Patrick Nafz, Thomas Kocher, Christiane Pink, Sebastian‐Edgar Baumeister, Stefan Reckelkamm, Stefanie Samietz, Sonya Nafz, Henry Völzke, Philipp Kanzow, Birte Holtfreter
Aim To investigate the association between dental restorations and adjacent periodontal status over a 7‐year period, using data from a population‐based cohort study. Materials and Methods We used 7‐year follow‐up data on the restorative and periodontal statuses of 88,793 tooth surfaces from 2158 SHIP‐TREND (Study of Health in Pomerania) participants. Using confounder‐adjusted and inverse‐probability‐weighted generalised estimating equations, we estimated the associations of restoration status with bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). Results Surfaces with dental restorations had significantly poorer periodontal outcomes than sound surfaces, with crowns having the greatest impact. At follow‐up, filled and crowned surfaces presented higher proportions of adjacent sites with BOP (18.5% and 22.4%, respectively) compared to sound surfaces (15.8%). Similarly, adjusted average PD was 1.93 mm adjacent to sound surfaces, 1.99 mm adjacent to surfaces with fillings and 2.14 mm adjacent to surfaces with crowns. The results remained consistent when the effects of incidentally placed fillings and crowns on follow‐up periodontal status were evaluated. Although effect modification by surface type was observed, no consistent patterns emerged across the different outcomes. Conclusion Dental restorations can have an adverse effect on periodontal health, emphasising the critical need for precise restorative techniques and post‐treatment maintenance.
{"title":"Associations Between Restoration Margins and Adjacent Periodontal Status—Longitudinal Results From SHIP‐TREND","authors":"Patrick Nafz, Thomas Kocher, Christiane Pink, Sebastian‐Edgar Baumeister, Stefan Reckelkamm, Stefanie Samietz, Sonya Nafz, Henry Völzke, Philipp Kanzow, Birte Holtfreter","doi":"10.1111/jcpe.70082","DOIUrl":"https://doi.org/10.1111/jcpe.70082","url":null,"abstract":"Aim To investigate the association between dental restorations and adjacent periodontal status over a 7‐year period, using data from a population‐based cohort study. Materials and Methods We used 7‐year follow‐up data on the restorative and periodontal statuses of 88,793 tooth surfaces from 2158 SHIP‐TREND (Study of Health in Pomerania) participants. Using confounder‐adjusted and inverse‐probability‐weighted generalised estimating equations, we estimated the associations of restoration status with bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). Results Surfaces with dental restorations had significantly poorer periodontal outcomes than sound surfaces, with crowns having the greatest impact. At follow‐up, filled and crowned surfaces presented higher proportions of adjacent sites with BOP (18.5% and 22.4%, respectively) compared to sound surfaces (15.8%). Similarly, adjusted average PD was 1.93 mm adjacent to sound surfaces, 1.99 mm adjacent to surfaces with fillings and 2.14 mm adjacent to surfaces with crowns. The results remained consistent when the effects of incidentally placed fillings and crowns on follow‐up periodontal status were evaluated. Although effect modification by surface type was observed, no consistent patterns emerged across the different outcomes. Conclusion Dental restorations can have an adverse effect on periodontal health, emphasising the critical need for precise restorative techniques and post‐treatment maintenance.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807510","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}
Spyridon K. Kouris, Yiorgos A. Bobetsis, Sophia Lionaki, Panagiotis N. Kanellopoulos, George Maropoulos, Panagiotis A. Koromantzos, Athanasios D. Protogerou, Phoebus N. Madianos
Aim To investigate the effect of non‐surgical periodontal therapy (NSPT) on renal function and glycaemic control in chronic kidney disease (CKD) patients over a 6‐month observation period, through a randomised clinical trial (RCT). Materials and Methods A total of 53 patients participated: 27 in the intervention group (IG) and 26 in the control group (CG). Outcomes included estimated glomerular filtration rate (eGFR, calculated using serum creatinine or both serum creatinine and cystatin‐C), urine albumin to urine creatinine ratio (uACR) and serum high‐sensitivity C‐reactive protein (hsCRP) levels. Glycaemic control was assessed using HbA1c levels in patients with diabetes mellitus (DM). Results Intra‐group ΔeGFR levels were 10.26 mL/min/1.73 m 2 ( p < 0.001) and 11.17 mL/min/1.73 m 2 ( p < 0.001), depending on the equation used, favouring IG. hsCRP levels were reduced by 84% ( p < 0.001) compared to CG; ΔHbA1c decreased by 0.54% ( p = 0.003) at 6 months. uACR was lower but only marginally (not statistically significant) in IG. Conclusion Despite its limitations, this RCT shows that NSPT enhances renal function—increasing eGFR and decreasing hsCRP—and improves glycaemic control in CKD patients with DM.
