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Impact of smoking habit on the subgingival proteome in patients with periodontitis. 吸烟习惯对牙周炎患者龈下蛋白质组的影响。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-16 DOI: 10.1002/JPER.24-0062
Triana Blanco-Pintos, Alba Regueira-Iglesias, Iryna Kuz, Alba Sánchez-Barco, Noelia Seijas-Otero, María Del Pilar Chantada-Vázquez, Carlos Balsa-Castro, Inmaculada Tomás
<p><strong>Background: </strong>Few investigations evaluated smoking's impact on the periodontal proteome. Therefore, this study aimed to analyse the influence of tobacco on the overall periodontal proteome and the differential expression of gingival crevicular fluid (GCF) proteins using sequential window acquisition of all theoretical mass spectra (SWATH-MS).</p><p><strong>Methods: </strong>GCF samples were collected from 40 periodontitis subjects (stages III-IV). These were separated based on smoking status into smokers (17), ex-smokers (10), and non-smokers (13). Samples were analysed using SWATH-MS, and proteins were identified using the UniProt human-specific database. Data are available via ProteomeXchange with the identifier PXD043474. Principal component analysis (PCA) was employed to examine the spectral mass distribution of the proteome. Protein expression was different for a p-value <0.05 and a log2 fold change ≥0.3 (upregulated) or ≤-0.3 (downregulated).</p><p><strong>Results: </strong>The distribution of overall proteome did not differ between non-smokers, smokers, and ex-smokers. Considering protein expression, 23 were differentially expressed in smokers vs. non-smokers (16 upregulated and 7 downregulated), 17 in ex-smokers vs. non-smokers (2 upregulated and 15 downregulated), and only 8 in smokers vs. ex-smokers (7 upregulated and 1 downregulated). Smoking increased the expression of proteins related to epithelial hyperkeratinization (keratins type II cytoskeletal 4, type I cytoskeletal 13 and type I cytoskeletal 19, cornulin, and fatty acid-binding protein 5). However, multiple immunoglobulins were underexpressed when comparing smokers and ex-smokers to non-smokers.</p><p><strong>Conclusion: </strong>Although smoking does not significantly modify the overall GCF proteome associated with periodontitis, it alters the expression of several proteins compared to never-smokers and ex-smokers.</p><p><strong>Plain language summary: </strong>Smoking is a critical risk factor for the development and progression of periodontitis. However, evidence of the effect of smoking on the subgingival proteome is scarce. Therefore, this study aimed to determine the impact of smoking on the overall proteome and differential expression of gingival crevicular fluid (GCF) proteins using the sequential window acquisition of all theoretical mass spectra (SWATH-MS) proteomic technique. For this purpose, GCF samples were collected from 40 subjects with periodontitis, of which 17 were smokers, 10 were ex-smokers, and 13 were non-smokers. These samples were analysed by SWATH-MS, and proteins were identified using the UniProt human-specific database. Analysis of the overall proteome showed that its distribution was not significantly different between smokers, ex-smokers, and non-smokers. However, several proteins were found to be differentially expressed according to the smoking status. Smoking can increase the expression of several keratins and proteins related
背景:很少有研究评估吸烟对牙周蛋白质组的影响。因此,本研究旨在利用所有理论质谱的顺序窗口采集(SWATH-MS)分析烟草对整体牙周蛋白质组的影响以及牙龈缝隙液(GCF)蛋白质的差异表达:方法:从 40 名牙周炎受试者(III-IV 期)中收集 GCF 样本。这些样本根据吸烟状况分为吸烟者(17 例)、戒烟者(10 例)和非吸烟者(13 例)。使用 SWATH-MS 对样本进行分析,并使用 UniProt 人类特异性数据库对蛋白质进行鉴定。数据可通过 ProteomeXchange 获取,标识符为 PXD043474。采用主成分分析法(PCA)检查蛋白质组的光谱质量分布。蛋白质表达的不同p值 结果:总体蛋白质组的分布在非吸烟者、吸烟者和戒烟者之间没有差异。在蛋白质表达方面,吸烟者与非吸烟者之间有 23 种蛋白质表达存在差异(16 种上调,7 种下调),戒烟者与非吸烟者之间有 17 种蛋白质表达存在差异(2 种上调,15 种下调),而吸烟者与戒烟者之间只有 8 种蛋白质表达存在差异(7 种上调,1 种下调)。吸烟增加了与上皮角化过度有关的蛋白质(角蛋白 II 型细胞骨架 4、I 型细胞骨架 13 和 I 型细胞骨架 19、玉米蛋白和脂肪酸结合蛋白 5)的表达。然而,与非吸烟者相比,吸烟者和戒烟者的多种免疫球蛋白表达不足:尽管吸烟不会明显改变与牙周炎相关的整体 GCF 蛋白体组,但与从不吸烟者和戒烟者相比,吸烟会改变几种蛋白质的表达。然而,有关吸烟对龈下蛋白质组影响的证据却很少。因此,本研究旨在利用所有理论质谱的顺序窗口获取(SWATH-MS)蛋白质组学技术,确定吸烟对总体蛋白质组和牙龈缝液(GCF)蛋白质差异表达的影响。为此,研究人员收集了 40 名牙周炎患者的牙龈龈沟液样本,其中 17 人为吸烟者,10 人为戒烟者,13 人为非吸烟者。采用 SWATH-MS 对这些样本进行了分析,并使用 UniProt 人类特异性数据库对蛋白质进行了鉴定。对整体蛋白质组的分析表明,吸烟者、戒烟者和非吸烟者之间的蛋白质分布没有明显差异。不过,有几种蛋白质的表达因吸烟状态而异。吸烟会增加几种角蛋白和与上皮过度角化有关的蛋白质的表达。然而,在戒烟者中,这些蛋白的表达水平会恢复到与非吸烟者相似的水平。此外,吸烟可能会降低与适应性免疫有关的蛋白质(如免疫球蛋白)的表达量。这种免疫抑制作用在戒烟者身上可能会持续存在。
