Journal of periodontal research最新文献

Aims: To assess the differences in the taxonomical and functional profile of the subgingival microbiota isolated from healthy subjects (HS) and patients with periodontitis (PP) from four different countries.

Methods: In this study, 80 subgingival samples from HS and PP from four different countries (Belgium, Chile, Peru, and Spain) were analyzed using shotgun metagenomic sequencing.

Results: The results indicated significant variation in α-diversity between HS and PP, segregated by country, with PP from Peru clearly standing out from the rest. In terms of composition, β-diversity was explained more by the country of origin (6.8%) than by the diagnosis (4.1%). In addition, more than 75 different taxa, 63 of which were identified at the species level, showed significantly different relative abundances when comparing the country of origin, diagnosis, and both variables combined. Moreover, 85 metabolic pathways showed significantly different relative abundances between HS and PP, with species commonly associated with periodontitis, such as Porphyromonas gingivalis and Tannerella forsythia, strongly contributing to the reinforcement of periodontitis-associated pathways. On the other hand, differences in functional profiles based on the country of origin were almost nonexistent, suggesting that variability in taxonomic profiles does not have a direct impact on healthy or periodontitis-associated functional profiles.

Conclusion: These findings suggest that microbial analysis should take into account the geographic origin of samples in order to provide a more accurate description of the subgingival microbiota. Moreover, they lay the groundwork for larger and more comprehensive studies that might analyze this phenomenon in the future.

Gingival recession occurrence is highly prevalent after orthodontic treatment, and keeratinised tissue width at baseline is significantly correlated with the prevalence, extension, and severity of gingival recession, clearly demonstrating the importance of evaluating periodontal factors in planning orthodontic treatment.

Aim: To assess the effect of connective tissue graft (CTG) in the treatment of periodontal intrabony defects (IDs), focusing on changes in postoperative gingival recession (GR) depth and regenerative outcomes.

Methods: A systematic search was conducted across MEDLINE-PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for articles published through December 31, 2024. Randomized controlled trials (RCTs) comparing treatment outcomes in IDs treated with or without CTG were included in a meta-regression analysis. A mixed-effect linear regression model was employed to estimate the effect of CTG on postoperative GR depth, probing depth (PPD) reduction, clinical attachment level (CAL) gain, and bone fill (BF).

Results: Twenty-three studies were selected, with five RCTs (176 IDs) included in the meta-regression. Of these, two RCTs compared bone graft (BG) + CTG to BG + resorbable membrane (MB), one compared periosteal vs. nonperiosteal CTG combined with BG, one compared open flap debridement (OFD) + CTG to OFD alone, and one compared BG + CTG to either OFD or MB. The use of CTG was significantly associated with a reduction in GR (mean effect size of 0.981 mm, 95% CI: 0.573 to 1.389, p = 0.001), PPD (mean effect size of 1.160 mm, 95% CI: 0.318 to 2.002, p = 0.010), as well as improvements in CAL (mean effect size of 1.105 mm, 95% CI: 0.420 to 1.790, p = 0.004) and BF (mean effect size of 1.382 mm, 95% CI: 0.595 to 2.169, p = 0.002).

Conclusion: Within the limitations of the study, the use of CTG in periodontal regenerative therapy for IDs appears beneficial in reducing postoperative GR and might further enhance regenerative outcomes compared to treatments without CTG.

Aims: Poor accuracy of diagnostic and prognostic tools prevents the prediction of peri-implant disease stability or progression. We analyzed metabolites from peri-implant crevicular fluid (PICF) samples from healthy and diseased implants to identify those diagnostic of health and peri-implant disease and predictive of peri-implant bone loss over time.

Methods: Clinical, radiographic examinations and PICF samples were collected from 59 healthy implants, 33 implants with peri-implantitis, and 38 implants with peri-implant mucositis in 71 subjects. A subset of implants was evaluated at 6, 12, 18, and 24 months. Over time, all initially healthy implants remained stable (Group B, N = 28), whereas 6 initially diseased implants continued to lose bone and 8 did not (Group C). PICF metabolites were measured using proton-nuclear magnetic resonance (1H-NMR) 2-dimensional Total Correlation Spectroscopy. PCA and PLS-DA tested the cross-sectional clustering and importance of each metabolite, while the AUC summarized the accuracy of predicting radiographic bone changes ≥ 1 mm at 6-month intervals.

