Yaniv Mayer, Eran Gabay, Amin Younis, Ofir Ginesin, Rafael S. Siroma, Shlomo Barak, Ido Georgy, Yoni Friedlander, Thabet Asbi, Hadar Giladi Zigdon, Jamil A. Shibli
BackgroundPulsed electromagnetic field (PEMF) therapy, renowned for its immunomodulatory effects and established efficacy in orthopedics, shows promise for managing peri‐implantitis by reducing soft tissue inflammation and marginal bone loss. This study aimed to compare the long‐term clinical and radiographic outcomes of nonsurgical peri‐implantitis treatment with and without PEMF therapy. This multicenter retrospective‐prospective analysis combined data from two centers.MethodsThirty‐three patients, with a total of 47 implants displaying peri‐implantitis diagnosed with pocket probing depths (PD) of 6–8 mm with bleeding on probing (BoP) and crestal bone loss ranging from 3–5 mm, completed this study. Nonsurgical mechanical debridement was conducted, and a novel healing abutment integrating active (25 test) or inactive (22 control) PEMF was installed. The abutments with PEMF provided an exposure ratio of 1/500–1/5000, an intensity of 0.05–0.5 mT, and a frequency of 10–50 kHz for 30 days. Patients were evaluated at baseline (T0), 3 months (T1), and 20 months (T2), assessing plaque index (PI), BoP, PD, recession depth (REC), suppuration (SUP), and radiographically measured vertical bone loss (VBL).ResultsFollow‐up assessments revealed a significantly lower mean of PD at the deepest site and BoP in the test group after a mean time of 20 months compared to the control (p < 0.001). Furthermore, within the test group, PD at the deepest site and mean PD decreased significantly between T0 and T2 (7.1 ± 1.5 mm to 4.6 ± 0.73 mm, 5.3 ± 1.3 mm to 3.7 ± 1.2 mm, respectively; p < 0.05). A decrease in mean PD was also observed in the control group for the latter (6.8 ± 1.1 mm to 5.4 ± 1.4 mm; p < 0.05). Although not significant, a positive trend was observed for VBL after 1 year in the test group compared to the control (0.2 ± 0.4 mm vs. −0.3 ± 0.11 mm). The clinical end point (PD < 5 mm, absence of BoP and/or SUP, and no bone loss) was 54.54% and 68% for the control and test group, respectively.ConclusionsThese findings suggest that focused PEMF therapy could offer a nonsurgical solution for peri‐implantitis that can achieve the clinical goals. Nevertheless, larger samples and longer follow‐ups are needed to understand its long‐term benefits and limitations.Plain Language SummaryThe nonsurgical treatments of dental implant infections often result in a limited impact of the inflammation, reducing the bleeding on the gums around the implants. To overcome this limitation during treatment, this study evaluated the pulsed electromagnetic field (PEMF) employed in several medical fields, such orthopedics, for its immunomodulatory and bone‐healing properties. A small device was coupled with the dental implant to release the pulse. The PEMF associated with nonsurgical debridement in the gums around diseased implants demonstrated that PEMF therapy improved the healthy status of t
脉冲电磁场（PEMF）疗法以其免疫调节作用和在骨科中已确立的疗效而闻名，通过减少软组织炎症和边缘骨质流失，有望治疗种植体周围炎。本研究旨在比较使用和不使用PEMF治疗的非手术治疗种植体周围炎的长期临床和影像学结果。这项多中心回顾性-前瞻性分析结合了两个中心的数据。方法33例患者共47颗种植体，均表现为种植体周围炎，诊断为口袋探查深度（PD）为6 - 8mm，探查时出血（BoP）和嵴骨丢失（3-5 mm）。进行了非手术机械清创，并安装了一种新型愈合基台，整合了活性（25测试）或非活性（22对照）的PEMF。使用PEMF的基台暴露比为1/500-1/5000，强度为0.05-0.5 mT，频率为10-50 kHz，持续30天。在基线（T0）、3个月（T1）和20个月（T2）对患者进行评估，评估斑块指数（PI）、BoP、PD、衰退深度（REC）、化脓（SUP）和x线测量的垂直骨丢失（VBL）。结果随访评估显示，平均20个月后，实验组最深部位PD和BoP的平均值明显低于对照组(p <；0.001)。此外，在试验组内，最深部位PD和平均PD在T0和T2之间显著降低（分别为7.1±1.5 mm至4.6±0.73 mm, 5.3±1.3 mm至3.7±1.2 mm）；p & lt;0.05)。后者的平均PD也在对照组中下降（6.8±1.1 mm至5.4±1.4 mm）；p & lt;0.05)。虽然不显著，但与对照组相比，试验组1年后VBL呈阳性趋势（0.2±0.4 mm vs - 0.3±0.11 mm）。临床终点(PD <；5 mm，无BoP和/或SUP，无骨质流失)，对照组和试验组分别为54.54%和68%。结论有针对性的脉冲电磁场治疗可以提供一种非手术治疗种植体周围炎的方法，可以达到临床目的。然而，需要更大的样本和更长时间的随访来了解其长期益处和局限性。牙种植体感染的非手术治疗通常导致炎症的影响有限，减少了种植体周围牙龈的出血。为了克服治疗过程中的这一局限性，本研究评估了脉冲电磁场（PEMF）在骨科等多个医学领域的免疫调节和骨愈合特性。一个小装置与牙齿植入物连接以释放脉冲。对患病种植体周围牙龈进行非手术清创的PEMF相关研究表明，治疗后12-26个月，PEMF治疗改善了这些种植体的健康状况。研究结果表明，无创PEMF治疗病变种植体的潜在临床益处。
{"title":"Pulsed electromagnetic field therapy on nonsurgical treatment of peri‐implantitis: 12–26 months follow‐up","authors":"Yaniv Mayer, Eran Gabay, Amin Younis, Ofir Ginesin, Rafael S. Siroma, Shlomo Barak, Ido Georgy, Yoni Friedlander, Thabet Asbi, Hadar Giladi Zigdon, Jamil A. Shibli","doi":"10.1002/jper.11384","DOIUrl":"https://doi.org/10.1002/jper.11384","url":null,"abstract":"BackgroundPulsed electromagnetic field (PEMF) therapy, renowned for its immunomodulatory effects and established efficacy in orthopedics, shows promise for managing peri‐implantitis by reducing soft tissue inflammation and marginal bone loss. This study aimed to compare the long‐term clinical and radiographic outcomes of nonsurgical peri‐implantitis treatment with and without PEMF therapy. This multicenter retrospective‐prospective analysis combined data from two centers.MethodsThirty‐three patients, with a total of 47 implants displaying peri‐implantitis diagnosed with pocket probing depths (PD) of 6–8 mm with bleeding on probing (BoP) and crestal bone loss ranging from 3–5 mm, completed this study. Nonsurgical mechanical debridement was conducted, and a novel healing abutment integrating active (25 test) or inactive (22 control) PEMF was installed. The abutments with PEMF provided an exposure ratio of 1/500–1/5000, an intensity of 0.05–0.5 mT, and a frequency of 10–50 kHz for 30 days. Patients were evaluated at baseline (T0), 3 months (T1), and 20 months (T2), assessing plaque index (PI), BoP, PD, recession depth (REC), suppuration (SUP), and radiographically measured vertical bone loss (VBL).ResultsFollow‐up assessments revealed a significantly lower mean of PD at the deepest site and BoP in the test group after a mean time of 20 months compared to the control (<jats:italic>p</jats:italic> < 0.001). Furthermore, within the test group, PD at the deepest site and mean PD decreased significantly between T0 and T2 (7.1 ± 1.5 mm to 4.6 ± 0.73 mm, 5.3 ± 1.3 mm to 3.7 ± 1.2 mm, respectively; <jats:italic>p</jats:italic> < 0.05). A decrease in mean PD was also observed in the control group for the latter (6.8 ± 1.1 mm to 5.4 ± 1.4 mm; <jats:italic>p</jats:italic> < 0.05). Although not significant, a positive trend was observed for VBL after 1 year in the test group compared to the control (0.2 ± 0.4 mm vs. −0.3 ± 0.11 mm). The clinical end point (PD < 5 mm, absence of BoP and/or SUP, and no bone loss) was 54.54% and 68% for the control and test group, respectively.ConclusionsThese findings suggest that focused PEMF therapy could offer a nonsurgical solution for peri‐implantitis that can achieve the clinical goals. Nevertheless, larger samples and longer follow‐ups are needed to understand its long‐term benefits and limitations.Plain Language SummaryThe nonsurgical treatments of dental implant infections often result in a limited impact of the inflammation, reducing the bleeding on the gums around the implants. To overcome this limitation during treatment, this study evaluated the pulsed electromagnetic field (PEMF) employed in several medical fields, such orthopedics, for its immunomodulatory and bone‐healing properties. A small device was coupled with the dental implant to release the pulse. The PEMF associated with nonsurgical debridement in the gums around diseased implants demonstrated that PEMF therapy improved the healthy status of t","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763317","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}
Julia C. Bond, Mabeline Velez, Robert McDonough, Sharon M. Casey, Lauren A. Wise, Yvette C. Cozier, Matthew P. Fox, Raul I. Garcia, Brenda Heaton
