Glayson P. Vitor, Ana P. Carvalho, Rafael P. Esteves Lima, Wadson Gomes Miconi, Fernando O. Costa, Luís O. M. Cota
BackgroundRecent evidence suggests that chronic inflammation may play a role in the development and clinical course of cancer. In this context, periodontitis (PE) has been associated with prostate cancer (PC), but the results are still inconsistent. Therefore, the aim of this study was to evaluate the potential association between PE and PC, and their shared risk factors.MethodsThis case–control study comprised 152 cases with PC and 220 controls. All participants underwent a complete periodontal examination, and sociodemographic and medical variables of interest were collected. The association between occurrence and severity of PC and covariates was assessed by binary and multinomial multivariate logistic regression, respectively.ResultsThe cases had a higher prevalence (p = 0.012) and severity (p = 0.007) of PE. The occurrence of PC was associated with an educational level <9 years (adjusted odds ratio [OR] = 1.93), smoking (adjusted OR = 2.62), alcohol consumption (adjusted OR = 3.45), diabetes (adjusted OR = 0.32), chronic hypertension (adjusted OR = 2.03), and PE (adjusted OR = 1.80). Regarding the severity of PC, Gleason grades 1 and 2 were associated with PE (adjusted OR = 1.96), but Gleason grades 3–5 were not.ConclusionPE was associated with the occurrence of PC. Males diagnosed with PE would potentially benefit from being screened for prostate alterations.Plain language summaryPeriodontitis is an infectious disease that affects the supporting structures of the teeth. It has been characterized as a chronic inflammatory stimulus with potential risk for the occurrence or worsening of the clinical course of cancer. We evaluated the potential relationship between periodontitis and prostate cancer, as well as their shared risk factors, in a case–control study comprising 372 male individuals. The participants were recruited in a urology outpatient clinic and underwent a complete periodontal examination. The results showed that individuals with prostate cancer presented a worse periodontal status and a higher prevalence and severity of periodontitis. Prostate cancer was mainly associated with educational level, smoking, alcohol consumption, and periodontitis. Individuals with periodontitis were 1.8 times more likely to have prostate cancer. Prostate‐specific antigen levels in individuals with periodontitis were also significantly higher. We concluded that periodontitis was associated with the occurrence of prostate cancer. Therefore, males diagnosed with periodontitis would potentially benefit from being screened for prostate alterations.
{"title":"Association between periodontitis and prostate cancer: A case–control study","authors":"Glayson P. Vitor, Ana P. Carvalho, Rafael P. Esteves Lima, Wadson Gomes Miconi, Fernando O. Costa, Luís O. M. Cota","doi":"10.1002/jper.24-0440","DOIUrl":"https://doi.org/10.1002/jper.24-0440","url":null,"abstract":"BackgroundRecent evidence suggests that chronic inflammation may play a role in the development and clinical course of cancer. In this context, periodontitis (PE) has been associated with prostate cancer (PC), but the results are still inconsistent. Therefore, the aim of this study was to evaluate the potential association between PE and PC, and their shared risk factors.MethodsThis case–control study comprised 152 cases with PC and 220 controls. All participants underwent a complete periodontal examination, and sociodemographic and medical variables of interest were collected. The association between occurrence and severity of PC and covariates was assessed by binary and multinomial multivariate logistic regression, respectively.ResultsThe cases had a higher prevalence (<jats:italic>p</jats:italic> = 0.012) and severity (<jats:italic>p</jats:italic> = 0.007) of PE. The occurrence of PC was associated with an educational level <9 years (adjusted odds ratio [OR] = 1.93), smoking (adjusted OR = 2.62), alcohol consumption (adjusted OR = 3.45), diabetes (adjusted OR = 0.32), chronic hypertension (adjusted OR = 2.03), and PE (adjusted OR = 1.80). Regarding the severity of PC, Gleason grades 1 and 2 were associated with PE (adjusted OR = 1.96), but Gleason grades 3–5 were not.ConclusionPE was associated with the occurrence of PC. Males diagnosed with PE would potentially benefit from being screened for prostate alterations.Plain language summaryPeriodontitis is an infectious disease that affects the supporting structures of the teeth. It has been characterized as a chronic inflammatory stimulus with potential risk for the occurrence or worsening of the clinical course of cancer. We evaluated the potential relationship between periodontitis and prostate cancer, as well as their shared risk factors, in a case–control study comprising 372 male individuals. The participants were recruited in a urology outpatient clinic and underwent a complete periodontal examination. The results showed that individuals with prostate cancer presented a worse periodontal status and a higher prevalence and severity of periodontitis. Prostate cancer was mainly associated with educational level, smoking, alcohol consumption, and periodontitis. Individuals with periodontitis were 1.8 times more likely to have prostate cancer. Prostate‐specific antigen levels in individuals with periodontitis were also significantly higher. We concluded that periodontitis was associated with the occurrence of prostate cancer. Therefore, males diagnosed with periodontitis would potentially benefit from being screened for prostate alterations.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"14 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143853539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luxu Wang,Ting Liu,Weidong Zhang,Hongrui Liu,Yuping Qi,Minqi Li
BACKGROUNDOne strategy to delay bone loss in periodontitis involves maintaining the osteogenic differentiation function of periodontal ligament stem cells (PDLSCs). The core circadian gene BMAL1 influences the fate of mesenchymal stem cells and is essential for regulating pyroptosis, apoptosis, and necroptosis. PANoptosis, a novel form of programmed cell death, simultaneously activates all 3 pathways. This study focuses on the role of BMAL1, the process of PANoptosis, and the osteogenic impairment of PDLSCs.METHODSA mouse periodontitis model was established to evaluate the expression of BMAL1 and osteogenic factors. We stimulated PDLSCs with lipopolysaccharide (LPS) and used a Western blot to detect PANoptosis-related factors. Osteogenic factors in PDLSCs were assessed using real-time quantitative polymerase chain reaction (RT-qPCR), Western blot, alkaline phosphatase, and alizarin red staining. The expression of ERK pathway proteins was examined by immunofluorescence and Western blot to investigate how BMAL1 regulates PANoptosis under inflammatory conditions.RESULTSTreatment with LPS leads to the downregulation of BMAL1 expression, which subsequently induces RIPK1-PANoptosome-mediated PANoptosis in PDLSCs, impairing their osteogenic differentiation function. Inhibition of the RIPK1-PANoptosome with Nec-1S improved the expression of osteogenic differentiation-related genes and proteins. Overexpression of BMAL1 using the synthetic ligand SR1078 alleviated these detrimental effects. Inhibition of the ERK pathway with U0126 reduced the expression of its downstream target AP-1, effectively reversing the impact of BMAL1 on PANoptosis.CONCLUSIONSThe downregulation of BMAL1 triggers PANoptosis in PDLSCs, leading to impaired osteogenic function under inflammatory conditions. This study provides new insights into the pathogenesis of periodontitis and suggests novel targets for its prevention and treatment.PLAIN LANGUAGE SUMMARYPeriodontitis is a chronic inflammatory condition of the oral cavity marked by the destruction of periodontal attachment and resorption of alveolar bone. One strategy to delay alveolar bone loss in periodontitis involves maintaining the osteogenic differentiation function of periodontal ligament stem cells (PDLSCs). The circadian rhythm influences the fate of mesenchymal stem cells, with the core circadian gene BMAL1 playing a crucial role in regulating pyroptosis, apoptosis, and necroptosis. PANoptosis is a novel form of programmed cell death, encompassing pyroptosis, apoptosis, and necroptosis, which may play a role in regulating the osteogenic activity of PDLSCs. Our study aims to detect the role of PANoptosis of PDLSCs in periodontitis and elucidate the underlying relationship between BMAL1 and PANoptosis. We found that treatment with lipopolysaccharide leads to the downregulation of BMAL1 expression, which subsequently induces RIPK1-PANoptosome-mediated PANoptosis in PDLSCs, impairing their osteogenic differentiation function.
