Journal of Clinical Periodontology最新文献_第8页

Risk factors for gingival invagination: A retrospective study 牙龈内陷的风险因素：回顾性研究

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

Journal of Clinical Periodontology

Pub Date : 2024-05-23 DOI: 10.1111/jcpe.14005

M. Han, S. H. Li, Y. Yao, Yijiao Zhao, L. P. You, Q. Zheng, X. M. Xu

Aim

This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction.

Materials and Methods

The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed-effects models and generalized propensity score weighting (GPSW) to develop a predictive model.

Results

Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento-enamel junction (MB1), mid-root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p < .05). Furthermore, a subsequent multivariable mixed-effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p < .001; odds ratio [OR_MB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986–93.807; OR_0.5<MB1<1mm = 22.309; 95% CI: 9.890–50.320). Row mixing model analysis performed after balancing covariates using GPSW showed that MB1 and vertical skeletal relationships were associated with gingival invagination (p < .05) with an increase in ORs. Therefore, in addition to MB1, the risk of gingival invagination is higher in hyperdivergent and normodivergent patients. During the establishment and internal validation of the predictive model, the area under the curve for all three models exceeded 0.7.

Conclusions

The risk of gingival invagination is higher in patients with MB1 < 1 mm and in normodivergent or hyperdivergent patients.

目的：本研究旨在确定前磨牙拔除后正畸治疗期间牙龈内陷的风险因素：收集 135 名前磨牙拔除后进行牙间隙封闭的患者的病历，并进行锥形束计算机断层扫描以确定是否存在牙龈内陷。采用混合效应模型和广义倾向评分加权法（GPSW）对风险因素进行了研究，以建立预测模型：单变量分析显示，拔牙部位、牙本质-釉质交界处根尖4毫米处的颊骨厚度（MB1）、根中颊骨厚度（MB2）和垂直骨骼关系与牙龈内陷有关（p MB1≤0.5mm] = 29.304；95% 置信区间[CI]：8.986-93.807；OR0.5 = 22.309；95% CI：9.890-50.320）。使用 GPSW 平衡协变量后进行的行混合模型分析表明，MB1 和垂直骨骼关系与牙龈内陷相关（p 结论：MB1 和垂直骨骼关系与牙龈内陷的风险相关：具有 MB1 和垂直骨骼关系的患者发生牙龈内陷的风险较高。

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引用次数: 0

Distinctive subgingival microbial signatures in older adults with different levels of cognitive function 不同认知功能水平的老年人牙龈下微生物特征各不相同。

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

Journal of Clinical Periodontology

Pub Date : 2024-05-20 DOI: 10.1111/jcpe.13997

Lili Chen, Xiuli Li, Jinxiu Liu, Zhaoyi Hou, Yongbao Wei, Mingfeng Chen, Bixia Wang, Huizhen Cao, Rongyan Qiu, Yuping Zhang, Xinli Ji, Ping Zhang, Mianxiang Xue, Linlin Qiu, Linlin Wang, Hong Li

Aim

To examine association between subgingival microbial signatures and levels of cognitive impairment in older adults.

Materials and Methods

We analysed subgingival plaque samples and 16S ribosomal RNA sequences for microbiota among 165 participants (normal controls [NCs]: 40, subjective cognitive decline [SCD]: 40, mild cognitive impairment [MCI]: 49 and dementia: 36).

Results

The bacterial richness was lower among individuals with worse cognitive function, and subgingival microbial communities differed significantly among the four groups. Declining cognitive function was associated with decreasing relative abundance of genera Capnocytophaga, Saccharibacteria_genera_incertae_sedis, Lautropia and Granulicatella, and increasing abundance of genus Porphyromonas. Moreover, there were differentially abundant genera among the groups. Random forest model based on subgingival microbiota could distinguish between cognitive impairment and NC (AUC = 0.933, 95% confidence interval 0.873–0.992). Significant correlations were observed between oral microbiota and sex, Montreal Cognitive Assessment (MoCA) score and Mini-Mental State Examination score. Partial correlation analysis showed that Leptotrichia and Burkholderia were closely negatively associated with the MoCA score after adjusting for multiple covariates. Gene function was not significantly different between SCD and NC groups, whereas three homozygous genes were altered in MCI patients and two in dementia patients.

