Aim: To investigate the effect of periodontitis on the long-term changes of the cardio-ankle vascular index (CAVI).
Materials and methods: A 10-year retrospective cohort study of 3842 Thai participants (range 25-76 years) with normal CAVI at the study initiation was undertaken. Full-mouth periodontal examination was performed by calibrated periodontists, and the extent and severity of periodontitis were determined at 5-year intervals. Serial CAVI measurements were used to examine the incidence of high CAVI (≥ 9.0) and changes in CAVI over time (ΔCAVI).
Results: Participants with a higher extent or severity of periodontitis were found to have a significantly higher mean ΔCAVI. The incidence of high CAVI was also observed to be higher in those with periodontitis compared to those without it. The adjusted risk ratios for developing high CAVI were 1.309 and 1.513 for localized and generalized periodontitis, respectively. Participants with severe periodontitis had a 37% higher likelihood of developing CAVI ≥ 9.0 compared to individuals with no/mild periodontitis. This risk was consistent with a significant change in ΔCAVI of 0.054-0.140.
Conclusions: Periodontitis, both in terms of extent and severity, was found to have a significant dose-dependent effect on the risk of developing high CAVI over a 10-year period, suggesting a causal relationship between these two parameters.
{"title":"Periodontitis Is Associated With Arterial Stiffness as Measured by Serial Cardio-Ankle Vascular Index (CAVI): A 10-Year Cohort Study.","authors":"Bantita Kanpittaya, Attawood Lertpimonchai, Sanutm Mongkornkarn, Lakshman Samaranayake, Nisakorn Thongmung, Thosaphol Limpijankit, Orawan Charatkulangkun","doi":"10.1111/jcpe.14086","DOIUrl":"https://doi.org/10.1111/jcpe.14086","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effect of periodontitis on the long-term changes of the cardio-ankle vascular index (CAVI).</p><p><strong>Materials and methods: </strong>A 10-year retrospective cohort study of 3842 Thai participants (range 25-76 years) with normal CAVI at the study initiation was undertaken. Full-mouth periodontal examination was performed by calibrated periodontists, and the extent and severity of periodontitis were determined at 5-year intervals. Serial CAVI measurements were used to examine the incidence of high CAVI (≥ 9.0) and changes in CAVI over time (ΔCAVI).</p><p><strong>Results: </strong>Participants with a higher extent or severity of periodontitis were found to have a significantly higher mean ΔCAVI. The incidence of high CAVI was also observed to be higher in those with periodontitis compared to those without it. The adjusted risk ratios for developing high CAVI were 1.309 and 1.513 for localized and generalized periodontitis, respectively. Participants with severe periodontitis had a 37% higher likelihood of developing CAVI ≥ 9.0 compared to individuals with no/mild periodontitis. This risk was consistent with a significant change in ΔCAVI of 0.054-0.140.</p><p><strong>Conclusions: </strong>Periodontitis, both in terms of extent and severity, was found to have a significant dose-dependent effect on the risk of developing high CAVI over a 10-year period, suggesting a causal relationship between these two parameters.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: This study aimed to investigate the hypoxic changes in periodontal tissues resulting from smoking and periodontitis by assessing levels of hypoxia-inducible factors (HIF-1α, HIF-2α, HIF-3α) and vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF).
Materials and methods: The study comprised 22 periodontally healthy non-smokers (Group H), 22 periodontally healthy smokers (Group HS), 22 non-smokers with periodontitis (Group P) and 22 smokers with periodontitis (Group PS). Clinical periodontal parameters were documented, and GCF samples were collected and analysed using enzyme-linked immunosorbent assay (ELISA).
Results: Significantly elevated levels of HIF-1α, HIF-3α and VEGF were observed in Groups HS, P and PS compared to Group H (p < 0.05). Moreover, higher HIF-2α levels were detected in the Groups HS and P compared to Group H (p < 0.05). Significant correlations were detected between all evaluated hypoxia biomarkers in the Group P (p < 0.05) except HIF-2α and HIF-3α. However, in the PS group, significant correlation appeared only between HIF-1α and HIF-2α (p < 0.05).