{"title":"BMAL1-downregulation drives PANoptosis and the osteogenic differentiation impairment of PDLSCs by ERK/AP-1 signaling pathway.","authors":"Luxu Wang,Ting Liu,Weidong Zhang,Hongrui Liu,Yuping Qi,Minqi Li","doi":"10.1002/jper.24-0497","DOIUrl":"https://doi.org/10.1002/jper.24-0497","url":null,"abstract":"BACKGROUNDOne strategy to delay bone loss in periodontitis involves maintaining the osteogenic differentiation function of periodontal ligament stem cells (PDLSCs). The core circadian gene BMAL1 influences the fate of mesenchymal stem cells and is essential for regulating pyroptosis, apoptosis, and necroptosis. PANoptosis, a novel form of programmed cell death, simultaneously activates all 3 pathways. This study focuses on the role of BMAL1, the process of PANoptosis, and the osteogenic impairment of PDLSCs.METHODSA mouse periodontitis model was established to evaluate the expression of BMAL1 and osteogenic factors. We stimulated PDLSCs with lipopolysaccharide (LPS) and used a Western blot to detect PANoptosis-related factors. Osteogenic factors in PDLSCs were assessed using real-time quantitative polymerase chain reaction (RT-qPCR), Western blot, alkaline phosphatase, and alizarin red staining. The expression of ERK pathway proteins was examined by immunofluorescence and Western blot to investigate how BMAL1 regulates PANoptosis under inflammatory conditions.RESULTSTreatment with LPS leads to the downregulation of BMAL1 expression, which subsequently induces RIPK1-PANoptosome-mediated PANoptosis in PDLSCs, impairing their osteogenic differentiation function. Inhibition of the RIPK1-PANoptosome with Nec-1S improved the expression of osteogenic differentiation-related genes and proteins. Overexpression of BMAL1 using the synthetic ligand SR1078 alleviated these detrimental effects. Inhibition of the ERK pathway with U0126 reduced the expression of its downstream target AP-1, effectively reversing the impact of BMAL1 on PANoptosis.CONCLUSIONSThe downregulation of BMAL1 triggers PANoptosis in PDLSCs, leading to impaired osteogenic function under inflammatory conditions. This study provides new insights into the pathogenesis of periodontitis and suggests novel targets for its prevention and treatment.PLAIN LANGUAGE SUMMARYPeriodontitis is a chronic inflammatory condition of the oral cavity marked by the destruction of periodontal attachment and resorption of alveolar bone. One strategy to delay alveolar bone loss in periodontitis involves maintaining the osteogenic differentiation function of periodontal ligament stem cells (PDLSCs). The circadian rhythm influences the fate of mesenchymal stem cells, with the core circadian gene BMAL1 playing a crucial role in regulating pyroptosis, apoptosis, and necroptosis. PANoptosis is a novel form of programmed cell death, encompassing pyroptosis, apoptosis, and necroptosis, which may play a role in regulating the osteogenic activity of PDLSCs. Our study aims to detect the role of PANoptosis of PDLSCs in periodontitis and elucidate the underlying relationship between BMAL1 and PANoptosis. We found that treatment with lipopolysaccharide leads to the downregulation of BMAL1 expression, which subsequently induces RIPK1-PANoptosome-mediated PANoptosis in PDLSCs, impairing their osteogenic differentiation function. ","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"33 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pengfei Liu,Huan Zhou,Tingting Wang,Zhenyuan Yu,Jiaqi Deng,Ruoyan Cao
BACKGROUNDThis study aims to assess the associations between exposures to thiocyanate and the risk of periodontitis among US adults.METHODSWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. We categorized periodontitis according to the 2017 classification scheme. Restricted cubic spline analysis and weighted multivariable logistic regression were employed to examine the relationship between thiocyanate exposure and periodontitis.RESULTSA total of 3319 participants were included in our study. We observed a J-shaped association between thiocyanate exposure and periodontitis, with an inflection point at 3.32. Before the inflection point, we noted a negative trend in the relationship between thiocyanate and periodontitis (odds ratio [OR] = 0.89, 95% CI: 0.73-1.08), particularly among smokers (OR = 0.31, 95% CI: 0.08-1.18). After the inflection point, we found a positive association (OR = 1.21, 95% CI: 1.03-1.42), particularly among non-obese individuals (OR = 1.42, 95% CI: 1.16-1.75) and non-hypertensive individuals (OR = 1.34, 95% CI: 1.12-1.61).CONCLUSIONA J-shaped relationship exists between thiocyanate exposure and periodontitis, indicating its complex role, and further prospective trials are necessary to confirm these findings.PLAIN LANGUAGE SUMMARYThiocyanate, a compound prevalent in both the environment and dietary sources, can impact health through mechanisms that are either protective or detrimental. This study sought to investigate the specific relationship between thiocyanate exposure and periodontitis utilizing data from the National Health and Nutrition Examination Survey (NHANES). The findings reveal that both insufficient and excessive levels of thiocyanate exposure are linked to an increased risk of periodontitis, underscoring the critical importance of maintaining an optimal range of thiocyanate exposure for periodontal health.