BackgroundSelf‐reported data can extend the reach of oral health research, but “Don't know” responses may threaten validity. We explored characteristics of participants who responded “Don't know” to a periodontal health question across three distinct cohorts.MethodsWe used data from three questionnaire‐based observational studies, namely, the Pregnancy Study Online (PRESTO) (N = 10,996), the Black Women's Health Study (BWHS) (N = 479), and the National Health and Nutrition Examination Survey (NHANES) (N = 15,502), to evaluate responses to questionnaire items related to periodontal health (e.g., “Has a dentist or dental hygienist ever told you that you have periodontitis or gum disease?”). We compared sociodemographic and behavioral factors across each response category (“Yes,” “No,” “Don't know”). We used Monte Carlo simulation to create multiple datasets of 100,000 participants under different scenarios to calculate the percent change in observed effect estimates in analyses using the full cohort compared to analytic cohorts excluding “Don't know” respondents.Results“Don't know” prevalences ranged from 1.6% to 4.1%. We observed differences between “Don't know” responders and those who answered “Yes” or “No” across all three cohorts. “Don't know” responders were more likely to have lower educational attainment, lower income, and reduced engagement with oral healthcare services. We observed substantial bias in complete‐case effect estimates in some simulated scenarios. Bias was larger when the underlying population prevalence of “Don't know” responses was higher.Conclusions“Don't know” responders had distinct patterns of sociodemographic characteristics and oral healthcare engagement. The degree of bias in complete‐case analysis was dependent on simulated factors.Plain Language SummaryResearch about oral health often asks people to answer questions about their teeth and gums. Sometimes people respond that they “Don't know” the answer to these questions, which can make data challenging for researchers to analyze. In this study, we used three different data sources to look at whether there were particular characteristics that were more common among people who said they “Don't know” in response to a question about their gum health. “Don't know” responses were not very common in any of the three groups, ranging from 1.6% in a representative survey of people in the United States to 4.1% in a group of women in the United States and Canada trying to become pregnant. In all three groups, people who said “Don't know” had a lower household income, less education, and were less likely to have seen a dentist recently. We also used simulated datasets to evaluate when excluding people who responded “Don't know” would be expected to cause the most bias in analyses. The expected bias increased with the number of “Don't know” responses in the data.
{"title":"Multi‐cohort evaluation of “Don't know” responders to self‐report oral health questions: Implications for etiologic research","authors":"Julia C. Bond, Mabeline Velez, Robert McDonough, Sharon M. Casey, Lauren A. Wise, Yvette C. Cozier, Matthew P. Fox, Raul I. Garcia, Brenda Heaton","doi":"10.1002/jper.11378","DOIUrl":"https://doi.org/10.1002/jper.11378","url":null,"abstract":"BackgroundSelf‐reported data can extend the reach of oral health research, but “Don't know” responses may threaten validity. We explored characteristics of participants who responded “Don't know” to a periodontal health question across three distinct cohorts.MethodsWe used data from three questionnaire‐based observational studies, namely, the Pregnancy Study Online (PRESTO) (<jats:italic>N</jats:italic> = 10,996), the Black Women's Health Study (BWHS) (<jats:italic>N</jats:italic> = 479), and the National Health and Nutrition Examination Survey (NHANES) (<jats:italic>N</jats:italic> = 15,502), to evaluate responses to questionnaire items related to periodontal health (e.g., “Has a dentist or dental hygienist ever told you that you have periodontitis or gum disease?”). We compared sociodemographic and behavioral factors across each response category (“Yes,” “No,” “Don't know”). We used Monte Carlo simulation to create multiple datasets of 100,000 participants under different scenarios to calculate the percent change in observed effect estimates in analyses using the full cohort compared to analytic cohorts excluding “Don't know” respondents.Results“Don't know” prevalences ranged from 1.6% to 4.1%. We observed differences between “Don't know” responders and those who answered “Yes” or “No” across all three cohorts. “Don't know” responders were more likely to have lower educational attainment, lower income, and reduced engagement with oral healthcare services. We observed substantial bias in complete‐case effect estimates in some simulated scenarios. Bias was larger when the underlying population prevalence of “Don't know” responses was higher.Conclusions“Don't know” responders had distinct patterns of sociodemographic characteristics and oral healthcare engagement. The degree of bias in complete‐case analysis was dependent on simulated factors.Plain Language SummaryResearch about oral health often asks people to answer questions about their teeth and gums. Sometimes people respond that they “Don't know” the answer to these questions, which can make data challenging for researchers to analyze. In this study, we used three different data sources to look at whether there were particular characteristics that were more common among people who said they “Don't know” in response to a question about their gum health. “Don't know” responses were not very common in any of the three groups, ranging from 1.6% in a representative survey of people in the United States to 4.1% in a group of women in the United States and Canada trying to become pregnant. In all three groups, people who said “Don't know” had a lower household income, less education, and were less likely to have seen a dentist recently. We also used simulated datasets to evaluate when excluding people who responded “Don't know” would be expected to cause the most bias in analyses. The expected bias increased with the number of “Don't know” responses in the data.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"1 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763324","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}
Shaghayegh Sobhani, Zheyan Liu, Cher L. Hoopes, Tammy Oung, Monicka Arora, Deepthi Sree Racha, Teresa Yang, Philip Kang, Fatemeh Momen‐Heravi
BackgroundType 2 diabetes (T2DM) and periodontitis have been suggested as risk factors for dental implant failure, but data supporting such a link are limited. This study investigates the association between T2DM and periodontitis and the risk of dental implant failure.MethodsA nested case‐control study with a risk‐set sampling scheme was performed. Implant failure cases (550 failed implants in 328 subjects) and controls (1156 implants in 502 subjects) with a mean of 59.07 months follow‐up were identified and information on patient‐related factors was collected from patient records. Univariate analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) between cases and controls. The impact of covariates and risk factors for implant failure was evaluated by multiple logistic regression.ResultsThe likelihood of implant failure was significantly elevated in smokers (OR = 2.70, 95% CI: 1.60–4.57), patients with T2DM (OR = 1.70, 95% CI: 1.11–2.61), and those with periodontitis (OR = 12.82, 95% CI: 7.12–23.08). The use of immunosuppressive medication also correlated with higher failure rates (OR = 2.75, 95% CI: 1.31–5.76). Stage III and IV periodontitis were associated with higher likelihood of implant failure, independent of T2DM and smoking (OR = 1.64, 95% CI: 1.24–2.18). Multivariate analysis identified independent risk factors, including periodontitis history, smoking, osteoporosis, and statin use, while adherence to periodontal maintenance significantly reduced failure risks. Implant placement in the maxilla short implant length (≤10 mm), and smoking were associated with early implant failure.ConclusionOur study findings substantiate the association between T2DM and periodontitis with an increased risk of dental implant failure. Our analysis underscores the influence of various patient‐related factors, including the use of immunosuppressive medications, smoking, and patient compliance, on the likelihood of implant failure.Plain Language SummaryPeople with type 2 diabetes or gum disease (also known as periodontitis) may face a higher chance of dental implants failing, but until now, evidence has been limited. This study looked at hundreds of people who had dental implants to see which factors might be linked to implant problems. It found that individuals who smoke, have diabetes, or have gum disease—especially advanced gum disease—are more likely to experience implant failure. Other health factors like taking immune‐suppressing medications, having osteoporosis, or using certain medications like statins also played a role. However, patients who kept up with regular dental cleanings and checkups were less likely to lose their implants. This research highlights the importance of managing health conditions and staying on top of dental care to improve the chances of successful dental implants.
