Medicine and Pharmacology

Abstract: Background/Objectives: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder associated with systemic inflammation, metabolic dysfunction, and altered intestinal permeability. Emerging evidence suggests interactions between oral health and systemic inflammatory pathways; however, phenotype-specific associations between oral hygiene status and systemic biomarkers in PCOS remain unclear. This study aimed to evaluate the relationship between oral hygiene indices and inflammatory, metabolic, and intestinal permeability biomarkers in women with classical and non-classical PCOS. Methods: This cross-sectional study included 83 women, consisting of 39 patients with classical PCOS and 44 patients with non-classical PCOS. Oral hygiene status was assessed using the Oral Hygiene Index–Simplified (OHI-S), including debris and calculus scores. Serum interleukin-1 beta (IL-1β), anti-Müllerian hormone (AMH), zonulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) were measured using enzyme-linked immunosorbent assay. Statistical analyses were performed to compare group characteristics and evaluate phenotype-specific correlations between oral hygiene indices and systemic biomarkers. Results: No significant differences were observed in debris score, calculus score, total OHI-S score, IL-1β, AMH, zonulin, or HOMA-IR among classical PCOS, non-classical PCOS, and control groups. In classical PCOS, the calculus score was negatively correlated with zonulin levels (ρ = −0.37; p = 0.022). In non-classical PCOS, debris score and total OHI-S score were positively correlated with zonulin levels (ρ = 0.46, p = 0.002 and ρ = 0.37, p = 0.013, respectively). No significant correlations were identified between oral hygiene indices and IL-1β, AMH, or HOMA-IR. Conclusions: Oral hygiene status and systemic biomarker levels did not differ significantly between women with PCOS and healthy controls. However, phenotype-specific associations between oral hygiene indices and zonulin suggest a potential role of the oral–intestinal axis in PCOS pathophysiology, particularly in non-classical PCOS.

Abstract: Background: Management of high sagittal split fractures of the mandibular condyle remains a formidable surgical chal-lenge due to limited visualization, technical difficulties in direct in-situ fixation, and the high risk of secondary avascular necrosis or temporomandibular joint (TMJ) ankylosis. Objectives: To evaluate the clinical outcomes and technical efficacy of the "Motamed Technique"a standardized protocol involving extracorporeal rigid internal fixation followed by anatomical re-implantation for complex high condylar split fractures. Methods: A retrospective evaluation was conducted on a clinical series of 11 consecutive patients (9 males, 2 females) presenting with severe, displaced high sagittal split condylar fractures secondary to high-velocity trauma. In all cases, the fragmented condylar segments were completely retrieved, stabilized ex-vivo on a back-table using a titanium X-shaped 3D mini-plate system (1.5 mm), and meticulously re-implanted into the glenoid fossa. Total cold ischemia time was strictly maintained between 10 to 20 minutes. The postoperative longitudinal follow-up period ranged from 6 to 11 months (mean duration: 8.6 months). Comprehensive post-operative tracking included clinical parameter checking, 3D Com-puted Tomography (3D-CT), and high-resolution dynamic Magnetic Resonance Imaging (MRI) to analyze bony union, vertical ramus height restoration, and articular disc kinetics. Results: All 11 patients achieved predictable and stable functional outcomes. At the definitive milestones, the mean maximum mouth opening (MMO) was 37.3 mm (range, 33–45 mm), demonstrating excellent vertical clearance and stable lateral/protrusive excursions. Pre-traumatic stable centric occlusion was perfectly restored and maintained in 100% of cases (n=11), with zero incidence of postoperative open bite or crossbite. Facial nerve motor function was entirely pre-served across the cohort (100% House-Brackmann Grade I at final follow-up). Longitudinal 3D-CT scans confirmed complete osseous union and anatomical alignment in all cases by the 4th postoperative month, with no radiographic evidence of condylar head resorption or hardware failure. Follow-up MRI findings demonstrated the preservation of TMJ dynamics, functional articular disc movement (with stable reduction in 3 cases), and a total absence of avascular necrosis or intra-articular effusion. No cases of TMJ ankylosis were reported. Conclusion: The Motamed Technique provides a reliable, reproducible, and biologically sound approach for managing intricate high condylar split fractures. By utilizing systematic extracorporeal mini-fixation, this protocol effectively overcomes intraoperative spatial limitations while ensuring excellent long-term anatomical stability, stable occlusion, and functional joint mobility without compromising facial nerve integrity.