{"title":"J-shaped associations between thiocyanate and periodontitis: A cross-sectional study from NHANES 2009-2014.","authors":"Pengfei Liu,Huan Zhou,Tingting Wang,Zhenyuan Yu,Jiaqi Deng,Ruoyan Cao","doi":"10.1002/jper.24-0832","DOIUrl":"https://doi.org/10.1002/jper.24-0832","url":null,"abstract":"BACKGROUNDThis study aims to assess the associations between exposures to thiocyanate and the risk of periodontitis among US adults.METHODSWe conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2014. We categorized periodontitis according to the 2017 classification scheme. Restricted cubic spline analysis and weighted multivariable logistic regression were employed to examine the relationship between thiocyanate exposure and periodontitis.RESULTSA total of 3319 participants were included in our study. We observed a J-shaped association between thiocyanate exposure and periodontitis, with an inflection point at 3.32. Before the inflection point, we noted a negative trend in the relationship between thiocyanate and periodontitis (odds ratio [OR] = 0.89, 95% CI: 0.73-1.08), particularly among smokers (OR = 0.31, 95% CI: 0.08-1.18). After the inflection point, we found a positive association (OR = 1.21, 95% CI: 1.03-1.42), particularly among non-obese individuals (OR = 1.42, 95% CI: 1.16-1.75) and non-hypertensive individuals (OR = 1.34, 95% CI: 1.12-1.61).CONCLUSIONA J-shaped relationship exists between thiocyanate exposure and periodontitis, indicating its complex role, and further prospective trials are necessary to confirm these findings.PLAIN LANGUAGE SUMMARYThiocyanate, a compound prevalent in both the environment and dietary sources, can impact health through mechanisms that are either protective or detrimental. This study sought to investigate the specific relationship between thiocyanate exposure and periodontitis utilizing data from the National Health and Nutrition Examination Survey (NHANES). The findings reveal that both insufficient and excessive levels of thiocyanate exposure are linked to an increased risk of periodontitis, underscoring the critical importance of maintaining an optimal range of thiocyanate exposure for periodontal health.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"66 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Balazs Feher,Eduardo H de Souza Oliveira,Poliana Mendes Duarte,Andreas A Werdich,William V Giannobile,Magda Feres
BACKGROUNDPeriodontitis is among the most prevalent chronic inflammatory conditions globally, and is associated with bone resorption, tooth loss, and systemic complications. While its treatment is largely standardized, individual outcomes vary, with some patients experiencing further disease progression despite adherence.METHODSWe developed a machine learning (ML) approach to predict individual outcomes 1 year post-treatment using retrospectively assessed baseline parameters. We trained a Random Forest model on 18 demographic, clinical, microbiological, and treatment-related features of 414 patients from randomized clinical trials (RCTs) in South America. We subsequently performed internal testing, interpretability analysis, and external testing on a second dataset of 78 patients from previous RCTs in North America and Europe exhibiting less severe disease.RESULTSIn internal testing, the ML model achieved an area under the receiver operator characteristics curve (AUROC) of 0.93, an area under the precision-recall curve (AUPRC) of 0.90, an F1-score of 0.82, and an out-of-bag score of 0.71. Relative importances were 0.42 for clinical, 0.33 for treatment-related, 0.21 for microbiological, and 0.04 for demographic features. In external testing, the ML model achieved an AUROC of 0.76, an AUPRC of 0.69, and an F1-score of 0.71.CONCLUSIONSOur study indicates that an ML-based approach can assist in predicting individual responses to periodontal treatment. Prospective validation is needed for clinical application.PLAIN LANGUAGE SUMMARYUsing comprehensive data from patients with periodontitis, an inflammatory condition of the tooth-supporting tissues, a machine learning model was trained to predict how well patients might respond to different treatments after 1 year. The model was externally tested in patient populations from 2 continents different from the training dataset. The results suggest that with further research and refinement, this tool could eventually become a valuable asset in personalizing treatment plans for improved patient outcomes.
{"title":"Machine learning-assisted prediction of clinical responses to periodontal treatment.","authors":"Balazs Feher,Eduardo H de Souza Oliveira,Poliana Mendes Duarte,Andreas A Werdich,William V Giannobile,Magda Feres","doi":"10.1002/jper.24-0737","DOIUrl":"https://doi.org/10.1002/jper.24-0737","url":null,"abstract":"BACKGROUNDPeriodontitis is among the most prevalent chronic inflammatory conditions globally, and is associated with bone resorption, tooth loss, and systemic complications. While its treatment is largely standardized, individual outcomes vary, with some patients experiencing further disease progression despite adherence.METHODSWe developed a machine learning (ML) approach to predict individual outcomes 1 year post-treatment using retrospectively assessed baseline parameters. We trained a Random Forest model on 18 demographic, clinical, microbiological, and treatment-related features of 414 patients from randomized clinical trials (RCTs) in South America. We subsequently performed internal testing, interpretability analysis, and external testing on a second dataset of 78 patients from previous RCTs in North America and Europe exhibiting less severe disease.RESULTSIn internal testing, the ML model achieved an area under the receiver operator characteristics curve (AUROC) of 0.93, an area under the precision-recall curve (AUPRC) of 0.90, an F1-score of 0.82, and an out-of-bag score of 0.71. Relative importances were 0.42 for clinical, 0.33 for treatment-related, 0.21 for microbiological, and 0.04 for demographic features. In external testing, the ML model achieved an AUROC of 0.76, an AUPRC of 0.69, and an F1-score of 0.71.CONCLUSIONSOur study indicates that an ML-based approach can assist in predicting individual responses to periodontal treatment. Prospective validation is needed for clinical application.PLAIN LANGUAGE SUMMARYUsing comprehensive data from patients with periodontitis, an inflammatory condition of the tooth-supporting tissues, a machine learning model was trained to predict how well patients might respond to different treatments after 1 year. The model was externally tested in patient populations from 2 continents different from the training dataset. The results suggest that with further research and refinement, this tool could eventually become a valuable asset in personalizing treatment plans for improved patient outcomes.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"108 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Bujila, Davi N. A. Silva, Sepehr Monajemzadeh, Taciane M. da Silveira, Naseim Elzakra, Maísa Casarin, Kimberly Flores, Clara Magyar, Julie Marchesan, Reuben Kim, Sotirios Tetradis, Flavia Q. Pirih
