Plasma cell granuloma (PCG) is a benign inflammatory lesion of reactive origin that is rarely found in the oral cavity. Accurate recognition is essential to differentiate it from malignant lesions and avoid overtreatment or unnecessary radical resections. We present the case of a 26-year-old female with no systemic history who presented with an asymptomatic, firm, erythematous gingival mass in the right upper posterior sextant. The lesion was associated with subgingival dental calculus and a deep carious lesion involving the first premolar and first molar. Treatment included complete surgical excision, extraction of both teeth, and bone curettage. Histopathological examination confirmed PCG, while immunohistochemistry showed CD138 positivity (70%) and polyclonal Kappa/Lambda expression, excluding monoclonal neoplastic restriction. At the 2-month follow-up, healing was satisfactory without recurrence. Histopathological and immunohistochemical evaluation provides a definitive diagnosis, and conservative surgical management is curative.

ObjectiveTo evaluate the clinical and radiographic outcomes of immediately loaded dental implants in patients with non-syndromic alveolar cleft following tertiary alveolar bone grafting (TABG).DesignProspective single-arm interventional clinical study.SettingSingle tertiary care centre.ParticipantsThirty non-syndromic patients (≥16 years) with a missing permanent tooth at the cleft site and previous secondary alveolar bone grafting.InterventionsTABG using autologous anterior iliac corticocancellous or mandibular symphyseal grafts, followed by titanium implant placement and immediate non-functional loading based on intraoperative assessment of primary stability, with recording of implant stability quotient (ISQ). Definitive functional loading was performed at 3 months, with final follow-up at 6 months post-loading.Main Outcome MeasuresClinical parameters (gingival index, plaque index, probing depth, width of keratinized gingiva, bleeding on probing, suppuration, pain/tenderness and mobility) alongside cone beam computed tomography-derived marginal bone loss (MBL) and ISQ, assessed at 3 and 6 months. Implant survival was analysed using Kaplan-Meier analysis.ResultsGraft success was achieved in 25/30 cases (83.3%), with implant placement feasible in 24 (96%). Six implants failed by 3 months follow-up due to mobility; remaining 18 demonstrated significant improvement in all clinical parameters with ISQ increasing from 63.88 ± 8.27 to 68.38 ± 7.90 (P < .001). Mean MBL was 0.38 ± 0.21 mm, within acceptable limits. No further failures occurred following definitive loading. Overall implant survival was 75% (18/24 implants) at 9 months.ConclusionWithin the limitations of this study, immediately loaded implants demonstrated acceptable short-term clinical and radiographic outcomes following TABG in young adults with non-syndromic alveolar clefts.

Periodontitis is an infectious and inflammatory disease. The inability to control clinical inflammation significantly contributes to unsuccessful periodontal treatment. As a key regulator of epigenetics, Sirtuin 6 is one of the NAD[+]-dependent histone deacetylase family members and has recently gained considerable interest in the context of inflammation. While MDL-800 has been demonstrated as an activator of SIRT6, its function in treating periodontitis remains unknown. In this study, animal experiments revealed that MDL-800 reduced alveolar bone resorption in ligature-induced periodontitis, particularly via reducing inflammation and inhibiting osteoclast production in a SIRT6-dependent manner. Furthermore, human gingival fibroblasts (HGFs) were exposed to lipopolysaccharide (LPS) to mimic periodontal inflammation in vitro. We noted that MDL-800 remarkably reduced expressions of pro-inflammatory cytokines in LPS-induced HGFs, which was neutralized by inhibiting SIRT6. Besides, MDL-800 could also reduce oxidative stress damage under inflammatory conditions. The suppression of AIM2 inflammasome activation was associated with the significant anti-inflammatory properties of MDL-800, as demonstrated by RNA sequencing and validation experiments. In conclusion, these findings suggest that MDL-800 was effective in reducing periodontal inflammation, partly by inhibiting AIM2 pathway in a SIRT6-dependent manner, demonstrating significant promise for enhancing therapeutic outcomes in periodontitis.

Gingival recession is a common periodontal condition characterized by apical migration of the gingival margin, resulting in root surface exposure, dentinal hypersensitivity, esthetic concerns, and increased susceptibility to root caries. Multiple adjacent gingival recessions present a therapeutic challenge because treatment aims to achieve root coverage while preserving gingival harmony and esthetic outcomes. The Zucchelli modification of the coronally advanced flap (CAF) has been widely used for the management of multiple recession defects due to its ability to achieve coronal advancement without vertical releasing incisions while preserving the interdental papillae. This case report describes the treatment of multiple adjacent maxillary gingival recessions in a 45-year-old female with well-controlled HIV infection receiving antiretroviral therapy. The patient presented with root sensitivity and esthetic concerns associated with gingival recession affecting the maxillary anterior region. Following comprehensive clinical and periodontal evaluation, root coverage therapy was performed using the Zucchelli modification of the CAF without connective tissue grafting. After meticulous root surface preparation and tension-free coronal advancement, the flap was stabilized with resorbable sutures. Postoperative healing was uneventful, and follow-up examination demonstrated increased root coverage, improved gingival contour, reduction of root exposure, and enhanced esthetics. The patient reported significant improvement in both function and appearance. In this case, the Zucchelli modification of the CAF without connective tissue grafting was feasible in a carefully selected patient with medically controlled HIV infection and was associated with favorable clinical healing and esthetic improvement during follow-up.