Conclusions

This is the first study to demonstrate an association between the composition, function and metabolic pathways of subgingival microbiota and different levels of cognitive function among older individuals. Future cohort studies should assess its diagnostic usefulness for cognitive impairment.

目的：研究龈下微生物特征与老年人认知障碍水平之间的关系：我们分析了 165 名参与者（正常对照组 [NCs]：40 人；主观认知功能下降组 [SCD]：40 人）的龈下菌斑样本和微生物群的 16S 核糖体 RNA 序列：40人，主观认知能力下降[SCD]：40人、轻度认知障碍[MCI]：49人和痴呆症：36人）的微生物群：结果：结果：认知功能下降者的细菌丰富度较低，龈下微生物群落在四个组别中差异显著。认知功能下降与 Capnocytophaga 属、Saccharibacteria_genera_incertae_sedis 属、Lautropia 属和 Granulicatella 属的相对丰度下降以及 Porphyromonas 属的丰度上升有关。此外，各组之间的菌属数量也存在差异。基于龈下微生物群的随机森林模型可以区分认知障碍和自闭症（AUC = 0.933，95% 置信区间为 0.873-0.992）。口腔微生物群与性别、蒙特利尔认知评估（MoCA）评分和迷你精神状态检查评分之间存在显著相关性。局部相关性分析表明，在调整多种协变量后，Leptotrichia 和 Burkholderia 与 MoCA 评分呈密切负相关。SCD组和NC组的基因功能无明显差异，而MCI患者的三个同源基因和痴呆患者的两个同源基因发生了改变：这是第一项证明龈下微生物群的组成、功能和代谢途径与老年人不同程度的认知功能之间存在关联的研究。未来的队列研究应评估其对认知障碍的诊断作用。

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引用次数: 0

Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading 短种植体（≤6 毫米）与≥10 毫米种植体在不同临床情况下的比较：通过荟萃分析、试验序列分析和证据质量分级对随机临床试验进行系统回顾。

IF 6.7 1区医学 Q1 Dentistry

Journal of Clinical Periodontology

Pub Date : 2024-05-20 DOI: 10.1111/jcpe.13981

Andrea Ravidà, Matteo Serroni, Wenche S. Borgnakke, Mario Romandini, I-Ching (Izzie) Wang, Claudia Arena, Marco Annunziata, Gennaro Cecoro, Muhammad H. A. Saleh

Aim

To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios.

Materials and Methods

Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses.

Results

Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar.

Conclusions

Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift. Trial registration: PROSPERO ID: CRD42021254365.

目的：系统识别、综合并批判性总结随机对照试验（RCT）中关于短种植体（≤6 mm）与长种植体（≥10 mm）在不同临床情况下的种植体存活率、边缘骨损失、生物和修复并发症方面的现有科学证据：采用 Cochrane 协作组织的偏倚风险工具和 GRADE 方法。采用随机效应荟萃分析对结果进行综合，并通过试验序列分析进行评估：结果：共纳入了 19 项 RCT 的 40 份报告，其中包括 2214 个（1097 个短植入体；1117 个长植入体）植入体。中度/高度确定性/高质量的证据表明，≤6毫米和≥10毫米种植体在非增量骨和全口修复中的任何一个颌骨中的5年存活率相似，在上颌骨中使用6毫米种植体代替上颌窦提升术的5年存活率也相似。然而，对于其余的种植体长度组合和临床情况，5 年存活率的证据仍然不确定或不充分。这些情况包括用4毫米和5毫米种植体替代上颌窦提升术，以及用所有长度≤6毫米的种植体替代用长种植体进行垂直嵴增高术。边缘骨水平以及短期和长期的生物或修复并发症相似：根据5年RCT研究的中度/高度确定性/高质量证据，在原生骨和全牙列修复中，≤6毫米的种植体可以替代≥10毫米的种植体，6毫米的种植体可以替代上颌窦提升术：试验注册：PROSPERO ID：试验注册：PROSPERO ID：CRD42021254365。