Abstract: Introduction: We investigated the direct effect of transverse maxillary constriction on nasal septal deviation (NSD) and nasal floor slanting. Methods: 60 growing Wistar rats (21days old) were divided into four groups (n=15): 1) Experimental Group 1 received active constriction force (100cN), 2) Experimental Group 2 received active expansion force (100cN), 3) Sham received the same spring as Experimental Groups without receiving any active force, and 4) Control group did not receive any appliance. Samples were collected after 28 days for microcomputed tomography (μCT) analysis. Results: Experimental Group 1 demonstrated maxillary constriction (both skeletal and dental), accompanied by mandibular shift on closure, clockwise mandibular rotation, and increased mandibular plane angle and facial height. Constriction also produced severe nasal floor slanting in the molar area that extended posteriorly. Nasal floor canting was accompanied by a slanted vomer and a C-shaped NSD. The direction of nasal floor canting and mandibular shift was always similar. Experimental Group 2, on the other hand, was not associated with nasal deviation, and a slight slanting of the nasal floor was observed only when there was a mandibular shift. Conclusion: Our study suggests that the constricting transverse forces applied to the maxilla can induce slanting of the nasal floor and, consequently, the vomer, which in turn can lead to nasal septal deviation. Slanting of the nasal floor is caused mainly by rotation of the hemimaxilla in response to transverse forces and changes in occlusal forces due to a mandibular shift.

Abstract: Background/Objectives: Periodontitis is the sixth most prevalent disease worldwide, affecting over 740 million people and representing a growing public health burden, particularly in transitional economies. While artificial intelligence (AI) technologies -including deep learning (DL) and machine learning (ML) -have demonstrated high diagnostic accuracy in controlled research settings, a critical implementation gap persists between proof-of-concept studies and real-world clinical deployment, especially in countries with nascent regulatory frameworks such as Kazakhstan. This systematic scoping review synthesizes global evidence on AI methodologies applied to periodontal diagnosis, risk prediction, and patient monitoring; evaluates regulatory and governance frameworks; and proposes an evidence-based five-stage implementation model contextualized for emerging health systems. Methods: Following PRISMA 2020 guidelines, a systematic literature search was conducted in PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library, supplemented by regulatory and grey literature. Search terms combined (‘artificial intelligence’ OR ‘machine learning’ OR ‘deep learning’) AND (‘periodontitis’ OR ‘periodontal disease’ OR ‘gingivitis’). Studies published from January 2015 to April 2025 were considered. Forty-five sources (36 peer-reviewed empirical and review studies plus 9 regulatory and grey-literature documents) meeting predefined inclusion criteria were included in qualitative synthesis. Results: Two dominant AI paradigms were identified: (1) image-based deep learning -particularly convolutional neural networks (CNNs) and Vision Transformers -achieving diagnostic accuracies of 73–98.6% for periodontal bone loss detection on panoramic and periapical radiographs; and (2) ML-based non-clinical predictive screening models using patient-reported data and salivary biomarkers. Digital patient management tools (smart toothbrushes, chatbots, IoT platforms) represent a third emerging application domain. Significant external validation performance drops were consistently observed across models, underscoring data quality, dataset heterogeneity, and sample-size constraints as primary barriers. Regulatory analysis revealed convergence of the EU AI Act, U.S. FDA framework, WHO guidance, and the emerging Kazakhstan AI Development Concept (2024–2029) around risk-based classification, algorithmic transparency, and post-market surveillance mandates. Conclusions: Safe, ethical, and clinically effective integration of AI in periodontology requires a phased implementation approach: establishing national multimodal databases, performing locally validated clinical trials, integrating certified tools into digital workflows, deploying continuous monitoring systems, and developing robust legal governance including liability and insurance mechanisms. Kazakhstan’s rapidly evolving regulatory infrastructure and digitalization strategy create a concrete opportunity to establish a replicable model for AI adoption in periodontal care across Central Asian and transitional economies.