{"title":"Periodontitis, type 2 diabetes, and other risk factors for implant failure: A nested case‐control study","authors":"Shaghayegh Sobhani, Zheyan Liu, Cher L. Hoopes, Tammy Oung, Monicka Arora, Deepthi Sree Racha, Teresa Yang, Philip Kang, Fatemeh Momen‐Heravi","doi":"10.1002/jper.11380","DOIUrl":"https://doi.org/10.1002/jper.11380","url":null,"abstract":"BackgroundType 2 diabetes (T2DM) and periodontitis have been suggested as risk factors for dental implant failure, but data supporting such a link are limited. This study investigates the association between T2DM and periodontitis and the risk of dental implant failure.MethodsA nested case‐control study with a risk‐set sampling scheme was performed. Implant failure cases (550 failed implants in 328 subjects) and controls (1156 implants in 502 subjects) with a mean of 59.07 months follow‐up were identified and information on patient‐related factors was collected from patient records. Univariate analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) between cases and controls. The impact of covariates and risk factors for implant failure was evaluated by multiple logistic regression.ResultsThe likelihood of implant failure was significantly elevated in smokers (OR = 2.70, 95% CI: 1.60–4.57), patients with T2DM (OR = 1.70, 95% CI: 1.11–2.61), and those with periodontitis (OR = 12.82, 95% CI: 7.12–23.08). The use of immunosuppressive medication also correlated with higher failure rates (OR = 2.75, 95% CI: 1.31–5.76). Stage III and IV periodontitis were associated with higher likelihood of implant failure, independent of T2DM and smoking (OR = 1.64, 95% CI: 1.24–2.18). Multivariate analysis identified independent risk factors, including periodontitis history, smoking, osteoporosis, and statin use, while adherence to periodontal maintenance significantly reduced failure risks. Implant placement in the maxilla short implant length (≤10 mm), and smoking were associated with early implant failure.ConclusionOur study findings substantiate the association between T2DM and periodontitis with an increased risk of dental implant failure. Our analysis underscores the influence of various patient‐related factors, including the use of immunosuppressive medications, smoking, and patient compliance, on the likelihood of implant failure.Plain Language SummaryPeople with type 2 diabetes or gum disease (also known as periodontitis) may face a higher chance of dental implants failing, but until now, evidence has been limited. This study looked at hundreds of people who had dental implants to see which factors might be linked to implant problems. It found that individuals who smoke, have diabetes, or have gum disease—especially advanced gum disease—are more likely to experience implant failure. Other health factors like taking immune‐suppressing medications, having osteoporosis, or using certain medications like statins also played a role. However, patients who kept up with regular dental cleanings and checkups were less likely to lose their implants. This research highlights the importance of managing health conditions and staying on top of dental care to improve the chances of successful dental implants.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"24 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736760","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}
Kaio Henrique Soares, Janelle Aguirre, Nathalia Vilela, Patrícia F. Gonçalves, Rafael Lazarin, Karin C. Schey, Poliana M. Duarte
BackgroundWhile several studies have compared the performance of alveolar ridge preservation (ARP) using different bone substitutes in terms of histological outcomes and maintenance of ridge dimensions, there is a lack of data comparing implant outcomes in ARP‐treated sites with different grafts. The aim of this retrospective cohort study was to compare the performance of dental implants placed in areas that underwent ARP with either allograft or xenograft, focusing on marginal bone loss, implant failure, and peri‐implantitis.MethodsPatient records were examined for those who received at least one dental implant in ARP areas, using either allograft or xenograft, or non‐grafted sockets. Implants were assessed for preloading crestal bone loss (PLCBL), post‐loading crestal bone loss (PoLCBL), early and late failure, and peri‐implantitis. Data were analyzed using bivariate methods and mixed‐effects Cox regression.ResultsA total of 509 implants in 390 subjects were analyzed. Implants in non‐grafted sockets or those with allograft or xenograft did not differ in PoLCBL ≥ 0.5 mm, early failure, late failure, or peri‐implantitis (<jats:italic>p</jats:italic> > 0.05). Implants placed in allograft‐treated sites had a significantly lower risk of developing PLCBL ≥ 0.5 mm (Hazard ratio [HR] = 0.84, 95% CI = 0.22 to 1.46; <jats:italic>p</jats:italic> = 0.0078), PLCBL ≥ 1.5 mm (HR = −1.27, 95% CI = −2.08 to −0.46; <jats:italic>p</jats:italic> = 0.0024), and PoLCBL ≥ 1.5 mm (HR = −1.14, 95% CI = −2.00 to −0.28; <jats:italic>p</jats:italic> = 0.0097) than those placed in non‐grafted sockets. Implants inserted in xenograft‐treated sites presented a tendency toward a lower risk of PLCBL ≥ 0.5 mm than those placed in non‐grafted sockets (HR = 1.03, 95% CI = 0.01 to 2.07; <jats:italic>p</jats:italic> = 0.052). No implants in xenograft‐treated sites developed PLCBL or PoLCBL ≥1.5 mm.ConclusionImplants placed in ARP areas with allograft or xenograft showed no significant differences in PLCBL, PoLCBL, implant failure, or peri‐implantitis, indicating both materials are reliable treatment options. ARP overall demonstrated a protective effect against crestal bone loss.Plain Language SummaryThe present study evaluated the clinical outcomes of implants placed in sites following alveolar ridge preservation (ARP) using allogeneic or xenogeneic biomaterials, addressing a gap in the current literature. Analysis of 509 implants in 390 subjects demonstrated that both biomaterial options are reliable, yielding comparable outcomes with no significant differences in marginal bone loss, implant failure, or peri‐implantitis. These findings suggest clinicians can choose allografts or xenografts for ARP based on individual preferences and clinical considerations. Furthermore, implants placed in grafted sites after ARP exhibited a lower incidence of peri‐implant bone loss compared with those placed in non‐grafted ridges, underscoring the protective effect of ARP on peri‐implant outcome