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引用次数: 0

Diagnostic accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test for detecting periodontitis in adults: A systematic review and meta-analysis 唾液活性基质金属蛋白酶（aMMP）-8 护理点测试检测成人牙周炎的诊断准确性：系统综述与荟萃分析。

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

Journal of Clinical Periodontology

Pub Date : 2024-05-19 DOI: 10.1111/jcpe.14000

Shimin Wei, Tingting Lin, Gustavo Sáenz-Ravello, Hanqi Gao, Yong Zhang, Maurizio S. Tonetti, Ke Deng

Objective

To determine the accuracy of salivary active matrix metalloproteinase (aMMP)-8 point-of-care test (POCT) for detecting periodontitis in adults, through meta-analysis.

Materials and Methods

Diagnostic studies evaluating the accuracy of salivary/oral rinse aMMP-8 POCT for detecting periodontitis in adults, when compared with clinical examination, were considered eligible. A comprehensive search was performed up to 31 August 2023 through five databases. Quality Assessment of Diagnostic Accuracy Studies 2 was utilized to evaluate the methodological quality of the included articles. Meta-analysis was performed using Bayesian bivariate hierarchical model and subgroup analysis.

Results

From 368 screened studies, 6 studies (4 cross-sectional and 2 longitudinal studies) were included in the meta-analysis. Overall, the pooled sensitivity and specificity of salivary aMMP-8-POCT for detecting periodontitis were 0.63 (95% CI: 0.41–0.82) and 0.84 (95% CI: 0.65–0.95), respectively. Subgroup analyses revealed that the 95% CI for oral fluid types, predefined diagnostic thresholds and the POCT systems largely overlapped, indicating that the differences between them may not be significant.

Conclusion

Salivary aMMP-8 POCT shows fair accuracy for detecting periodontitis. The diagnostic accuracy cannot be significantly influenced by the types of oral fluids, predefined diagnostic thresholds or the specific POCT systems used. More research is needed to confirm the clinical utility and implementation of aMMP-8 POCT in the diagnosis of periodontitis.

摘要通过荟萃分析确定唾液活性基质金属蛋白酶（aMMP）-8护理点检测（POCT）检测成人牙周炎的准确性：与临床检查相比，评估唾液/漱口液aMMP-8 POCT检测成人牙周炎准确性的诊断性研究均符合条件。截至 2023 年 8 月 31 日，通过五个数据库进行了全面检索。诊断准确性研究质量评估 2 用于评估纳入文章的方法学质量。采用贝叶斯双变量层次模型和亚组分析进行了元分析：从筛选出的 368 项研究中，有 6 项研究（4 项横断面研究和 2 项纵向研究）被纳入荟萃分析。总体而言，唾液 aMMP-8-POCT 检测牙周炎的汇总灵敏度和特异度分别为 0.63（95% CI：0.41-0.82）和 0.84（95% CI：0.65-0.95）。亚组分析显示，口腔液类型、预定义诊断阈值和POCT系统的95% CI基本重叠，表明它们之间的差异可能并不显著：唾液 aMMP-8 POCT 检测牙周炎的准确性尚可。诊断准确性不会受到口腔液类型、预定义诊断阈值或所使用的特定 POCT 系统的明显影响。要确认 aMMP-8 POCT 在牙周炎诊断中的临床实用性和实施情况，还需要进行更多的研究。

