Journal of Clinical Periodontology最新文献_第7页

Perceptions, Attitudes and Needs of Periodontitis Patients: A Qualitative Systematic Review 牙周炎患者的认知、态度和需求：定性系统回顾

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-27 DOI: 10.1111/jcpe.14058

Camila Pinheiro Furquim, Lina J. Suárez, Renata Tavares, Belén Retamal-Valdes, Murilo Fernando Neuppmann Feres, Magda Feres

Aim

Patient-reported outcomes (PROs) hold significant potential in guiding clinical decision making, yet their utilization in periodontal trials has been limited. This systematic review aimed to critically synthesize and analyse qualitative studies that evaluated the knowledge and impact of periodontitis and its treatment on patients' lives, as well as their motivations, expectations and experiences in seeking treatment.

Materials and Methods

Six databases were searched up to March 2024 for qualitative studies on periodontitis patients. Studies were quality-assessed using the JBI Critical Appraisal and ConQual tools. Two authors independently extracted the findings, with discrepancies resolved by a third reviewer.

Results

Thirteen studies from 2006 to 2023 across four continents, involving 215 participants, identified five themes related to periodontitis: (i) knowledge about periodontitis and its treatment; (ii) impact of periodontitis on patients' lives; (iii) motivation and treatment expectations; (iv) obstacles to treatment; and (v) treatment impact on patients' lives.

Conclusion

Significant physical and psychosocial impacts of periodontitis on patients' lives were identified, along with critical gaps in knowledge and awareness, emphasizing the important role of dentists in patient education. Specific PROs for use in validated instruments tailored to periodontitis were identified. These results can enhance patient-centred care by guiding future studies in accurately assessing patient perspectives on their condition and treatment.

目的患者报告结果（PROs）在指导临床决策方面具有很大的潜力，但其在牙周试验中的应用却很有限。本系统性综述旨在批判性地综合和分析定性研究，这些研究评估了牙周炎及其治疗对患者生活的了解和影响，以及患者寻求治疗的动机、期望和经历。使用 JBI Critical Appraisal 和 ConQual 工具对研究进行了质量评估。结果从 2006 年到 2023 年横跨四大洲的 13 项研究，涉及 215 名参与者，确定了与牙周炎相关的五个主题：(i) 对牙周炎及其治疗的了解；(ii) 牙周炎对患者生活的影响；(iii) 治疗动机和治疗期望；(iv) 治疗障碍；以及 (v) 治疗对患者生活的影响。结论确定了牙周炎对患者生活造成的重大生理和心理影响，以及在知识和认识方面存在的重大差距，强调了牙科医生在患者教育方面的重要作用。研究还确定了可用于专门针对牙周炎的验证工具的特定PROs。这些结果可以指导未来的研究准确评估患者对其病情和治疗的看法，从而加强以患者为中心的护理。

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引用次数: 0

Ten-Year Follow-Up of Oral Implants in Bone With Limited Bucco-Oral Dimensions: A Prospective Case Series 颊-口腔尺寸有限的骨内口腔种植体的十年随访：前瞻性病例系列

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-25 DOI: 10.1111/jcpe.14063

M. Alami, N. Ntovas, G. Penne, W. Teughels, M. Quirynen, A. Castro, A. Temmerman

Background

It has been suggested that 1–2 mm of bone width at the buccal and lingual aspect is required for a successful long-term implant outcome. Low levels of evidence support this minimum threshold of bone width. This prospective study aimed at evaluating the outcome of implants placed in alveolar ridges with limited bucco-oral dimensions.

Materials and Methods

One-hundred implants (dia. 3.5 mm) were placed in 28 patients with narrow alveolar ridge dimensions (<4.5 mm width) without augmentation procedures and conventionally loaded. Intra-oral radiographs were taken at implant placement and abutment connection and at 1, 2, 3, 5 and 10 years of follow-up. At the 10-year follow-up (21 patients; 75 implants), full-mouth periodontal charting was performed, and the peri-implant keratinized tissue width and attachment type were recorded. Two calibrated periodontists analysed the peri-implant bone changes.

Results

After 10 years, all implants showed successful osseointegration and a cumulative survival rate of 100%. The implants were placed 0.85 mm ± 0.89 mm subcrestally. After 10 years, the marginal bone was located 1.59 ± 2.11 mm apical to the implant shoulder. Throughout this period of follow-up, the mean annual marginal bone loss was 0.094 mm. Furthermore, 84% of implants in 72% of patients presented with bleeding on probing.