{"title":"The Effect of Periodontal Therapy on Renal Function and Diabetes Control in Patients With Chronic Kidney Disease. A Randomised Controlled Clinical Trial","authors":"Spyridon K. Kouris, Yiorgos A. Bobetsis, Sophia Lionaki, Panagiotis N. Kanellopoulos, George Maropoulos, Panagiotis A. Koromantzos, Athanasios D. Protogerou, Phoebus N. Madianos","doi":"10.1111/jcpe.70059","DOIUrl":"https://doi.org/10.1111/jcpe.70059","url":null,"abstract":"Aim To investigate the effect of non‐surgical periodontal therapy (NSPT) on renal function and glycaemic control in chronic kidney disease (CKD) patients over a 6‐month observation period, through a randomised clinical trial (RCT). Materials and Methods A total of 53 patients participated: 27 in the intervention group (IG) and 26 in the control group (CG). Outcomes included estimated glomerular filtration rate (eGFR, calculated using serum creatinine or both serum creatinine and cystatin‐C), urine albumin to urine creatinine ratio (uACR) and serum high‐sensitivity C‐reactive protein (hsCRP) levels. Glycaemic control was assessed using HbA1c levels in patients with diabetes mellitus (DM). Results Intra‐group ΔeGFR levels were 10.26 mL/min/1.73 m <jats:sup>2</jats:sup> ( <jats:italic>p</jats:italic> < 0.001) and 11.17 mL/min/1.73 m <jats:sup>2</jats:sup> ( <jats:italic>p</jats:italic> < 0.001), depending on the equation used, favouring IG. hsCRP levels were reduced by 84% ( <jats:italic>p</jats:italic> < 0.001) compared to CG; ΔHbA1c decreased by 0.54% ( <jats:italic>p</jats:italic> = 0.003) at 6 months. uACR was lower but only marginally (not statistically significant) in IG. Conclusion Despite its limitations, this RCT shows that NSPT enhances renal function—increasing eGFR and decreasing hsCRP—and improves glycaemic control in CKD patients with DM.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"28 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807509","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}
Emilio Couso‐Queiruga, Manrique Fonseca, Vivianne Chappuis, Gustavo‐Avila Ortiz, Giovanni E. Salvi, Frank Schwarz, Clemens Raabe
Objectives To compare the long‐term survival rate and prevalence of peri‐implant diseases between bone‐level (BL) and tissue‐level (TL) titanium implants. The secondary objective was to assess the effect of implant diameter and other risk indicators of peri‐implant diseases on the outcomes of implant therapy. Materials and Methods Adult patients with at least one non‐molar implant‐supported prosthesis (ISP) were included in the study. Relevant clinical and radiographic outcomes, along with patient‐related, anatomical, surgical and prosthetic‐related factors, were analysed. Results A total of 266 patients and 336 ISPs were included after a mean follow‐up of 11.2 ± 1.5 years. Implant survival rates at the implant level were 99.4% and 98.2% for BL and TL implants, respectively. The prevalence of peri‐implant health, mucositis and peri‐implantitis was comparable between BL (21.1%, 67.5% and 11.4%, respectively) and TL implants (20.5%, 70.5% and 9.0%). Implants with a diameter of 3.3 mm showed lower peri‐implantitis rates (7.2%) compared to those with 4.1 mm (13.3%; p = 0.02). Notably, 3.3 mm TL implants exhibited a significantly lower peri‐implantitis rate (4.8%) than BL implants (9.6%; p < 0.001). Multilevel regression at the implant level showed that parafunctional habits (OR = 0.33, 95% CI: 0.12–0.91) and greater mucosal thickness (OR = 0.44, 95% CI: 0.32–0.60) were cross‐sectionally associated with decreased odds of mucositis, whereas higher plaque scores were cross‐sectionally associated with increased odds (OR = 1.29, 95% CI: 1.03–1.61). Age was cross‐sectionally associated with peri‐implantitis (OR = 0.96, 95% CI: 0.93–0.99), higher plaque score (OR = 1.45, 95% CI: 1.11–1.90), larger implant diameter (OR = 2.98, 95% CI: 1.19–7.45) and smoking (OR = 4.54, 95% CI: 1.42–14.5), while greater mucosal thickness (OR = 0.17, 95% CI: 0.08–0.37) was cross‐sectionally associated with a reduced risk of developing this condition. Conclusions BL and TL implants at non‐molar sites exhibited comparable survival and peri‐implant disease rates. However, TL implants with 3.3 mm diameter showed lower peri‐implantitis rates. A higher plaque score increased the risk of both mucositis and peri‐implantitis, whereas smoking was a strong risk indicator for peri‐implantitis. Greater mucosal thickness was protective against both conditions.
{"title":"Bone‐Level Versus Tissue‐Level Titanium Dental Implants: A Comparative Cross‐Sectional Study","authors":"Emilio Couso‐Queiruga, Manrique Fonseca, Vivianne Chappuis, Gustavo‐Avila Ortiz, Giovanni E. Salvi, Frank Schwarz, Clemens Raabe","doi":"10.1111/jcpe.70080","DOIUrl":"https://doi.org/10.1111/jcpe.70080","url":null,"abstract":"Objectives To compare the long‐term survival rate and prevalence of peri‐implant diseases between bone‐level (BL) and tissue‐level (TL) titanium implants. The secondary objective was to assess the effect of implant diameter and other risk indicators of peri‐implant diseases on the outcomes of implant therapy. Materials and Methods Adult patients with at least one non‐molar implant‐supported prosthesis (ISP) were included in the study. Relevant clinical and radiographic outcomes, along with patient‐related, anatomical, surgical and prosthetic‐related factors, were analysed. Results A total of 266 patients and 336 ISPs were included after a mean follow‐up of 11.2 ± 1.5 years. Implant survival rates at the implant level were 99.4% and 98.2% for BL and TL implants, respectively. The prevalence of peri‐implant health, mucositis and peri‐implantitis was comparable between BL (21.1%, 67.5% and 11.4%, respectively) and TL implants (20.5%, 70.5% and 9.0%). Implants with a diameter of 3.3 mm showed lower peri‐implantitis rates (7.2%) compared to those with 4.1 mm (13.3%; <jats:italic>p</jats:italic> = 