Abstract: Background: Anatomical variations of the mental nerve are critical to recognize during maxillo-facial trauma surgery to prevent iatrogenic nerve injury. The nerve typically divides into three main branches upon exiting the mental foramen. Case Presentation: A 27-year-old male presented to the Department of craniomaxillofacial Sur-gery at Sherbin Central Hospital following a motor vehicle accident, sustaining a mandibular parasymphyseal fracture. During an open reduction and internal fixation via a mandibular ves-tibular approach, an unusually superficial neurovascular configuration was noted. Meticulous skeletonization revealed a rare six-branch arborization of the mental nerve arising from a single foramen. All six branches were carefully isolated and preserved during fracture reduction and miniplate osteosynthesis. Post-operative neurosensory assessment confirmed completely intact sensation.Conclusion: This case highlights the importance of adaptive surgical dissection and a high index of anatomical suspicion during trauma surgery to avoid permanent neu-rosensory deficits.

Abstract: The concept of allogenic tooth transplantation has been known since the early stages of modern oral surgery. Despite numerous successful clinical cases, a deeper understanding of the biological and technical aspects of this method is still required to enable its safe and effective implementation in routine clinical practice. In this case report, we describe an allogenic tooth transplantation performed between a mother and her son. In the mother, teeth 14 and 24 had been extracted more than 10 years earlier due to failed endodontic treatment. Only minimal spontaneous space closure between adjacent teeth occurred, and therefore orthodontic space reopening was not required prior to transplantation. The donor teeth were the son’s maxillary first premolars, which were indicated for extraction for orthodontic reasons. The procedure was preceded by a detailed CBCT analysis, establishment of a surgical plan, and definition of the transplantation protocol. Using CAD/CAM-based 3D printing, replicas of the donor teeth were fabricated and used intraoperatively as guides during preparation of the recipient sites within the alveolar bone. The recipient sockets were prepared using instruments from an implant surgical kit. The 3D tooth models enabled precise adaptation of the recipient bed to the morphology of the donor roots, thereby minimizing the extra-alveolar time. Following atraumatic extraction, the donor teeth were immediately transplanted into the recipient. This report presents a case combining 3D printing technology with allogenic tooth transplantation. This approach allows reduction of extra-alveolar time, minimizes unnecessary alveolar bone loss, and improves primary stability of the transplant. The aim of this study is to expand current knowledge regarding the potential use of allogenic tooth transplantation in combination with 3D printing and to support its broader application in clinical dental practice, similarly to other medical fields where transplantation procedures demonstrate high success rates.

Abstract: Background: The aim of this study is to evaluate the influence of biomimetic remineralization on the performance of four universal adhesive systems applied to artificially caries-affected dentin before and after artificial aging. Methods: One hundred and four human molars were allocated to sixteen groups according to dentin condition (sound or biomimetically remineralized), adhesive system (FuturaBond® M+, Scotchbond™ Universal, Prime&Bond Active®, and One Coat7 Universal®), and aging (24h or 10,000 thermocycles). Artificially caries-affected dentin was prepared through pH cycling and then remineralized with CPP-ACP. Field-emission scanning electron microscopy (FEG-SEM) evaluated the adhesive interface. SBS testing assessed bond performance, and failure modes were classified under magnification. Results: Biomimetic remineralization modified the adhesive interface and influenced bond performance depending on adhesive system and aging. Scotchbond and Prime&Bond produced thicker adhesive layers than One Coat (p≤0.05), persisting after thermocycling (p<0.01). Futurabond showed greater resin tag formation in remineralized dentin compared with Scotchbond (p=0.04) and One Coat (p=0.004). Universal adhesives showed higher bond strength to sound dentin (p<0.001) than to biomimetic remineralized dentin. Failure patterns varied with substrate and aging. Conclusion: Biomimetic remineralization did not significantly alter bond strength among universal adhesives but positively influenced adhesive interface morphology.