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引用次数: 0

Periodontal inflammatory and microbial profiles in healthy young African Americans and Caucasians 健康年轻非裔美国人和白种人的牙周炎症和微生物概况。

IF 6.7 1区医学 Q1 Dentistry

Journal of Clinical Periodontology

Pub Date : 2024-05-19 DOI: 10.1111/jcpe.13989

Samer Sabbagh, Reuben Adatorwovor, Sreenatha Kirakodu, Marcia V. Rojas-Ramirez, Mohanad Al-Sabbagh, Dolphus Dawson, Jussara Gonçalves Fernandes, Manuela Maria Viana Miguel, Alejandro Villasante-Tezanos, Luciana Shaddox

Aim

This study aimed to compare microbial and inflammatory profiles in periodontally/systemically healthy African American (AA) and Caucasian (C) individuals.

Materials and Methods

Thirty-seven C and 46 AA aged from 5 to 25 years were evaluated regarding periodontal disease, caries, microbial subgingival profile via 16-s sequencing, as well as salivary and gingival crevicular fluid (GCF) inflammatory profile via multiplex assay.

Results

Greater probing depth percentage was detected in AA (p = .0075), while a higher percentage of caries index (p = .0069) and decayed, missing, filled teeth (DMFT) index (p = .0089) was observed in C, after adjusting for number of teeth, sex and age. Salivary levels of IL-6, IL-8 and TNFα were higher for C, whereas GCF levels of eotaxin, IL-12p40, IL-12p70, IL-2 and MIP-1α were higher in AA (p < .05). Different microbial profiles were observed between the races (p = .02). AA presented higher abundance of periodontopathogens (such as Tanerella forsythia, Treponema denticola, Filifactor alocis, among others), and C presented more caries-associated bacteria (such as Streptococcus mutans and Prevotella species). Bacillaceae and Lactobacillus species were associated with higher DMFT index, whereas Fusobacterium and Tanerella species with periodontal disease parameters.

Conclusions

A different inflammatory and bacterial profile was observed between healthy AA and C, which may predispose these races to higher susceptibility to specific oral diseases.

目的：本研究旨在比较牙周/全身健康的非裔美国人（AA）和高加索人（C）的微生物和炎症特征：对 37 名 C 和 46 名 AA（年龄在 5 至 25 岁之间）进行了牙周病、龋齿、龈下微生物特征（通过 16-s 测序）以及唾液和龈沟液（GCF）炎症特征（通过多重检测）方面的评估：结果：在对牙齿数量、性别和年龄进行调整后，发现 AA 患儿的探诊深度百分比更高（p = .0075），而 C 患儿的龋齿指数（p = .0069）和蛀牙、缺失牙、补牙（DMFT）指数（p = .0089）百分比更高。在健康的 AA 和 C 之间观察到了不同的炎症和细菌特征，这可能使这些种族更容易患特定的口腔疾病。

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引用次数: 0

Oral microbiota of patients with phenylketonuria: A nation-based cross-sectional study 苯丙酮尿症患者的口腔微生物群：以国家为基础的横断面研究

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

Journal of Clinical Periodontology

Pub Date : 2024-05-14 DOI: 10.1111/jcpe.13998

Memduh Bingöl, Alessio Cardilli, Anne Carolin Bingöl, Ulrike Löber, Corinna Bang, Andre Franke, Theodosia Bartzela, Skadi Beblo, Eberhard Mönch, Simone Stolz, Arne S. Schaefer, Sofia Kirke Forslund, Gesa M. Richter

Aim

The oral microenvironment contributes to microbial composition and immune equilibrium. It is considered to be influenced by dietary habits. Phenylketonuria (PKU) patients, who follow a lifelong low-protein diet, exhibit higher prevalence of oral diseases such as periodontitis, offering a suitable model to explore the interplay between diet, oral microbiota and oral health.

Materials and Methods

We conducted 16S rDNA sequencing on saliva and subgingival plaque from 109 PKU patients (ages 6–68 years) and 114 age-matched controls and correlated oral microbial composition and dental health.