0.02). Notably, 3.3 mm TL implants exhibited a significantly lower peri‐implantitis rate (4.8%) than BL implants (9.6%; <jats:italic>p</jats:italic> < 0.001). Multilevel regression at the implant level showed that parafunctional habits (OR = 0.33, 95% CI: 0.12–0.91) and greater mucosal thickness (OR = 0.44, 95% CI: 0.32–0.60) were cross‐sectionally associated with decreased odds of mucositis, whereas higher plaque scores were cross‐sectionally associated with increased odds (OR = 1.29, 95% CI: 1.03–1.61). Age was cross‐sectionally associated with peri‐implantitis (OR = 0.96, 95% CI: 0.93–0.99), higher plaque score (OR = 1.45, 95% CI: 1.11–1.90), larger implant diameter (OR = 2.98, 95% CI: 1.19–7.45) and smoking (OR = 4.54, 95% CI: 1.42–14.5), while greater mucosal thickness (OR = 0.17, 95% CI: 0.08–0.37) was cross‐sectionally associated with a reduced risk of developing this condition. Conclusions BL and TL implants at non‐molar sites exhibited comparable survival and peri‐implant disease rates. However, TL implants with 3.3 mm diameter showed lower peri‐implantitis rates. A higher plaque score increased the risk of both mucositis and peri‐implantitis, whereas smoking was a strong risk indicator for peri‐implantitis. Greater mucosal thickness was protective against both conditions.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"3 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145807679","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}
Thomas Kocher, Sebastian‐Edgar Baumeister, Henry Völzke, Matthias Nauck, Peter Meisel, Karsten Suhre, Uwe Völker, Nele Friedrich, Birte Holtfreter
Background Theobromine, a methylxanthine mainly found in chocolate, has been suggested to possess various health‐promoting properties. This study aimed to investigate the long‐term effect of salivary theobromine levels on periodontitis severity using 7‐ and 10‐year follow‐up data from the prospective Studies of Health in Pomerania (SHIP‐TREND and SHIP‐START). Materials and Methods We conducted a non‐targeted metabolomics analysis of salivary methylxanthines in 679 participants from SHIP‐TREND and 953 participants from SHIP‐START. Inverse‐probability‐of‐treatment‐weighted generalised linear models were used to assess the relationship between salivary theobromine and periodontal variables, including bleeding on probing, probing depth and clinical attachment loss. Results Higher salivary theobromine levels were significantly associated with improved periodontal health, as evidenced by lower mean probing depth and a reduced percentage of sites with probing depth ≥ 3 mm. The results were successfully replicated in the SHIP‐START data and extended to a lower clinical attachment loss. Discussion Our cohort studies suggest that elevated salivary theobromine levels are associated with improved periodontal parameters over 7 and 10 years. These results indicate the potential for theobromine‐containing products to support periodontal health, warranting further investigation through randomised controlled trials.
{"title":"Elevated Salivary Theobromine and Long‐Term Improvement of Periodontal Health in Two Cohort Studies","authors":"Thomas Kocher, Sebastian‐Edgar Baumeister, Henry Völzke, Matthias Nauck, Peter Meisel, Karsten Suhre, Uwe Völker, Nele Friedrich, Birte Holtfreter","doi":"10.1111/jcpe.70072","DOIUrl":"https://doi.org/10.1111/jcpe.70072","url":null,"abstract":"Background Theobromine, a methylxanthine mainly found in chocolate, has been suggested to possess various health‐promoting properties. This study aimed to investigate the long‐term effect of salivary theobromine levels on periodontitis severity using 7‐ and 10‐year follow‐up data from the prospective Studies of Health in Pomerania (SHIP‐TREND and SHIP‐START). Materials and Methods We conducted a non‐targeted metabolomics analysis of salivary methylxanthines in 679 participants from SHIP‐TREND and 953 participants from SHIP‐START. Inverse‐probability‐of‐treatment‐weighted generalised linear models were used to assess the relationship between salivary theobromine and periodontal variables, including bleeding on probing, probing depth and clinical attachment loss. Results Higher salivary theobromine levels were significantly associated with improved periodontal health, as evidenced by lower mean probing depth and a reduced percentage of sites with probing depth ≥ 3 mm. The results were successfully replicated in the SHIP‐START data and extended to a lower clinical attachment loss. Discussion Our cohort studies suggest that elevated salivary theobromine levels are associated with improved periodontal parameters over 7 and 10 years. These results indicate the potential for theobromine‐containing products to support periodontal health, warranting further investigation through randomised controlled trials.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"45 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730639","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}
Hamoun Sabri, Parham Hazrati, Lorenzo Tavelli, Carlos Garaicoa‐Pazmino, Javier Calatrava, Hom‐Lay Wang, Shayan Barootchi