BackgroundBisphosphonates (BPs) are effective in managing bone diseases due to their anti‐resorptive properties but are linked to medication‐related osteonecrosis of the jaw (MRONJ), particularly concerning dental implants. This study explored the combined impact of ligature‐induced peri‐implant inflammation and zoledronic acid (ZA), a BP, using a murine model.MethodsTwenty‐four mice underwent bilateral maxillary molar extractions and implant placements, with ZA or vehicle treatment and ligature placement on the left side. Two groups were defined: group 1 (vehicle‐treated) with control (Veh‐C) and ligature (Veh‐L) implants, and group 2 (ZA‐treated) with control (ZA‐C) and ligature (ZA‐L) implants. Clinical, micro‐CT, histological, and immunohistochemical analyses were performed. We hypothesized that peri‐implant inflammation elevates MRONJ risk with BP treatment.ResultsLigature groups showed increased soft tissue edema compared to controls, without differences between vehicle and ZA treatments. The Veh‐L group exhibited significantly greater bone loss than other groups. Histology showed higher inflammatory infiltrate in ligature groups. Osteocyte empty lacunae and osteonecrosis were significantly greater in ZA‐L. Picrosirius red staining revealed disorganized collagen fibers and separation in ZA‐L. Immunohistochemistry showed increased neutrophils (NIMP‐R14+) and monocytes/macrophages (CD11b+) in the ligature groups, with no significant differences between Veh‐C and ZA‐C.ConclusionLigature treatment enhances peri‐implant inflammation, with ZA heightening the risk of MRONJ. These findings highlight the critical importance of early detection and management of peri‐implant inflammation in patients undergoing BP therapy, particularly those at high risk of MRONJ. Clinicians should emphasize preventive measures, such as regular monitoring of peri‐implant health and reducing local inflammatory triggers, to mitigate the adverse effects of BPs on peri‐implant bone health.Plain language summaryDental implants are a reliable solution to replace missing teeth. However, like natural teeth, implants can develop inflammation around them—peri‐implantitis. Our study found that, when this inflammation occurs in patients taking BPs (a medication commonly used to treat osteoporosis and other bone diseases), the risk of developing a serious jaw condition called osteonecrosis (ONJ) increases significantly. ONJ prevents the jawbone from healing properly, leading to pain, infection, and even exposed bone. These findings highlight the importance of preventing and managing inflammation around dental implants to reduce the risk of complications, especially in patients taking BPs. Our research suggests regular dental check‐ups and proper oral hygiene can help maintain implant health and prevent severe bone‐related conditions. Patients and healthcare providers can take proactive steps to improve long‐term oral health outcomes by understanding these risks.
{"title":"Peri‐implant inflammation increases the risk of osteonecrosis in mice treated with bisphosphonate","authors":"Ana Bujila, Davi N. A. Silva, Sepehr Monajemzadeh, Taciane M. da Silveira, Naseim Elzakra, Maísa Casarin, Kimberly Flores, Clara Magyar, Julie Marchesan, Reuben Kim, Sotirios Tetradis, Flavia Q. Pirih","doi":"10.1002/jper.24-0760","DOIUrl":"https://doi.org/10.1002/jper.24-0760","url":null,"abstract":"BackgroundBisphosphonates (BPs) are effective in managing bone diseases due to their anti‐resorptive properties but are linked to medication‐related osteonecrosis of the jaw (MRONJ), particularly concerning dental implants. This study explored the combined impact of ligature‐induced peri‐implant inflammation and zoledronic acid (ZA), a BP, using a murine model.MethodsTwenty‐four mice underwent bilateral maxillary molar extractions and implant placements, with ZA or vehicle treatment and ligature placement on the left side. Two groups were defined: group 1 (vehicle‐treated) with control (Veh‐C) and ligature (Veh‐L) implants, and group 2 (ZA‐treated) with control (ZA‐C) and ligature (ZA‐L) implants. Clinical, micro‐CT, histological, and immunohistochemical analyses were performed. We hypothesized that peri‐implant inflammation elevates MRONJ risk with BP treatment.ResultsLigature groups showed increased soft tissue edema compared to controls, without differences between vehicle and ZA treatments. The Veh‐L group exhibited significantly greater bone loss than other groups. Histology showed higher inflammatory infiltrate in ligature groups. Osteocyte empty lacunae and osteonecrosis were significantly greater in ZA‐L. Picrosirius red staining revealed disorganized collagen fibers and separation in ZA‐L. Immunohistochemistry showed increased neutrophils (NIMP‐R14+) and monocytes/macrophages (CD11b+) in the ligature groups, with no significant differences between Veh‐C and ZA‐C.ConclusionLigature treatment enhances peri‐implant inflammation, with ZA heightening the risk of MRONJ. These findings highlight the critical importance of early detection and management of peri‐implant inflammation in patients undergoing BP therapy, particularly those at high risk of MRONJ. Clinicians should emphasize preventive measures, such as regular monitoring of peri‐implant health and reducing local inflammatory triggers, to mitigate the adverse effects of BPs on peri‐implant bone health.Plain language summaryDental implants are a reliable solution to replace missing teeth. However, like natural teeth, implants can develop inflammation around them—peri‐implantitis. Our study found that, when this inflammation occurs in patients taking BPs (a medication commonly used to treat osteoporosis and other bone diseases), the risk of developing a serious jaw condition called osteonecrosis (ONJ) increases significantly. ONJ prevents the jawbone from healing properly, leading to pain, infection, and even exposed bone. These findings highlight the importance of preventing and managing inflammation around dental implants to reduce the risk of complications, especially in patients taking BPs. Our research suggests regular dental check‐ups and proper oral hygiene can help maintain implant health and prevent severe bone‐related conditions. Patients and healthcare providers can take proactive steps to improve long‐term oral health outcomes by understanding these risks.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"34 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143832441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Panagiotis Ntovas, Lorenzo Tavelli, Basir A. Barmak, Ronald E. Jung, Maria‐Elisa Galarraga‐Vinueza
BackgroundThe aim of this study was to evaluate the effect of surgical guide design and type of blade, in relation to soft tissue thickness, on the accuracy of computer‐assisted crown lengthening.MethodsA set of fully dentate anatomic maxilla models was implemented, using 2 types of soft‐tissue masks with a mean thickness of 1.5 and 3.5 mm, respectively, to simulate a clinical scenario of altered passive eruption. In total, 5 different gingivectomy techniques were assessed, implementing 3 different types of guidance and 2 different blades. The osteotomy was performed using 2 surgical guide designs. After each operation, the models were scanned and superimposed with the initial virtual design, to evaluate the accuracy of each evaluated approach through a set of linear measurements.ResultsFor the gingivectomy as well as for the osteotomy, the mean discrepancy was increased in the presence of increased soft tissue thickness (p < 0.05). The integration of supporting planes led to a decrease in the discrepancy compared to the conventional double guide design for both of the investigated soft‐tissue thicknesses (p < 0.05). For the models with the normal soft tissue thickness, a lower mean discrepancy was presented, when a mini blade was used instead of a conventional surgical blade, irrespective of the guide design (p < 0.05).ConclusionComputer‐assisted crown lengthening can be considered a feasible treatment option. Soft tissue thickness has to be taken into consideration during the design of the surgical template, in order additional support to be provided when it is needed. Surgical templates with integrated supporting planes can increase the accuracy of computer‐assisted crown lengthening.Plain language summaryGingival architecture plays a crucial role in achieving smile harmony. For patients seeking an esthetic smile, periodontal plastic surgery can be a valuable option, as it can improve the harmony between the teeth and the gingiva. Excessive gingiva display can be managed using various treatment approaches, depending on the etiology. When periodontal surgery is a part of the treatment plan, the procedure can be digitally planned using a 3D diagnostic design and seamlessly transferred to the surgical field through a 3D printed surgical template. The present research aimed to evaluate the influence of surgical guide design, gingival thickness, and surgical blade type on the accuracy of the periodontal surgery. Two different designs of surgical templates, providing a different degree of guidance, as well as 2 types of surgical blades were used to simulate the surgical procedure. To evaluate the aforementioned parameters, models with 2 different gingival mask thickness were used. Based to the results of the present study, gingival thickness, surgical template design, and blade type can significantly affect the accuracy of the surgery procedure.