Abstract: Molar-Incisor Hypomineralization (MIH) is a developmental defect of the enamel that affects molars and incisors, with white, yellowish or brownish spots as its main charac-teristics, which may present characteristics of fragility in these regions, with a chance of fractures. This observational study investigates the efficacy of imaging tests requested in orthodontic documentation, in this case, cone beam computed tomography (CBCT) as an additional and profound possibility for identifying and diagnosing HMI. Children aged between 6 and 12 years were selected, who had clinically diagnosed HMI, and who participated in another study, where the request for CBCT was made possible. Of the 26 examinations evaluated, out of a total of 13 patients, 59 teeth were identified, of which 81% were white spots, 9% yellow/brown spots, and 10% had fractures. The results concluded that there is a visual possibility by the professional of the defects of the imaging exams, especially in CBCT, with the possibility of extension measurements; however, knowledge of the clinical condition is still the preponderant factor for the differential diagnosis of this enamel defect. It can be concluded that it is possible to observe HMI lesions on CBCT images, but the orthodontist needs to be qualified in this identification, through the additional tests that already make up his diagnostic arsenal. With this, relationships of difficulties in your clinic can be identified earlier, such as loss of space in the arch, dif-ficulty in bonding accessories, among others.

Abstract: Digital dentistry increasingly relies on artificial intelligence to automate restorative design. Yet the ability of generative networks to produce multiple clinically plausible solutions for the same prosthetic field remains insufficiently evaluated. This study assessed the creative potential of a previously developed three-dimensional generative adversarial network (3DGAN) for screw-retained implant crown design. Nine AI-generated implant crown designs were analyzed, consisting of three independently generated crowns for each of three different prosthetic fields. Within each set, the crowns were superimposed and compared using “MeshLab”. Mean HD, maximum HD, and RMS values were recorded, with 0.05 model units used as the threshold for identifying insufficient morphological variation. The overall mean HD was 3.32 model units, the mean maximum HD was 16.18 model units, and the mean RMS value was 4.40 model units. No pairwise comparison showed values equal to or below 0.05 model units. In conclusion we found that the investigated 3DGAN demonstrates real creative potential.

Abstract: This longitudinal, randomized, controlled clinical study investigates the efficacy of different methods of rapid maxillary post-expansion containment (RME) in children. The post-MRE containment phase is critical to prevent recurrences and ensure the stability of the results obtained. Traditionally, restraint methods include maintaining the Hyrax-type expander or using removable appliances such as the Hawley plate. This study compares these two methods in terms of maxillary transverse stability, evidencing the patients’ adaptation and quality of life. Forty children aged 6 to 12 years were selected and randomly divided into two groups: Group 1 (maintenance of the Hyrax expander for 6 months) and Group 2 (replacement of the removable Hawley plate appliance for 6 months). Three questionnaires performed on quality of life were applied at Time 0 (T0: initial assessment) and Time 1 [T1: use of restraint (G1: Hyrax; G2: Removable retainer)]. Data analysis was carried out using observational methods referring to the graphs obtained from the answers to the questionnaires. The results of this study provide evidence on better clinical practices, promoting health and quality of life of orthodontically treated children.

Abstract: Background: Persistent challenges in healthcare infection control, particularly the need for rapid hand hygiene during continuous patient care, highlight limitations of current personal protective equipment (PPE). We developed a lightweight face shield integrating a disinfectant reservoir to enable immediate point-of-care hand sanitisation. Methods: A dual-function system was designed comprising a polyethylene terephthalate glycol (PETG) visor (23 × 23 cm, 0.20 mm) and a modular disinfectant reservoir (25–100 mL). Components were fabricated using CAD, 3D printing, and PETG forming. The reservoir features a touch-activated, self-sealing valve delivering approximately 3 mL per activation. Benchtop testing assessed dosing consistency, leak-tightness, attachment security, material compatibility with alcohol-based disinfectants, and durability. Results: The visor weighed 13.4 g, with total system mass of 103.4 g (empty) and 203.4 g (maximum fill). Cervical torque increased from 0.084 to 0.282 N·m, supporting continuous wear for 60–90 minutes. Testing confirmed consistent dosing, reliable resealing, leak-free performance, and PETG stability after disinfectant exposure. Conclusions: This dual-function visor integrates facial protection with immediate hand sanitisation, addressing critical infection-control challenges in dentistry. Its low cost, reusability, and modular design support chairside use and mobile dentistry, while enabling future integration of wearable sensors.