Objective To investigate the associations between peri‐implant phenotype characteristics and long‐term outcomes of soft tissue–level implants. Methods Twenty‐five tissue‐level implants from a previous controlled clinical trial were evaluated at 1‐ and 5‐year follow‐ups after crown delivery. Data included ultrasonographic scans (mucosal thickness and supracrestal tissue height), standardised 2D radiographs, cone beam computed tomography, clinical outcomes (mucosal recession, probing pocket depth, bleeding on probing), patient‐reported outcomes and peri‐implant health status. Standard logistic and linear regression models were used to analyse associations of implant‐ and patient‐related factors with outcomes, including peri‐implant disease status, mucosal recession and marginal bone level (MBL) changes. Results Five‐year implant survival was 100%, with peri‐implant mucositis diagnosed in 36% of the implants. Mean MBL changes from the first to the fifth year was 0.29 ± 0.29 mm. Baseline (pre‐surgical) buccal soft‐tissue thickness < 1.5 mm (OR: 5.20, p = 0.007) and increased plaque scores (OR: 30.11, p < 0.001) were associated with peri‐implant mucositis, whereas buccal bone thickness ≥ 1.5 mm (OR: 0.48, p = 0.039), mucosal thickness around implant (OR: 0.20, p = 0.001) and supracrestal tissue height (OR: 0.50, p = 0.002) emerged as protective factors. Mucosal recession was significantly associated with baseline buccal soft‐tissue thickness < 1.5 mm (estimate = 0.27, p = 0.03) and keratinised mucosa width of < 2 mm (estimate = 0.39, p = 0.021). Clinical thresholds associated with long‐term peri‐implant health were defined as follows: supracrestal tissue height ≥ 2.8 mm, restorative emergence angle ≤ 35.5°, mucosal thickness 1.8 mm and buccal bone thickness 1.5 mm. Patients reported a high overall satisfaction (visual analogue scale: 88.2%). Colour Doppler ultrasonography showed a strong correlation between tissue perfusion and peri‐implant disease ( r = 0.93, p < 0.001). Conclusions Within the limitations of this study, tissue‐level implants showed excellent survival rates and patient satisfaction at 5 years. Several peri‐implant parameters—such as supracrestal tissue height ≥ 2.8 mm, restorative emergence angle ≤ 35.5° and buccal bone thickness ≥ 1.5 mm—were associated with favourable outcomes. These exploratory thresholds may be considered hypothesis‐generating and could help guide future research and clinical monitoring, although validation in larger cohorts is essential. Trial Registration: www.clinicaltrials.gov/study/NCT02925078
目的探讨软组织水平种植体的种植体周围表型特征与长期预后之间的关系。方法在冠植入后1年和5年的随访中，对来自先前对照临床试验的25个组织级种植体进行评估。数据包括超声扫描（粘膜厚度和阴茎上组织高度）、标准化二维x线片、锥束计算机断层扫描、临床结果（粘膜消退、探查袋深度、探查时出血）、患者报告的结果和种植体周围的健康状况。采用标准logistic和线性回归模型分析种植体和患者相关因素与结果的相关性，包括种植体周围疾病状态、粘膜消退和边缘骨水平（MBL）变化。结果种植体5年生存率为100%，36%的种植体被诊断为种植体周围粘膜炎。第一至第五年MBL平均变化为0.29±0.29 mm。基线（术前）颊软组织厚度1.5 mm （OR: 5.20, p = 0.007）和增加的菌斑评分（OR: 30.11, p = 0.001）与种植体周围粘膜炎相关，而颊骨厚度≥1.5 mm （OR: 0.48, p = 0.039）、种植体周围粘膜厚度（OR: 0.20, p = 0.001）和切上组织高度（OR: 0.50, p = 0.002）成为保护因素。粘膜退缩与基线颊软组织厚度1.5 mm（估计= 0.27,p = 0.03）和角化粘膜宽度2 mm（估计= 0.39,p = 0.021）显著相关。与种植体周围长期健康相关的临床阈值定义如下：切上组织高度≥2.8 mm，修复体出牙角≤35.5°，粘膜厚度1.8 mm，颊骨厚度1.5 mm。患者报告了较高的总体满意度（视觉模拟量表：88.2%）。彩色多普勒超声显示组织灌注与种植体周围疾病有很强的相关性（r = 0.93, p < 0.001）。结论：在本研究的局限性内，组织级植入物在5年内具有良好的生存率和患者满意度。几个种植体周围参数，如切上组织高度≥2.8 mm，修复体涌现角≤35.5°和颊骨厚度≥1.5 mm，与良好的结果相关。这些探索性阈值可能被认为是假设生成，可以帮助指导未来的研究和临床监测，尽管在更大的队列中验证是必不可少的。试验注册：www.clinicaltrials.gov/study/NCT02925078
{"title":"Impact of Peri‐Implant Phenotype on Implant Therapy Outcomes: A 5‐Year Cohort Analysis on Soft Tissue—Level Implants","authors":"Hamoun Sabri, Parham Hazrati, Lorenzo Tavelli, Carlos Garaicoa‐Pazmino, Javier Calatrava, Hom‐Lay Wang, Shayan Barootchi","doi":"10.1111/jcpe.70062","DOIUrl":"https://doi.org/10.1111/jcpe.70062","url":null,"abstract":"Objective To investigate the associations between peri‐implant phenotype characteristics and long‐term outcomes of soft tissue–level implants. Methods Twenty‐five tissue‐level implants from a previous controlled clinical trial were evaluated at 1‐ and 5‐year follow‐ups after crown delivery. Data included ultrasonographic scans (mucosal thickness and supracrestal tissue height), standardised 2D radiographs, cone beam computed tomography, clinical outcomes (mucosal recession, probing pocket depth, bleeding on probing), patient‐reported outcomes and peri‐implant health status. Standard logistic and linear regression models were used to analyse associations of implant‐ and patient‐related factors with outcomes, including peri‐implant disease status, mucosal recession and marginal bone level (MBL) changes. Results Five‐year implant survival was 100%, with peri‐implant mucositis diagnosed in 36% of the implants. Mean MBL changes from the first to the fifth year was 0.29 ± 0.29 mm. Baseline (pre‐surgical) buccal soft‐tissue thickness < 1.5 mm (OR: 5.20, <jats:italic>p</jats:italic> = 0.007) and increased plaque scores (OR: 30.11, <jats:italic>p</jats:italic> < 0.001) were associated with peri‐implant mucositis, whereas buccal bone thickness ≥ 1.5 mm (OR: 0.48, <jats:italic>p</jats:italic> = 0.039), mucosal thickness around implant (OR: 0.20, <jats:italic>p</jats:italic> = 0.001) and supracrestal tissue height (OR: 0.50, <jats:italic>p</jats:italic> = 0.002) emerged as protective factors. Mucosal recession was significantly associated with baseline buccal soft‐tissue thickness < 1.5 mm (estimate = 0.27, <jats:italic>p</jats:italic> = 0.03) and keratinised mucosa width of < 2 mm (estimate = 0.39, <jats:italic>p</jats:italic> = 0.021). Clinical thresholds associated with long‐term peri‐implant health were defined as follows: supracrestal tissue height ≥ 2.8 mm, restorative emergence angle ≤ 35.5°, mucosal thickness 1.8 mm and buccal bone thickness 1.5 mm. Patients reported a high overall satisfaction (visual analogue scale: 88.2%). Colour Doppler ultrasonography showed a strong correlation between tissue perfusion and peri‐implant disease ( <jats:italic>r</jats:italic> = 0.93, <jats:italic>p</jats:italic> < 0.001). Conclusions Within the limitations of this study, tissue‐level implants showed excellent survival rates and patient satisfaction at 5 years. Several peri‐implant parameters—such as supracrestal tissue height ≥ 2.8 mm, restorative emergence angle ≤ 35.5° and buccal bone thickness ≥ 1.5 mm—were associated with favourable outcomes. These exploratory thresholds may be considered hypothesis‐generating and could help guide future research and clinical monitoring, although validation in larger cohorts is essential. Trial