Results

PKU patients exhibited worse dental health, reduced oral microbial diversity and a difference in the abundance of specific taxa, especially Actinobacteriota species, compared to controls. PKU patients with poor periodontal health exhibited higher alpha diversity than the orally healthy ones, marked by high abundance of the genus Tannerella. Notably, the observed taxonomic differences in PKU patients with normal indices of decayed/missing/filled teeth, plaque control record, gingival bleeding index and periodontal screening and recording index generally differed from microbial signatures of periodontitis.

Conclusions

PKU patients' reduced microbial diversity may be due to their diet's metabolic challenges disrupting microbial and immune balance, thus increasing oral inflammation. Higher alpha diversity in PKU patients with oral inflammation is likely related to expanded microbial niches.

目的：口腔微环境有助于微生物组成和免疫平衡。它被认为受到饮食习惯的影响。终生低蛋白饮食的苯丙酮尿症（PKU）患者口腔疾病（如牙周炎）发病率较高，这为探讨饮食、口腔微生物群和口腔健康之间的相互作用提供了一个合适的模型：我们对109名PKU患者（6-68岁）和114名年龄匹配的对照者的唾液和龈下菌斑进行了16S rDNA测序，并将口腔微生物组成与牙齿健康联系起来：结果：与对照组相比，PKU 患者的牙齿健康状况更差，口腔微生物多样性降低，特定类群的丰度也有差异，尤其是放线菌群。与口腔健康的患者相比，牙周健康状况较差的北京大学患者表现出更高的α多样性，其特点是唐纳菌属的丰度较高。值得注意的是，在蛀牙/缺牙/补牙指数、牙菌斑控制记录、牙龈出血指数和牙周筛查与记录指数正常的PKU患者中，观察到的分类差异与牙周炎的微生物特征普遍不同：PKU患者的微生物多样性减少可能是由于他们的饮食代谢挑战破坏了微生物和免疫平衡，从而增加了口腔炎症。有口腔炎症的北京大学患者体内α多样性较高可能与微生物壁龛扩大有关。

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引用次数: 0

Polarized M2 macrophages induced by glycosylated nano-hydroxyapatites activate bone regeneration in periodontitis therapy 糖基化纳米羟基磷灰石诱导的极化 M2 巨噬细胞可激活牙周炎治疗中的骨再生。

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

Journal of Clinical Periodontology

Pub Date : 2024-05-12 DOI: 10.1111/jcpe.13999

Dan Qiao, Shuyu Cheng, Shiyuan Song, Wen Zhang, Bin Chen, Fuhua Yan, Yangheng Zhang

Aim

To investigate the association between periodontal macrophage polarization states and the alveolar bone levels, and to assess whether glycosylated nano-hydroxyapatites (GHANPs) could improve bone regeneration in periodontitis by inducing macrophage M2 polarization.

Materials and Methods

The change of macrophage polarization state in inflammatory periodontal tissues (with bone loss) was examined using clinical gingival samples. The relationship between macrophage phenotype and bone level in periodontal bone loss and repair was evaluated using a mouse periodontitis model. The effect of GHANPs on macrophage polarization was assessed by the in vitro model of lipopolysaccharide (LPS)-stimulated inflammation. The polarization-related markers were detected by immunofluorescence staining, real-time polymerase chain reaction and enzyme-linked immunosorbent assay analysis. The therapeutic effect of GHANPs on alveolar bone loss was explored in experimental periodontitis by histological staining and micro-CT analysis.

Results

A lower macrophage M2/M1 ratio was observed in periodontitis-affected human gingival tissues. The results of animal experiments demonstrated a positive correlation between a lower Arg-1/iNOS ratio and accelerated alveolar bone loss; also, the proportion of Arg-1-positive macrophages increased during bone repair and regeneration. The administration of GHANPs partially restored M2 macrophage polarization after LPS stimulation. GHANPs increased alveolar bone repair and regeneration in experimental periodontitis induced by ligation, potentially related to their macrophage M2 transition regulation.