虽然有几项研究比较了不同骨替代物在牙槽嵴保存（ARP）的组织学结果和牙槽嵴尺寸维持方面的表现，但缺乏比较不同移植物在ARP处理部位种植结果的数据。本回顾性队列研究的目的是比较同种异体或异种移植牙种植体放置在ARP区域的性能，重点关注边缘骨丢失、种植体失效和种植体周围炎。方法对在ARP区接受过至少一颗种植体的患者进行记录分析，包括同种异体移植或异种移植或未移植的牙槽。对种植体进行预加载牙冠骨丢失（PLCBL）、加载后牙冠骨丢失（PoLCBL）、早期和晚期失效以及种植体周围炎的评估。数据分析采用双变量方法和混合效应Cox回归。结果390例患者共509颗种植体。未移植的种植体、同种异体或异种移植的种植体在PoLCBL≥0.5 mm、早期失败、晚期失败或种植体周围炎方面没有差异(p >；0.05)。植入同种异体移植物治疗部位的植入物发生PLCBL≥0.5 mm的风险显著降低(风险比[HR] = 0.84, 95% CI = 0.22至1.46；p = 0.0078), PLCBL≥1.5 mm (HR = - 1.27, 95% CI = - 2.08 ~ - 0.46；p = 0.0024), PoLCBL≥1.5 mm (HR = - 1.14, 95% CI = - 2.00 ~ - 0.28；P = 0.0097)。植入异种移植物治疗部位的种植体出现PLCBL≥0.5 mm的风险低于未植入的种植体(HR = 1.03, 95% CI = 0.01 ~ 2.07；P = 0.052)。结论同种异体或异种移植物放置在ARP区域的种植体在PLCBL、PoLCBL、种植体失败或种植体周围炎方面没有显著差异，表明这两种材料都是可靠的治疗选择。ARP总体上显示出对牙冠骨质流失的保护作用。本研究评估了使用同种异体或异种生物材料在牙槽嵴保存（ARP）后放置种植体的临床结果，解决了当前文献中的空白。对390名受试者的509个种植体的分析表明，这两种生物材料的选择都是可靠的，在边缘骨质流失、种植体失效或种植体周围炎方面没有显著差异。这些发现提示临床医生可以根据个人喜好和临床考虑选择同种异体移植或异种移植进行ARP。此外，与放置在未移植骨脊处的种植体相比，放置在ARP后种植体植入部位的种植体在种植体周围骨质流失的发生率较低，这强调了ARP对种植体周围结果的保护作用。
{"title":"Effect of allograft and xenograft ridge preservation on dental implant outcomes: A retrospective cohort study","authors":"Kaio Henrique Soares, Janelle Aguirre, Nathalia Vilela, Patrícia F. Gonçalves, Rafael Lazarin, Karin C. Schey, Poliana M. Duarte","doi":"10.1002/jper.24-0852","DOIUrl":"https://doi.org/10.1002/jper.24-0852","url":null,"abstract":"BackgroundWhile several studies have compared the performance of alveolar ridge preservation (ARP) using different bone substitutes in terms of histological outcomes and maintenance of ridge dimensions, there is a lack of data comparing implant outcomes in ARP‐treated sites with different grafts. The aim of this retrospective cohort study was to compare the performance of dental implants placed in areas that underwent ARP with either allograft or xenograft, focusing on marginal bone loss, implant failure, and peri‐implantitis.MethodsPatient records were examined for those who received at least one dental implant in ARP areas, using either allograft or xenograft, or non‐grafted sockets. Implants were assessed for preloading crestal bone loss (PLCBL), post‐loading crestal bone loss (PoLCBL), early and late failure, and peri‐implantitis. Data were analyzed using bivariate methods and mixed‐effects Cox regression.ResultsA total of 509 implants in 390 subjects were analyzed. Implants in non‐grafted sockets or those with allograft or xenograft did not differ in PoLCBL ≥ 0.5 mm, early failure, late failure, or peri‐implantitis (<jats:italic>p</jats:italic> > 0.05). Implants placed in allograft‐treated sites had a significantly lower risk of developing PLCBL ≥ 0.5 mm (Hazard ratio [HR] = 0.84, 95% CI = 0.22 to 1.46; <jats:italic>p</jats:italic> = 0.0078), PLCBL ≥ 1.5 mm (HR = −1.27, 95% CI = −2.08 to −0.46; <jats:italic>p</jats:italic> = 0.0024), and PoLCBL ≥ 1.5 mm (HR = −1.14, 95% CI = −2.00 to −0.28; <jats:italic>p</jats:italic> = 0.0097) than those placed in non‐grafted sockets. Implants inserted in xenograft‐treated sites presented a tendency toward a lower risk of PLCBL ≥ 0.5 mm than those placed in non‐grafted sockets (HR = 1.03, 95% CI = 0.01 to 2.07; <jats:italic>p</jats:italic> = 0.052). No implants in xenograft‐treated sites developed PLCBL or PoLCBL ≥1.5 mm.ConclusionImplants placed in ARP areas with allograft or xenograft showed no significant differences in PLCBL, PoLCBL, implant failure, or peri‐implantitis, indicating both materials are reliable treatment options. ARP overall demonstrated a protective effect against crestal bone loss.Plain Language SummaryThe present study evaluated the clinical outcomes of implants placed in sites following alveolar ridge preservation (ARP) using allogeneic or xenogeneic biomaterials, addressing a gap in the current literature. Analysis of 509 implants in 390 subjects demonstrated that both biomaterial options are reliable, yielding comparable outcomes with no significant differences in marginal bone loss, implant failure, or peri‐implantitis. These findings suggest clinicians can choose allografts or xenografts for ARP based on individual preferences and clinical considerations. Furthermore, implants placed in grafted sites after ARP exhibited a lower incidence of peri‐implant bone loss compared with those placed in non‐grafted ridges, underscoring the protective effect of ARP on peri‐implant outcome","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"26 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736763","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}
Joelle E Foster,Claire C Coleman,Archontia A Palaiologou,Brian L Mealey
BACKGROUNDAllografts and xenografts are viable options for alveolar ridge preservation. This study evaluated histologic wound healing when using demineralized freeze-dried bone allograft (DFDBA) alone, in fiber or particulate form, and in combination with xenograft. Alveolar dimensional changes were also evaluated.METHODSThis four-arm, parallel, randomized controlled trial included 120 patients with a nonmolar tooth receiving extraction and ridge preservation who were blindly randomized into one of four groups: DFDBA particulate alone (DCP), DFDBA fibers alone (DCF), xenograft combined with DCP (DPX), and xenograft combined with DCF (DFX). After 18-20 weeks of healing, bone cores were collected for histologic analysis of vital bone, residual allograft, residual xenograft, and connective tissue. Ridge dimensional changes were evaluated with standardized measuring stents.RESULTSThere was no difference in mean vital bone formation between DCP (37.33%) and DCF (40.76%) or between DPX (24.46%) or DFX (23.85%), but more vital bone was present when DFDBA in either form was used alone (DCF, DCP) compared to combining with xenograft (DFX, DPX). Significantly less residual allograft was found in DCF (3.57%) compared to DCP (16.5%). Similarly, when combined with xenograft, there was less residual allograft with DFDBA fibers (DFX = 2.19%) than with particles (DPX = 9.88%). No significant differences in alveolar ridge dimensional change were noted between the groups.CONCLUSIONDFDBA fibers resulted in less residual allograft compared to DFDBA particulate. Allograft-alone groups had more vital bone than groups with xenograft, but there was no difference between fiber allograft and particulate allograft alone.CLINICAL TRIAL NUMBERClinicaltrials.gov NCT05400213 PLAIN LANGUAGE SUMMARY: Placing a bone graft in the socket after tooth extraction can decrease bone loss during healing in preparation for a dental implant. This study collected histologic wound healing data on human bone graft materials in a fiber and particle form alone and in combination with a cow-derived (bovine) bone graft material. One hundred twenty patients who needed a tooth extracted enrolled in the study, and one of the four bone graft materials was placed in the site. After 18-20 weeks of healing, patients returned for placement of a dental implant. At this time, a bone sample was collected for microscopic examination. Measurements of the bone dimensions at the site were also done. The fiber bone graft material resorbed more rapidly relative to the particulate form, but there was no difference in new bone formed between the fibers and particles. The human bone grafts in either fiber or particle form used alone also formed more new bone than when they were mixed with the bovine bone graft. Clinically, the bone dimensions did not show significant differences between the four groups.
