International Journal of Research and Reports in Dentistry

Oral–Gut Microbial Translocation Axis in Periodontitis: A Critical Review of Mechanisms and Systemic Implications (2015–2025)

Prakash Pai Gurpur, Mundoor Manjunath Dayakar, H. A. Impana — Tue, 26 May 2026 00:00:00 +0000

Periodontitis is a dysbiosis-driven chronic inflammatory disease affecting the tooth-supporting structures that extends its pathological influence well beyond the oral cavity. Over the past decade, the oral–gut microbial translocation axis has emerged as a biologically compelling framework through which periodontal dysbiosis may shape the composition and functional output of the intestinal microbiota, with downstream consequences for systemic health. This review critically examines the mechanistic basis of oral-to-gut bacterial translocation, addressing the survival of swallowed periodontal pathogens through the gastric environment, their disruption of intestinal colonisation resistance, impairment of epithelial tight junction integrity, and induction of systemic immunological cascades involving Th17 cells, regulatory T cells, and inflammasome activation. A comprehensive literature search was conducted across the following electronic databases: PubMed/MEDLINE, Web of Science, Scopus, Embase, and Google Scholar. The roles of keystone periodontal pathogens—principally Porphyromonas gingivalis, Fusobacterium nucleatum, and Klebsiella spp.—are scrutinised in both animal models and clinical studies. The review further evaluates evidence linking the oral–gut axis to inflammatory bowel disease, colorectal cancer, metabolic-associated steatotic liver disease, and cardiovascular disease. The effect of non-surgical periodontal therapy on gut microbial composition is assessed, alongside emerging microbiome-targeted therapeutic strategies including probiotics, prebiotics, and bacteriophage-based approaches. The synthesis of current evidence reveals a bidirectional and mechanistically intricate communication channel between the oral and intestinal ecosystems, yet causal inference from human data remains constrained by methodological heterogeneity, the preponderance of cross-sectional designs, and residual confounding. Future longitudinal and interventional research employing multi-omics platforms is necessary to translate the mechanistic insights reviewed herein into actionable clinical guidance.

Hazards of Mercury Toxicity and Other Heavy Metal Intoxication: A Critical Review

M. Narayan Rao — Wed, 03 Jun 2026 00:00:00 +0000

Heavy metal contamination poses an enduring and increasingly urgent public health challenge. Mercury, lead, cadmium, arsenic, and several other metals occur widely in terrestrial and aquatic environments as a consequence of both natural geological processes and expanding anthropogenic activity. Chronic, low-level exposure to these substances is now recognised as a major driver of non-communicable disease burden globally, contributing to neurological deterioration, renal dysfunction, cardiovascular disease, skeletal pathology, and multiple forms of cancer. Their toxicity is mediated through interconnected mechanisms that include the generation of reactive oxygen species, disruption of intracellular calcium signalling, enzyme inhibition through binding to sulphydryl groups, and impairment of DNA repair. Particularly vulnerable populations include children, pregnant women, artisanal miners, and communities reliant on contaminated drinking water or subsistence fishing. Despite growing scientific understanding and the emergence of international regulatory instruments such as the Minamata Convention, exposures at toxicologically relevant levels remain widespread. This review critically examines the sources, environmental distribution, mechanistic toxicology, clinical manifestations, diagnostic approaches, treatment strategies, and regulatory context of the principal hazardous heavy metals. Evidence drawn from peer-reviewed literature published predominantly between 2000 and 2026 is synthesised to identify knowledge gaps, highlight persistent challenges in clinical management, and inform priorities for future research and policy action. The findings suggested that heavy metal intoxication, being a major global public health threat, require stronger prevention, monitoring, and treatment strategies to reduce its long-term health and environmental impacts. This study is limited by incomplete geographic representation, undercoverage of certain metals and emerging biomarkers, and reliance on existing literature, indicating the need for future large-scale, globally inclusive epidemiological and mechanistic research on heavy metal toxicity.

Digital Workflow-assisted Lithium Disilicate Resin-Bonded Fixed Dental Prosthesis for Missing Maxillary Lateral Incisor: A CARE-Compliant Case Report

S. O. Chandana, B. Leela, D. B. Nandeshwar — Wed, 27 May 2026 00:00:00 +0000

Background: Resin-bonded fixed dental prostheses (RBFDPs) represent a minimally invasive solution for replacing missing anterior teeth. The evolution of ceramic materials, particularly lithium disilicate, combined with digital CAD-CAM workflows has significantly enhanced the clinical predictability and aesthetic outcomes of these restorations.

Case Presentation: A 33-year-old male patient presented with a missing maxillary left lateral incisor (#12) and multiple missing mandibular anterior teeth following trauma. A lithium disilicate RBFDP was planned and fabricated using intraoral scanning and CAD-CAM technology for the maxillary arch. Abutment preparation was conservative, with supragingival shoulder finish lines created on teeth #11 and #13. The prosthesis was cemented with self-adhesive resin cement following acid etching protocols.

Conclusion: This case demonstrates that lithium disilicate RBFDPs fabricated through a digital workflow provide a reliable, aesthetic, and minimally invasive alternative to conventional fixed partial dentures and implant-supported prostheses for selected patients. Meticulous case selection, surface preparation, and adhesive protocol adherence are pivotal to long-term success.