Conclusion: Our findings indicate that smoking and periodontitis induce comparable hypoxic effects in periodontal tissues, as evidenced by the evaluated biomarkers. Further research is warranted to gain a deeper understanding of the mechanisms underlying hypoxia in periodontal tissues.
{"title":"Hypoxic Responses in Periodontal Tissues: Influence of Smoking and Periodontitis.","authors":"Bejna Bozyel, Özlem Doğan, Serenay Elgün, Burcu Özdemir","doi":"10.1111/jcpe.14087","DOIUrl":"https://doi.org/10.1111/jcpe.14087","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the hypoxic changes in periodontal tissues resulting from smoking and periodontitis by assessing levels of hypoxia-inducible factors (HIF-1α, HIF-2α, HIF-3α) and vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF).</p><p><strong>Materials and methods: </strong>The study comprised 22 periodontally healthy non-smokers (Group H), 22 periodontally healthy smokers (Group HS), 22 non-smokers with periodontitis (Group P) and 22 smokers with periodontitis (Group PS). Clinical periodontal parameters were documented, and GCF samples were collected and analysed using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Significantly elevated levels of HIF-1α, HIF-3α and VEGF were observed in Groups HS, P and PS compared to Group H (p < 0.05). Moreover, higher HIF-2α levels were detected in the Groups HS and P compared to Group H (p < 0.05). Significant correlations were detected between all evaluated hypoxia biomarkers in the Group P (p < 0.05) except HIF-2α and HIF-3α. However, in the PS group, significant correlation appeared only between HIF-1α and HIF-2α (p < 0.05).</p><p><strong>Conclusion: </strong>Our findings indicate that smoking and periodontitis induce comparable hypoxic effects in periodontal tissues, as evidenced by the evaluated biomarkers. Further research is warranted to gain a deeper understanding of the mechanisms underlying hypoxia in periodontal tissues.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lingfei Wei, Yuanyuan Sun, Dedong Yu, Herman Pieterse, Daniel Wismeijer, Yuelian Liu, Yiqun Wu
Aim: This first randomized controlled trial in humans aimed to assess the efficacy and safety of low-dosage Escherichia coli-derived recombinant human bone morphogenetic protein 2 (ErhBMP-2)-incorporated biomimetic calcium phosphate coating-functionalized β-TCP (ErhBMP-2/BioCaP/β-TCP) as a novel bone substitute using the tooth-extraction-socket-healing model.
Materials and methods: Forty patients requiring dental implants after single-root tooth extraction were enrolled in this study and randomly assigned into three groups: ErhBMP-2/BioCaP/β-TCP (N = 15), β-TCP (N = 15) and natural healing (N = 10). New bone volume density from histomorphometric analyses was evaluated 6 weeks post-operatively as the primary outcome, and other histomorphometric analyses, alveolar bone and soft-tissue changes were the secondary outcomes. Safety parameters included adverse events, soft-tissue healing, oral health impact profile, serum BMP-2 concentrations and other laboratory tests.
Results: The findings revealed a significant increase in new bone volume density in patients treated with ErhBMP-2/BioCaP/β-TCP compared to those receiving β-TCP alone. The required bone augmentation procedures during implant placement surgery in the ErhBMP-2/BioCaP/β-TCP group were significantly less than in the natural healing group. There were no significant differences in safety parameters among the three groups.
Conclusion: This clinical trial primarily proved the safety and efficacy of ErhBMP-2/BioCaP/β-TCP as a promising bone substitute.
