Journal of periodontal research最新文献

Aims: This study aimed to evaluate the reliability and applicability of novel methods for determining gingival phenotypes and compare them with currently recommended methods.

Methods: Six maxillary anterior teeth from 50 systemically and periodontally healthy patients were evaluated using two conventional methods (periodontal probe translucency method [PP] and transgingival measurement with an endodontic file [EF]), and two novel methods (colored biotype probe translucency method [CBP] and transgingival measurement with a Florida probe [FP]). All data were statistically analyzed. Intra-examiner reproducibility and inter-examiner reproducibility for all methods were analyzed using 10 randomly selected patients who were re-evaluated for each analysis.

Results: Moderate agreement was found between EF and PP, with statistically significant differences between median gingival thickness (GT) values for thick 0.8 mm (0.5-1.1 mm) and thin 1 mm (0.6-1.7 mm) phenotypes, and a threshold GT value of ≤0.92 mm (p < .001). FP and PP also showed moderate agreement, with statistically significant differences between median GT values for thick and thin phenotypes (0.80 mm [0.40-1.60 mm] and 0.89 mm [0.40-1.60 mm], respectively), and a threshold GT value of ≤0.8 mm (p < .001). PP and CBP values showed a substantial agreement (p < .001). A statistically significant difference was found between median EF values and CBP categories (p < .001); however, paired comparisons showed that the distinction was applicable only between thin and other phenotypes.

Conclusion: Although CBP was found to be successful in detecting the thin phenotype, it was not successful in distinguishing between medium, thick, and very thick phenotypes; moreover, it did not appear to offer any advantages over PP. Although FP may be preferable to EF in measuring gingival thickness, the cost of FP is a disadvantage.

Background: Hyperglycemic conditions is associated with more severe periodontitis and poorer outcomes after nonsurgical periodontal treatment (NPT). Then, these patients are candidates for adjunctive therapy associated with NPT. This study evaluates the effect of photobiomodulation (PBMT) at different wavelengths on periodontal repair in non-hyperglycemic/hyperglycemic animals.

Materials and methods: Sixty-four rats were submitted to induction of periodontitis by ligatures. Hyperglycemia was induced in half of these animals, whereas the other half remained non-hyperglycemic. The animals were subdivided into 4 groups according to the PBMT protocol applied at the time of ligature removal (n = 8): CTR: Without PBMT; IRL: PBMT with infrared laser (808 nm); RL: PBMT with red laser (660 nm); and RL-IRL: PBMT with red (660 nm) and infrared laser (808 nm). After a period of 7 days, the animals were euthanized. The parameters assessed by microtomography were the bone volume relative to total tissue volume (BV/TV%), distance from the cemento-enamel junction to the top of the bone crest (CEJ-CB), trabecular thickness, space between trabeculae, and number of trabeculae. Additionally, the percentage of inflammatory cells, blood vessels, and connective tissue matrix were assessed by histomorphometric analysis.

Results: PBMT reduced bone loss and increased trabecular density in hyperglycemic animals (p < .05), with RL being more effective in reducing linear bone loss (CEJ-CB), whereas RL-IRL was more effective in maintaining BV/TV%. PBMT reduced blood vessels and increased the connective tissue component in hyperglycemic animals (p < .05). RL-IRL reduced inflammatory cells regardless of the systemic condition of the animal (p < .05).

Conclusion: PBMT (RL, RL-IRL) improves the repair of periodontal tissues in hyperglycemic animals.

Aim: This study investigated the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and moderate/severe periodontitis and the role of blood pressure as a mediator in this association. A second aim was to assess the role of cardiometabolic conditions such as obesity, hypertension, and dyslipidemia as potential effect modifiers.

Methods: Data from 5733 US adults aged 30-64 years and with complete periodontal examination were analyzed (NHANES 2011-2014). Participants were classified as having moderate/severe periodontitis or mild/no periodontitis according to the CDC/AAP criteria as the outcome. The exposure was the TyG index, while both systolic (SBP), and diastolic (DBP) blood pressure were tested as mediators using parametric g-formula. Analyses were adjusted for relevant confounders, namely, age, sex, ethnicity, poverty-income ratio, and smoking, using inverse probability treatment weighting. Obesity status (based on a body mass index ≥30 kg/m²), self-report of hypertension and dyslipidemia (calculated based on the thresholds provided by National Cholesterol Education Program-Adult Treatment Panel-III) were tested as effect modifiers.