Conclusion

After 10 years of functional loading, implants placed in alveolar ridges with limited bucco-oral dimensions (≤4.5 mm) exhibited only minimum marginal bone loss.

背景有人认为，要想获得成功的长期种植效果，颊侧和舌侧的骨宽度必须达到 1-2 毫米。支持这一最小骨宽度阈值的证据较少。这项前瞻性研究旨在评估在颊--口腔尺寸有限的牙槽脊上植入种植体的效果。材料和方法在 28 名牙槽脊尺寸狭窄（宽度为 4.5 毫米）的患者中植入了 100 个种植体（直径为 3.5 毫米），这些种植体没有经过扩增程序，采用传统方式植入。在植入种植体和基台连接处以及 1、2、3、5 和 10 年的随访期间拍摄了口腔内放射线照片。在 10 年的随访中（21 名患者；75 个种植体），进行了全口牙周制图，记录了种植体周围角化组织的宽度和附着类型。结果10年后，所有种植体均成功实现骨结合，累积存活率为100%。种植体植入胸骨下 0.85 毫米 ± 0.89 毫米。10 年后，边缘骨位于种植体肩部 1.59 ± 2.11 mm 的顶端。在整个随访期间，平均每年的边缘骨损失为 0.094 毫米。此外，72% 患者的 84% 种植体在探诊时有出血现象。结论经过 10 年的功能负荷后，在颊-口腔尺寸有限（≤4.5 毫米）的牙槽脊上植入的种植体仅表现出最低限度的边缘骨流失。

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引用次数: 0

Is Starch Intake Associated With Periodontal Status? An 11-Year Longitudinal Analysis Among Finnish Adults 淀粉摄入量与牙周状况有关吗？芬兰成年人 11 年的纵向分析

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-24 DOI: 10.1111/jcpe.14072

F. H. Jangda, A. L. Suominen, A. Lundqvist, S. Männistö, A. Golkari, E. Bernabé

Aim

To evaluate the association between baseline starch intake (amount and sources) and changes in periodontal status over 11 years in adults.

Methods

Adults aged 30–82 years, who participated in the Finnish Health 2000 survey and were re-examined in 2004/2005 and/or 2011 were included in the study. The consumption of total starch and six relevant food groups (potatoes, fried potatoes, roots and tubers, pasta, wholegrains and legumes) over the past year was determined at baseline with a validated food frequency questionnaire. The number of teeth with periodontal pocketing ≥ 4 mm (NTPP) was recorded during clinical examinations in 2000, 2004/2005 and 2011. The association between baseline starch intake and the 11-year change in the NTPP was tested in mixed-effects negative binomial regression models, adjusting for covariates.

Results

A total of 1369 adults were included in the analysis. The mean NTPP was 4.1 ± 5.6, 6.3 ± 5.6, and 4.8 ± 5.9 in waves 1, 2 and 3, respectively. Baseline starch intake (in g/day or % energy intake) was not associated with changes in the NTPP after adjustment for covariates. In analysis by food groups, the baseline intake of wholegrains was negatively associated with the NTPP at baseline.

Conclusion

This study found no evidence of an association between baseline starch intake and changes in periodontal status. Baseline intake of wholegrains was associated with better periodontal status at baseline.

目的评估基线淀粉摄入量（数量和来源）与成年人牙周状况在11年中的变化之间的关系。方法将参加芬兰2000年健康调查并在2004/2005年和/或2011年接受复查的30-82岁成年人纳入研究。在基线期，通过有效的食物频率问卷调查确定过去一年总淀粉和六类相关食物（马铃薯、油炸马铃薯、块根和块茎、面食、全麦和豆类）的消费量。2000年、2004/2005年和2011年的临床检查记录了牙周袋≥4毫米（NTPP）的牙齿数量。在混合效应负二项回归模型中检验了基线淀粉摄入量与11年NTPP变化之间的关系，并对协变量进行了调整。第 1、2 和 3 波的平均 NTPP 分别为 4.1 ± 5.6、6.3 ± 5.6 和 4.8 ± 5.9。基线淀粉摄入量（克/天或能量摄入百分比）与共变因素调整后的 NTPP 变化无关。结论本研究没有发现基线淀粉摄入量与牙周状况变化之间存在关联的证据。全谷物的基线摄入量与基线牙周状况的改善有关。