{"title":"The Clinical Efficacy and Safety of ErhBMP-2/BioCaP/β-TCP as a Novel Bone Substitute Using the Tooth-Extraction-Socket-Healing Model: A Proof-of-Concept Randomized Controlled Trial.","authors":"Lingfei Wei, Yuanyuan Sun, Dedong Yu, Herman Pieterse, Daniel Wismeijer, Yuelian Liu, Yiqun Wu","doi":"10.1111/jcpe.14084","DOIUrl":"https://doi.org/10.1111/jcpe.14084","url":null,"abstract":"<p><strong>Aim: </strong>This first randomized controlled trial in humans aimed to assess the efficacy and safety of low-dosage Escherichia coli-derived recombinant human bone morphogenetic protein 2 (ErhBMP-2)-incorporated biomimetic calcium phosphate coating-functionalized β-TCP (ErhBMP-2/BioCaP/β-TCP) as a novel bone substitute using the tooth-extraction-socket-healing model.</p><p><strong>Materials and methods: </strong>Forty patients requiring dental implants after single-root tooth extraction were enrolled in this study and randomly assigned into three groups: ErhBMP-2/BioCaP/β-TCP (N = 15), β-TCP (N = 15) and natural healing (N = 10). New bone volume density from histomorphometric analyses was evaluated 6 weeks post-operatively as the primary outcome, and other histomorphometric analyses, alveolar bone and soft-tissue changes were the secondary outcomes. Safety parameters included adverse events, soft-tissue healing, oral health impact profile, serum BMP-2 concentrations and other laboratory tests.</p><p><strong>Results: </strong>The findings revealed a significant increase in new bone volume density in patients treated with ErhBMP-2/BioCaP/β-TCP compared to those receiving β-TCP alone. The required bone augmentation procedures during implant placement surgery in the ErhBMP-2/BioCaP/β-TCP group were significantly less than in the natural healing group. There were no significant differences in safety parameters among the three groups.</p><p><strong>Conclusion: </strong>This clinical trial primarily proved the safety and efficacy of ErhBMP-2/BioCaP/β-TCP as a promising bone substitute.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joerg Meyle, France Lambert, Lewis Winning, Kristina Bertl, Corinna Bruckmann, Martin Biosse Duplan, Peter Harrison, Isabelle Laleman, Nikos Mattheos, Ana Molina, Andreas Stavropoulos, Yvonne C. M. de Waal, Haitam Yousfi, Henrik Dommisch, Ioannis Polyzois, Moritz Kebschull
AimTo (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 MethodsA 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.ResultsPart‐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).DiscussionConsidering 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.ConclusionThe proposed framework for part‐time professional development is expected to enhance professional qualification.
{"title":"Continuing Professional Development (CPD) and Vocational Education and Training (VET) in Periodontology and Implant Dentistry","authors":"Joerg Meyle, France Lambert, Lewis Winning, Kristina Bertl, Corinna Bruckmann, Martin Biosse Duplan, Peter Harrison, Isabelle Laleman, Nikos Mattheos, Ana Molina, Andreas Stavropoulos, Yvonne C. M. de Waal, Haitam Yousfi, Henrik Dommisch, Ioannis Polyzois, Moritz Kebschull","doi":"10.1111/jcpe.14071","DOIUrl":"https://doi.org/10.1111/jcpe.14071","url":null,"abstract":"AimTo (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 MethodsA 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.ResultsPart‐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).DiscussionConsidering 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.ConclusionThe proposed framework for part‐time professional development is expected to enhance professional qualification.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ren Jie Jacob Chew,Charlene Enhui Goh,Xin Yi Sheena Lin,Feng Jun Bryan Oh,Ruiqi Paul Sim,Philip M Preshaw,Kai Soo Tan
AIMSTo determine the relationship between microbiome dysbiosis indices and biofilm immunogenicity and their prognostic implications on periodontal treatment response.MATERIALS AND METHODSThirty periodontally healthy controls and 30 periodontitis cases (stage III) were recruited. Cases received non-surgical periodontal therapy (NSPT), and their treatment response at 6 months was evaluated using a treat-to-target endpoint (≤ 4 sites with probing depths ≥ 5 mm). Pooled subgingival biofilm samples were obtained from controls and cases. The V3-4 hypervariable region of the 16S rRNA gene was sequenced and two compositional indices (subgingival microbiome dysbiosis index, SMDI, and dysbiosis ratio, DR) were calculated. Nuclear factor kappa-B (NF-κB) activation elicited by biofilm samples in monocytic reporter cells was quantified to assess biofilm immunogenicity.RESULTSSMDI, DR and biofilm immunogenicity were highly diagnostic for periodontitis (area under curves [AUC] > 0.90, p < 0.001). Among periodontitis cases, all three microbial parameters were significantly reduced after NSPT (p < 0.001). Cases achieving the treat-to-target endpoint had lower pre-treatment SMDI and biofilm immunogenicity (p < 0.05) and different microbial recolonization patterns from poor responders. Both measures predicted treatment response (AUC of 0.767 and 0.835, respectively, p < 0.05).CONCLUSIONSubgingival biofilm dysbiosis quantified using SMDI and biofilm immunogenicity was diagnostic of periodontitis and predictive of NSPT outcomes.
