replicating peri-implant intra-osseous defects, including a soft tissue replica. The entire implant periphery was instrumented for 5 or 15s per implant sextant (i.e., in total 30 or 90s per implant), with one of two different APWJ devices using either a glycine or an erythritol powder. Residual biofilm imitation was automatically assessed on standardized photographs and expressed as percentage of the exposed implant surface.

RESULTS: Implant surface (ε2:0.253, p < 0.001) and instrumentation time (ε2:0.044, p = 0.036) had a moderate and small effect, respectively, on the outcome, that is, instrumenting turned compared to modified surface implants as well as using a longer compared to a shorter instrumentation time resulted in less residual biofilm imitation. Complete biofilm imitation removal was achieved only in four turned implants, treated for 15s per sextant. Every second turned implant presented with a maximum of 5% residual biofilm imitation, while only two modified implants achieved this level of cleanliness.

CONCLUSION: In a non-surgical peri-implantitis treatment simulation with APWJ devices, superior biofilm imitation removal was achieved at turned implants, and a longer instrumentation time resulted in less residual biofilm imitation. Modified implants had high chances of incomplete biofilm imitation removal, especially at the apical part of the defect. Complete biofilm imitation removal was in general largely unpredictable.

Objective: To evaluate, in a simulation of surgical peri-implantitis treatment, the impact of type of handpiece, device settings, and instrumentation time on the efficacy of airflowing in cleaning the implant surface, depending on the type of bone defect and implant surface. Methods: Turned and modified surface implants (54 each) were coated with biofilm imitation and mounted on resin models replicating purely horizontal or circumferential intraosseous peri-implant defects (both 5 mm deep). Implants were instrumented with an airflowing device using a supra- or submucosal handpiece, with three settings: (a) power 5, 5 s (b) power 10, 5 s, and (c) power 5, 15 s per implant/defect sextant. Results: The amount of residual biofilm imitation was associated with defect configuration, type of handpiece, and device settings (p < 0.15); implant surface did not have an effect. In horizontal defects, with the supramucosal handpiece, only 3 of 54 implants showed > 5% residual biofilm imitation and 23 of 54 implants were completely clean; with the submucosal handpiece, 12 of 18 implants showed ≤ 5% residual biofilm imitation when used for 15 s/sextant, yet none were completely clean. In intraosseous defects, all implants presented ≤ 5% residual biofilm imitation and 10 of 18 implants were completely clean with the submucosal handpiece used for 15 s/sextant; the supramucosal handpiece was largely inefficacious. Conclusion: Within the limitations of this laboratory study, peri-implant bone defect configuration should dictate the choice of airflowing handpiece (i.e., for horizontal defects, the supramucosal handpiece; for intraosseous defects, the submucosal handpiece) and intrasurgical airflowing requires a prolonged instrumentation time, but not increased power.

BACKGROUND: Periodontitis and inflammatory bowel disease (IBD) are chronic, progressive inflammatory diseases with shared aetiopathogenetic mechanisms. Research suggests that IBD patients are at increased risk of developing periodontitis, which may, in turn, exacerbate IBD activity and disability. This study examines whether periodontitis is associated with increased IBD activity, severity, disability and reduced quality of life.

METHODS: An online survey was distributed to Swedish IBD patients, covering demographics, oral health, and IBD characteristics. Validated tools were used where possible, and data were combined with a similar Danish study.

RESULTS: A total of 786 IBD patients (371 Crohn's disease [CD] and 415 ulcerative colitis [UC]) completed the survey. Self-reported severe periodontitis was significantly associated with poorer IBD disability scores [coef. 5.07 (1.86; 8.27)], more self-reported active disease [OR 1.72 (1.19; 2.49)], higher self-reported disease activity in the preceding 12 months [OR 1.44 (1.05; 1.98)], and reduced quality of life [Coef. -1.45 (-3.01; 0.10)]. Self-reported tooth loss also correlated with poorer disability scores [Coef. 4.47 (0.71; 8.22)] and showed a trend toward greater self-reported disease severity [OR 1.57 (0.97; 2.52)]. Combined Danish-Swedish analysis confirmed these findings.

CONCLUSIONS: This study, although based purely on self-reported data at a single timepoint, reinforces associations between periodontitis, tooth loss and worse IBD outcomes, emphasizing the need for greater focus on oral health in IBD management.

Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).

Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.

Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.

Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care.

Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.

Aim: To (i) evaluate structured postgraduate part-time programs in periodontology, including those addressing peri-implant diseases, among members of the European Federation of Periodontology (EFP), (ii) the impact of the 2018 classification scheme and EFP clinical practice guidelines and (iii) propose a framework for periodontal vocational education and training.

Materials and methods: A summary of relevant European guidelines for vocational education and training was compiled. In a survey and in a systematic review, current part-time programs in continuing professional education in periodontology as well as in prevention and management of peri-implant diseases were examined. The implementation and dissemination of the 2018 classification scheme and the EFP clinical practice guidelines were assessed by literature analysis. Based on these findings, a framework for periodontal vocational education and training was generated.

Results: Part-time programs for professional development in periodontology are established in nine EFP member countries. The systematic review identified lack of knowledge in prevention and management of peri-implant diseases among dental practitioners and hygienists. Continuing professional development was found to be important for education in prevention, classification and management of periodontal as well as peri-implant diseases. The proposed European framework consists of an escalator model with three levels (certificate, diploma and master).

Discussion: Considering the identified variation in the national programs, there is a need to improve education in periodontal and peri-implant diseases. The proposed frameworkmay will help harmonize the national structures.

Conclusion: The proposed framework for part-time professional development is expected to enhance professional qualification.