{"title":"Healing following ridge preservation using demineralized allograft particles or fibers alone, and combined with xenograft.","authors":"Joelle E Foster,Claire C Coleman,Archontia A Palaiologou,Brian L Mealey","doi":"10.1002/jper.11374","DOIUrl":"https://doi.org/10.1002/jper.11374","url":null,"abstract":"BACKGROUNDAllografts and xenografts are viable options for alveolar ridge preservation. This study evaluated histologic wound healing when using demineralized freeze-dried bone allograft (DFDBA) alone, in fiber or particulate form, and in combination with xenograft. Alveolar dimensional changes were also evaluated.METHODSThis four-arm, parallel, randomized controlled trial included 120 patients with a nonmolar tooth receiving extraction and ridge preservation who were blindly randomized into one of four groups: DFDBA particulate alone (DCP), DFDBA fibers alone (DCF), xenograft combined with DCP (DPX), and xenograft combined with DCF (DFX). After 18-20 weeks of healing, bone cores were collected for histologic analysis of vital bone, residual allograft, residual xenograft, and connective tissue. Ridge dimensional changes were evaluated with standardized measuring stents.RESULTSThere was no difference in mean vital bone formation between DCP (37.33%) and DCF (40.76%) or between DPX (24.46%) or DFX (23.85%), but more vital bone was present when DFDBA in either form was used alone (DCF, DCP) compared to combining with xenograft (DFX, DPX). Significantly less residual allograft was found in DCF (3.57%) compared to DCP (16.5%). Similarly, when combined with xenograft, there was less residual allograft with DFDBA fibers (DFX = 2.19%) than with particles (DPX = 9.88%). No significant differences in alveolar ridge dimensional change were noted between the groups.CONCLUSIONDFDBA fibers resulted in less residual allograft compared to DFDBA particulate. Allograft-alone groups had more vital bone than groups with xenograft, but there was no difference between fiber allograft and particulate allograft alone.CLINICAL TRIAL NUMBERClinicaltrials.gov NCT05400213 PLAIN LANGUAGE SUMMARY: Placing a bone graft in the socket after tooth extraction can decrease bone loss during healing in preparation for a dental implant. This study collected histologic wound healing data on human bone graft materials in a fiber and particle form alone and in combination with a cow-derived (bovine) bone graft material. One hundred twenty patients who needed a tooth extracted enrolled in the study, and one of the four bone graft materials was placed in the site. After 18-20 weeks of healing, patients returned for placement of a dental implant. At this time, a bone sample was collected for microscopic examination. Measurements of the bone dimensions at the site were also done. The fiber bone graft material resorbed more rapidly relative to the particulate form, but there was no difference in new bone formed between the fibers and particles. The human bone grafts in either fiber or particle form used alone also formed more new bone than when they were mixed with the bovine bone graft. Clinically, the bone dimensions did not show significant differences between the four groups.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"31 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693307","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}
Marta M. A. Pereira, Rafael Scaf de Molon, Valentim A. R. Barão, Jamil A. Shibli, Anton Sculean, Flavia Q. Pirih, Erica D. de Avila
<div> <section> <h3> Background</h3> <p>Peri-implantitis, an inflammatory condition occurring in the supportive tissues, is triggered by a dysbiotic biofilm that grows on implant and/or abutment surfaces. Consequently, the entire surface becomes a notorious culprit, fostering bacterial adhesion that might lead to progressive loss of supporting bone. To combat peri-implantitis, research groups worldwide have diligently pursued the development of new antimicrobial coatings. However, for the successful development of coating materials, it is crucial to clarify their intended function. In this review, we propose a clear classification of coating strategies aimed at either preventing or treating peri-implantitis.</p> </section> <section> <h3> Methods</h3> <p>We first delve deep within the concepts of prevention and treatment, as well as the physicochemical properties and biological requirements of each dental implant component for interacting with host tissue cells, to unravel and guide materials and technique complexity according to each purpose.</p> </section> <section> <h3> Results</h3> <p>From a preventive standpoint, the goal is to impede disease initiation. This requires coating materials that can withstand the hostile oral environment indefinitely. In the treatment category, where the disease is already established, the coating material should act directly at the infected site. Furthermore, the physicochemical properties of the new antimicrobial coating must respect the properties required by each part of the implant to not compromise the interaction of the bone-biomaterial and soft tissue-biomaterial interfaces.</p> </section> <section> <h3> Conclusion</h3> <p>Despite considerable efforts in designing antimicrobial coatings, commercial success has remained elusive thus far. This underscores the need to consider essential components to facilitate the construction, validation, and eventual clinical potential of antimicrobial coatings for future marketing.</p> </section> <section> <h3> Plain Language Summary</h3> <p>In this review, we have raised an essential point about the importance of considering both biological and chemical challenges in the development of antimicrobial coatings for preventing and treating peri-implantitis. From a preventive perspective, these coatings need to be designed to withstand the complex environment of the oral cavity while maintaining their integrity and functionality. This requires coatings that can resist changes in environmental factors. Conversely, in the treatment category, material coatings need to be responsive t
{"title":"Surveying coating strategies for peri-implantitis management: Clinical implications and classificatory approaches","authors":"Marta M. A. Pereira, Rafael Scaf de Molon, Valentim A. R. Barão, Jamil A. Shibli, Anton Sculean, Flavia Q. Pirih, Erica D. de Avila","doi":"10.1002/JPER.24-0462","DOIUrl":"10.1002/JPER.24-0462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peri-implantitis, an inflammatory condition occurring in the supportive tissues, is triggered by a dysbiotic biofilm that grows on implant and/or abutment surfaces. Consequently, the entire surface becomes a notorious culprit, fostering bacterial adhesion that might lead to progressive loss of supporting bone. To combat peri-implantitis, research groups worldwide have diligently pursued the development of new antimicrobial coatings. However, for the successful development of coating materials, it is crucial to clarify their intended function. In this review, we propose a clear classification of coating strategies aimed at either preventing or treating peri-implantitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We first delve deep within the concepts of prevention and treatment, as well as the physicochemical properties and biological requirements of each dental implant component for interacting with host tissue cells, to unravel and guide materials and technique complexity according to each purpose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From a preventive standpoint, the goal is to impede disease initiation. This requires coating materials that can withstand the hostile oral environment indefinitely. In the treatment category, where the disease is already established, the coating material should act directly at the infected site. Furthermore, the physicochemical properties of the new antimicrobial coating must respect the properties required by each part of the implant to not compromise the interaction of the bone-biomaterial and soft tissue-biomaterial interfaces.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite considerable efforts in designing antimicrobial coatings, commercial success has remained elusive thus far. This underscores the need to consider essential components to facilitate the construction, validation, and eventual clinical potential of antimicrobial coatings for future marketing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain Language Summary</h3>\u0000 \u0000 <p>In this review, we have raised an essential point about the importance of considering both biological and chemical challenges in the development of antimicrobial coatings for preventing and treating peri-implantitis. From a preventive perspective, these coatings need to be designed to withstand the complex environment of the oral cavity while maintaining their integrity and functionality. This requires coatings that can resist changes in environmental factors. Conversely, in the treatment category, material coatings need to be responsive t","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"96 10","pages":"1077-1087"},"PeriodicalIF":3.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669378","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}