{"title":"Prognostic Impact of Microbiome Dysbiosis: A Prospective Study.","authors":"Ren Jie Jacob Chew,Charlene Enhui Goh,Xin Yi Sheena Lin,Feng Jun Bryan Oh,Ruiqi Paul Sim,Philip M Preshaw,Kai Soo Tan","doi":"10.1111/jcpe.14082","DOIUrl":"https://doi.org/10.1111/jcpe.14082","url":null,"abstract":"AIMSTo determine the relationship between microbiome dysbiosis indices and biofilm immunogenicity and their prognostic implications on periodontal treatment response.MATERIALS AND METHODSThirty periodontally healthy controls and 30 periodontitis cases (stage III) were recruited. Cases received non-surgical periodontal therapy (NSPT), and their treatment response at 6 months was evaluated using a treat-to-target endpoint (≤ 4 sites with probing depths ≥ 5 mm). Pooled subgingival biofilm samples were obtained from controls and cases. The V3-4 hypervariable region of the 16S rRNA gene was sequenced and two compositional indices (subgingival microbiome dysbiosis index, SMDI, and dysbiosis ratio, DR) were calculated. Nuclear factor kappa-B (NF-κB) activation elicited by biofilm samples in monocytic reporter cells was quantified to assess biofilm immunogenicity.RESULTSSMDI, DR and biofilm immunogenicity were highly diagnostic for periodontitis (area under curves [AUC] > 0.90, p < 0.001). Among periodontitis cases, all three microbial parameters were significantly reduced after NSPT (p < 0.001). Cases achieving the treat-to-target endpoint had lower pre-treatment SMDI and biofilm immunogenicity (p < 0.05) and different microbial recolonization patterns from poor responders. Both measures predicted treatment response (AUC of 0.767 and 0.835, respectively, p < 0.05).CONCLUSIONSubgingival biofilm dysbiosis quantified using SMDI and biofilm immunogenicity was diagnostic of periodontitis and predictive of NSPT outcomes.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142488305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Gómez-Polo, Manuel Antonio Sánchez de Martín, Adrian Curto, Javier Montero, Ana María Martín Casado
Aim: While the importance of gingival aesthetics is increasingly recognized, a questionnaire quantifying its psychosocial impact is still lacking. We have adapted the validated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) for the gingival context. This study's aim was to develop a new Psychosocial Impact of Gingival Aesthetics Questionnaire (PIGAQ) and test its validity for the general population in Spain, exploring the underlying dimensions of the construct assessed.
Materials and methods: The PIDAQ was adapted to address gingival aesthetics. PIGAQ (23 items) was completed by 200 patients aged from 18 to 85 years, and socio-demographic variables were recorded. The four-dimensional structure of the PIDAQ was respected, adapting the subscales to focus on the gingiva. Descriptive analysis, assessments of reliability and validity and an exploratory factor analysis were performed.
Results: The revised PIGAQ (now containing 20 items) has a Cronbach's alpha coefficient of 0.88 with four underlying factors explaining 61.5% of the total variance. Three items (SI-1, PI-2 and PI-5) were eliminated because of unacceptable fit indices. The Cronbach's alpha coefficients for the subscales are as follows: Gingival Self-Confidence, 0.85; Social Impact, 0.84; Psychological Impact, 0.79; and Aesthetic Concern, 0.76.
Conclusion: PIGAQ is a reliable and potentially valid instrument for assessing psychosocial perceptions of gingival aesthetics. The scale was shown to have a satisfactory factor structure and level of internal consistency.