Registration: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"http://www.clinicaltrials.gov/study/NCT02925078\">www.clinicaltrials.gov/study/NCT02925078</jats:ext-link>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"33 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730641","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 Effective prevention of periodontitis requires addressing multiple modifiable health behaviours (MHBs). This study aimed to examine how MHBs interact and to identify the key behaviours that could serve as targets for intervention. Materials and Methods We analysed data from a large, population‐based survey using questionnaires conducted in China during 2021–2023. Logistic regression was used to examine associations between self‐reported periodontitis and multiple MHBs. Network analysis was applied to assess interrelationships among MHBs and identify central MHBs. Results Among 85,483 participants, 12.8% reported periodontitis. Ten MHBs were associated with self‐reported periodontitis. Ever smoking, ever drinking, unhealthy bedtime, frequent consumption of sugar‐sweetened snacks and beverages, insufficient vegetable or fruit intake and toothbrushing less than twice daily were linked to higher prevalence, while insufficient physical activity, no daily flossing and absence of annual dental checkups were linked to lower prevalence. Network analysis identified ever smoking, ever drinking, toothbrushing frequency and dental checkups as the most central behaviours, with variations observed across different subgroups. Conclusion This study identified key MHBs and revealed differences in central behaviours across subgroups. Ever smoking, ever drinking, toothbrushing frequency and annual dental checkups may represent priority targets for tailored prevention strategies. Future research is warranted to inform integrated interventions.
{"title":"Network Analysis of Health Behaviours Associated With Periodontitis in Chinese Adults","authors":"Ruiying Fu, Yuting Xie, Huang Huang, Peiyuan Sun, Xiuqi Ma, Zhuolun Hu, Yingtai Chen, Xiaofeng Bi, Qiong Chen, Shaokai Zhang, Yin Liu, Ranran Qie, Jiankun Wei, Miaochang Chen, Jieying Zhong, Zhi Qi, Fan Yao, Lijuan Gao, Huanling Yu, Fen Liu, Yao Zhao, Baozhong Chen, Xiaoli Wei, Shasha Qin, Yuhui Du, Guoyu Zhou, Fangfang Yu, Yue Ba, Tingting Shang, Yaqun Zhang, Shan Zheng, Dongmei Xie, Xiaolan Chen, Xiaoling Liu, Cairong Zhu, Weiwei Wu, Yongliang Feng, Ying Wang, Qi Yan, Mengyao Wu, Yubing Lin, Kaiyong Zou, Yawei Zhang","doi":"10.1111/jcpe.70075","DOIUrl":"https://doi.org/10.1111/jcpe.70075","url":null,"abstract":"Aim Effective prevention of periodontitis requires addressing multiple modifiable health behaviours (MHBs). This study aimed to examine how MHBs interact and to identify the key behaviours that could serve as targets for intervention. Materials and Methods We analysed data from a large, population‐based survey using questionnaires conducted in China during 2021–2023. Logistic regression was used to examine associations between self‐reported periodontitis and multiple MHBs. Network analysis was applied to assess interrelationships among MHBs and identify central MHBs. Results Among 85,483 participants, 12.8% reported periodontitis. Ten MHBs were associated with self‐reported periodontitis. Ever smoking, ever drinking, unhealthy bedtime, frequent consumption of sugar‐sweetened snacks and beverages, insufficient vegetable or fruit intake and toothbrushing less than twice daily were linked to higher prevalence, while insufficient physical activity, no daily flossing and absence of annual dental checkups were linked to lower prevalence. Network analysis identified ever smoking, ever drinking, toothbrushing frequency and dental checkups as the most central behaviours, with variations observed across different subgroups. Conclusion This study identified key MHBs and revealed differences in central behaviours across subgroups. Ever smoking, ever drinking, toothbrushing frequency and annual dental checkups may represent priority targets for tailored prevention strategies. Future research is warranted to inform integrated interventions.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730643","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 To identify novel non‐syndromic hereditary gingival fibromatosis (nsHGF)–associated pathogenic variants and discover therapeutic targets for innovative, minimally invasive therapies. Materials and Methods Whole‐genome sequencing was performed to identify the pathogenic variant in a family with nsHGF. Levels of fibrosis markers and the yes‐associated protein/transcriptional coactivator with PDZ‐binding motif (YAP/TAZ) in gingival fibroblasts were measured by qPCR, western blot and immunofluorescence. Conditioned medium from gingival fibroblasts was used to treat THP‐1‐derived macrophages. In vivo pro‐fibrotic behaviour of CHYMASE ‐silenced gingival fibroblasts and verteporfin‐loaded exosome efficacy were evaluated in NOD/SCID mice. Results We identified a novel CHYMASE ( CMA1 ) nonsense mutation (c.114C>A, p.Tyr38*) in the nsHGF family. This mutation caused chymase deficiency in the patient's gingival fibroblasts, directly leading to extracellular matrix (ECM) overproduction through YAP/TAZ activation. Moreover, CHYMASE ‐silenced gingival fibroblasts promoted interleukin‐6 (IL‐6) secretion by macrophages, thereby amplifying pro‐fibrotic responses in gingival fibroblasts. The YAP inhibitor verteporfin suppressed ECM overproduction in CHYMASE ‐silenced gingival fibroblasts. In vivo, topical administration of verteporfin‐loaded exosomes significantly attenuated chymase deficiency–induced fibrosis. Conclusion Our findings support the pathogenic role of the CHYMASE mutation in nsHGF, establish chymase deficiency and consequent YAP/TAZ activation as the underlying mechanism and propose verteporfin‐loaded exosomes as a promising therapeutic strategy for nsHGF‐associated gingival overgrowth.