Abstract: In oral surgery, the classification of the proximity of the mandibular third molar to the mandibular canal, typically performed on panoramic radiographs, is essential for surgical planning. While artificial intelligence (AI) tools have been explored for this task, their performance is limited due to data scarcity and class imbalance. In this work, we study the potential of synthetic data generation for this task using Denoising Diffusion Probabilistic Models (DDPMs) and Generative Adversarial Networks (GANs), both unconditional and conditioned to the tooth-canal relationship. We used public datasets to create and label a training dataset of 5416 images. The results show the lowest Fréchet inception distance (FID) / second-highest Inception Score (IS) for the unconditional GAN (32.48 / 2.14). The unconditional DDPM showed an FID of 34.28 and IS of 1.95. Conditional models showed similar IS but a worse overall FID of 68.19 and 219.11 for DDPM and GAN, respectively. In a paired observer study between the two unconditional models, clinical observers found the DDPM image to be more realistic in 69.6% of cases. Future work should investigate downstream effects of GANs and DDPMs used in data augmentation for the training of an AI classifier.

Abstract: Background/Objectives: This study evaluates the adaptation of a novel filling material (Odne®Fill, Switzerland) to the walls of the shaped root canal using micro-computed tomography. Methods: Fourteen extracted human molars (6 maxillary and 8 mandibular), comprising a total of 32 root canals, were included. After canal preparation, all canals were filled with Odne®Fill according to the manufacturer’s instructions. Periapical radiographs and micro-computed tomography were used to assess the extent of canal wall coverage by the filling material. Surface coverage was quantified by image segmentation and statistically analyzed. Results: The percentage of canal wall coverage ranged from 93.31% to 99.98%. The mean coverage rate was 97.63% (SD 1.70%) and the median was 98.23%, indicating a high degree of adaptation of the filling material to the ex vivo prepared canal walls. Conclusions: Under the conditions of this ex vivo study Odne®Fill demonstrated high canal wall adaptation values. These findings should be interpreted with caution and further com-parative and long-term studies are required before clinical relevance can be established.

Abstract: Nano-engineering strategies have been increasingly applied to enhance the biological performance of calcium silicate–based materials; however, the optimal concentration of nano-hydroxyapatite (HANP) remains unclear. This study evaluated the bone-healing response to different concentrations of HANP incorporated into mineral trioxide aggregate (MTA) and bioceramic (BC) sealers in an experimental rabbit model. Thirty adult New Zealand white rabbits were allocated into two experimental groups according to sealer type: HANP-modified MTA and HANP-modified BC (n = 15 each). Two standardized circular intrabony defects were created bilaterally in the maxillary diastema of each rabbit. In the MTA group, the right-side defects were filled with 2% and 4% HANP-modified MTA, while on the left side one defect received 6% HANP-modified MTA and the adjacent defect was left as control. The same protocol was followed for the BC group using corresponding HANP concentrations. Five rabbits per group were sacrificed at 2, 4, and 8 weeks postoperatively for histopathological hematoxylin and eosin (H&E) and Masson trichrome staining. The results demonstrated significant differences among groups at all-time points, with 4% HANP showing the most favorable biological response, including reduced inflammatory cell infiltration, increased new bone formation, and improved collagen organization compared with lower and higher concentrations. Pairwise comparisons at matched HANP concentrations revealed no statistically significant differences between HANP-modified MTA and BC groups. These findings indicate that HANP incorporation enhances the biological performance of calcium silicate–based sealers in a concentration-dependent manner, with 4% representing an optimal formulation for promoting bone regeneration.

