Journal of periodontology最新文献

Background: This study aimed to perform a prediction model validation for furcation involvement (FI) risk in molars receiving a new fixed prosthesis (FP) using a unique cohort assessed at three time points.

Methods: Following the Oral Health Statistical (OHStat) reporting guidelines, this cohort study examined 181 patients (203 molars) from 2018-2023. Teeth without FI were followed longitudinally post-crown placement at 1- (T1), 3- (T2), and 5-years (T3). A logistic regression model was built in order to predict FI and the related performance was assessed through metrics like AUC, sensitivity, specificity, and calibration.

Results: FI was observed in 4.43% of teeth at 1 year, increasing to 21.67% at 3 years and 28.57% at 5 years. Univariate analysis revealed significant predictors at 3-5 years: a history of periodontitis was associated with higher FI risk at 5 years (RR = 3.56, p = 0.024), with advanced stages also increasing risk-stage III: RR = 2.59 at 3 years and RR = 3.32 at 5 years; stage IV: RR = 3.76 at 3 years and RR = 3.75 at 5 years. Short root trunks significantly increased FI risk across all intervals (1 year: RR = 3.96; 3 years: RR = 6.08; 5 years: RR = 4.75). Medium trunks did not differ significantly from long trunks. The predictive model performed best at 3 years (AUC = 0.81, sensitivity = 0.79, specificity = 0.87) and remained robust at 5 years (AUC = 0.76, sensitivity = 0.69, specificity = 0.90).

Conclusion: The predictive model demonstrated high accuracy with a substantial ability to identify FI cases over time. Clinicians should consider such an assessment before crown or bridge restoration, with particular caution in patients with periodontitis.

Background: The aim of the present study was to examine whether age and sex affected the prevalence and severity of periodontal conditions in patients attending an academic dental clinic.

Methods: Electronic health record (EHR) data on the demographic characteristics and periodontal conditions of patients presented for a comprehensive periodontal evaluation were extracted from the institutional dental EHR database. Retrospective analysis of independent associations of age, sex, and other subject characteristics with periodontal conditions was determined using multinomial logistic regression. The null hypothesis stating that age and sex were not associated with the increased prevalence and/or severity of periodontal conditions was tested at a significance level α < 0.05.

Results: A total of 5027 subjects met the inclusion criteria. Clinical gingival health (CGH), gingivitis, and periodontitis were diagnosed in 4.2%, 5.2%, and 55.8% of patients, respectively. Severe periodontitis was diagnosed in 84.6% of the 4302 patients with periodontitis and was significantly associated with each year of age increase (odds ratio [OR] 1.13; 95% confidence interval [CI] 1.11, 1.15) and male sex (OR 2.02; 95% CI 1.30, 3.15). The combined effect of a 15-year age increase and male sex was reflected in the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). The combined effect of older age and male sex is shown by the increased odds of severe periodontitis (OR 12.63; 95% CI 9.57, 16.67). Similar associations were found between age, male sex, and total periodontitis, but not CGH and gingivitis.

Conclusion: Increasing age and male sex significantly correlated with increased odds of total and severe periodontitis.

Plain language summary: Periodontitis, or inflammatory gum disease, affects many adults in the United States and worldwide. Various factors, such as smoking and diabetes mellitus, increase the risk of periodontitis and the severity of its symptoms. To determine if periodontitis occurs more commonly and is more severe according to patient age and sex, the study used health records from almost 8,000 patients attending dental clinics at the University of Texas School of Dentistry (Houston, TX) from 2007 to 2020. The results demonstrated that adult patients who were older or males had periodontitis more often than those who were younger or female, respectively. Periodontitis was also more severe in older or male patients. These results show that older adults and males can be considered vulnerable individuals when it comes to diagnosing periodontitis. Therefore, dentists should pay more attention to these patients, and individualized treatment methods need to be considered for providing dental care to the gums of these patients.

Background: Oral mucosa heals with minimal scar formation compared with other tissues. The aim of this study was to explore the differential healing properties between keratinized gingiva and non-keratinized alveolar mucosa, and to analyze the healing dynamic of these tissues through a clinical photograph-based prospective study.