{"title":"Influence of soft tissue thickness, blade type, and guide design, on computer‐assisted esthetic crown lengthening","authors":"Panagiotis Ntovas, Lorenzo Tavelli, Basir A. Barmak, Ronald E. Jung, Maria‐Elisa Galarraga‐Vinueza","doi":"10.1002/jper.24-0860","DOIUrl":"https://doi.org/10.1002/jper.24-0860","url":null,"abstract":"BackgroundThe aim of this study was to evaluate the effect of surgical guide design and type of blade, in relation to soft tissue thickness, on the accuracy of computer‐assisted crown lengthening.MethodsA set of fully dentate anatomic maxilla models was implemented, using 2 types of soft‐tissue masks with a mean thickness of 1.5 and 3.5 mm, respectively, to simulate a clinical scenario of altered passive eruption. In total, 5 different gingivectomy techniques were assessed, implementing 3 different types of guidance and 2 different blades. The osteotomy was performed using 2 surgical guide designs. After each operation, the models were scanned and superimposed with the initial virtual design, to evaluate the accuracy of each evaluated approach through a set of linear measurements.ResultsFor the gingivectomy as well as for the osteotomy, the mean discrepancy was increased in the presence of increased soft tissue thickness (<jats:italic>p</jats:italic> < 0.05). The integration of supporting planes led to a decrease in the discrepancy compared to the conventional double guide design for both of the investigated soft‐tissue thicknesses (<jats:italic>p</jats:italic> < 0.05). For the models with the normal soft tissue thickness, a lower mean discrepancy was presented, when a mini blade was used instead of a conventional surgical blade, irrespective of the guide design (<jats:italic>p</jats:italic> < 0.05).ConclusionComputer‐assisted crown lengthening can be considered a feasible treatment option. Soft tissue thickness has to be taken into consideration during the design of the surgical template, in order additional support to be provided when it is needed. Surgical templates with integrated supporting planes can increase the accuracy of computer‐assisted crown lengthening.Plain language summaryGingival architecture plays a crucial role in achieving smile harmony. For patients seeking an esthetic smile, periodontal plastic surgery can be a valuable option, as it can improve the harmony between the teeth and the gingiva. Excessive gingiva display can be managed using various treatment approaches, depending on the etiology. When periodontal surgery is a part of the treatment plan, the procedure can be digitally planned using a 3D diagnostic design and seamlessly transferred to the surgical field through a 3D printed surgical template. The present research aimed to evaluate the influence of surgical guide design, gingival thickness, and surgical blade type on the accuracy of the periodontal surgery. Two different designs of surgical templates, providing a different degree of guidance, as well as 2 types of surgical blades were used to simulate the surgical procedure. To evaluate the aforementioned parameters, models with 2 different gingival mask thickness were used. Based to the results of the present study, gingival thickness, surgical template design, and blade type can significantly affect the accuracy of the surgery procedure.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"15 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mina Youssef, Dimitris N. Tatakis, Catherine Demko, Gian Pietro Schincaglia
BackgroundThe widespread adoption of digital technologies in dentistry has transformed workflows and practices. However, limited, if any, information is available on the extent of digital workflow integration in periodontics. This study aims to evaluate literacy, utilization, and knowledge of digital technologies, specifically implant navigation systems, among American board‐certified periodontists.MethodsThis study utilized a survey with 16 multiple choice questions, sent through an online survey tool. Associations of survey responses with demographics, that is, experience (implant case load) and practice type, were statistically analyzed.ResultsA significant proportion of periodontists have incorporated digital technologies into their practices, with a majority utilizing cone beam computed tomography (CBCT) scanners and implant planning software. However, the adoption of more advanced technologies, such as dynamic or robotic navigation, remains limited. There was a significant difference in dynamic navigation utilization by participant experience and in robotic navigation utilization by practice type. Among the study participants, 40% reported the use of static navigation, with a notable percentage reporting its benefits in terms of increased accuracy and reduced morbidity for implant placement surgery. Despite a prevailing belief that digital tools are particularly valuable in complex cases, concerns about cost, complexity, and necessity were expressed regarding the adoption of these technologies.ConclusionThere is widespread utilization of certain digital technologies, for example, three‐dimensional radiography and static navigation, and very limited utilization of others, for example, robotic navigation, among US periodontists. Further research is needed to provide evidence of the benefits and efficacy of these technologies.Plain language summaryA questionnaire was sent to implant and gum disease specialists in the United States, focused on evaluating the level of usage and understanding of different digital technologies in the field of implant placement in dentistry. Specialists were asked to answer questions related to their experience in the field, the kind of dental practice they were working at (corporate, private, or academic institution), and if they were using any of the available new dental technologies (including dental implant robots) in their practice. Results showed that most of the responding specialists were using 3D dental X‐ray machines and software for planning the positions of dental implants on 3D X‐rays, and around 40% of respondents were 3D‐printing a resin template (guide) to facilitate accurate dental implant placement in the planned position. However, the usage of more advanced technologies, such as robotic arms, has not yet been widely adopted. It was clear that the kind of technology used was greatly affected by the kind of dental practice, and advanced technologies are used more in academic institutions than in an