{"title":"Validation of a New Questionnaire for Assessing the Psychosocial Impact of Gingival Aesthetics (PIGAQ).","authors":"Cristina Gómez-Polo, Manuel Antonio Sánchez de Martín, Adrian Curto, Javier Montero, Ana María Martín Casado","doi":"10.1111/jcpe.14081","DOIUrl":"https://doi.org/10.1111/jcpe.14081","url":null,"abstract":"<p><strong>Aim: </strong>While the importance of gingival aesthetics is increasingly recognized, a questionnaire quantifying its psychosocial impact is still lacking. We have adapted the validated Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) for the gingival context. This study's aim was to develop a new Psychosocial Impact of Gingival Aesthetics Questionnaire (PIGAQ) and test its validity for the general population in Spain, exploring the underlying dimensions of the construct assessed.</p><p><strong>Materials and methods: </strong>The PIDAQ was adapted to address gingival aesthetics. PIGAQ (23 items) was completed by 200 patients aged from 18 to 85 years, and socio-demographic variables were recorded. The four-dimensional structure of the PIDAQ was respected, adapting the subscales to focus on the gingiva. Descriptive analysis, assessments of reliability and validity and an exploratory factor analysis were performed.</p><p><strong>Results: </strong>The revised PIGAQ (now containing 20 items) has a Cronbach's alpha coefficient of 0.88 with four underlying factors explaining 61.5% of the total variance. Three items (SI-1, PI-2 and PI-5) were eliminated because of unacceptable fit indices. The Cronbach's alpha coefficients for the subscales are as follows: Gingival Self-Confidence, 0.85; Social Impact, 0.84; Psychological Impact, 0.79; and Aesthetic Concern, 0.76.</p><p><strong>Conclusion: </strong>PIGAQ is a reliable and potentially valid instrument for assessing psychosocial perceptions of gingival aesthetics. The scale was shown to have a satisfactory factor structure and level of internal consistency.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
King‐Lun Dominic Ho, Ka‐Leong Ryan Ho, George Pelekos, Wai‐Keung Leung, Maurizio S. Tonetti
Background and AimClinical practice guidelines suggest access flap surgery for managing deep residual pockets after steps 1 and 2 of periodontal therapy. Papilla‐preservation flap surgery (PPFS) is the least invasive approach to access and instrument biofilm‐contaminated root surfaces. Endoscopic‐assisted subgingival debridement (EASD) may enhance the outcomes of repeated instrumentation and provide a minimally invasive non‐surgical alternative.MethodsThis was a single‐blind, controlled, randomized, parallel‐group, non‐inferiority 12‐month trial comparing EASD with PPFS. Male and female adults with generalized stage III periodontitis and persistent periodontal pockets associated with an intrabony defect after steps 1 and 2 of periodontal therapy were recruited at Prince Philip Dental Hospital. Inter‐group differences in clinical attachment level (CAL) changes at 12 months were the primary outcome. Secondary outcomes included pocket resolution (no pocket > 5 mm and no pocket > 4 with bleeding on probing), radiographic bone changes, treatment time, early wound healing and quality‐of‐life measurements.ResultsSixty‐two subjects (30 EASD and 32 PPFS) were included in the intention‐to‐treat analysis. CAL gains were 2.0 ± 1.0 and 1.8 ± 1.0 mm for test and controls, respectively. The 95% CI of the inter‐group difference was −0.3 to 0.8 mm and within the stipulated 1‐mm non‐inferiority margin. No inter‐group differences were observed (i) in pocket resolution, which was achieved in more than 87% of cases for all groups/time points, and (ii) in radiographic bone healing. The treatment time was significantly shorter for EASD than for PPFS. Better early wound healing index scores were observed for EASD. No inter‐group differences in pain, quality of life or safety were detected.ConclusionsEASD was not inferior to PPFS for managing residual pockets associated with intrabony defects. The observed outcome profile supports additional developments and studies to validate EASD as an alternative to surgery for isolated persistent pockets (ChiCTR‐INR‐16008407).