Jaret O Simonsen,Michael P Mills,Brian L Mealey,Lea El Hachem,Hassem Geha,Kerri Font,Charles A Powell
BACKGROUNDThe primary objective of this study is to evaluate the accuracy of 3-dimensional (3D) imaging in detecting radiographic and morphological graft changes compared to traditional 2-dimensional (2D) imaging. Additionally, the study aims to assess the distribution of graft material and the extent of resorption occurring between baseline and 6 months post-implant placement following transcrestal sinus augmentation.METHODSThis study employed a transcrestal approach utilizing an osseodensification protocol for sinus augmentation with mineralized freeze-dried bone allograft. Immediately post-operatively, a standardized periapical radiograph (PA) was taken using a standardized paralleling device with bite registration material. Furthermore, a low-volume cone beam computed tomography (CBCT) radiograph was obtained. Following a 6-month healing period, both radiographs were repeated for analysis and comparison to baseline parameters.RESULTSA total of 22 subjects completed the study. At 6 months post-surgery, PA evaluations indicated a reduction in apical graft height (AGH) of 55.9%, endo-sinus bone gain (ESBG) reduction of 29.6%, and elevated membrane apex (EMA) reduction of 8.4%. CBCT analysis showed slightly higher reductions, with AGH, ESBG, and EMA reductions of 60.4%, 32.6%, and 12.2%, respectively. A paired t-test comparing the accuracy of the 2D and 3D models' ability to detect changes in graft material resulted in a p-value of 0.2168.CONCLUSIONSPeriapical imaging is relatively accurate when standardized, whereas CBCT provides a more precise representation of the graft material distribution and reduction. Significant reductions in AGH, ESBG, and EMA were observed at 6 months, with PAs indicating less change in bone augmentation compared to CBCT.CLINICALTRIALSGOV IDENTIFIERNCT06296459 PLAIN LANGUAGE SUMMARY: The removal of posterior teeth results in expansion of the maxillary sinus, which can limit the bony support for dental implants. To overcome this, the maxillary sinus can be augmented through various techniques and with various materials. This study evaluated augmenting the sinus with a transcrestal approach utilizing a freeze-dried bone allograft. At 6 months postoperatively, x-ray evaluation demonstrated a reduction in graft height and endo-sinus bone gain. Comparison of imaging techniques revealed statistical accuracy of both 2D and 3D models to detect changes in the graft material.
{"title":"Radiographic changes in the maxillary sinus following closed sinus augmentation.","authors":"Jaret O Simonsen,Michael P Mills,Brian L Mealey,Lea El Hachem,Hassem Geha,Kerri Font,Charles A Powell","doi":"10.1002/jper.11376","DOIUrl":"https://doi.org/10.1002/jper.11376","url":null,"abstract":"BACKGROUNDThe primary objective of this study is to evaluate the accuracy of 3-dimensional (3D) imaging in detecting radiographic and morphological graft changes compared to traditional 2-dimensional (2D) imaging. Additionally, the study aims to assess the distribution of graft material and the extent of resorption occurring between baseline and 6 months post-implant placement following transcrestal sinus augmentation.METHODSThis study employed a transcrestal approach utilizing an osseodensification protocol for sinus augmentation with mineralized freeze-dried bone allograft. Immediately post-operatively, a standardized periapical radiograph (PA) was taken using a standardized paralleling device with bite registration material. Furthermore, a low-volume cone beam computed tomography (CBCT) radiograph was obtained. Following a 6-month healing period, both radiographs were repeated for analysis and comparison to baseline parameters.RESULTSA total of 22 subjects completed the study. At 6 months post-surgery, PA evaluations indicated a reduction in apical graft height (AGH) of 55.9%, endo-sinus bone gain (ESBG) reduction of 29.6%, and elevated membrane apex (EMA) reduction of 8.4%. CBCT analysis showed slightly higher reductions, with AGH, ESBG, and EMA reductions of 60.4%, 32.6%, and 12.2%, respectively. A paired t-test comparing the accuracy of the 2D and 3D models' ability to detect changes in graft material resulted in a p-value of 0.2168.CONCLUSIONSPeriapical imaging is relatively accurate when standardized, whereas CBCT provides a more precise representation of the graft material distribution and reduction. Significant reductions in AGH, ESBG, and EMA were observed at 6 months, with PAs indicating less change in bone augmentation compared to CBCT.CLINICALTRIALSGOV IDENTIFIERNCT06296459 PLAIN LANGUAGE SUMMARY: The removal of posterior teeth results in expansion of the maxillary sinus, which can limit the bony support for dental implants. To overcome this, the maxillary sinus can be augmented through various techniques and with various materials. This study evaluated augmenting the sinus with a transcrestal approach utilizing a freeze-dried bone allograft. At 6 months postoperatively, x-ray evaluation demonstrated a reduction in graft height and endo-sinus bone gain. Comparison of imaging techniques revealed statistical accuracy of both 2D and 3D models to detect changes in the graft material.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"14 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652709","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}
Lingjun Yan, Bingqin Xie, Yanfen Li, Zilin Liu, Yu Huang, Baochang He, Yu Qiu, Lan Luo, Fuhua Yan, Fa Chen
<div> <section> <h3> Background</h3> <p>This study aimed to provide an updated assessment of the global, regional, and national burden of oral disorders from 1990 to 2021, and forecast trends for the next 30 years.</p> </section> <section> <h3> Methods</h3> <p>Data on incidence, prevalence, and disability-adjusted life years (DALYs) were extracted from the Global Burden of Diseases(GBD) 2021. The changing trends in the burden of oral disorders and subtypes were estimated using percentage change. The Nordpred model based on the age-period-cohort analysis was used to predict the burden of oral disorders over the next 30 years.</p> </section> <section> <h3> Results</h3> <p>From 1990 to 2021, all oral disorders exhibited a 35.54% incidence, reaching 3.74 billion cases. Regional analysis revealed that Tropical Latin America and Southeast Asia had higher age-standardized incidence rates(ASIR). Dental caries in permanent teeth increased by 6.0% in the ASIR, while deciduous teeth caries declined by 7.83%. Periodontal disease incidence surged by 76.32% to 89.6 million cases, with discrepancies between sexes—1.05% decrease in males and a 1.14% increase in females. Edentulism incidence rose dramatically by 93.56%, totaling 26.5 million cases. Projections for the next 30 years suggest a continued rise in oral disorder cases, with the ASIR expected to rise, particularly in periodontal diseases.</p> </section> <section> <h3> Conclusions</h3> <p>The rising global burden of oral disorders, notably periodontal diseases, remains a significant public health challenge. Factors such as poor oral hygiene and disparities in healthcare access might contribute to these trends. Targeted preventive measures, including community education and alongside partnerships between researchers and policy-makers, are crucial for mitigating their impact on public health.</p> </section> <section> <h3> Plain Language Summary</h3> <p>Our study examines the increasing global impact of oral diseases from 1990 to 2021 and predicts their trajectory over the next 30 years. We analyzed data on how often these conditions occur and the years of healthy life lost due to them. Overall, we found that oral disorders affected an alarming 3.74 billion people by 2021, with regions like Tropical Latin America and Southeast Asia showing particularly high rates. Notably, dental cavities in adult teeth grew by 6%, while those in children's teeth declined. However, gum disease and tooth loss saw significant increases—gum disease cases shot up by over 76%, with a notable rise among women. Looking ahead, we expect