{"title":"Knowledge and use of digital technologies in periodontal practices in the United States: A survey study","authors":"Mina Youssef, Dimitris N. Tatakis, Catherine Demko, Gian Pietro Schincaglia","doi":"10.1002/jper.24-0306","DOIUrl":"https://doi.org/10.1002/jper.24-0306","url":null,"abstract":"BackgroundThe widespread adoption of digital technologies in dentistry has transformed workflows and practices. However, limited, if any, information is available on the extent of digital workflow integration in periodontics. This study aims to evaluate literacy, utilization, and knowledge of digital technologies, specifically implant navigation systems, among American board‐certified periodontists.MethodsThis study utilized a survey with 16 multiple choice questions, sent through an online survey tool. Associations of survey responses with demographics, that is, experience (implant case load) and practice type, were statistically analyzed.ResultsA significant proportion of periodontists have incorporated digital technologies into their practices, with a majority utilizing cone beam computed tomography (CBCT) scanners and implant planning software. However, the adoption of more advanced technologies, such as dynamic or robotic navigation, remains limited. There was a significant difference in dynamic navigation utilization by participant experience and in robotic navigation utilization by practice type. Among the study participants, 40% reported the use of static navigation, with a notable percentage reporting its benefits in terms of increased accuracy and reduced morbidity for implant placement surgery. Despite a prevailing belief that digital tools are particularly valuable in complex cases, concerns about cost, complexity, and necessity were expressed regarding the adoption of these technologies.ConclusionThere is widespread utilization of certain digital technologies, for example, three‐dimensional radiography and static navigation, and very limited utilization of others, for example, robotic navigation, among US periodontists. Further research is needed to provide evidence of the benefits and efficacy of these technologies.Plain language summaryA questionnaire was sent to implant and gum disease specialists in the United States, focused on evaluating the level of usage and understanding of different digital technologies in the field of implant placement in dentistry. Specialists were asked to answer questions related to their experience in the field, the kind of dental practice they were working at (corporate, private, or academic institution), and if they were using any of the available new dental technologies (including dental implant robots) in their practice. Results showed that most of the responding specialists were using 3D dental X‐ray machines and software for planning the positions of dental implants on 3D X‐rays, and around 40% of respondents were 3D‐printing a resin template (guide) to facilitate accurate dental implant placement in the planned position. However, the usage of more advanced technologies, such as robotic arms, has not yet been widely adopted. It was clear that the kind of technology used was greatly affected by the kind of dental practice, and advanced technologies are used more in academic institutions than in an","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"183 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhao Wang, Ju Han Song, Jung-Woo Kim, Seung-Hee Kwon, Xianyu Piao, Sin-Hye Oh, Suk-Gyun Park, Sun-Hun Kim, Je-Hwang Ryu, Ok-Su Kim, Jeong-Tae Koh
<p><strong>Background: </strong>Periodontitis is a destructive disease that affects periodontal tissue. While current research focuses on disease management, research on tissue repair remains limited. Metformin, a first-line medication for diabetes treatment, has positive effects on bone health in nondiabetic patients. However, its potential for repairing periodontal tissue remains unclear. Therefore, this study aimed to evaluate the reparative effects of metformin on periodontitis-damaged periodontal tissue in mice.</p><p><strong>Methods: </strong>A mouse model of periodontal repair was used, in which silk ligatures were removed from the molars after inducing periodontitis, followed by metformin administration. Histomorphometric and histological analyses were conducted to assess comprehensive repair of the periodontium. Additional in vitro studies were conducted to determine the effect of metformin on the function of the individual cells that comprise the periodontium.</p><p><strong>Results: </strong>Metformin treatment promoted the repair of periodontal ligament, alveolar bone, and cementum affected by periodontitis, as evaluated using microcomputed tomography based morphometric and histologic analyses. The therapeutic effect was linked to mitigating persistent inflammatory activity during periodontitis resolution, primarily attributed to the sustained presence of interleukin-1 beta (IL-1β), which may delay tissue repair. In vitro studies simulating this pathological condition showed that AMP-activated protein kinase (AMPK) activation by metformin counteracted the effect of IL-1β, inhibited osteoclast differentiation and restored the osteogenic differentiation capacity of periodontal ligament cells and cementoblasts.</p><p><strong>Conclusion: </strong>These findings suggest that metformin holds promise for repairing periodontal tissue following periodontitis, potentially through modulating inflammatory responses and regulating cellular differentiation processes.</p><p><strong>Plain language summary: </strong>Periodontitis is a serious gum disease that destroys the structures that support the teeth, such as ligaments and bone. While current treatments focus on preventing further damage, little progress has been made in achieving complete restoration of damaged tissue. In this study, we investigated whether metformin, a common diabetes drug, could help repair periodontal tissue. Using a mouse model of periodontitis, we removed ligatures placed around the teeth to allow healing, followed by metformin treatment. Our results showed that metformin promoted the repair of key tissues such as the periodontal ligament, alveolar bone, and cementum. An important observation in this study is the persistence of inflammatory activity during periodontitis resolution, where prolonged inflammation, driven by molecules such as interleukin-1β (IL-1β), appears to hinder tissue recovery. Metformin was found to counteract prolonged inflammation by reducing IL-1β acti
{"title":"Metformin reverses periodontal destruction caused by experimental periodontitis by inhibiting interleukin-1β activity.","authors":"Zhao Wang, Ju Han Song, Jung-Woo Kim, Seung-Hee Kwon, Xianyu Piao, Sin-Hye Oh, Suk-Gyun Park, Sun-Hun Kim, Je-Hwang Ryu, Ok-Su Kim, Jeong-Tae Koh","doi":"10.1002/JPER.24-0684","DOIUrl":"https://doi.org/10.1002/JPER.24-0684","url":null,"abstract":"<p><strong>Background: </strong>Periodontitis is a destructive disease that affects periodontal tissue. While current research focuses on disease management, research on tissue repair remains limited. Metformin, a first-line medication for diabetes treatment, has positive effects on bone health in nondiabetic patients. However, its potential for repairing periodontal tissue remains unclear. Therefore, this study aimed to evaluate the reparative effects of metformin on periodontitis-damaged periodontal tissue in mice.</p><p><strong>Methods: </strong>A mouse model of periodontal repair was used, in which silk ligatures were removed from the molars after inducing periodontitis, followed by metformin administration. Histomorphometric and histological analyses were conducted to assess comprehensive repair of the periodontium. Additional in vitro studies were conducted to determine the effect of metformin on the function of the individual cells that comprise the periodontium.