{"title":"Endoscopic Re‐Instrumentation of Intrabony Defect–Associated Deep Residual Periodontal Pockets Is Non‐Inferior to Papilla Preservation Flap Surgery: A Randomized Trial","authors":"King‐Lun Dominic Ho, Ka‐Leong Ryan Ho, George Pelekos, Wai‐Keung Leung, Maurizio S. Tonetti","doi":"10.1111/jcpe.14075","DOIUrl":"https://doi.org/10.1111/jcpe.14075","url":null,"abstract":"Background and AimClinical practice guidelines suggest access flap surgery for managing deep residual pockets after steps 1 and 2 of periodontal therapy. Papilla‐preservation flap surgery (PPFS) is the least invasive approach to access and instrument biofilm‐contaminated root surfaces. Endoscopic‐assisted subgingival debridement (EASD) may enhance the outcomes of repeated instrumentation and provide a minimally invasive non‐surgical alternative.MethodsThis was a single‐blind, controlled, randomized, parallel‐group, non‐inferiority 12‐month trial comparing EASD with PPFS. Male and female adults with generalized stage III periodontitis and persistent periodontal pockets associated with an intrabony defect after steps 1 and 2 of periodontal therapy were recruited at Prince Philip Dental Hospital. Inter‐group differences in clinical attachment level (CAL) changes at 12 months were the primary outcome. Secondary outcomes included pocket resolution (no pocket > 5 mm and no pocket > 4 with bleeding on probing), radiographic bone changes, treatment time, early wound healing and quality‐of‐life measurements.ResultsSixty‐two subjects (30 EASD and 32 PPFS) were included in the intention‐to‐treat analysis. CAL gains were 2.0 ± 1.0 and 1.8 ± 1.0 mm for test and controls, respectively. The 95% CI of the inter‐group difference was −0.3 to 0.8 mm and within the stipulated 1‐mm non‐inferiority margin. No inter‐group differences were observed (i) in pocket resolution, which was achieved in more than 87% of cases for all groups/time points, and (ii) in radiographic bone healing. The treatment time was significantly shorter for EASD than for PPFS. Better early wound healing index scores were observed for EASD. No inter‐group differences in pain, quality of life or safety were detected.ConclusionsEASD was not inferior to PPFS for managing residual pockets associated with intrabony defects. The observed outcome profile supports additional developments and studies to validate EASD as an alternative to surgery for isolated persistent pockets (ChiCTR‐INR‐16008407).","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142448264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Su Young Lee, René Daher, Jin‐Hyung Jung, Kyungdo Han, Irena Sailer, Jae‐Hyun Lee
AimThis nationwide population‐based cohort study aimed to assess the incidence of implant complication treatments, including implant removal procedures and peri‐implantitis treatments, in relation to implant surfaces and abutment types.MethodsData from the National Health Insurance Service, covering approximately 50 million individuals, were used. Implants and abutments were categorized by codes, including surfaces such as resorbable blasting media, sandblasted large grit and acid‐etched (SA) and hydroxyapatite coating, along with abutment structures (one‐piece straight, two‐piece straight, angled). The incidence of implant complication treatments was analysed using Kaplan–Meier curves and Cox proportional hazards regression (α = 0.05).ResultsThe study included 2,354,706 implants. The SA group had the lowest hazard ratio for implant removal procedures (p < 0.0001). No significant differences were found in the risk of peri‐implantitis treatments between implant surfaces (p = 0.0587). The risk of implant complication treatments did not differ significantly by the abutment type (p = 0.9542). The incidence rate of implant complication treatments was < 3.9 per 1000 implant‐years across all groups.ConclusionsThe SA group showed a slightly lower risk of late implant loss, whereas no significant association was found for the abutment type groups. All implant and abutment type groups showed an incidence rate of < 3.9 per 1000 implant‐years for complication treatments.