Methods: Fourteen patients received 26 interdental piezocisions as part of orthodontic therapy. Piezocisions penetrated through the oral mucosa, the periosteum, and the cortical bone. They overlapped both keratinized gingiva and non-keratinized alveolar mucosa. Wounds were evaluated at four time points (1, 3, 8, and 20 weeks) by measuring the Mucosal Scarring Index (MSI) on standardized photographs.

Results: The analysis included 364 incisions evaluated at four time-points. The scar length showed a significant reduction up to 3 weeks in the alveolar mucosa (p < 0.001) and up to 8 weeks in the gingiva (p = 0.048). At 1 week, the posterior regions had higher MSI scoring than the anterior regions, particularly in the mandibular alveolar mucosa. No significant changes in the scar length or MSI scores were observed after 8 weeks, indicating stabilization of the healing processes. By 20 weeks, 64.05% and 52.22% of the incisions were devoid of scars in the gingiva and alveolar mucosa, respectively.

Conclusion: The study confirmed that both oral mucosa and gingiva heal with no scar or minimal scarring, following full-thickness incisions. Neither keloid nor hypertrophic scars were observed. No significant differences were found between gingiva and alveolar mucosa in terms of final scar visibility. However, healing outcomes were notably less favorable in the posterior regions, highlighting the influence of anatomical location.

Plain language summary: Oral mucosa exhibits minimal scar formation compared with other tissues. Studies evaluating the healing dynamics of the various intraoral tissue types remain limited. This prospective study investigates the healing characteristics of keratinized gingiva and non-keratinized alveolar mucosa, by focusing on scar formation following piezocision. Complete wound closure was observed at all sites 1 week after surgery. More than half of the piezocisions produced no visible scarring. Notably, even though the incisions penetrated the full thickness of the tissue and involved perforation of the vestibular cortical bone, no significant scarring was observed. However, increased scar visibility was noted in patients with pigmented gingiva. The healing results appear to vary according to anatomical regions.

Background: To assess clinical and anatomical risk indicators for mid-buccal gingival recessions (GRs) in the mandibular anterior region using digital and tomographic tools.

Methods: A cross-sectional study was conducted on 103 patients (618 teeth). Clinical examination, intraoral scanning, and cone-beam computed tomography (CBCT) were combined to record the keratinized tissue width (KTW), gingival phenotype, GR type (RT), probing pocket depth, clinical attachment level, recession depth (RD), tooth-ridge angulation, tooth malpositioning (TM), buccal bone thickness (BBT), buccal bone dehiscence (BBD), root prominence (RP), gingival thickness (GT), and papilla height (PH). Associations with GR were analyzed using multilevel regression with generalized estimation equations.

Results: Gingival recession was observed in 70.9% of patients and 38.3% of teeth, most often RT2. Central incisors were most affected. Univariate analysis associated GR to age, tooth type, TM, reduced KTW, decreased BBT, increased BBD, and RT, while thicker phenotypes showed protective effects. Multivariable analysis confirmed five independent predictors: age, tooth type, TM (OR = 3.11), reduced KTW (OR = 0.64), and greater BBD (OR = 1.64). RD increased with age (+0.03 mm/year) and BBD (+0.21 mm).

Conclusions: Tooth malposition, inadequate KTW, and BBD are key risk indicators for gingival recession in the mandibular anterior region. Their identification is essential for preventive and therapeutic strategies.

Plain language summary: Gingival recession, the apical migration of the gingival margin, is a common condition with implications for dental sensitivity, esthetics, and long-term periodontal health. The lower anterior region is particularly susceptible, yet the anatomical and clinical factors contributing to this vulnerability are not fully defined using digital tools. In this cross-sectional study of 103 patients (618 teeth), we integrated clinical examination, digital intraoral scanning, and CBCT to quantify soft and hard tissue characteristics. Recession was present in 70.9% of patients and 38.3% of teeth, predominantly affecting the central incisors. Multivariable analysis identified five independent risk indicators: older age, tooth type, tooth malposition, reduced keratinized tissue width, and buccal bone dehiscence. Recession depth increased with age and dehiscence severity. These findings underscore the critical role of both soft and hard tissue anatomy in determining susceptibility to gingival recession, providing a framework for risk assessment, preventive strategies, and individualized treatment planning in clinical practice.