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引用次数: 0

Extracellular Release of a Disintegrin and Metalloproteinase Correlates With Periodontal Disease Severity 细胞外崩解素和金属蛋白酶的释放与牙周病严重程度有关

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-24 DOI: 10.1111/jcpe.14073

Ahmad Aljohmani, Hakon Heinze, Federico Guillermo Gharzia, Bashar Reda, Ahmed Mohamed Mostafa Abdrabou, Sören L. Becker, Markus Bischoff, Matthias Hannig, Daniela Yildiz

Aim

Periodontal disease is driven by oral pathogens, including Porphyromonas gingivalis, and the release of inflammatory cytokines. These cytokines (e.g., TNF) or their receptors (e.g., IL-1R) are substrates of a disintegrin and metalloproteinases (ADAMs). In this study, we aimed to determine the effects of ADAMs on periodontal disease phenotypes.

Materials and Methods

Western blot and FRET-based activity measurements of the gingival crevicular fluid (GCF) of patients were compared with those of infected (P. gingivalis) or cytokine-stimulated oral keratinocytes and primary human neutrophils, respectively. This was accompanied by an analysis of the released extracellular vesicles and MMP9 activity.

Results

In the GCF of patients, ADAM8 protein expression and activity were correlated with disease stage, whereas ADAM10 protein expression was inversely correlated with disease stage. Infection and the resulting cytokine release orchestrated the release of soluble ADAM8 by oral keratinocytes and primary neutrophils as soluble ectodomain and on exosomes, respectively. Furthermore, ADAM8 regulated the release of ADAM10 and MMP9.

Conclusion

Dysregulation of cell-associated and extracellular ADAM proteolytic activity may be an essential regulatory element in the progression of periodontal disease driven by ADAM8. The influence of ADAM8 on disease onset and the evaluation of targeting ADAM8 as a potential and novel local treatment option should be addressed in future translational in vivo studies.

目的牙周疾病是由包括牙龈卟啉单胞菌在内的口腔病原体和炎性细胞因子的释放引起的。这些细胞因子（如 TNF）或其受体（如 IL-1R）是崩解酶和金属蛋白酶（ADAMs）的底物。在本研究中，我们旨在确定 ADAMs 对牙周疾病表型的影响。材料与方法分别将患者牙龈缝隙液（GCF）的 Western 印迹和 FRET 活性测量结果与受感染（牙龈脓疱病）或细胞因子刺激的口腔角质形成细胞和原代人类中性粒细胞的测量结果进行比较。结果在患者的 GCF 中，ADAM8 蛋白表达和活性与疾病分期相关，而 ADAM10 蛋白表达与疾病分期成反比。感染和由此导致的细胞因子释放分别协调了口腔角质形成细胞和原发性中性粒细胞以可溶性外域和外泌体的形式释放可溶性 ADAM8。此外，ADAM8 还能调节 ADAM10 和 MMP9 的释放。结论细胞相关和细胞外 ADAM 蛋白水解活性的失调可能是 ADAM8 驱动牙周病进展的一个重要调节因素。ADAM8 对疾病发生的影响以及将 ADAM8 作为一种潜在的新型局部治疗方案的评估，应在未来的体内转化研究中加以探讨。

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引用次数: 0

Gingival Crevicular Fluid Biomarkers During Periodontitis Progression and After Periodontal Treatment 牙周炎进展期间和牙周治疗后的龈沟液生物标志物

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-15 DOI: 10.1111/jcpe.14061

Flavia Teles, Lynn Martin, Michele Patel, Weiming Hu, Kyle Bittinger, Michael J. Kallan, Ganesh Chandrasekaran, Andrew J. Cucchiara, William V. Giannobile, Danielle Stephens, Alpdogan Kantarci

Objective

To identify gingival crevicular fluid (GCF)-derived inflammatory markers of periodontitis progression and periodontal treatment impact.

Methods

Periodontally healthy (H; n = 112) and periodontitis (P; n = 302) patients were monitored bi-monthly for 1 year without therapy. Periodontitis patients were re-examined 6 months after non-surgical periodontal therapy (NSPT). Levels of 64 biomarkers were measured in the GCF samples collected at each visit from progressing (n = 12 sites in H; n = 76 in P) and stable (n = 100 in H, n = 225 in P) sites. Clinical parameters and log-transformed analyte levels were averaged within clinical groups at each time point and analysed using linear mixed models.