Abstract: Accurate, complete-arch digital implant impressions remain challenging because cumulative image stitching distortion may increase across geometrically complex edentulous arches. This in vitro study evaluated the influence of implant spatial configuration on the trueness of complete-arch digital implant impressions obtained using current-generation intraoral scanners. Three edentulous mandibular models representing different implant spatial configurations were fabricated: closely spaced parallel implants, widely distributed parallel implants, and angulated implants. Seven intraoral scanners (Trios 3, Trios 4, Trios 5, Medit i500, Primescan 1, Primescan 2, and Aoralscan 3) were evaluated. Ten scans were acquired per model and scanner, generating 210 STL datasets. A CAD replacement workflow based on scan body library geometries was performed prior to deviation analysis. Trueness was evaluated using root-mean-square (RMS) deviation values following iterative closest point alignment with reference datasets obtained using a laboratory scanner. Statistical analysis was performed using two-way ANOVA and post hoc comparisons (α=.05). Significant differences were observed among scanners (p< .001), implant configurations (p< .001), and their interaction (p< .001). Lower RMS deviation values were generally observed in the closely spaced implant configuration, whereas widely distributed implants demonstrated the highest deviations across most scanners. Primescan 1 and Primescan 2 exhibited lower RMS deviation values and smaller increases in distortion across geometrically complex configurations. The spatial configuration of implants significantly influenced the trueness of complete-arch digital implant impressions. Increased implant spatial complexity was associated with greater cumulative stitching distortion during intraoral scanning procedures. Scanner performance varied with implant configuration, suggesting differing resistance to cumulative distortion among current-generation intraoral scanners.

Abstract: Background/Objectives: Long-term clinical data on direct posterior composite restorations are scarce. This study evaluated their performance after almost three decades using selected FDI criteria. Temporal changes were tracked across follow-up exams, including within a predefined subcohort. Methods: This observational follow-up involved 21 patients with 57 posterior composite restorations placed in 1995–1996. The 2025 follow-up used FDI criteria to assess functional, esthetic, and biological properties, classifying outcomes as clinically acceptable, intervention needed, or failure. Descriptive analyses were applied to the entire cohort. Longitudinal analyses were conducted on a subcohort of 14 patients with 27 restorations at three time points. Exploratory analyses assessed associations with restoration factors, caries experience, and gingival health. Results: In 2025, 54.4% of restorations were clinically acceptable, 28.1% required intervention, and 17.5% were failures. Functional criteria remained mostly acceptable, though form and contour showed the highest mean values. In the longitudinal subcohort, significant changes over time were observed in anatomical form and occlusal wear. Retention, marginal adaptation, proximal contact, and surface luster did not change significantly. Biologically, restorations available for direct assessment had low incidences of secondary caries, hard-tissue defects, and postoperative sensitivity or pulpal issues. Conclusions: Posterior composite restorations can function for nearly three decades but gradually deteriorate in certain aspects. Long-term changes mainly involve cumulative functional aging of the anatomical form and occlusal wear, rather than widespread biological failure. These findings underline the importance of differentiated long-term assessment and support conservative management approaches where clinically feasible before replacement is undertaken.

Abstract: Background: Periodontitis is a chronic inflammatory disease increasingly associated with systemic immune dysregulation and microbial imbalance beyond the oral cavity. Emerging evidence suggests that gut microbiome dysbiosis contributes to periodontal inflammation through the oral–gut microbial axis. Methods: This systematic review was conducted according to PRISMA guidelines using the PECOS framework. A comprehensive literature search was performed across PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL, and Google Scholar databases to identify studies evaluating the association between gut microbiota and periodontitis, including microbiome alterations, inflammatory pathways, and microbiome-modulating interventions. Results: The included studies demonstrated that patients with periodontitis frequently exhibit reduced gut microbial diversity, enrichment of pro-inflammatory taxa, impaired intestinal barrier function, and elevated inflammatory mediators including C-reactive protein, interleukin-6, and tumor necrosis factor-alpha. Several studies identified translocation of periodontal pathogens such as Porphyromonas gingivalis and Fusobacterium nucleatum to the gastrointestinal tract, supporting the existence of an oral–gut axis. Probiotics, prebiotics, synbiotics, and periodontal therapy showed potential benefits in improving periodontal parameters and restoring microbial homeostasis. Conclusions: Current evidence supports a significant relationship between gut microbiome dysbiosis and periodontitis through immune, inflammatory, and metabolic mechanisms. However, heterogeneity among studies and limited longitudinal evidence warrant further standardized clinical and mechanistic investigations to establish causality and optimize microbiome-targeted therapeutic strategies in periodontal disease.