{"title":"Global burden of oral disorders with projections over the next 30 years","authors":"Lingjun Yan, Bingqin Xie, Yanfen Li, Zilin Liu, Yu Huang, Baochang He, Yu Qiu, Lan Luo, Fuhua Yan, Fa Chen","doi":"10.1002/JPER.24-0638","DOIUrl":"10.1002/JPER.24-0638","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to provide an updated assessment of the global, regional, and national burden of oral disorders from 1990 to 2021, and forecast trends for the next 30 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on incidence, prevalence, and disability-adjusted life years (DALYs) were extracted from the Global Burden of Diseases(GBD) 2021. The changing trends in the burden of oral disorders and subtypes were estimated using percentage change. The Nordpred model based on the age-period-cohort analysis was used to predict the burden of oral disorders over the next 30 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1990 to 2021, all oral disorders exhibited a 35.54% incidence, reaching 3.74 billion cases. Regional analysis revealed that Tropical Latin America and Southeast Asia had higher age-standardized incidence rates(ASIR). Dental caries in permanent teeth increased by 6.0% in the ASIR, while deciduous teeth caries declined by 7.83%. Periodontal disease incidence surged by 76.32% to 89.6 million cases, with discrepancies between sexes—1.05% decrease in males and a 1.14% increase in females. Edentulism incidence rose dramatically by 93.56%, totaling 26.5 million cases. Projections for the next 30 years suggest a continued rise in oral disorder cases, with the ASIR expected to rise, particularly in periodontal diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The rising global burden of oral disorders, notably periodontal diseases, remains a significant public health challenge. Factors such as poor oral hygiene and disparities in healthcare access might contribute to these trends. Targeted preventive measures, including community education and alongside partnerships between researchers and policy-makers, are crucial for mitigating their impact on public health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain Language Summary</h3>\u0000 \u0000 <p>Our study examines the increasing global impact of oral diseases from 1990 to 2021 and predicts their trajectory over the next 30 years. We analyzed data on how often these conditions occur and the years of healthy life lost due to them. Overall, we found that oral disorders affected an alarming 3.74 billion people by 2021, with regions like Tropical Latin America and Southeast Asia showing particularly high rates. Notably, dental cavities in adult teeth grew by 6%, while those in children's teeth declined. However, gum disease and tooth loss saw significant increases—gum disease cases shot up by over 76%, with a notable rise among women. Looking ahead, we expect","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"96 11","pages":"1291-1303"},"PeriodicalIF":3.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652726","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}
Angelica Leticia Reis Pavanelli, Sâmmea Martins Vieira, Camila Chierici Marcantonio, Gisele Faria, Sotirios Tetradis, Pedro Paulo Chaves de Souza, Joni Augusto Cirelli, Rafael Scaf de Molon
<div> <section> <h3> Background</h3> <p>Periodontitis is a chronic inflammatory condition that leads to progressive destruction of the alveolar bone. Currently, there is a lack of effective adjuvant treatments to nonsurgical periodontal therapy offering strong antiresorptive properties. Tanshinone IIA (T-IIA), a lipophilic compound derived from <i>Salvia miltiorrhiza</i>, exhibits various biological properties. This study investigates the antiresorptive activity of tanshinone as an adjuvant therapy for periodontitis.</p> </section> <section> <h3> Methods</h3> <p>Forty 8-week-old male C57BL6/J mice were randomly assigned to four experimental groups: control (C), periodontitis (P), T-IIA, and sodium tanshinone IIA sulfonate (STS). The C group did not undergo experimental periodontitis, while the P, T-IIA, and STS groups were induced with periodontitis by placing ligatures around the first maxillary molars bilaterally. Tanshinones (40 mg/kg) were administered daily via oral gavage immediately following ligature placement for 10 days. The P group received only the vehicle solution. Microcomputed tomography (micro-CT) and histological, immunohistochemical, and real-time quantitative polymerase chain reaction (RT-qPCR) analyses were performed.</p> </section> <section> <h3> Results</h3> <p>T-IIA and STS significantly reduced the infiltration of inflammatory cells in the connective tissue and increased the percentage of fibroblasts. This treatment also mitigated alveolar bone loss caused by ligature placement compared to the P group, enhancing bone mineral density and improving bone architectural parameters. The T-IIA and STS groups effectively lowered the number of osteoclasts and significantly downregulated the production of IL-1β, IL-17, and MMP-13. The mRNA level of cathepsin K was significantly reduced in the STS group compared to the P and T-IIA groups, whereas IL-1β, TNF-α, and RANKL were not statistically different among groups.</p> </section> <section> <h3> Conclusion</h3> <p>Our findings demonstrate that T-IIA and STS prevent periodontitis-induced bone loss by controlling inflammation and inhibiting osteoclastogenesis. This suggests that these compounds possess dual antiresorptive and anti-inflammatory properties, making them promising novel therapeutic agents for treating periodontitis.</p> </section> <section> <h3> Plain Language Summary</h3> <p>Periodontitis is a serious gum disease that damages the bone supporting teeth, often leading to tooth loss. While current treatments aim to clean the affected areas, they do not always prevent further bone