目的发现新的非综合征性遗传性牙龈纤维瘤病（nsHGF）相关的致病变异，并发现创新的微创治疗靶点。材料和方法采用全基因组测序方法鉴定一个nsHGF家族的致病变异。通过qPCR、western blot和免疫荧光检测牙龈成纤维细胞中纤维化标志物和yes相关蛋白/带PDZ结合基序的转录共激活因子（YAP/TAZ）的水平。使用牙龈成纤维细胞的条件培养基处理THP‐1来源的巨噬细胞。在NOD/SCID小鼠中评估了CHYMASE沉默的牙龈成纤维细胞的体内促纤维化行为和载维替porfin的外泌体功效。结果在nsHGF家族中发现了一个新的CHYMASE （CMA1）无义突变（c.114C> a, p.Tyr38*）。这种突变导致患者的牙龈成纤维细胞中乳糜酶缺乏，通过YAP/TAZ激活直接导致细胞外基质（ECM）过量产生。此外，CHYMASE沉默的牙龈成纤维细胞促进巨噬细胞分泌白细胞介素- 6 (IL - 6)，从而增强了牙龈成纤维细胞的促纤维化反应。YAP抑制剂维替波芬抑制CHYMASE沉默的牙龈成纤维细胞中ECM的过量产生。在体内，局部施用载维替波芬的外泌体可显著减轻乳糜酶缺乏症引起的纤维化。结论我们的研究结果支持了CHYMASE突变在nsHGF中的致病作用，确定了CHYMASE缺陷和随后的YAP/TAZ激活是潜在的机制，并提出了满载维替波芬的外泌体作为治疗nsHGF相关牙龈过度生长的有希望的治疗策略。
{"title":"Non‐Syndromic Hereditary Gingival Fibromatosis Driven by Chymase Deficiency Is Attenuated by Verteporfin‐Loaded Exosomes","authors":"Xin Chen, Yuqing Guo, Yangqiao Qing, Runze Li, Haotian Luo, Hio Cheng Ieong, Bingyan Guo, Zichun Huang, Yungshan Teng, Ruoyu Li, Wenfeng Li, Danying Chen, Yang Cao, Weicai Wang, Chen Zhou","doi":"10.1111/jcpe.70077","DOIUrl":"https://doi.org/10.1111/jcpe.70077","url":null,"abstract":"Aim To identify novel non‐syndromic hereditary gingival fibromatosis (nsHGF)–associated pathogenic variants and discover therapeutic targets for innovative, minimally invasive therapies. Materials and Methods Whole‐genome sequencing was performed to identify the pathogenic variant in a family with nsHGF. Levels of fibrosis markers and the yes‐associated protein/transcriptional coactivator with PDZ‐binding motif (YAP/TAZ) in gingival fibroblasts were measured by qPCR, western blot and immunofluorescence. Conditioned medium from gingival fibroblasts was used to treat THP‐1‐derived macrophages. In vivo pro‐fibrotic behaviour of <jats:italic>CHYMASE</jats:italic> ‐silenced gingival fibroblasts and verteporfin‐loaded exosome efficacy were evaluated in NOD/SCID mice. Results We identified a novel <jats:italic>CHYMASE</jats:italic> ( <jats:italic>CMA1</jats:italic> ) nonsense mutation (c.114C>A, p.Tyr38*) in the nsHGF family. This mutation caused chymase deficiency in the patient's gingival fibroblasts, directly leading to extracellular matrix (ECM) overproduction through YAP/TAZ activation. Moreover, <jats:italic>CHYMASE</jats:italic> ‐silenced gingival fibroblasts promoted interleukin‐6 (IL‐6) secretion by macrophages, thereby amplifying pro‐fibrotic responses in gingival fibroblasts. The YAP inhibitor verteporfin suppressed ECM overproduction in <jats:italic>CHYMASE</jats:italic> ‐silenced gingival fibroblasts. In vivo, topical administration of verteporfin‐loaded exosomes significantly attenuated chymase deficiency–induced fibrosis. Conclusion Our findings support the pathogenic role of the <jats:italic>CHYMASE</jats:italic> mutation in nsHGF, establish chymase deficiency and consequent YAP/TAZ activation as the underlying mechanism and propose verteporfin‐loaded exosomes as a promising therapeutic strategy for nsHGF‐associated gingival overgrowth.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"39 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145730642","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}
AIMPregnancy gingivitis is potentially modifiable, making it a promising target for preventive strategies to reduce adverse obstetrical outcomes. The primary objective of this study was to evaluate whether an interdental hygiene intervention in early pregnancy could reduce obstetrical complications. Exploratory analyses focused on potential biological pathways linking oral inflammation and obstetrical outcomes.MATERIALS AND METHODSA two-arm randomised controlled trial (RCT) with cluster allocation (1:1) was conducted in six antenatal clinics in Senegal among nulliparous women at 12 weeks. Participants received either a daily calibrated interdental brushing intervention (Intervention) or usual oral hygiene (Control). Follow-up visits were scheduled at 5 and 8 months. The primary endpoint was a composite of preterm birth, low birth weight, small for gestational age or pre-eclampsia, analysed exploratorily under the intention-to-treat principle.RESULTSA total of 323 women were randomised (162 intervention, 161 control). The composite outcome occurred in 28.4% of the intervention group and 24.2% of the control group (p = 0.449). After adjustment, the intervention was not significantly associated (aOR = 0.65; 95% CI: 0.39-1.10; p = 0.107). Exploratory analyses suggested that interdental bleeding and C-reactive protein (CRP) could act as mediators, accounting for ~60% of the effect, with the remaining ~40% representing a direct effect. No intervention-related adverse events were observed.CONCLUSIONThis RCT did not demonstrate a significant reduction in obstetrical complications with early interdental prophylaxis. However, the intervention was safe, acceptable and feasible within antenatal care, highlighting the need for adequately powered trials to clarify its potential clinical impact.