Results: The findings showed the TyG index to be associated with increased odds of moderate/severe periodontitis [odds ratio (OR), 95% confidence interval (CI) = 1.17 (1.11-1.23)], with 50% of the total effect mediated by SBP. Stratified analysis showed a stronger association in individuals with obesity, hypertension, and dyslipidemia compared to those without these conditions. However, in those taking anti-hypertensive medications, the association was partially mitigated. Sensitivity analysis using imputed data showed consistent results.

Conclusion: The TyG index was associated with increased odds of moderate/severe periodontitis, especially in individuals with obesity, hypertension, and dyslipidemia. SBP levels partially mediated this association.

Aim: The aim of this study was to evaluate the clinical and radiographic effects of hyaluronic acid (HA) gel application as an adjunct to minimally invasive nonsurgical treatment (MINST) in intrabony defects ≥3 mm.

Methods: A total of 36 patients were included and randomly assigned to two groups: (a) MINST + HA (test; n = 17) and (b) MINST (control, n = 19). Subgingival 0.8% HA gel was applied in intrabony defects of test group and repeated 4 weeks following MINST protocol. Clinical measurements including probing depth (PD), clinical attachment level (CAL), and gingival recession (GR) were recorded at baseline and repeated at 3 and 6 months. Radiographic evaluation was performed at baseline and 6 months.

Results: Test group showed significantly greater reduction in PD and gain in CAL at 3 months compared to baseline than that of controls (p < .05), but the changes (Δ) at 6 months compared to baseline did not differ between the groups (p > .05). Although, both groups showed statistically significant GR in all evaluated time periods (p < .05), control group showed higher ΔGR than that of test group (p < .05). There was no significant difference between the groups in terms of radiographic defect fill/bone gain (p > .05).

Conclusions: The additional use of 0.8% HA gel in the treatment of periodontal intrabony defects did not provide additional benefits in clinical and radiographic parameters. On the other hand, GR measurements showed favorable results in the test group.

Aims: Orthodontic treatment commonly results in orthodontically induced inflammatory root resorption (OIIRR). This condition arises from excessive orthodontic force, which triggerslocal inflammatory responses and impedes cementoblasts' mineralization capacity. Low-intensity pulsed ultrasound (LIPUS) shows potential in reducing OIIRR. However, the precise mechanisms through which LIPUS reduces OIIRR remain unclear. This study aimed to explore the effects and mechanisms of LIPUS on the mineralization of force-treated cementoblasts and its impact on OIIRR.

Methods: We established a rat OIIRR model and locally administered LIPUS stimulation for 7 and 14 days. We analyzed root resorption volume, osteoclast differentiation, and the expression of osteocalcin and yes-associated protein 1 (YAP1) using micro-computed tomography (micro-CT), hematoxylin and eosin, tartrate-resistant acid phosphatase, immunofluorescence and immunohistochemistry staining. In vitro, we applied compressive force and LIPUS to the immortalized mouse cementoblasts (OCCM30). We assessed mineralization using alkaline phosphatase (ALP) staining, alizarin red staining, real-time quantitative polymerase chain reaction, Western blotting and immunofluorescence staining.

Results: In rats, LIPUS reduced OIIRR, as evidenced by micro-CT analysis and histological staining. In vitro, LIPUS enhanced mineralization of force-treated OCCM30 cells, as indicated by ALP and alizarin red staining, upregulated mRNA expression of mineralization-related genes, and increased protein expression of mineralization markers. Mechanistically, LIPUS activated YAP1 signaling via the cytoskeleton-Lamin A/C pathway, supported by immunofluorescence and Western blot analysis.

Conclusion: This study demonstrates that LIPUS promotes mineralization in force-treated cementoblasts and reduces OIIRR by activating YAP1 through the cytoskeletal-Lamin A/C signaling pathway. These findings provide fresh insights into how LIPUS benefits orthodontic treatment and suggest potential strategies for preventing and treating OIIRR.

Aim: The aim of this study is to assess early wound healing expression of local angiogenic biomarkers following connective tissue graft (CTG) at dental implant sites.

Methods: Twenty-eight subjects with single dental implants exhibiting a soft tissue dehiscence were included and randomly treated with CTG, either with coronally advanced flap (CAF) or with tunnel technique (TUN). Peri-implant crevicular fluid (PICF) was collected at the midfacial and midlingual aspect of the implant sites at baseline and at 3, 7, 14, 30, and 90 days after the surgical intervention. The expression of angiogenin (ANG), fibroblast growth factor-2 (FGF-2), platelet-derived growth factor (PDGF), tissue inhibitor of metalloproteinases-2 (TIMP-2), and vascular endothelial growth factor (VEGF) was investigated over a period of 3 months. Patient-reported outcomes, clinical measurements, and ultrasonography scans at multiple time points were also evaluated.