{"title":"Anti-inflammatory and antiresorptive activities of tanshinone-IIA mitigate alveolar bone destruction in mice with experimental periodontitis","authors":"Angelica Leticia Reis Pavanelli, Sâmmea Martins Vieira, Camila Chierici Marcantonio, Gisele Faria, Sotirios Tetradis, Pedro Paulo Chaves de Souza, Joni Augusto Cirelli, Rafael Scaf de Molon","doi":"10.1002/JPER.24-0618","DOIUrl":"10.1002/JPER.24-0618","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontitis is a chronic inflammatory condition that leads to progressive destruction of the alveolar bone. Currently, there is a lack of effective adjuvant treatments to nonsurgical periodontal therapy offering strong antiresorptive properties. Tanshinone IIA (T-IIA), a lipophilic compound derived from <i>Salvia miltiorrhiza</i>, exhibits various biological properties. This study investigates the antiresorptive activity of tanshinone as an adjuvant therapy for periodontitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty 8-week-old male C57BL6/J mice were randomly assigned to four experimental groups: control (C), periodontitis (P), T-IIA, and sodium tanshinone IIA sulfonate (STS). The C group did not undergo experimental periodontitis, while the P, T-IIA, and STS groups were induced with periodontitis by placing ligatures around the first maxillary molars bilaterally. Tanshinones (40 mg/kg) were administered daily via oral gavage immediately following ligature placement for 10 days. The P group received only the vehicle solution. Microcomputed tomography (micro-CT) and histological, immunohistochemical, and real-time quantitative polymerase chain reaction (RT-qPCR) analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>T-IIA and STS significantly reduced the infiltration of inflammatory cells in the connective tissue and increased the percentage of fibroblasts. This treatment also mitigated alveolar bone loss caused by ligature placement compared to the P group, enhancing bone mineral density and improving bone architectural parameters. The T-IIA and STS groups effectively lowered the number of osteoclasts and significantly downregulated the production of IL-1β, IL-17, and MMP-13. The mRNA level of cathepsin K was significantly reduced in the STS group compared to the P and T-IIA groups, whereas IL-1β, TNF-α, and RANKL were not statistically different among groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings demonstrate that T-IIA and STS prevent periodontitis-induced bone loss by controlling inflammation and inhibiting osteoclastogenesis. This suggests that these compounds possess dual antiresorptive and anti-inflammatory properties, making them promising novel therapeutic agents for treating periodontitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain Language Summary</h3>\u0000 \u0000 <p>Periodontitis is a serious gum disease that damages the bone supporting teeth, often leading to tooth loss. While current treatments aim to clean the affected areas, they do not always prevent further bone","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"96 10","pages":"1138-1153"},"PeriodicalIF":3.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144630446","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}
Guixin Zhu, Ke Yang, Tiqian Liu, Yuhuang Chen, Ran Li, Junchi Dong, Liang Xing
BackgroundPeriodontitis, an inflammatory condition, results from the immune response to pathogenic microorganisms. Gingival defects from periodontitis enable these microorganisms, along with immune cells and inflammatory proteins, to enter the bloodstream, potentially causing systemic inflammation and contributing to systemic diseases. Conversely, systemic diseases can worsen periodontitis by inducing inflammation.MethodsIn this study, we investigated the connection between periodontitis and blood immune cell phenotypes/circulating inflammation‐associated proteins using bidirectional Mendelian randomization (MR). We also analyzed the interplay between immune cells, inflammation proteins, and periodontitis through a two‐step mediation analysis. Besides, we utilized sensitivity analyses, including the MR‐PRESSO outlier test, MR Egger intercept, Cochran's Q statistic, Steiger filter, and leave‐one‐out analysis. Confounder‐related instrumental variants were filtered through the Open Targets Genetics. Additionally, the results were supported by triangulation of high‐throughput sequencing dataset analyses and animal models.ResultsMR analysis identified three proteins—programmed cell death 1 ligand 1 (PD‐L1), eotaxin, and neurturin (NRTN)—with protective roles against periodontitis, alongside three proteins—protein S100‐A12 (S100A12), C‐X‐C motif chemokine ligand (CXCL) 11, and sulfotransferase 1A1 (SULT1A1)—identified as risk factors. Furthermore, our study revealed 16 immunocyte phenotypes causally linked to periodontitis. Conversely, periodontitis was associated with heightened circulating levels of CXCL 9/10/11. Notably, periodontitis influenced the characteristics of circulating immune cells, particularly regulatory T cells (Treg), maturation stages of T cells, and conventional dendritic cells (cDC). Additionally, single‐cell and bulk‐RNA sequencing and animal models verified the above results.ConclusionsThis study underscores the close connection between periodontitis and systemic inflammation, laying the groundwork for targeted immunotherapy against periodontitis and supporting the link between periodontitis and systemic diseases.Plain Language SummaryThis study explored the bidirectional causal relationship between periodontitis and systemic inflammation, demonstrating a causal relationship between periodontitis and specific circulating inflammatory proteins and immune cell phenotypes, indicating that the treatment of periodontitis needs to consider the systemic inflammatory state and that the systemic inflammatory state may be involved in the link between periodontitis and systemic diseases.
{"title":"Causal network between periodontitis and systemic inflammation: Triangulating evidence from Mendelian randomization and sequencing datasets","authors":"Guixin Zhu, Ke Yang, Tiqian Liu, Yuhuang Chen, Ran Li, Junchi Dong, Liang Xing","doi":"10.1002/jper.24-0382","DOIUrl":"https://doi.org/10.1002/jper.24-0382","url":null,"abstract":"BackgroundPeriodontitis, an inflammatory condition, results from the immune response to pathogenic microorganisms. Gingival defects from periodontitis enable these microorganisms, along with immune cells and inflammatory proteins, to enter the bloodstream, potentially causing systemic inflammation and contributing to systemic diseases. Conversely, systemic diseases can worsen periodontitis by inducing inflammation.MethodsIn this study, we investigated the connection between periodontitis and blood immune cell phenotypes/circulating inflammation‐associated proteins using bidirectional Mendelian randomization (MR). We also analyzed the interplay between immune cells, inflammation proteins, and periodontitis through a two‐step mediation analysis. Besides, we utilized sensitivity analyses, including the MR‐PRESSO outlier test, MR Egger intercept, Cochran's <jats:italic>Q</jats:italic> statistic, Steiger filter, and leave‐one‐out analysis. Confounder‐related instrumental variants were filtered through the Open Targets Genetics. Additionally, the results were supported by triangulation of high‐throughput sequencing dataset analyses and animal models.ResultsMR analysis identified three proteins—programmed cell death 1 ligand 1 (PD‐L1), eotaxin, and neurturin (NRTN)—with protective roles against periodontitis, alongside three proteins—protein S100‐A12 (S100A12), C‐X‐C motif chemokine ligand (CXCL) 11, and sulfotransferase 1A1 (SULT1A1)—identified as risk factors. Furthermore, our study revealed 16 immunocyte phenotypes causally linked to periodontitis. Conversely, periodontitis was associated with heightened circulating levels of CXCL 9/10/11. Notably, periodontitis influenced the characteristics of circulating immune cells, particularly regulatory T cells (Treg), maturation stages of T cells, and conventional dendritic cells (cDC). Additionally, single‐cell and bulk‐RNA sequencing and animal models verified the above results.ConclusionsThis study underscores the close connection between periodontitis and systemic inflammation, laying the groundwork for targeted immunotherapy against periodontitis and supporting the link between periodontitis and systemic diseases.Plain Language SummaryThis study explored the bidirectional causal relationship between periodontitis and systemic inflammation, demonstrating a causal relationship between periodontitis and specific circulating inflammatory proteins and immune cell phenotypes, indicating that the treatment of periodontitis needs to consider the systemic inflammatory state and that the systemic inflammatory state may be involved in the link between periodontitis and systemic diseases.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"21 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586250","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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