{"title":"Interdental Brushing and Obstetrical Outcomes in Nulliparous Pregnant Women: Insights From a Cluster Randomised Controlled Trial.","authors":"Denis Bourgeois,Aida Kanoute,Daouda Faye,Marta Mazur,Hervé Perrier,Roman Ardan,Céline Clément,Lucio Souza Gonçalves,Romain Lan,Florence Carrouel","doi":"10.1111/jcpe.70070","DOIUrl":"https://doi.org/10.1111/jcpe.70070","url":null,"abstract":"AIMPregnancy gingivitis is potentially modifiable, making it a promising target for preventive strategies to reduce adverse obstetrical outcomes. The primary objective of this study was to evaluate whether an interdental hygiene intervention in early pregnancy could reduce obstetrical complications. Exploratory analyses focused on potential biological pathways linking oral inflammation and obstetrical outcomes.MATERIALS AND METHODSA two-arm randomised controlled trial (RCT) with cluster allocation (1:1) was conducted in six antenatal clinics in Senegal among nulliparous women at 12 weeks. Participants received either a daily calibrated interdental brushing intervention (Intervention) or usual oral hygiene (Control). Follow-up visits were scheduled at 5 and 8 months. The primary endpoint was a composite of preterm birth, low birth weight, small for gestational age or pre-eclampsia, analysed exploratorily under the intention-to-treat principle.RESULTSA total of 323 women were randomised (162 intervention, 161 control). The composite outcome occurred in 28.4% of the intervention group and 24.2% of the control group (p = 0.449). After adjustment, the intervention was not significantly associated (aOR = 0.65; 95% CI: 0.39-1.10; p = 0.107). Exploratory analyses suggested that interdental bleeding and C-reactive protein (CRP) could act as mediators, accounting for ~60% of the effect, with the remaining ~40% representing a direct effect. No intervention-related adverse events were observed.CONCLUSIONThis RCT did not demonstrate a significant reduction in obstetrical complications with early interdental prophylaxis. However, the intervention was safe, acceptable and feasible within antenatal care, highlighting the need for adequately powered trials to clarify its potential clinical impact.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"36 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710895","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 To identify shared genetic architectures and molecular pathways underlying the frequent co‐occurrence of stage III/IV grade C periodontitis under 35 years of age (PIII/IV‐C< 35y) and abnormal root morphology (ARM), using a family‐based SNP set and transcriptomic approach. Materials and Methods We conducted a family‐based study using whole‐genome genotyping of 148 Han Chinese individuals from 52 families, including 52 probands, 35 mothers, 32 fathers and 29 siblings. The participants included 65 comorbidity cases, 29 PIII/IV‐C< 35y‐only cases, 27 ARM‐only cases and 27 controls. Whole‐genome genotyping and bi‐clustering were used to identify SNP sets associated with each phenotype, and transcriptomic profiling was performed to validate gene expression changes. Results Among 109 SNP sets, 91 (83.5%) showed ≥ 40% comorbidity risk. Fifty‐four and 27 SNP sets were significantly associated with PIII/IV‐C< 35y and ARM, respectively. Six genotype subnetworks were enriched for neural development and inflammation pathways, particularly IL‐17 signalling. Transcriptome data confirmed down‐regulation of KLHL29 , HSF2 and COL13A1 in PIII/IV‐C< 35y, and a reduction in GJA1 expression in comorbidity cases. Conclusions This study reveals a shared genetic architecture between PIII/IV‐C< 35y and ARM, implicating neural development and inflammatory pathways in their co‐occurrence. Key genes such as GJA1 may advance mechanistic understanding and support early identification of high‐risk individuals.