Conclusions

The findings of this study indicate that the induction of macrophage M2 polarization can be considered a viable approach for enhancing inflammatory bone repair. Additionally, GHANPs show potential in the clinical treatment of periodontitis.

目的：研究牙周巨噬细胞极化状态与牙槽骨水平之间的关联，并评估糖基化纳米羟基磷灰石（GHANPs）是否能通过诱导巨噬细胞M2极化改善牙周炎患者的骨再生：使用临床牙龈样本研究了炎症性牙周组织（骨质流失）中巨噬细胞极化状态的变化。使用小鼠牙周炎模型评估了巨噬细胞表型与牙周骨质流失和修复过程中骨水平之间的关系。体外脂多糖（LPS）刺激炎症模型评估了 GHANPs 对巨噬细胞极化的影响。通过免疫荧光染色、实时聚合酶链反应和酶联免疫吸附分析检测了极化相关标记物。通过组织学染色和显微 CT 分析，探讨了 GHANPs 对实验性牙周炎牙槽骨流失的治疗效果：结果：在受牙周炎影响的人类牙龈组织中观察到较低的巨噬细胞 M2/M1 比率。动物实验结果表明，较低的 Arg-1/iNOS 比率与牙槽骨流失加速之间存在正相关；此外，在骨修复和再生过程中，Arg-1 阳性巨噬细胞的比例会增加。在 LPS 刺激后，给予 GHANPs 可部分恢复 M2 巨噬细胞的极化。在结扎诱导的实验性牙周炎中，GHANPs增加了牙槽骨的修复和再生，这可能与其巨噬细胞M2转化调节有关：本研究结果表明，诱导巨噬细胞 M2 极化可被视为加强炎性骨修复的一种可行方法。此外，GHANPs 在牙周炎的临床治疗中也显示出潜力。

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引用次数: 0

Contemporary educational methods in periodontology. 当代牙周病学教育方法。

IF 6.7 1区医学 Q1 Dentistry

Journal of Clinical Periodontology

Pub Date : 2024-05-09 DOI: 10.1111/jcpe.13986

Philip M Preshaw, Christoph A Ramseier, Bruno G Loos, Aušra Balčiūnaitė, Tin Crnić, Kevin Davey, Henrik Dommisch, Johanna B Ettmayer, Anthony Roberts, E Etienne Verheijck, Clemens Walter, Graziano Zappalà

Aim: The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID-19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face-to-face (F2F) teaching and the move to student-centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels.

Materials and methods: Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated.

Results: The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student-centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms.

Conclusions: Live F2F teaching continues to be highly trusted; however, all types of student-centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.

目的：2009年召开的第一届欧洲牙周教育研讨会就本科生（UG）、研究生（PG）和继续职业发展（CPD）水平的牙周教育范围提出了建议，定义了能力和学习成果，这在当时有助于确定牙周教学课程。第19届欧洲牙周病学研讨会和第2届欧洲牙周病学教育共识研讨会（欧洲牙周病学教育）于2023年召开，旨在确定牙周病学教育的变化和未来发展（包括COVID-19大流行所带来的变化和发展），以及牙周病学教学和培训的方法和形式。本综述旨在评估当前有关牙周病学教育方法的知识，包括传统的面对面（F2F）教学、向以学生为中心的方法转变、虚拟学习方法和数字技术的使用，以及混合式教学（包括教学交付和评估）在UG、PG和CPD层面的应用：对文献进行了系统检索，以确定相关研究。提取数据并整理描述性摘要：大流行严重破坏了传统的 F2F 教学，但也为快速实施替代和补充教学方法提供了机会。尽管在线学习已成为牙周教育不可或缺的一部分，但教师和学生都倾向于某种形式的 F2F 教学。混合式教学在牙周教育的许多领域都是可行的，无论是知识和技能的学习还是评估。以学生为中心的方法和混合式教学法（如翻转课堂）似乎非常有效，同步和异步授课的在线/虚拟课堂也备受推崇。利用触觉方法和虚拟现实（VR）进行学习能增强教育体验，特别是当 VR 与传统方法相结合时。教师的素质对于各种形式的最佳知识传授仍然起着决定性作用：现场 F2F 教学仍然备受信赖；然而，所有以学生为中心的互动式知识传授形式都被认为是一种进步。虽然数字化方法为教育提供了创新，但将虚拟方法和传统方法结合起来的混合方法似乎是实现学习成果最大化的最佳方法。牙周教育的所有领域（UG、PG 和 CPD）都能从这些方法中受益；然而，还需要更多的研究来评估这些方法在知识传授、技能发展和评估方面的益处。