Results

During monitoring, progressing sites had significantly higher levels of IL-1β, MMP-8, IL-12p40, EGF and VEGF. MMP-9 and Periostin were significantly more elevated in stable sites. Distinct cytokine profiles were observed based on baseline PD. Treatment led to significant reductions in Eotaxin, Flt-3L, GDF-15, GM-CSF, IL-1β, IL-17, MIP-1d, RANTES and sCD40L, and increases in IP-10 and MMP-9.

Conclusion

Distinct cytokine signatures observed in stable and progressing sites were maintained over time in the absence of treatment and significantly affected by NSPT.

目的确定牙龈缝隙液（GCF）衍生的牙周炎进展和牙周治疗影响的炎症标志物：方法：对牙周健康（H；n = 112）和牙周炎（P；n = 302）患者进行为期一年的双月监测。牙周炎患者在接受非手术牙周治疗（NSPT）6个月后接受复查。在每次就诊时从进展期（H = 12 个部位；P = 76 个部位）和稳定期（H = 100 个部位；P = 225 个部位）采集的 GCF 样本中测量了 64 种生物标志物的水平。临床参数和对数转换的分析物水平在每个时间点的临床组内取平均值，并使用线性混合模型进行分析：结果：在监测过程中，进展部位的 IL-1β、MMP-8、IL-12p40、EGF 和 VEGF 水平明显升高。MMP-9和Periostin在稳定部位明显升高。根据基线PD观察到不同的细胞因子特征。治疗导致Eotaxin、Flt-3L、GDF-15、GM-CSF、IL-1β、IL-17、MIP-1d、RANTES和sCD40L明显降低，IP-10和MMP-9升高：结论：在稳定和进展部位观察到的不同细胞因子特征在没有治疗的情况下长期存在，并受到NSPT的显著影响。

{"title":"Gingival Crevicular Fluid Biomarkers During Periodontitis Progression and After Periodontal Treatment","authors":"Flavia Teles, Lynn Martin, Michele Patel, Weiming Hu, Kyle Bittinger, Michael J. Kallan, Ganesh Chandrasekaran, Andrew J. Cucchiara, William V. Giannobile, Danielle Stephens, Alpdogan Kantarci","doi":"10.1111/jcpe.14061","DOIUrl":"10.1111/jcpe.14061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify gingival crevicular fluid (GCF)-derived inflammatory markers of periodontitis progression and periodontal treatment impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Periodontally healthy (H; <i>n</i> = 112) and periodontitis (P; <i>n</i> = 302) patients were monitored bi-monthly for 1 year without therapy. Periodontitis patients were re-examined 6 months after non-surgical periodontal therapy (NSPT). Levels of 64 biomarkers were measured in the GCF samples collected at each visit from progressing (<i>n</i> = 12 sites in H; <i>n</i> = 76 in P) and stable (<i>n</i> = 100 in H, <i>n</i> = 225 in P) sites. Clinical parameters and log-transformed analyte levels were averaged within clinical groups at each time point and analysed using linear mixed models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During monitoring, progressing sites had significantly higher levels of IL-1β, MMP-8, IL-12p40, EGF and VEGF. MMP-9 and Periostin were significantly more elevated in stable sites. Distinct cytokine profiles were observed based on baseline PD. Treatment led to significant reductions in Eotaxin, Flt-3L, GDF-15, GM-CSF, IL-1β, IL-17, MIP-1d, RANTES and sCD40L, and increases in IP-10 and MMP-9.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Distinct cytokine signatures observed in stable and progressing sites were maintained over time in the absence of treatment and significantly affected by NSPT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 1","pages":"40-55"},"PeriodicalIF":5.8,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Does Periodontitis Increase the Risk for Future Cardiovascular Events? Long-Term Follow-Up of the PAROKRANK Study 牙周炎会增加未来心血管事件的风险吗？PAROKRANK研究的长期随访。

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-11 DOI: 10.1111/jcpe.14064

Anna Norhammar, Per Näsman, Kåre Buhlin, Ulf de Faire, Giulia Ferrannini, Anders Gustafsson, Barbro Kjellström, Thomas Kvist, Eva Levring Jäghagen, Bertil Lindahl, Åke Nygren, Ulf Näslund, Elisabet Svenungsson, Björn Klinge, Lars Rydén, for the PAROKRANK Study Group

Background and Aim

The study ‘Periodontitis and Its Relation to Coronary Artery Disease’ (PAROKRANK) reported an association between periodontitis (PD) and the first myocardial infarction (MI). This follow-up study aims to test the hypothesis that those with PD—compared to periodontally healthy individuals—are at increased risk for cardiovascular (CV) events and death.

