Journal of periodontal research最新文献

Aim: This prospective cohort study aimed to evaluate the incidence and risk/protective factors of peri-implantitis over time.

Methods: A university-representative cohort was evaluated at baseline and after a mean follow-up time of 3.9 years. The main outcome was the incidence of peri-implantitis, defined as bone loss > 1 mm between the two examinations in implants showing bleeding on probing. Putative risk/protective factors assessed at baseline were tested through multilevel (mixed-effects) logistic regression analyses.

Results: A total of 73 patients with 322 implants were included. During the follow-up period, 14 implants (4.3%) were lost in 9 patients (12.3%). Incidence of peri-implantitis was observed in 22.2% of patients and 9.4% of implants. In the final multilevel multiple logistic regression model, the following factors were associated with occurrence of peri-implantitis: periodontitis severity (stage IV periodontitis: OR = 41.29; 95% CI: 4.10-415.54), periodontal bone loss/age ratio (> 1: OR = 8.87; 95% CI: 1.47-53.73), smoking (current smokers: OR = 7.84; 95% CI: 1.83-33.50), sleep duration (> 7 h: OR = 19.97; 95% CI: 1.69-236.39), implant location (incisor: OR = 60.60; 95% CI: 4.04-908.33), restoration type (full-arch fixed restorations: OR = 89.84; 95% CI: 3.66-2202.97), and restoration margin location (juxta-marginal: OR = 14.17; 95% CI: 1.20-166.76). Keratinized tissue width assessed at baseline was not associated with incidence of peri-implantitis.

Conclusion: Approximately one in five patients and one in 10 implants experienced incident peri-implantitis over a nearly four-year period. Periodontitis (Stage IV and Grade C), lifestyles (smoking and sleep duration), implant location, and prosthetic factors (restoration type and margin location) emerged as risk factors for peri-implantitis.

Aim: To characterize the impact of periodontitis and of Steps I-II of periodontal therapy on microbiome composition, function, and metabolic output across the oral and gut environments.

Methods: A multi-omics analysis was performed on saliva and stool samples collected from 50 systemically healthy individuals with and without Stage III-IV periodontitis. For participants with periodontitis, samples were analyzed both at baseline and 3 months after Steps I-II of periodontal therapy. High-throughput whole metagenome sequencing was used to profile microbial taxa and functional genes, NMR-based metabolomics profiled host-microbial metabolites. Single-omic differential abundance analysis between healthy samples and periodontitis samples was performed with MaAsLin2, while analysis between pre- and post-treatment was conducted with timeOmics. Variable selection and subsequent supervised multivariate analysis to determine group-separating markers utilized multi-level sparse Partial Least Squares Discriminant Analysis (sPLS-DA) through mixOmics. KEGG pathway enrichment was analyzed using clusterProfiler, whereas multi-omic data integration was performed with multi-block Partial Least Squares regression analysis.

Results: Periodontitis was associated with significant compositional and functional changes in both saliva and stool, with increased abundance of pathobionts and loss of health-associated taxa in both niches. A subset of species was shared across oral and gut habitats, with detectable differences across clinical groups. As functional potential, periodontitis enriched microbial pro-inflammatory pathways (lipopolysaccharide biosynthesis, bacterial motility) and depleted beneficial short-chain fatty acid (SCFA)- and vitamin-producing functions. Metabolomic profiles revealed reduced SCFAs and amino acids in periodontitis, with elevated pro-inflammatory metabolites (succinate, trimethylamine) in both saliva and stool. Following therapy, microbial communities and their metabolic output partially reverted toward health-associated profiles, particularly in saliva. Stool samples showed subtler but consistent shifts, including a decrease in some typically oral species and decreased succinate and methylamine and restoration of amino acid and SCFA-related metabolites.

Conclusions: Periodontitis is associated with coordinated microbial and metabolic signatures across the oral and gut environments. Non-surgical periodontal therapy promotes partial ecological restoration in both niches, supporting the view of oral health as a modifiable target for influencing systemic microbial homeostasis.

Trial registration: ClinicalTrials.gov identification number: NCT04826926.

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Aims: Although static navigation (sCAIS) has been shown to be a well-established technique in clinical practice, innovative methods such as dynamic navigation (dCAIS) are currently on the rise. The objective of this systematic review is to compare the accuracy of freehand (FH), sCAIS, and dCAIS.

Methods: Following PRISMA guidelines, a systematic review and meta-analysis with electronic and manual searches for comparative studies on transfer accuracy (TA) of freehand dental implant placement versus sCAIS versus dCAIS in pre-clinical and clinical studies was conducted. The main outcome was TA between planned and placed implant positions, measured via axial, global coronal, and global apical deviations reported as mean values with standard deviation.

Results: A total of 37 of 4511 screened articles were included, reporting data on 3104 implants across 606 models and 801 patients. Clinical studies revealed no statistically significant differences in TA between dCAIS and sCAIS. The pooled mean deviations were as follows: axial deviation -0.09° [95% CI: -0.66 to 0.48; PI: -2.11; 1.93], global coronal deviation -0.03 mm [95% CI: -0.16 to 0.11; PI: -0.47; 0.42], and global apical deviation -0.24 mm [95% CI: -0.48 to 0.00; PI: -1.12; 0.64]. However, subgroup analysis including RCTs only demonstrated that both sCAIS and dCAIS achieved statistically significantly higher accuracy in all investigated deviation parameters compared to the freehand protocol.

Conclusion: Both static and dynamic computer-assisted implant placement techniques are considered reliable methods for enhancing accurate implant positioning, offering significantly greater accuracy compared to the conventional freehand approach. The presence of bias risks and notable heterogeneity in the included investigations warrants careful consideration of the results.

Aim: To examine the impact of emulated natural tooth preservation or dental rehabilitation scenarios on diet quality among older adults in the United States, assessing what diet quality would be if people's dentition or rehabilitation status were improved.

Methods: Data from 2606 participants aged ≥ 60 across four NHANES cycles (2011-2018) were analyzed. Dentition status and prosthetic rehabilitation were clinically assessed, and diet quality was measured using the Healthy Eating Index (HEI)-2020. The modified treatment policies (MTP) framework was used to emulate hypothetical interventions of retaining natural teeth or providing prosthetic rehabilitation. Odds ratios (OR) for achieving better diet quality under each scenario were estimated using doubly robust targeted maximum likelihood estimation (TMLE).

Results: If all participants retained ≥ 25 teeth, the likelihood of achieving better HEI scores increased by 51% (OR = 1.51, 95% CI: 1.32-1.69). In a pragmatic scenario where each dentition group was shifted up by one level (edentulous → 1-9 teeth, 1-9 teeth → 10-19 teeth, 10-19 teeth → 20-25 teeth, 1-9 teeth → ≥ 25 teeth), the population had a 20% higher likelihood of achieving better diet quality (OR = 1.22, 95% CI: 1.14-1.29). Prosthetic rehabilitation yielded comparatively smaller effects, with rehabilitation in individuals with < 25 teeth improving the likelihood of better diet quality by 8% (OR = 1.08, 95% CI: 1.03-1.12).

Conclusion: The present observational study suggests that preserving natural teeth has a stronger population-level impact on diet quality than prosthetic rehabilitation replacing missing teeth in older adults.

This RCT offers a nuanced understanding of nonsurgical peri-implantitis management (air polishing with erythritol versus ultrasonic instrumentation, in combination with systemic metronidazole), integrating both clinical and patient-centered outcomes. The results showed that the ultrasonic instrumentation reduced probing depth and bleeding on probing, throughout the 12-month period.