</p><p><strong>Results: </strong>Metformin treatment promoted the repair of periodontal ligament, alveolar bone, and cementum affected by periodontitis, as evaluated using microcomputed tomography based morphometric and histologic analyses. The therapeutic effect was linked to mitigating persistent inflammatory activity during periodontitis resolution, primarily attributed to the sustained presence of interleukin-1 beta (IL-1β), which may delay tissue repair. In vitro studies simulating this pathological condition showed that AMP-activated protein kinase (AMPK) activation by metformin counteracted the effect of IL-1β, inhibited osteoclast differentiation and restored the osteogenic differentiation capacity of periodontal ligament cells and cementoblasts.</p><p><strong>Conclusion: </strong>These findings suggest that metformin holds promise for repairing periodontal tissue following periodontitis, potentially through modulating inflammatory responses and regulating cellular differentiation processes.</p><p><strong>Plain language summary: </strong>Periodontitis is a serious gum disease that destroys the structures that support the teeth, such as ligaments and bone. While current treatments focus on preventing further damage, little progress has been made in achieving complete restoration of damaged tissue. In this study, we investigated whether metformin, a common diabetes drug, could help repair periodontal tissue. Using a mouse model of periodontitis, we removed ligatures placed around the teeth to allow healing, followed by metformin treatment. Our results showed that metformin promoted the repair of key tissues such as the periodontal ligament, alveolar bone, and cementum. An important observation in this study is the persistence of inflammatory activity during periodontitis resolution, where prolonged inflammation, driven by molecules such as interleukin-1β (IL-1β), appears to hinder tissue recovery. Metformin was found to counteract prolonged inflammation by reducing IL-1β acti","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jung-Tae Lee, Seok Hyun Lee, Baek Sun Choi, Sungtae Kim
<p><strong>Background: </strong>Collagenated bovine bone mineral (CBBM) is used for maxillary sinus elevation-based augmentation. We compared collagen degradation in cross-linked (CL) CBBM and non-cross-linked (NCL) CBBM (in vitro) and preclinical results in CBBM-CL, CBBM-NCL, deproteinized bovine bone mineral (DBBM), and DBBM with fibrin sealant grafts (in vivo) after repair of perforated Schneiderian membrane (SM).</p><p><strong>Methods: </strong>Collagenase-based degradation rates of CBBM-CL and CBBM-NCL were compared in vitro and in vivo (CBBM-CL, CBBM-NCL, DBBM, and DBBM with fibrin glue; n = 12 defects per group). After bilateral maxillary SM perforation (5 mm) during sinus elevation, we performed bone substitute-based augmentation. At 4 and 12 weeks postoperatively, volumetric, histologic, and histomorphometric analyses were performed.</p><p><strong>Results: </strong>Complete degradation and 33% retention of collagen content after 24 and 72 h were noted in CBBM-NCL and CBBM-CL, respectively. CBBM-NCL demonstrated significant differences in total augmentation volume (TAV) compared to DBBM and DBBM with fibrin glue, as well as in new bone volume (NBV) compared to DBBM with fibrin glue. At 12 weeks, significant differences were observed between CBBM-NCL and DBBM in NBV. There were no significant differences across all groups in vertical bone increase in 4 and 12 weeks. DBBM and DBBM with fibrin glue showed more irregularly shaped patterns than CBBM-CL and CBBM-NCL. At 12 weeks, ossification progressed in all groups. At 4 weeks, DBBM with fibrin glue seemed to demonstrate early ossification at the perforation site in histological observations compared to DBBM alone; however, no differences were observed at 12 weeks.</p><p><strong>Conclusion: </strong>CBBM for perforated SM repair confers bone stability and ossification. CBBM-CL was noninferior to CBBM-NCL in volume stability. The findings indicate that the CL collagen in CBBM-CL contributes to enhanced graft stability over time. Fibrin glue appeared to have a positive effect on early ossification in histological evaluations, but this effect was not evident at 12 weeks.</p><p><strong>Plain language summary: </strong>Collagenated bovine bone mineral (CBBM) is used for maxillary sinus elevation-based augmentation. We compared collagen degradation in cross-linked (CL) CBBM and non-cross-linked (NCL) CBBM (in vitro) and preclinical results in CBBM-CL, CBBM-NCL, deproteinized bovine bone mineral (DBBM), and DBBM with fibrin sealant (in vivo) after repair of perforated Schneiderian membrane (SM). After bilateral maxillary SM perforation (5 mm) during sinus elevation, we performed bone substitute-based augmentation. At 4 and 12 weeks postoperatively, volumetric, histologic, as well as histomorphometric analyses were performed. Based on this study, CL collagen in CBBM-CL contributes to enhanced graft stability over time. Fibrin glue appeared to have a positive effect on early ossification in histologic
{"title":"Comparison of four bone substitute types in sinus augmentation with perforated Schneiderian membrane: An experimental study.","authors":"Jung-Tae Lee, Seok Hyun Lee, Baek Sun Choi, Sungtae Kim","doi":"10.1002/JPER.24-0663","DOIUrl":"https://doi.org/10.1002/JPER.24-0663","url":null,"abstract":"<p><strong>Background: </strong>Collagenated bovine bone mineral (CBBM) is used for maxillary sinus elevation-based augmentation. We compared collagen degradation in cross-linked (CL) CBBM and non-cross-linked (NCL) CBBM (in vitro) and preclinical results in CBBM-CL, CBBM-NCL, deproteinized bovine bone mineral (DBBM), and DBBM with fibrin sealant grafts (in vivo) after repair of perforated Schneiderian membrane (SM).</p><p><strong>Methods: </strong>Collagenase-based degradation rates of CBBM-CL and CBBM-NCL were compared in vitro and in vivo (CBBM-CL, CBBM-NCL, DBBM, and DBBM with fibrin glue; n = 12 defects per group). After bilateral maxillary SM perforation (5 mm) during sinus elevation, we performed bone substitute-based augmentation. At 4 and 12 weeks postoperatively, volumetric, histologic, and histomorphometric analyses were performed.</p><p><strong>Results: </strong>Complete degradation and 33% retention of collagen content after 24 and 72 h were noted in CBBM-NCL and CBBM-CL, respectively. CBBM-NCL demonstrated significant differences in total augmentation volume (TAV) compared to DBBM and DBBM with fibrin glue, as well as in new bone volume (NBV) compared to DBBM with fibrin glue. At 12 weeks, significant differences were observed between CBBM-NCL and DBBM in NBV. There were no significant differences across all groups in vertical bone increase in 4 and 12 weeks. DBBM and DBBM with fibrin glue showed more irregularly shaped patterns than CBBM-CL and CBBM-NCL. At 12 weeks, ossification progressed in all groups. At 4 weeks, DBBM with fibrin glue seemed to demonstrate early ossification at the perforation site in histological observations compared to DBBM alone; however, no differences were observed at 12 weeks.