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引用次数: 0

Dynamic analyses of a soft tissue–implant interface: Biological responses to immediate versus delayed dental implants 软组织-种植体界面的动态分析：即刻种植体与延迟种植体的生物反应

IF 6.7 1区医学 Q1 Dentistry

Journal of Clinical Periodontology

Pub Date : 2024-05-06 DOI: 10.1111/jcpe.13980

Fabiana Aellos, Joseph A. Grauer, Kasidy G. Harder, Julia S. Dworan, Giacomo Fabbri, Pedro L. Cuevas, Xue Yuan, Bo Liu, John B. Brunski, Jill A. Helms

Aim

To qualitatively and quantitatively evaluate the formation and maturation of peri-implant soft tissues around ‘immediate’ and ‘delayed’ implants.

Materials and Methods

Miniaturized titanium implants were placed in either maxillary first molar (mxM1) fresh extraction sockets or healed mxM1 sites in mice. Peri-implant soft tissues were evaluated at multiple timepoints to assess the molecular mechanisms of attachment and the efficacy of the soft tissue as a barrier. A healthy junctional epithelium (JE) served as positive control.

Results

No differences were observed in the rate of soft-tissue integration of immediate versus delayed implants; however, overall, mucosal integration took at least twice as long as osseointegration in this model. Qualitative assessment of Vimentin expression over the time course of soft-tissue integration indicated an initially disorganized peri-implant connective tissue envelope that gradually matured with time. Quantitative analyses showed significantly less total collagen in peri-implant connective tissues compared to connective tissue around teeth around implants. Quantitative analyses also showed a gradual increase in expression of hemidesmosomal attachment proteins in the peri-implant epithelium (PIE), which was accompanied by a significant inflammatory marker reduction.

Conclusions

Within the timeframe examined, quantitative analyses showed that connective tissue maturation never reached that observed around teeth. Hemidesmosomal attachment protein expression levels were also significantly reduced compared to those in an intact JE, although quantitative analyses indicated that macrophage density in the peri-implant environment was reduced over time, suggesting an improvement in PIE barrier functions. Perhaps most unexpectedly, maturation of the peri-implant soft tissues was a significantly slower process than osseointegration.

目的定性和定量评估 "即刻 "和 "延迟 "种植体周围种植体软组织的形成和成熟。在多个时间点对种植体周围软组织进行评估，以评估附着的分子机制以及软组织作为屏障的功效。结果在即刻种植体与延迟种植体的软组织结合率上没有观察到差异；但总体而言，在该模型中，粘膜结合所需的时间至少是骨结合时间的两倍。对软组织整合过程中波形蛋白表达的定性评估表明，种植体周围结缔组织包膜最初比较混乱，随着时间的推移逐渐成熟。定量分析显示，与种植体周围牙齿周围的结缔组织相比，种植体周围结缔组织中的胶原蛋白总量明显较少。定量分析还显示，种植体周围上皮（PIE）中半脂质体附着蛋白的表达量逐渐增加，同时炎症标记物也明显减少。虽然定量分析显示随着时间的推移，种植体周围环境中的巨噬细胞密度有所降低，表明 PIE 的屏障功能有所改善，但与完整的 JE 相比，半膜附着蛋白的表达水平也明显降低。也许最出乎意料的是，种植体周围软组织的成熟过程明显慢于骨结合过程。