{"title":"Shared Genotypic Architectures of Stage III / IV Grade C Periodontitis Under 35 Years of Age (Former Aggressive Periodontitis) and Abnormal Root Morphology: A Family‐Based Study","authors":"Xiaoyuan Guan, Xiaoyi Li, Dafang Chen, Li Xu, Wenjing Li, Ruifang Lu, Xian'e Wang, Huanxin Meng","doi":"10.1111/jcpe.70071","DOIUrl":"https://doi.org/10.1111/jcpe.70071","url":null,"abstract":"Aim To identify shared genetic architectures and molecular pathways underlying the frequent co‐occurrence of stage III/IV grade C periodontitis under 35 years of age (PIII/IV‐C< 35y) and abnormal root morphology (ARM), using a family‐based SNP set and transcriptomic approach. Materials and Methods We conducted a family‐based study using whole‐genome genotyping of 148 Han Chinese individuals from 52 families, including 52 probands, 35 mothers, 32 fathers and 29 siblings. The participants included 65 comorbidity cases, 29 PIII/IV‐C< 35y‐only cases, 27 ARM‐only cases and 27 controls. Whole‐genome genotyping and bi‐clustering were used to identify SNP sets associated with each phenotype, and transcriptomic profiling was performed to validate gene expression changes. Results Among 109 SNP sets, 91 (83.5%) showed ≥ 40% comorbidity risk. Fifty‐four and 27 SNP sets were significantly associated with PIII/IV‐C< 35y and ARM, respectively. Six genotype subnetworks were enriched for neural development and inflammation pathways, particularly IL‐17 signalling. Transcriptome data confirmed down‐regulation of <jats:italic>KLHL29</jats:italic> , <jats:italic>HSF2</jats:italic> and <jats:italic>COL13A1</jats:italic> in PIII/IV‐C< 35y, and a reduction in <jats:italic>GJA1</jats:italic> expression in comorbidity cases. Conclusions This study reveals a shared genetic architecture between PIII/IV‐C< 35y and ARM, implicating neural development and inflammatory pathways in their co‐occurrence. Key genes such as <jats:italic>GJA1</jats:italic> may advance mechanistic understanding and support early identification of high‐risk individuals.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680105","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}
Li Niu, Xiaojing Ke, Wei Zhou, Baochun Tan, Junjie Zhao, Bin Chen, Yanfen Li, Peng Zhang, Fuhua Yan, Houxuan Li
Aim To assess a new material in comparison with free gingival graft (FGG) for increasing the width of keratinised tissue (KT). Material and Methods Forty‐six participants were randomly allocated to the absorbable gradient membrane (AGM) or the FGG group. This trial used inter‐patient comparison to establish the non‐inferiority of AGM compared to FGG. The primary outcome (KT) was examined from baseline to 3 years after surgery. Secondary outcomes included the plaque index (PI), bleeding index (BI), gingival recession (GR), probing depth (PD), immunoglobulin E (IgE) level, postoperative pain, aesthetics and patient satisfaction. Results The width of KT in the AGM group was non‐inferior to that of the FGG group at all short‐term follow‐ups (1, 3 and 6 months), with a pre‐defined margin of 1 mm. However, this non‐inferiority disappeared by 3 years after operation. From 6 months to 3 years, the GR associated with FGG significantly decreased, while that associated with AGM showed no significant change between adjacent time points. No significant differences were observed in PI, BI, PD or IgE levels between the groups. AGM required shorter surgery times and secured better aesthetic outcomes than FGG. Conclusion AGM showed short‐term non‐inferiority to FGG for KT augmentation. However, the non‐inferiority was not sustained at 3 years. Trial Registration The study was registered with the China Clinical Trial Center under ChiCTR2000034683. Informed consent was obtained from all participants
{"title":"Clinical Evaluation of Absorbable Gradient Membrane vs. Free Gingival Grafts for Periodontal Soft‐Tissue Augmentation: A Randomised Controlled Clinical Trial","authors":"Li Niu, Xiaojing Ke, Wei Zhou, Baochun Tan, Junjie Zhao, Bin Chen, Yanfen Li, Peng Zhang, Fuhua Yan, Houxuan Li","doi":"10.1111/jcpe.70073","DOIUrl":"https://doi.org/10.1111/jcpe.70073","url":null,"abstract":"Aim To assess a new material in comparison with free gingival graft (FGG) for increasing the width of keratinised tissue (KT). Material and Methods Forty‐six participants were randomly allocated to the absorbable gradient membrane (AGM) or the FGG group. This trial used inter‐patient comparison to establish the non‐inferiority of AGM compared to FGG. The primary outcome (KT) was examined from baseline to 3 years after surgery. Secondary outcomes included the plaque index (PI), bleeding index (BI), gingival recession (GR), probing depth (PD), immunoglobulin E (IgE) level, postoperative pain, aesthetics and patient satisfaction. Results The width of KT in the AGM group was non‐inferior to that of the FGG group at all short‐term follow‐ups (1, 3 and 6 months), with a pre‐defined margin of 1 mm. However, this non‐inferiority disappeared by 3 years after operation. From 6 months to 3 years, the GR associated with FGG significantly decreased, while that associated with AGM showed no significant change between adjacent time points. No significant differences were observed in PI, BI, PD or IgE levels between the groups. AGM required shorter surgery times and secured better aesthetic outcomes than FGG. Conclusion AGM showed short‐term non‐inferiority to FGG for KT augmentation. However, the non‐inferiority was not sustained at 3 years. Trial Registration The study was registered with the China Clinical Trial Center under ChiCTR2000034683. Informed consent was obtained from all participants","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"372 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674128","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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