</p><p><strong>Conclusion: </strong>CBBM for perforated SM repair confers bone stability and ossification. CBBM-CL was noninferior to CBBM-NCL in volume stability. The findings indicate that the CL collagen in CBBM-CL contributes to enhanced graft stability over time. Fibrin glue appeared to have a positive effect on early ossification in histological evaluations, but this effect was not evident at 12 weeks.</p><p><strong>Plain language summary: </strong>Collagenated bovine bone mineral (CBBM) is used for maxillary sinus elevation-based augmentation. We compared collagen degradation in cross-linked (CL) CBBM and non-cross-linked (NCL) CBBM (in vitro) and preclinical results in CBBM-CL, CBBM-NCL, deproteinized bovine bone mineral (DBBM), and DBBM with fibrin sealant (in vivo) after repair of perforated Schneiderian membrane (SM). After bilateral maxillary SM perforation (5 mm) during sinus elevation, we performed bone substitute-based augmentation. At 4 and 12 weeks postoperatively, volumetric, histologic, as well as histomorphometric analyses were performed. Based on this study, CL collagen in CBBM-CL contributes to enhanced graft stability over time. Fibrin glue appeared to have a positive effect on early ossification in histologic","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica D Koster, David E Deas, Archontia Palaiologou, David J Lasho, Anibal Diogenes
Background: The purpose of this randomized, three-armed clinical trial is to determine if a postoperative injection of 0.5% bupivacaine is more effective than 2% lidocaine in controlling pain after periodontal flap surgery.
Methods: Seventy-six patients planned for similar periodontal surgeries were included. Prior to surgery, patients were randomized to receive one cartridge (1.7 mL) of either 2% lidocaine, 0.5% bupivacaine, or 0.9% sodium chloride as a local injection immediately postoperatively. A standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen was used to manage postoperative pain. Patients recorded pain levels on a 21-point numerical rating scale (NRS-21) as well as analgesic usage via a phone application at 4, 8, 12, 24, and 48 h, postoperatively.
Results: While NRS-21 data suggested a consistent trend toward decreased pain with both bupivacaine and lidocaine administration compared with placebo, there were no statistically significant differences in pain response or analgesic usage at any time between the three groups.
Conclusions: This study showed no statistically significant differences in pain or analgesic usage after periodontal flap surgery following postoperative injections with either bupivacaine, lidocaine, or placebo.
Plain language summary: Long-acting local anesthetic, notably bupivacaine, has been given immediately following dental procedures to reduce the amount of postoperative pain and discomfort. This study aimed to study the immediate effects of bupivacaine compared with a shorter acting local anesthetic (lidocaine) and a placebo (0.9% sodium chloride). Seventy-six patients underwent various dental surgeries where reflection of the soft tissue was performed. At the conclusion of surgery, patients were randomized into one of the three groups and the appropriate blinded cartridge of bupivacaine, lidocaine, or placebo was injected into the surgical site. Patients reported their pain on a numeric rating scale from 0-10 (NRS-21) as well as the number of pain medications taken via a phone application at 4, 8, 12, 24, and 48 h after the surgery. Demographic and secondary variables such as amount of anesthetic given and length of surgery were also collected. While NRS-21 data suggested a consistent trend toward decreased pain with both bupivacaine and lidocaine administration compared with placebo, there were no significant differences in pain response or pain medication usage at any time between the three groups.
{"title":"Immediate postoperative anesthesia with either lidocaine or bupivacaine: A short-term clinical response.","authors":"Jessica D Koster, David E Deas, Archontia Palaiologou, David J Lasho, Anibal Diogenes","doi":"10.1002/JPER.25-0045","DOIUrl":"https://doi.org/10.1002/JPER.25-0045","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this randomized, three-armed clinical trial is to determine if a postoperative injection of 0.5% bupivacaine is more effective than 2% lidocaine in controlling pain after periodontal flap surgery.</p><p><strong>Methods: </strong>Seventy-six patients planned for similar periodontal surgeries were included. Prior to surgery, patients were randomized to receive one cartridge (1.7 mL) of either 2% lidocaine, 0.5% bupivacaine, or 0.9% sodium chloride as a local injection immediately postoperatively. A standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen was used to manage postoperative pain. Patients recorded pain levels on a 21-point numerical rating scale (NRS-21) as well as analgesic usage via a phone application at 4, 8, 12, 24, and 48 h, postoperatively.</p><p><strong>Results: </strong>While NRS-21 data suggested a consistent trend toward decreased pain with both bupivacaine and lidocaine administration compared with placebo, there were no statistically significant differences in pain response or analgesic usage at any time between the three groups.</p><p><strong>Conclusions: </strong>This study showed no statistically significant differences in pain or analgesic usage after periodontal flap surgery following postoperative injections with either bupivacaine, lidocaine, or placebo.</p><p><strong>Plain language summary: </strong>Long-acting local anesthetic, notably bupivacaine, has been given immediately following dental procedures to reduce the amount of postoperative pain and discomfort. This study aimed to study the immediate effects of bupivacaine compared with a shorter acting local anesthetic (lidocaine) and a placebo (0.9% sodium chloride). Seventy-six patients underwent various dental surgeries where reflection of the soft tissue was performed. At the conclusion of surgery, patients were randomized into one of the three groups and the appropriate blinded cartridge of bupivacaine, lidocaine, or placebo was injected into the surgical site. Patients reported their pain on a numeric rating scale from 0-10 (NRS-21) as well as the number of pain medications taken via a phone application at 4, 8, 12, 24, and 48 h after the surgery. Demographic and secondary variables such as amount of anesthetic given and length of surgery were also collected. While NRS-21 data suggested a consistent trend toward decreased pain with both bupivacaine and lidocaine administration compared with placebo, there were no significant differences in pain response or pain medication usage at any time between the three groups.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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