Results: At baseline, the Cadaverine/Lysine and Putrescine/Lysine signatures diagnosed peri-implantitis (AUC = 0.76 and 0.70; p < 0.000) with good accuracy, while alpha-ketoglutarate diagnosed implant health (AUC = 0.706; p = 0.002). Combining metabolites increased diagnostic accuracy (AUC_{Cadaverine/Lysine+Methionine} = 0.81; p < 0.01). Proline and 1-3-diaminopropane predicted future bone loss (AUC_Proline = 0.917 and AUC_{1-3-diaminopropane} = 0.854). ANOVA post hoc analysis established that biotin and propionate levels were higher in Group C compared to Groups A and B (p < 0.001; AUC_biotin = 0.889; AUC_propionate = 0.87). Valine levels were higher in Groups A and C compared to Group B (p = 0.002; AUC = 0.841).

Conclusions: ¹H-NMR 2-dimensional spectroscopy identified PICF metabolites diagnostic of peri-implantitis with high accuracy. Despite the small number of affected implants, metabolite signatures that predict future bone loss in peri-implantitis appear to be different from those diagnostic of peri-implantitis.

Aims: To evaluate the adjunctive effect of enamel matrix derivative (EMD) in the reconstructive surgical therapy of peri-implantitis.

Methods: Forty subjects (44 implants) affected by peri-implantitis (PPD ≥ 5 mm, positive BOP/SOP, intraosseous defect with a depth of ≥ 3 mm and width of ≤ 4 mm) were randomly allocated to one of two surgical protocols: control (access flap + bone graft + resorbable membrane) or test (access flap + bone graft + resorbable membrane + EMD). Clinical outcomes (PPD, BOP, SOP, buccal REC, and buccal KM) were assessed at baseline, 6 and 12 months after surgery. Radiographic marginal bone levels (MBL) and patient-reported outcomes (PROs) were recorded at baseline and at 12 months. Post-operative complications and Early Healing Index (EHI) scores were recorded at 2 weeks. The primary outcome was PPD change. Two composite outcomes (CO) were assessed: CO1 was defined as "implant not lost, PPD ≤ 5 mm, REC ≤ 1 mm and complete absence of BOP/SOP"; CO2 defined as CO1 but allowing for 1 site with BOP.

Results: Four patients (four implants) were lost to follow-up. At 12 months, no implants were lost, 73% of implants presented with PPD ≤ 5 mm (control: 65.2%; test: 81.0%; p = 0.316) and PPD reduction amounted to 4.0 ± 1.7 and 4.3 ± 2.4 mm in control and test groups, respectively (p = 0.105). No significant differences in terms of clinical, radiographic, composite and PROs were observed between groups. No significant differences in EHI scores were found at 2 weeks between groups.

Conclusion: This study failed to demonstrate any benefit of the adjunctive use of EMD in the reconstructive surgical therapy of peri-implantitis.

Trial registration: ISRCTN18159776 (https://doi.org/10.1186/ISRCTN18159776).

Aims: Periodontal diseases pose significant challenges to oral health, making the regeneration of periodontal tissues a critical therapeutic goal. The goal is to restore dental function by repairing damaged tissue and reconstructing the healthy connective structure between the teeth and the alveolar bone. This study aimed to investigate the effects of selcopintide (SCPT) on the differentiation of periodontal ligament cells (PDLCs), cementoblasts, and osteoblasts in vitro, as well as the regeneration of periodontal tissue using a periodontal tissue defect model in dogs in vivo.

Methods: The expression of periodontal tissue marker genes, including periostin (POSTN), cementum attachment protein (CAP), dentin matrix protein 1 (DMP1), and bone sialoprotein (BSP), was investigated in vitro. Chronic one-wall intrabony defects were created in a total of 12 beagle dogs (n = 6 at 6 and 12 weeks, respectively), and the surgical sites were treated with no treatment, guided tissue regeneration (GTR), GTR with SCPT 50 μg/0.1 mL, 100 μg/0.1 mL, and 250 μg/0.1 mL. The effects of SCPT on the regeneration of periodontal tissues, such as periodontal ligament (PDL), cementum, and bone, were analyzed in vivo.

Results: SCPT influenced the proliferation and differentiation of cementoblasts and PDLCs. Real-time polymerase chain reaction analysis showed that SCPT upregulated the expression of POSTN, CAP, DMP1, and BSP compared to the control. In the periodontal defect model, SCPT regenerated the periodontal complex. Additionally, the arrangement of the newly formed PDL-like fibers was perpendicular to the newly formed cementum and alveolar bone, similar to Sharpey's fibers in natural teeth, compared with the control.

Conclusion: In this preclinical study, histological and immunohistochemical analyses suggest that GTR with SCPT might be associated with increased periodontal ligament attachment and enhanced cementum and alveolar bone formation. Additional research with a larger sample size is needed to establish the optimal therapeutic protocols and validate the regenerative potential of SCPT.

Aims: To explore the potential of metabolomic profiles of oral rinse samples to distinguish between patients with severe periodontitis (stage III/IV) and non-periodontitis controls. This is coupled to an analysis of differences in metabolomic profiles between individuals without periodontitis, patients with localized periodontitis, and patients with generalized periodontitis.