Altered passive eruption is a common esthetic condition characterized by excessive gingival coverage of the anatomical crowns, resulting in short clinical crowns, excessive gingival display, and compromised smile esthetics. This case report describes the management of altered passive eruption in a 27-year-old male patient who presented with hypersensitivity affecting several maxillary anterior teeth, excessive gingival display, and dissatisfaction with the appearance of his smile. The patient reported that these conditions negatively affected his self-confidence in both social and professional settings. Clinical examination revealed short clinical crowns and unfavorable tooth proportions associated with excessive gingival tissue coverage. A treatment plan consisting of surgical smile design with gingivoplasty and osteoplasty was developed to establish appropriate gingival architecture and supracrestal tissue attachment prior to restorative treatment. Following flap elevation and osseous recontouring, favorable healing, improved gingival symmetry, and increased clinical crown length were achieved. After soft tissue maturation, esthetic veneer rehabilitation was completed to optimize tooth proportions and smile harmony. The combination of periodontal surgery and restorative treatment resulted in improved gingival contours and smile esthetics, while the patient reported resolution of the previously reported dental hypersensitivity and satisfaction with the treatment outcome. This case highlights the importance of a multidisciplinary approach in the management of altered passive eruption and illustrates how coordinated periodontal and restorative treatment can contribute to favorable short-term esthetic and clinical outcomes.

LL-37 is an antimicrobial peptide involved in antimicrobial defence, inflammatory regulation, tissue repair, and bone regeneration in the oral cavity. Salivary and gingival crevicular fluid LL-37 levels are associated with disease activity and treatment responses. Although there is solid mechanistic and preclinical data on LL-37, research on clinical applications of this remarkable peptide seem to be stalled due to a multitude of factors. The use of LL-37 in clinical practice is affected by proteolytic degradation, cytotoxicity at higher concentrations, microbial tolerance, biofilm protection, rapid salivary clearance, and high production costs. Our review provides a comprehensive update emphasizing the key gaps in LL-37 research and the translational challenges faced by researchers. We also suggest a three-pronged roadmap to future approaches comprising (i) rational peptide engineering and smart nanocarrier-based delivery, (ii) host-directed induction of endogenous LL-37 via vitamin D and short-chain fatty acid pathways, and (iii) standardisation of salivary/gingival crevicular fluid LL-37 as a non-invasive biomarker, aimed at developing LL-37 as a viable diagnostic and therapeutic agent in periodontal disease, dental caries, endodontic infections, oral mucosal disorders, and oral squamous cell carcinoma. Peptide derivatives, nanocarrier-based delivery systems, combination therapy, and vitamin D-mediated induction are being studied to improve its stability and therapeutic activity. LL-37 may have strong applications in oral diagnosis, prevention, and treatment of oral diseases, if the safety, efficacy, and delivery methods are effectively enhanced.

This study aims to comprehensively examine the interrelationships among physical activity, stress, and oral health status in university students to provide empirical evidence for targeted oral health promotion strategies. A survey was conducted among current university students in mainland China. Physical activity was evaluated via the International Physical Activity Questionnaire Short Form, and stress was measured through the 14-item Perceived Stress Scale. Oral health status was evaluated through self-reported indicators, including gingival bleeding, toothache, and oral ulcer. Data were analyzed using multivariable logistic regression and structural equation modeling. A P value < .05 was considered statistically significant. A total of 1578 participants were included. Findings revealed that 47.7% of students had insufficient physical activity, while 38.7% reported high or excessive stress. Multivariable logistic regression showed that insufficient physical activity and elevated stress levels were associated with an increased risk of gingival bleeding and oral ulcers (P < .05). Structural equation modeling showed that physical activity was negatively associated with perceived stress (standardized coefficient = -0.360, P < .05), and perceived stress was positively associated with self‑reported oral symptoms (standardized coefficient = 0.411, P < .05). However, the direct association between physical activity and oral symptoms was not statistically significant (standardized coefficient = -0.009, P = .765). Physical activity, stress, and oral health are closely intertwined. Insufficient activity and high stress are critical determinants of poor oral health among university students. The observed association between physical activity and oral symptoms was mediated primarily through perceived stress rather than a direct effect. Universities should implement integrated interventions that encourage regular exercise and provide mental health support to enhance the holistic and oral well-being of the student population.