Methods

A total of 1587 participants (age <75 years; females 19%) had a dental examination including panoramic radiographs between 2010 and 2014. PD was categorized as healthy (≥80% alveolar bone height), mild/moderate (79%–66%) or severe (<66%). A composite CV event (first of all-cause death, non-fatal MI or stroke and hospitalization following to heart failure) was investigated during a mean follow-up period of 9.9 years (range 0.2–12.5 years). Participants were divided into two groups: those with and without PD. The primary event rate, stratified by periodontal status at baseline, was calculated using the Kaplan–Meier method and Cox regression.

Results

The number of events was 187 in the 985 periodontally healthy participants (19%) and 174 in the 602 participants with PD (29%; p < 0.0001). Those with PD had a higher likelihood for a future event (hazard ratio [HR] = 1.26; 95% CI: 1.01–1.57; p = 0.038), following adjustment for age, smoking and diabetes.

Conclusion

The PAROKRANK follow-up revealed that CV events were more common among participants with PD, which supports the assumption that there might be a direct relation between PD and CV disease.

背景和目的 "牙周炎及其与冠状动脉疾病的关系"（PAROKRANK）研究报告了牙周炎（PD）与首次心肌梗塞（MI）之间的关系。本后续研究旨在验证以下假设：与牙周健康的人相比，患有牙周炎的人发生心血管（CV）事件和死亡的风险更高。方法共有 1587 名参与者（年龄小于 75 岁；女性占 19%）在 2010 年至 2014 年期间进行了牙科检查，包括全景 X 光片。牙周病分为健康（牙槽骨高度≥80%）、轻度/中度（79%-66%）或重度（<66%）。在平均 9.9 年（0.2-12.5 年）的随访期间，对复合心血管事件（首次全因死亡、非致命性心肌梗死或中风以及心力衰竭住院）进行了调查。参与者被分为两组：有和没有帕金森病的患者。结果985名牙周健康的参与者中发生了187起事件（19%），602名患有帕金森病的参与者中发生了174起事件（29%；P < 0.0001）。在对年龄、吸烟和糖尿病等因素进行调整后，患有牙周病的参与者未来发生事件的可能性更高（危险比 [HR] = 1.26；95% CI：1.01-1.57；p = 0.038）。

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引用次数: 0

The Potential Effect of Periodontal Disease on the Development of Metabolic Syndrome: A 10-Year Observational Study in a Thai Adult Cohort 牙周病对代谢综合征发展的潜在影响：一项为期 10 年的泰国成人队列观察研究。

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-10 DOI: 10.1111/jcpe.14068

Benjar Issaranggun Na Ayuthaya, Attawood Lertpimonchai, Lakshman Samaranayake, Prin Vathesatogkit, Lalitsara Thienpramuk, Wichaya Wisitrasameewong, Suphot Tamsailom

Aim

As data are sparse on the long-term association between periodontal diseases and development of metabolic syndrome (MetS), we investigated their relationship in a Thai cohort over a 10-year observational period.

Methods

Medical records and data on periodontal assessments of 2161 employees of the Electricity Generating Authority of Thailand collected at two time points, 2003 and 2013, were used. Experienced periodontists used standard national and international criteria to define periodontitis and MetS. The impact of baseline periodontitis on subsequent MetS incidence and its components was evaluated using regression analyses.

Results

The severity and extent of periodontitis significantly predicted MetS incidence over a decade, with a higher incidence of MetS in individuals with poorer periodontal health. A single percentage increase in the periodontitis extent raised the risk of MetS incidence by 0.4% and the risk of developing individual components of MetS by 0.2%. Independent of periodontal health, age of an individual emerged as a factor impacting MetS development.

Conclusion

This study highlights the potential effect of the severity and extent of periodontitis on the increased incidence and progression of MetS. Hyperglycaemia and hypertension were the two MetS components most significantly affected by the existence of periodontitis.