{"title":"Risk of Late Implant Loss and Peri‐Implantitis Based on Dental Implant Surfaces and Abutment Types: A Nationwide Cohort Study in the Elderly","authors":"Su Young Lee, René Daher, Jin‐Hyung Jung, Kyungdo Han, Irena Sailer, Jae‐Hyun Lee","doi":"10.1111/jcpe.14079","DOIUrl":"https://doi.org/10.1111/jcpe.14079","url":null,"abstract":"AimThis nationwide population‐based cohort study aimed to assess the incidence of implant complication treatments, including implant removal procedures and peri‐implantitis treatments, in relation to implant surfaces and abutment types.MethodsData from the National Health Insurance Service, covering approximately 50 million individuals, were used. Implants and abutments were categorized by codes, including surfaces such as resorbable blasting media, sandblasted large grit and acid‐etched (SA) and hydroxyapatite coating, along with abutment structures (one‐piece straight, two‐piece straight, angled). The incidence of implant complication treatments was analysed using Kaplan–Meier curves and Cox proportional hazards regression (<jats:italic>α</jats:italic> = 0.05).ResultsThe study included 2,354,706 implants. The SA group had the lowest hazard ratio for implant removal procedures (<jats:italic>p</jats:italic> < 0.0001). No significant differences were found in the risk of peri‐implantitis treatments between implant surfaces (<jats:italic>p</jats:italic> = 0.0587). The risk of implant complication treatments did not differ significantly by the abutment type (<jats:italic>p</jats:italic> = 0.9542). The incidence rate of implant complication treatments was < 3.9 per 1000 implant‐years across all groups.ConclusionsThe SA group showed a slightly lower risk of late implant loss, whereas no significant association was found for the abutment type groups. All implant and abutment type groups showed an incidence rate of < 3.9 per 1000 implant‐years for complication treatments.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vincenzo Iorio-Siciliano,Andrea Blasi,Leopoldo Mauriello,Giovanni E Salvi,Luca Ramaglia,Anton Sculean
AIMTo evaluate the clinical outcomes of moderate intrabony defects treated with minimally invasive non-surgical technique (MINST) with or without adjunctive delivery of cross-linked hyaluronic acid (xHyA) gel.MATERIALS AND METHODSForty-two patients with 42 interdental intrabony defects were randomly assigned to test (MINST + xHyA) or control procedures (MINST alone). Probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and bleeding on probing (BOP) at the treated sites were assessed at baseline and at 3 and 6 months. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) were recorded at baseline and after 6 months. Radiographic evaluation was performed at baseline and after 6 months, assessing the defect fill (DF) and radiographic defect angle (RDA). The primary outcome variable was PD change.RESULTSThirty-eight patients completed the trial without any adverse events. At 6 months, a statistically significant improvement (p < 0.05) was measured in all clinical parameters except GR (p > 0.05). However, no statistically significant differences were found between the experimental and control procedures (p > 0.05). Statistically significant differences between the test and control sites were observed at 3 months for PD and CAL changes (p < 0.05). The DF change was statistically significant when comparing experimental and control procedures at 6 months (p < 0.05). Both procedures failed to show statistically significant differences in terms of RDA changes at 6 months (p > 0.05).CONCLUSIONWithin their limitations, the present results indicate that (a) treatment of intrabony defects with MINST, with or without application of xHyA gel, resulted in statistically significant improvements in the investigated clinical parameters at 3 and 6 months after therapy, and (b) although the adjunctive use of xHyA gel to MINST improved the clinical outcomes compared with MINST alone up to 3 months, statistically significant differences were not observed at 6 months. The study protocol was registered in ClinicalTrial.gov (NCT05188898).