Abstract: The TM7x strain is a genetic variant of the bacterium Nanosynbacter lyticus, which belongs to the Saccharibacteria phylum within the Candidate Phyla Radiation (CPR) or Patescibacteria group. Its biology differs significantly from that of other bacterial phyla, and its ecological role in the oral cavity remains largely undefined. Through a organyzed and comprehensive literature review, we aim to define the role this bacterium plays within the oral ecosystem. We identified relevant studies from primary sources, included scientific articles from preclinical and clinical studies obtained from three digital databases. The bacterial strain TM7x is an obligate epibiont that exhibits autonomous energy me-tabolism and utilizes a type IV pili system to adhere to its direct host, Schaalia odontolytica. It interacts with its host in two stages: initially as an epipatobiont and subsequently as an episymbiont. TM7x plays a complex ecological role by modulating the host’s metabolism and structure toward a less virulent phenotype resistant to phage attack, while also in-fluencing the human host through immunomodulation and tissue protection. This organism has transitioned from being considered 'biological dark matter' to a key model for understanding coevolution within the human microbiome. Its ability to protect the host from phages, induce protective biofilms, and suppress destructive inflammatory responses positions it as a vital component of human oral microbiome homeostasis.

Abstract: Background: Type 2 diabetes mellitus (T2DM) and periodontitis are chronic inflammatory conditions. Periodontitis may amplify low-grade systemic inflammation in people with T2DM. High-sensitivity C-reactive protein (hsCRP) reflects this inflammatory burden, but the effect of non-surgical periodontal therapy (NSPT) on hsCRP in T2DM remains uncertain. Objective: To evaluate whether NSPT changes hsCRP at 3 and 6 months compared with oral hygiene instructions alone in patients with T2DM and periodontitis. Methods: Predefined secondary analysis of a 1:1 parallel-group randomized trial with assessments at baseline, 3 months, and 6 months. Participants received scaling and root planing plus oral hygiene instructions (intervention) or oral hygiene instructions only (control). Fasting hsCRP (mg/L) was analyzed on the log scale using mixed-effects models; effects are presented as exponentiated ratios with 95% confidence intervals. Sensitivity analyses included baseline-adjusted analysis of covariance (ANCOVA) and covariate-adjusted mixed models. An exploratory group-adjusted regression examined associations between periodontal changes and hsCRP change. Results: Eighty-nine participants were randomized (45 control, 44 intervention), with hsCRP available for most participants through 6 months. There was no between-group difference at 3 months (ratio 0.958; 95% CI 0.875–1.049; p=0.358). At 6 months, hsCRP was lower in the NSPT group than in controls (ratio 0.809; 95% CI 0.738–0.887; p<0.001), corresponding to ~19% lower hsCRP; the model-based geometric mean hsCRP at 6 months was 2.66 mg/L versus 3.26 mg/L. Periodontal measures improved more with NSPT, but changes in periodontal measures were not independently associated with hsCRP change after group adjustment. Conclusions: In patients with T2DM and periodontitis, NSPT was associated with lower hsCRP at 6 months, suggesting a potential systemic anti-inflammatory benefit. These findings support periodontal care as part of integrated management in T2DM.

Abstract: Background/Objectives: Endodontic success in maxillary first molars is often complicated by their complex anatomy, increasing the risk of procedural errors in "danger zones" where dentine is thin. While global data on root morphology exists, population-specific information for South Africans is lacking. This study aims to quantify root dentine thickness in a Black South African sample using a novel software program to enhance accuracy for preoperative planning and improved clinical outcomes. Methods: Micro-CT scans of 97 maxillary first molars (57 individuals) were analyzed. Den-tine thickness was measured at 0.1 mm intervals using a novel surface-to-interface software tool, which enabled automated, high-precision quantification of complex curved geometries. Data were standardized into 1 mm segments for analysis. Reliability trials confirmed high precision (within 0.0001 mm). Results: Buccal and lingual surfaces of mesiobuccal and distobuccal roots were consistently thicker than mesial and distal surfaces. All roots showed progressive thinning toward the apical third. Conversely, palatal roots exhibited an opposing pattern with mesial and distal surfaces that were thicker than buccal and lingual aspects. Age correlations were not statistically significant. Conclusions: The study identifies specific anatomical patterns in root dentine thickness within a South African sample. The thinner mesial and distal walls of buccal roots represent critical "danger zones" for clinicians. The novel software proved highly effective for precise morphometric mapping and offers a versatile framework for broader endodontic research. These findings provide essential data for optimizing endodontic treatment strategies and the development of population-specific dental instruments.