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引用次数: 0

Three-dimensional imaging analysis of CAD/CAM custom-milled versus prefabricated allogeneic block remodelling at 6 months and long-term follow-up of dental implants: A retrospective cohort study 牙科植入物 6 个月和长期随访时，CAD/CAM 定制铣制与预制异体块重塑的三维成像分析：一项回顾性队列研究。

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

Journal of Clinical Periodontology

Pub Date : 2024-05-06 DOI: 10.1111/jcpe.13995

Anna Seidel, Yago Leira, Pilar Batalla, Leticia Caneiro, Manfred Wichmann, Juan Blanco

Aim

This retrospective cohort study aimed to volumetrically investigate the bone stability rate of prefabricated allogeneic bone blocks (PBB) and computer-aided design (CAD)/computer-aided manufacturing (CAM) custom-milled allogeneic bone blocks (CCBB) for ridge augmentation.

Materials and Methods

Nineteen patients were treated with 20 allografts: 11 CCBB, 9 PBB; 10 in the maxilla and 10 in the mandible. Clinical treatment history and cone beam computed tomography scans before surgery (t₀), directly after graft surgery (t₁) and after 6 months of healing prior to implant insertion (t₂) were evaluated using a three-dimensional evaluation software for absolute bone volume, stability as well as vertical and horizontal bone gain. Furthermore, the inserted implants were analysed for survival, marginal bone loss (MBL) and complications for a mean follow-up period of 43.75 (±33.94) months.

Results

A mean absolute volume of 2228.1 mm³ (±1205) was grafted at t₁. The bone stability rate was 87.6% (±9.9) for CCBB and 83.0% (±14.5) for PBB. The stability was higher in the maxilla (91.6%) than in the mandible (79.53%). Surgery time of PBB was longer than for CCBB (mean Δ = 52 min). The survival rate of the inserted implants was 100% with a mean MBL of 0.41 mm (±0.37).

Conclusion

The clinical performance of both allograft block designs was equally satisfactory for vertical and horizontal bone grafting prior to implant placement.

Clinical Trial Registration

ClinicalTrials.gov: NCT06027710.

目的：这项回顾性队列研究旨在从体积上调查预制同种异体骨块（PBB）和计算机辅助设计（CAD）/计算机辅助制造（CAM）定制铣制同种异体骨块（CCBB）用于牙脊增量的骨稳定率：19名患者接受了20例同种异体骨移植治疗：11例CCBB，9例PBB；上颌骨10例，下颌骨10例。手术前（t0）、移植物手术后（t1）和种植体植入前（t2）6个月愈合后，使用三维评估软件对临床治疗史和锥形束计算机断层扫描进行评估，以确定绝对骨量、稳定性以及垂直和水平骨增量。此外，在平均 43.75 (±33.94) 个月的随访期内，还对植入种植体的存活率、边缘骨损失（MBL）和并发症进行了分析：结果：第 1 次植骨的平均绝对体积为 2228.1 mm3（±1205）。CCBB和PBB的骨稳定率分别为87.6%（±9.9）和83.0%（±14.5）。上颌骨的稳定性（91.6%）高于下颌骨（79.53%）。PBB手术时间长于CCBB（平均Δ = 52分钟）。植入种植体的存活率为100%，平均MBL为0.41毫米（±0.37）：结论：对于种植体植入前的垂直和水平骨移植，两种同种异体移植块设计的临床表现同样令人满意：临床试验注册：ClinicalTrials.gov：临床试验注册：ClinicalTrials.gov：NCT06027710。

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引用次数: 0