Methods: Periodontitis patients and controls were recruited, all aged ≥ 40 years. Study participants were asked to rinse vigorously for 30 s with 10 mL phosphate buffered saline. Metabolites were identified using a semi-targeted liquid chromatography tandem mass spectrometry (LC-MS/MS) platform.

Results: In total, 38 periodontitis patients (18 localized, 20 generalized stage III/IV periodontitis patients) and 16 controls were included. Metabolomic profiles of oral rinse samples were able to distinguish patients with severe periodontitis (stage III/IV) from non-periodontitis controls. Among various variables for the severity of periodontitis, we found that the number of sites with deep pockets (PPD) ≥ 6 mm explained best the differences in metabolomic profiles between controls and patients with severe periodontitis. Subjects with a high number of sites with PPD ≥ 6 mm were characterized by a higher level of phosphorylated nucleotides, amino acids, peptides, and dicarboxylic acids. Metabolomic profiles were also significantly different between controls vs. generalized periodontitis and between localized periodontitis vs. generalized periodontitis (p < 0.05).

Conclusion: Our study demonstrates that simply collected oral rinse samples are suitable for LC-MS/MS based metabolomic analysis. We show that a metabolomic profile with a substantial number of metabolites can distinguish severe periodontitis patients from non-periodontitis controls. These observations can be a basis for further studies into screening to identify subjects with the risk of having severe periodontitis.

Aim: Circulating platelets are essential in hemostasis, thrombosis, and immune responses. Modifications in platelet function may impact immunological reactions to dental biofilm and cardiovascular health. Understanding changes in platelet status and activity in patients with periodontitis is still a subject of investigation. This study aimed to synthesize evidence from observational studies that investigated platelet status and activity in patients with and without periodontitis.

Methods: MEDLINE-PubMed, EMBASE, and Cochrane-CENTRAL Library databases were searched up to November 2024. Primary outcomes included platelet count (PC) and mean platelet volume (MPV). Secondary outcomes encompassed any other biomarker relevant to platelet status and activity. Methodological quality was evaluated using the Newcastle-Ottawa scale, and heterogeneity was analyzed. Descriptive analysis of outcomes and meta-analysis, incorporating trial sequential analysis of PC and MPV, were conducted. The body of evidence was graded by utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).

Results: 3621 unique records were identified, resulting in 23 eligible studies with 22 variables evaluating the platelet status. Fourteen studies exhibited a low risk of bias, and 9 exhibited moderate risk of bias. PC in patients with periodontitis was significantly higher compared to individuals without periodontitis (Mean Difference (MD) = 23.55 ×10⁹/L, 95% CI [7.68; 39.43]). There was no statistically significant difference between the groups for MPV (MD = 0.16 fL, 95% CI [-0.49; 0.82]). Trial sequential analysis indicated a conclusive meta-analysis of PC and highlighted the need for additional data on MPV from future trials.

Conclusions: The certainty is moderate for slightly higher PC in patients with periodontitis compared to individuals without it and low for no difference in MPV between the two groups. The evidence is not robust to claim a clear difference in other platelet activation biomarkers between the two groups.

Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) by number: CRD42023439051.

Adults who began smoking regularly in early childhood (before 10 years) face an especially high risk of edentulism if they continue smoking into adulthood. Comprehensive tobacco control policies should target early childhood, ultimately contributing to the prevention of subsequent edentulism and other noncommunicable diseases.

Aim: Different approaches have been proposed for implant placement following tooth extraction. A Consensus conference was organised to provide expert-based recommendations for the treatment of the postextraction site in the aesthetic zone in conjunction with implant therapy.

Methods: A panel of eight experts with a documented longstanding clinical and research experience in the field of implant therapy in the aesthetic zone were invited to participate in a structured survey. Participants were asked to select their preferred treatment approach for different clinical scenarios of the postextraction site from a list of different treatment options. Results were summarised and discussed in person at a 2 day consensus conference. Based on the outcome, treatment recommendations were phrased and are reported here.

Results: The group agreed that in case of an intact alveolus, immediate implant placement with immediate prosthetics represents the reference choice if proper primary stability can be achieved and the buccal bone plate is present. A bone-to-implant gap more than 2 mm should be seeked and grafted. Alveolar ridge preservation and early placement with contour augmentation may represent an alternative. If the alveolus is compromised, a staged approach (early or delayed placement) with bone augmentation may be preferred.

Conclusions: The characteristics of the site, in terms of the available bone volume, the integrity of the buccal bone plate and the periodontal phenotype are determining factors in the therapeutic choice. Therefore, case selection based on well-defined selection criteria is extremely important and is the adequate way to guide the clinician in choosing the most appropriate approach to postextraction site management and timing for implant placement.