Results: The longitudinal regression revealed a significant difference in the expression of VEGF and TIMP-2 between CAF- and TUN-treated sites over 3 months (p = .033 and p = .004, respectively), whereas no significant differences were observed for ANG, FGF-2 and PDGF between the two groups. At 7 days, a direct correlation was observed between ANG levels and ultrasonographic color velocity in the CAF group (p < .001) and between ANG levels and ultrasonographic color power in the TUN group (p = .028). VEGF levels and ultrasonographic mean perfused area of the CTG were significantly correlated at the 7-day time point (p < .001 for both CAF and TUN). The expression of VEGF at 7 days was directly associated with mucosal thickness gain at 1 year (p < .001 for both groups). Early TIMP-2 expression showed an inverse correlation with time to recovery (p = .002). TIMP-2 levels at 3 months exhibited inverse correlations with mean dehiscence coverage (p = .004) and the rate of complete dehiscence coverage (p = .012).

Conclusion: PICF biomarkers can be used to monitor early wound healing events following soft tissue grafting at implant sites. VEGF and TIMP-2 showed correlations with the 1-year clinical and volumetric outcomes, as well as with post-operative patient-reported outcomes and Doppler Ultrasonographic tissue perfusion-related parameters.

Periodontitis is a multifactorial immune-mediated disease exacerbated by dysregulated alveolar bone homeostasis. Timely intervention is crucial for disease management to prevent tooth loss. To successfully manage periodontitis, it is imperative to understand the cellular and molecular mechanisms involved in its pathogenesis to develop novel treatment modalities. Non-surgical periodontal therapy (NSPT) such as subgingival instrumentation/debridement has been the underlying treatment strategy over the past decades. However, new NSPT approaches that target key signaling pathways regulating alveolar bone homeostasis have shown positive clinical outcomes. This narrative review aims to discuss endogenous bone homeostasis mechanisms impaired in periodontitis and highlight the clinical outcomes of preventive periodontal therapy to avoid invasive periodontal therapies. Although the anti-resorptive therapeutic adjuncts have demonstrated beneficial outcomes, adverse events have been reported. Diverse immunomodulatory therapies targeting the osteoblast/osteoclast (OB/OC) axis have shown promising outcomes in vivo. Future controlled randomized clinical trials (RCT) would help clinicians and patients in the selection of novel preventing therapies targeting key molecules to effectively treat or prevent periodontitis.

Introduction: The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long-term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT-4 and GPT-3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in-service examination questions posed by the American Academy of Periodontology (AAP).

Methods: Under a comparative cross-sectional study design, a corpus of 1312 questions from the annual in-service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi-square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub-analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions.

Results: ChatGPT-4 (total average: 79.57%) outperformed all human control groups as well as GPT-3.5 and Google Gemini in all exam years (p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% (p = .01), 73.29% (p = .02), 75.73% (p < .01), and 72.18% (p = .0008) for the exams from 2020 to 2023 compared to ChatGPT-3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first- (63.48% ± 31.67) and second-year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third-year residents (69.06% ± 30.45).

Conclusions: Within the confines of this analysis, ChatGPT-4 exhibited a robust capability in answering AAP in-service exam questions in terms of accuracy and reliability while Gemini and ChatGPT-3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image-based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT-4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.

Periodontitis is widely acknowledged as the most prevalent type of oral inflammation, arising from the dynamic interplay between oral pathogens and the host's immune responses. It is also recognized as a contributing factor to various systemic diseases. Dysbiosis of the oral microbiota can significantly alter the composition and diversity of the gut microbiota. Researchers have delved into the links between periodontitis and systemic diseases through the "oral-gut" axis. However, whether the associations between periodontitis and the gut microbiota are simply correlative or driven by causative mechanistic interactions remains uncertain. This review investigates how dysbiosis of the gut microbiota impacts periodontitis, drawing on existing preclinical and clinical data. This study highlights potential mechanisms of this interaction, including alterations in subgingival microbiota, oral mucosal barrier function, neutrophil activity, and abnormal T-cell recycling, and offers new perspectives for managing periodontitis, especially in cases linked to systemic diseases.