目的由于有关牙周疾病与代谢综合征（MetS）发展之间长期关系的数据稀少，我们在泰国的一个队列中调查了这两者之间长达 10 年的观察期关系。方法使用 2003 年和 2013 年两个时间点收集的泰国发电局 2161 名员工的医疗记录和牙周评估数据。经验丰富的牙周病专家采用标准的国内和国际标准来定义牙周炎和 MetS。结果牙周炎的严重程度和范围可显著预测十年内 MetS 的发病率，牙周健康状况较差的人 MetS 发病率较高。牙周炎程度每增加一个百分点，MetS的发病风险就会增加0.4%，而MetS各组成部分的发病风险则会增加0.2%。结论：本研究强调了牙周炎的严重程度和范围对 MetS 的发病率增加和发展的潜在影响。高血糖和高血压是受牙周炎影响最大的两种 MetS 成分。

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引用次数: 0

Effect of Discontinuation of Supportive Periodontal Therapy on Periodontal Status—A Retrospective Study 停止牙周支持疗法对牙周状况的影响--一项回顾性研究。

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-05 DOI: 10.1111/jcpe.14062

Thomas Kocher, Karoline Lösler, Christiane Pink, Hans Jörgen Grabe, Birte Holtfreter

Aim

To assess the impact of active (APT) and supportive periodontal therapy (SPT) on the change in probing depth (PD) and annual tooth loss in partially and fully compliant and drop-out patients.

Material and Methods

Data of 280 periodontally treated partially and fully compliant (regular supportive visits, SPT duration 5.5 ± 4.5 years) and 55 drop-out patients (SPT and drop-out duration 8.3 ± 3.8 years, only drop-out duration 5.3 ± 3.7 years) were recorded. PD data and the number of teeth present at the start of APT (T1) and at the start of SPT (T2) were taken from the patient files and evaluated at the time of the final examination (T3).

Results

Annual tooth loss during SPT was significantly higher (p < 0.001) in drop-out patients than in partially and fully compliant patients (0.31 ± 0.50 vs. 0.19 ± 0.55, respectively). In partially and fully compliant and drop-out patients, the mean PD (all available site data) decreased significantly between T1 (3.61 ± 0.82 vs. 3.70 ± 0.73 mm) and T2 (2.68 ± 0.40 vs. 2.76 ± 0.42 mm), while the values increased again slightly up to T3 (2.74 ± 0.41 vs. 2.99 ± 0.75 mm).

Conclusions

In partially and fully compliant patients, SPT had a positive impact on PD stability and medium-term tooth preservation. In contrary to expectations, drop-out patients, PD did not return to baseline values, although PD stability was not achieved.

目的：评估积极牙周治疗（APT）和支持性牙周治疗（SPT）对部分和完全达标以及辍学患者探诊深度（PD）变化和年牙齿脱落的影响：记录了280名牙周治疗部分达标和完全达标患者（定期支持性就诊，SPT持续时间为5.5 ± 4.5年）以及55名辍学患者（SPT和辍学持续时间为8.3 ± 3.8年，仅辍学持续时间为5.3 ± 3.7年）的数据。从患者档案中获取PD数据以及APT开始时（T1）和SPT开始时（T2）的牙齿数量，并在最终检查时（T3）进行评估：结果：SPT期间的年牙齿脱落率明显更高（p 结论：SPT期间的年牙齿脱落率明显高于APT期间：在部分和完全达标的患者中，SPT 对 PD 稳定性和中期牙齿保存有积极影响。与预期相反，退出的患者虽然没有达到 PD 稳定度，但 PD 没有恢复到基线值。

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引用次数: 0

Experimental Periodontitis Worsens Dopaminergic Neuronal Degeneration 实验性牙周炎加剧多巴胺能神经元退化

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-02 DOI: 10.1111/jcpe.14065

Gabrielle Jacob, Bruna A. Milan, Livia Rodrigues Antonieto, Yara Levi, Marcela Costa Ribeiro, Raquel Nassar, Manoel Damião de Sousa-Neto, Jardel Francisco Mazzi-Chaves, Michel Reis Messora, Flavia Aparecida Chaves Furlaneto, Glauce C. Nascimento, Elaine Del-Bel

Aim

To investigate the hypothesis supporting the link between periodontitis and dopaminergic neuron degeneration.

Materials and Methods

Adult male Wistar rats were used to induce dopaminergic neuronal injury with 6-hydroxydopamine (6-OHDA) neurotoxin and experimental periodontitis via ligature placement. Motor function assessments were conducted before and after periodontitis induction in controls and 6-OHDA-injury-induced rats. Tissue samples from the striatum, jaw and blood were collected for molecular analyses, encompassing immunohistochemistry of tyrosine hydroxylase, microglia and astrocyte, as well as micro-computed tomography, to assess alveolar bone loss and for the analysis of striatal oxidative stress and plasma inflammatory markers.