Nonsurgical Endodontic Management of a Three-Rooted Maxillary First Premolar: A Case Report

K. Shreekrishna, Karanam Apoorva Prakash, B. S. Keshava Prasad — Tue, 02 Jun 2026 00:00:00 +0000

Successful endodontic treatment relies on accurate diagnosis and thorough management of the entire root canal system, especially in teeth with anatomical variations. Maxillary first premolars are known for their complex root canal morphology, and the presence of three roots and three canals is considered a rare anatomical variation that can present both diagnostic and treatment challenges. Failure to identify such unusual anatomy may result in incomplete debridement and compromised treatment outcomes. This case report describes the nonsurgical endodontic management of a three-rooted maxillary first premolar in a 35-year-old male patient who presented with spontaneous pain in the upper left posterior region. Clinical examination and sensibility tests suggested irreversible pulpitis in tooth #24. During working length determination, an additional root was suspected on radiographic examination and was subsequently confirmed using cone-beam computed tomography (CBCT). Modification of the access cavity to a T-shaped design, combined with 3.5× magnification and careful canal exploration, enabled the identification of three distinct canals—mesiobuccal, distobuccal, and palatal. Cleaning and shaping were carried out using hand and rotary instrumentation with copious irrigation using 3% sodium hypochlorite and 17% EDTA, followed by intracanal calcium hydroxide medication and obturation using BIO C SEALER with gutta-percha. Accurate diagnosis aided by CBCT and careful treatment planning contributed to the successful management of this uncommon anatomical variation.

Effect of Ultraviolet Photofunctionalization on Early Osseointegration of Titanium Dental Implants in the Mandibular Region: A Randomized Controlled Trial

Aditi Shreya, K. Khinnavar Poonam, B. Nandeeshwar — Wed, 03 Jun 2026 00:00:00 +0000

Background and Objectives: Titanium surface photofunctionalization using ultraviolet (UV) irradiation has emerged as a promising adjunct to conventional implant protocols. This study aimed to evaluate and compare early osseointegration between photofunctionalized and non-photofunctionalized titanium dental implants placed in the mandibular region.

Methods: This randomized double-blinded controlled trial enrolled 24 patients (12 male, 12 female; age 25–40 years) requiring mandibular implant placement. Participants were randomly allocated to receive either UV-treated (n=12) or conventional non-UV (n=12) titanium implants. UV photofunctionalization was performed for 20 seconds using a DIO UV Irradiator prior to implant placement. Implant stability was assessed using resonance frequency analysis (Osstell Mentor; ISQ values) at baseline (immediately after placement), 4 weeks, 8 weeks, and 4 months postoperatively. Marginal bone levels were evaluated on standardized intraoral periapical radiographs at baseline, 8 weeks, and 4 months. Peri-implant soft tissue was assessed at 4 and 8 weeks using the Mombelli modified gingival index (mGI). Statistical analysis was performed using IBM SPSS version 25; intergroup comparisons used unpaired t-tests and chi-square tests.

Results: No significant difference in ISQ values was observed between groups at baseline or 4 weeks (p=0.152 and p=0.174, respectively). At 8 weeks and 4 months, the UV group demonstrated significantly higher ISQ values (p=0.021 and p=0.004, respectively). Both mesial and distal marginal bone loss were significantly lower in the UV group compared to the non-UV group (p=0.041 and p=0.021, respectively). Soft tissue assessment revealed no significant intergroup difference at either 4 weeks (p=1.00) or 8 weeks (p=1.00).

Conclusion: UV photofunctionalization significantly enhances implant stability and reduces peri-implant marginal bone loss from 8 weeks onward, without adversely affecting peri-implant soft tissue health. This technique represents a clinically practical and effective adjunct for improving early osseointegration outcomes, particularly in regions requiring higher predictability.

Oral Health Knowledge and Practices Among Primary School Teachers in Harare, Zimbabwe

Chiedza Runyararo Akino, Cleopatra Matanhire-Zihanzu, Pride Mucheto — Thu, 28 May 2026 00:00:00 +0000

Background: Primary school teachers play a key role in shaping children’s health behaviours, including oral hygiene practices. Adequate oral health knowledge among teachers can contribute to early prevention of dental diseases and promotion of healthy habits among school-aged children. However, limited awareness may negatively influence both their own oral health practices and the health education they provide to learners.

Aims: The study aims to assess oral health knowledge and practices among primary school teachers in Harare, Zimbabwe.

Study Design: A descriptive mixed-methods study with both qualitative and quantitative data.

Place and Duration of Study: Primary schools in Harare, between July 2020 and April 2021.

Methodology: The study population included all primary schools in Harare, excluding schools located in armed forces’ camps. Participating schools were selected using simple random sampling through the lottery method. A sample size of 33 was calculated using EpiInfo 7, with a 10% non-response rate considered.

Results: The response rate was 93.93% (31 schools). Only 9 (29%) respondents correctly identified the number of deciduous teeth, while 13 (42%) knew the correct number of permanent teeth. About 8 (26%) could correctly describe dental plaque. Only 16% had visited a dentist in the past six months, while 16% had never visited a dentist. Among those who had visited a dentist, 74% sought care due to dental problems rather than routine check-ups.

Conclusion: Oral health knowledge among primary school teachers in Harare was low, and their oral health-seeking behaviour was largely problem-driven. There is a need for targeted oral health education programs to improve teachers’ knowledge and encourage preventive dental care practices.