Systemic sclerosis is a chronic, autoimmune, multisystemic disease characterized by aberrant extracellular matrix protein deposition and extreme progressive microvasculopathy. These processes lead to damage within the skin, lungs, or gastrointestinal tract, but also to facial changes with physiognomic and functional alterations, and dental and periodontal lesions. Orofacial manifestations are common in SSc but are frequently overshadowed by systemic complications. In clinical practice, oral manifestations of SSc are suboptimally addressed, while their management is not included in the general treatment recommendations. Periodontitis is associated with autoimmune-mediated systemic diseases, including systemic sclerosis. In periodontitis, the microbial subgingival biofilm induces host-mediated inflammation with subsequent tissue damage, periodontal attachment, and bone loss. When these diseases coexist, patients experience additive damage, increasing malnutrition, and morbidity. The present review discusses the links between SSc and periodontitis, and provides a clinical guide for preventive and therapeutical approaches in the management of these patients.

Lactoferrin is a cationic glycoprotein found in different compartments of the body and secreted mostly by glandular epithelia and neutrophils. Although initially considered that its functions derive solely from its iron-binding capacity, further research demonstrated the pleiotropic nature of the glycoprotein. Thereby, lactoferrin fulfills various essential physiological functions based on its anti-infectious, immunomodulatory and antioxidative properties. In the oral cavity, lactoferrin is an central component of the local defense mechanisms, and based on its versatility, it can prevent the occurrence and progression of different local pathologies, including periodontitis. Microbiological and inflammatory periodontitis-induced modifications influence the local levels of secreted lactoferrin, the protein becoming a potential diagnosis biomarker of periodontal disease. Moreover, lactoferrin has a potential adjunctive therapeutic benefit in periodontal treatment, based on the interference of the biomolecule with local microorganisms, its anti-inflammatory and antioxidative activity. Additionally, the adverse effects of lactoferrin administration seem less evident as compared to other adjunctive agents. Thus, the present study aims to review the most important characteristics of lactoferrin in different oral pathologies, particularly in periodontitis.

Objectives. The objective of the study was to investigate the clinical performance of two different resin-based materials 6 months after their placement in dental non-carious cervical lesions (NCCL). This study also aimed to evaluate the effects of the materials on periodontal tissues in terms of clinical changes of several periodontal parameters. Material and methods. NCCLs characteristics (localization, morphology, dimensions) were preoperatively recorded. The clinical behavior of the restorations based on the modified United States Public Health Service (USPHS) criteria and periodontal parameters (plaque index, bleeding index, probing depth, and attachment loss) were assessed at baseline and after 1, 3 and 6 months. Results. No significant modifications were recorded for the modified USPHS criteria 6 months after the placement of NCCL restorations excepting postoperative hypersensitivity which was associated with 4 restorations after 6 months. Significant improvements of plaque and bleeding indices were recorded, while no significant modifications were noted for the other periodontal parameters. Conclusions. Considering the clinical success related to the good clinical behavior and the positive effect of the restorations on the periodontal status, the experimental conventional composites and giomers could be considered as a good therapeutic option for the restoration of NCCLs.

Introduction. As oral mesenchymal stromal cells (MSCs) have not, to date, been isolated from systemic sclerosis (SSc) patients, the aim of this in vitro experiment was to characterize gingival MSCs (SScgMSCs) and granulation tissue MSCs (SScgtMSCs) from SSc and to evaluate their functionality in comparison to healthy MSCs (hMSCs), in normal or hyaluronic acid (HA) culture media. Materials and Methods. Isolated cells were described by immunophenotyping of surface antigen make-up and by trilineage mesenchymal differentiation capacity. Colony-Forming Unit-Fibroblast (CFU-F) test and migration potential evaluated MSC functionality. Results. All types of MSCs displayed positivity for the following surface markers: CD29, CD73, CD90, CD105, CD44, and CD79a. These cells did not express CD34, CD45, HL-DR, and CD14. Isolated MSCs differentiated into osteoblasts, adipocytes, and chondroblasts. The frequency of CFU-F for SScgtMSCs was significantly lower than that of hMSCs (p = 0.05) and SScgMSCs (p = 0.004) in normal medium, and also markedly lower than that of SScgMSCs (p = 0.09) in HA medium. Following HA exposure, both SScgMSCs and SScgtMSCs migrated significantly less (p = 0.033 and p = 0.005, respectively) than hMSCs. Conclusions. A reduced functionality of MSCs derived from SSc as compared to hMSCs was observed. HA in culture medium appeared to significantly stimulate the migration potential of hMSCs.

Systemic sclerosis (SSc) is a rare connective tissue disorder characterized by a wide range of manifestations, including oral changes. The pathogenesis of SSc is complex and remains incompletely understood. In the development of SSc following mechanisms are involved: immune activation, vascular alterations, and increased accumulation of extracellular collagen matrix. Genetics plays an important role in SSc development. Oral manifestations of SSc include microstomia, xerostomia, telangiectasia, periodontitis, increased width of the periodontal ligament, and alveolar bone resorption. These manifestations are a significant cause of comorbidities and a decreased quality of life in SSc patients. Education on oral hygiene and home-based orofacial physiotherapy may improve the oral status of these patients. A multidisciplinary team should be involved in the management of SSc.