Results

The results indicated motor impairment in 6-OHDA-injury-induced rats exacerbated by periodontitis, worsening dopaminergic striatal degeneration. Periodontitis alone or in combination with 6-OHDA-induced lesion was able to increase striatal microglia, while astrocytes were increased by the combination only. Periodontitis increased striatal reactive oxygen species levels and plasma tumour necrosis factor-alpha levels in rats with 6-OHDA-induced lesions and decreased the anti-inflammatory interleukin-10.

Conclusions

This study provides original insights into the association between periodontitis and a neurodegenerative condition. The increased inflammatory pathway associated with both 6-OHDA-induced dopaminergic neuron lesion and periodontal inflammatory processes corroborates that the periodontitis-induced systemic inflammation may aggravate neuroinflammation in Parkinson's-like disease, potentially hastening disease progression.

目的：研究支持牙周炎与多巴胺能神经元变性之间联系的假说：用6-羟基多巴胺（6-OHDA）神经毒素诱导成年雄性Wistar大鼠多巴胺能神经元损伤，并通过结扎诱导实验性牙周炎。在牙周炎诱导前后，对对照组和 6-OHDA 损伤诱导组大鼠进行了运动功能评估。采集纹状体、颌骨和血液组织样本进行分子分析，包括酪氨酸羟化酶、小胶质细胞和星形胶质细胞的免疫组化，以及微计算机断层扫描，以评估牙槽骨损失，并分析纹状体氧化应激和血浆炎症标志物：结果表明，牙周炎加剧了6-OHDA损伤诱导大鼠的运动障碍，并加重了多巴胺能纹状体变性。牙周炎单独或与6-OHDA诱导的病变合并可增加纹状体小胶质细胞，而星形胶质细胞仅在合并时增加。牙周炎增加了6-OHDA诱导病变大鼠纹状体活性氧水平和血浆肿瘤坏死因子-α水平，并降低了抗炎性白细胞介素-10：本研究为牙周炎与神经退行性疾病之间的联系提供了新的见解。6-OHDA诱导的多巴胺能神经元病变和牙周炎症过程相关的炎症通路增加证实了牙周炎诱导的全身炎症可能会加重帕金森病样疾病的神经炎症，从而可能加速疾病的进展。

{"title":"Experimental Periodontitis Worsens Dopaminergic Neuronal Degeneration","authors":"Gabrielle Jacob, Bruna A. Milan, Livia Rodrigues Antonieto, Yara Levi, Marcela Costa Ribeiro, Raquel Nassar, Manoel Damião de Sousa-Neto, Jardel Francisco Mazzi-Chaves, Michel Reis Messora, Flavia Aparecida Chaves Furlaneto, Glauce C. Nascimento, Elaine Del-Bel","doi":"10.1111/jcpe.14065","DOIUrl":"10.1111/jcpe.14065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the hypothesis supporting the link between periodontitis and dopaminergic neuron degeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Adult male Wistar rats were used to induce dopaminergic neuronal injury with 6-hydroxydopamine (6-OHDA) neurotoxin and experimental periodontitis via ligature placement. Motor function assessments were conducted before and after periodontitis induction in controls and 6-OHDA-injury-induced rats. Tissue samples from the striatum, jaw and blood were collected for molecular analyses, encompassing immunohistochemistry of tyrosine hydroxylase, microglia and astrocyte, as well as micro-computed tomography, to assess alveolar bone loss and for the analysis of striatal oxidative stress and plasma inflammatory markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicated motor impairment in 6-OHDA-injury-induced rats exacerbated by periodontitis, worsening dopaminergic striatal degeneration. Periodontitis alone or in combination with 6-OHDA-induced lesion was able to increase striatal microglia, while astrocytes were increased by the combination only. Periodontitis increased striatal reactive oxygen species levels and plasma tumour necrosis factor-alpha levels in rats with 6-OHDA-induced lesions and decreased the anti-inflammatory interleukin-10.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides original insights into the association between periodontitis and a neurodegenerative condition. The increased inflammatory pathway associated with both 6-OHDA-induced dopaminergic neuron lesion and periodontal inflammatory processes corroborates that the periodontitis-induced systemic inflammation may aggravate neuroinflammation in Parkinson's-like disease, potentially hastening disease progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 1","pages":"159-170"},"PeriodicalIF":5.8,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119920","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}