{"title":"Non-Surgical Treatment of Moderate Periodontal Intrabony Defects With Adjunctive Cross-Linked Hyaluronic Acid: A Single-Blinded Randomized Controlled Clinical Trial.","authors":"Vincenzo Iorio-Siciliano,Andrea Blasi,Leopoldo Mauriello,Giovanni E Salvi,Luca Ramaglia,Anton Sculean","doi":"10.1111/jcpe.14078","DOIUrl":"https://doi.org/10.1111/jcpe.14078","url":null,"abstract":"AIMTo evaluate the clinical outcomes of moderate intrabony defects treated with minimally invasive non-surgical technique (MINST) with or without adjunctive delivery of cross-linked hyaluronic acid (xHyA) gel.MATERIALS AND METHODSForty-two patients with 42 interdental intrabony defects were randomly assigned to test (MINST + xHyA) or control procedures (MINST alone). Probing depth (PD), clinical attachment level (CAL), gingival recession (GR) and bleeding on probing (BOP) at the treated sites were assessed at baseline and at 3 and 6 months. Full-mouth plaque score (FMPS) and full-mouth bleeding score (FMBS) were recorded at baseline and after 6 months. Radiographic evaluation was performed at baseline and after 6 months, assessing the defect fill (DF) and radiographic defect angle (RDA). The primary outcome variable was PD change.RESULTSThirty-eight patients completed the trial without any adverse events. At 6 months, a statistically significant improvement (p < 0.05) was measured in all clinical parameters except GR (p > 0.05). However, no statistically significant differences were found between the experimental and control procedures (p > 0.05). Statistically significant differences between the test and control sites were observed at 3 months for PD and CAL changes (p < 0.05). The DF change was statistically significant when comparing experimental and control procedures at 6 months (p < 0.05). Both procedures failed to show statistically significant differences in terms of RDA changes at 6 months (p > 0.05).CONCLUSIONWithin their limitations, the present results indicate that (a) treatment of intrabony defects with MINST, with or without application of xHyA gel, resulted in statistically significant improvements in the investigated clinical parameters at 3 and 6 months after therapy, and (b) although the adjunctive use of xHyA gel to MINST improved the clinical outcomes compared with MINST alone up to 3 months, statistically significant differences were not observed at 6 months. The study protocol was registered in ClinicalTrial.gov (NCT05188898).","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AIMTo investigate the role of lncRNA Lockd in mandibular mesenchymal stem cell (M-MSC) proliferation and osteogenic capability in the inflammatory microenvironment, focusing on its interaction with SUZ12.MATERIALS AND METHODSUsing lncR Lockd knockdown/overexpression cell models and a murine periodontitis model, we explored Lockd's effects on M-MSC proliferation and osteogenic capability in the inflammatory microenvironment. Predictions from multiple databases and a series of rescue experiments revealed the regulatory role of the Lockd/SUZ12 signalling axis of M-MSC in the inflammatory microenvironment.RESULTSLockd was found to stimulate M-MSC proliferation but impair osteogenic differentiation. The in vitro studies suggested that the activation of Lockd negatively inhibited the osteogenic differentiation process and may ultimately impact bone formation in periodontitis. Mechanistically, it was elucidated that Lockd interacts with SUZ12, a core component of the polycomb repressive complex 2 (PRC2), and may affect the PRC2 complex's role in osteogenic gene expression.CONCLUSIONSLockd boosts the proliferation of M-MSCs but inhibits their osteogenic differentiation by interacting with SUZ12, potentially inhibiting osteogenic capability in the inflammatory microenvironment.
{"title":"Lockd Enhances Mandibular Mesenchymal Stem Cell Proliferation While Inhibiting Osteogenic Capability via Binding With SUZ12 in the Inflammatory Microenvironment.","authors":"Yahui Lu,Xiaolei Ruan,Gang Xiao,Yueming Dai,Gen Li,Guanhui Cai,Lihe Zheng,Zhaolan Guan,Wen Sun,Hua Wang","doi":"10.1111/jcpe.14076","DOIUrl":"https://doi.org/10.1111/jcpe.14076","url":null,"abstract":"AIMTo investigate the role of lncRNA Lockd in mandibular mesenchymal stem cell (M-MSC) proliferation and osteogenic capability in the inflammatory microenvironment, focusing on its interaction with SUZ12.MATERIALS AND METHODSUsing lncR Lockd knockdown/overexpression cell models and a murine periodontitis model, we explored Lockd's effects on M-MSC proliferation and osteogenic capability in the inflammatory microenvironment. Predictions from multiple databases and a series of rescue experiments revealed the regulatory role of the Lockd/SUZ12 signalling axis of M-MSC in the inflammatory microenvironment.RESULTSLockd was found to stimulate M-MSC proliferation but impair osteogenic differentiation. The in vitro studies suggested that the activation of Lockd negatively inhibited the osteogenic differentiation process and may ultimately impact bone formation in periodontitis. Mechanistically, it was elucidated that Lockd interacts with SUZ12, a core component of the polycomb repressive complex 2 (PRC2), and may affect the PRC2 complex's role in osteogenic gene expression.CONCLUSIONSLockd boosts the proliferation of M-MSCs but inhibits their osteogenic differentiation by interacting with SUZ12, potentially inhibiting osteogenic capability in the inflammatory microenvironment.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142439355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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