引用次数: 0

A Randomized Controlled Trial on the Timing of Soft-Tissue Augmentation in Immediate Implant Placement: Hard-Tissue Changes and Clinical Outcome 即刻种植体植入中软组织增量时机的随机对照试验：硬组织变化与临床效果。

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology

Pub Date : 2024-09-01 DOI: 10.1111/jcpe.14060

Jan Cosyn, Thibault Struys, Pieter-Jan Van Hove, Stefanie De Buyser, Thomas De Bruyckere

Aim

To assess the impact of the timing of soft-tissue augmentation (STA) on mean buccal bone changes following immediate implant placement (IPP) in the anterior maxilla.

Materials and Methods

Patients with a failing tooth and intact buccal bone wall in the anterior maxilla (15–25) were enrolled in this randomized controlled trial. Following single IIP and socket grafting, they were randomly allocated to the control group (immediate STA performed during the same surgical procedure) or the test group (delayed STA performed 3 months later). Implants were placed with a surgical guide and immediately restored with an implant-supported provisional crown. Changes in bone dimensions were assessed using superimposed CBCT images taken prior to surgery and at 1-year follow-up. Clinical outcomes were registered at 1-year follow-up.

Results

Twenty patients were randomized to each group (control: 16 females, 4 males, mean age 57.6; test: 9 females, 11 males, mean age 54.2). Ten patients in the control group and 13 patients in the test group had a thick bone wall phenotype. Estimated marginal mean horizontal buccal bone loss at 1 mm below the implant shoulder was −0.553 and −0.898 mm for the control and test group, respectively. The estimated mean difference of 0.344 mm in favour of the control group was not significant (95% CI: −0.415 to 1.104; p = 0.363). Also at all other horizontal and vertical levels, no significant differences could be observed between the groups. The combination of socket grafting and STA enabled counteraction of any buccal soft-tissue loss (≥ 0 mm) at 1 mm below the implant shoulder in 82% of the patients in the control group and in 75% of the patients in the test group (p = 1.000). The clinical outcome was favourable in both groups, yet implants in the control group demonstrated slightly less marginal bone loss (median difference 0.20 mm; 95% CI: 0.00–0.44; p = 0.028).

Conclusion

In patients with an intact and mainly thick buccal bone wall in the anterior maxilla, the timing of STA following IIP had no significant impact on mean buccal bone loss.

Trial Registration

ClinicalTrials.gov identifier: NCT05537545

目的：评估上颌前牙即刻种植体植入（IPP）后软组织增量（STA）时机对平均颊骨变化的影响：本随机对照试验招募了上颌前牙失败且颊骨壁完整的患者（15-25 人）。在单颗 IIP 和牙槽移植后，他们被随机分配到对照组（在同一手术过程中立即进行 STA）或试验组（3 个月后延迟进行 STA）。使用手术导板植入种植体，并立即用种植体支撑的临时牙冠进行修复。使用手术前和随访 1 年时所拍摄的 CBCT 叠加图像对骨尺寸的变化进行评估。结果：每组随机分配 20 名患者（对照组：16 名女性，4 名男性，平均年龄 57.6 岁；试验组：9 名女性，11 名男性，平均年龄 54.2 岁）。对照组和测试组分别有 10 名和 13 名患者具有厚骨壁表型。对照组和测试组在种植体肩部下方 1 毫米处的边缘平均水平颊骨损失估计分别为-0.553 毫米和-0.898 毫米。对照组的估计平均值为 0.344 毫米，差异不显著（95% CI：-0.415 至 1.104；P = 0.363）。此外，在所有其他水平和垂直水平上，两组之间也没有明显差异。在对照组和试验组中，分别有 82% 和 75% 的患者在种植体肩部下方 1 mm 处的颊软组织缺损（≥ 0 mm）得到了修复（p = 1.000）。两组患者的临床结果都很好，但对照组的种植体边缘骨质流失略少（中位数差异为 0.20 毫米；95% CI：0.00-0.44；p = 0.028）：结论：对于上颌前牙颊骨壁完整且主要较厚的患者，IIP后的STA时机对平均颊骨损失没有显著影响：试验注册：ClinicalTrials.gov identifier：NCT05537545。

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引用次数: 0