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引用次数: 0
AAP President's Address* AAP 主席致辞*
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-09-14 DOI: 10.1002/JPER.24-0190
David K. Okano
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引用次数: 0
B10 cells regulate macrophage polarization to alleviate inflammation and bone loss in periodontitis B10 细胞调节巨噬细胞极化,缓解牙周炎的炎症和骨质流失
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-30 DOI: 10.1002/jper.24-0114
Guoqin Cao, Qiuping Xu, Shengyuan Huang, Dong Dai, Jilei Wang, Wei Li, Yue Zhao, Jiang Lin, Xiaozhe Han
BackgroundThe polarization of macrophages into an anti‐inflammatory phenotype is crucial for resolving periodontal inflammation. It has been reported that B10 cells can regulate the immune response of macrophages during inflammation and are also able to regulate inflammation in periodontitis. However, whether B10 cells’ regulation function in periodontitis is related to macrophage polarization remains unclear. This study aims to investigate whether B10 cells can regulate macrophage polarization in periodontitis.MethodsMacrophages were cocultured with B10 cells in vitro for 5 days. After coculture, macrophages were obtained for analysis directly or followed by stimulation with Pg‐LPS/IFN‐γ or IL‐4/IL‐13. Flow cytometry and/or reverse transcriptase‐polymerase chain reaction (RT‐PCR) were employed to detect the expression of IL‐1β, iNOS, TNF‐α, CD206, and ARG‐1 in macrophages. B10 cells were transferred on the 5th day after ligation in wild or macrophage‐depletion mice. Toluidine blue and TRAP staining were used to evaluate alveolar bone resorption and osteoclast activation. Immunohistochemistry was employed to detect the expression of CD68, IL‐1β, TNF‐α, iNOS, ARG‐1, and IL‐10. Immunofluorescence was used to detect the expression of CD68+CD86+M1 macrophages and CD68+CD206+M2 macrophages.ResultsIn vitro, B10 cells inhibit the expression of IL‐1β, iNOS, and TNF‐α in macrophages while increasing the expression of CD206 and ARG‐1. In experimental periodontitis, B10 cells inhibit the polarization of CD68+CD86+M1 macrophages and iNOS expression but enhance the polarization of CD68+CD206+M2 macrophages and ARG‐1 expression. Importantly, the depletion of macrophages partially weakened the regulation function of B10 cells in periodontitis.ConclusionsB10 cells promote M2 macrophage polarization, inhibit M1 macrophage polarization in periodontitis, and alleviate periodontitis partially by regulating macrophage polarization.
背景巨噬细胞极化为抗炎表型对解决牙周炎症至关重要。有报道称,B10 细胞能在炎症期间调节巨噬细胞的免疫反应,也能在牙周炎中调节炎症。然而,B10细胞在牙周炎中的调节功能是否与巨噬细胞极化有关仍不清楚。本研究旨在探讨B10细胞能否调控牙周炎中巨噬细胞的极化。方法将巨噬细胞与 B10 细胞体外共培养 5 天,共培养后直接或在 Pg-LPS/IFN-γ 或 IL-4/IL-13 刺激下获得巨噬细胞进行分析。采用流式细胞术和/或逆转录聚合酶链反应(RT-PCR)检测巨噬细胞中IL-1β、iNOS、TNF-α、CD206和ARG-1的表达。野生小鼠或巨噬细胞缺失小鼠在结扎后第 5 天转移 B10 细胞。甲苯胺蓝和TRAP染色用于评估牙槽骨吸收和破骨细胞活化。免疫组化用于检测 CD68、IL-1β、TNF-α、iNOS、ARG-1 和 IL-10 的表达。结果在体外,B10 细胞抑制巨噬细胞中 IL-1β、iNOS 和 TNF-α 的表达,同时增加 CD206 和 ARG-1 的表达。在实验性牙周炎中,B10细胞抑制了CD68+CD86+M1巨噬细胞的极化和iNOS的表达,但增强了CD68+CD206+M2巨噬细胞的极化和ARG-1的表达。结论 B10细胞在牙周炎中促进M2巨噬细胞极化,抑制M1巨噬细胞极化,并通过调节巨噬细胞极化部分缓解牙周炎。
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引用次数: 0
Lipocalin-2 as a fundamental protein in type 2 diabetes and periodontitis in mice. 脂联素-2 是 2 型糖尿病和小鼠牙周炎的基本蛋白。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-27 DOI: 10.1002/JPER.24-0215
Diana Laura Sólis-Suarez, Saúl Ernesto Cifuentes-Mendiola, Patricia González-Alva, Adriana Patricia Rodríguez-Hernández, Arnulfo Martínez-Dávalos, Fulgencio Eduardo Llamosas-Hernandez, Marycarmen Godínez-Victoria, Ana Lilia García-Hernández

Background: Lipocalin-2 (LCN-2) is an osteokine that suppresses appetite, stimulates insulin secretion, regulates bone remodeling, and is induced by proinflammatory cytokines. The aim of this work was to investigate the participation of LCN-2 in periodontitis associated with type 2 diabetes (T2D) by evaluating alveolar bone loss, glycemic control, inflammation, and femur fragility.

Methods: A murine model of periodontitis with T2D and elevated LCN-2 concentration was used. Functional LCN-2 inhibition was achieved using an anti-LCN-2 polyclonal antibody, and isotype immunoglobulin G was used as a control. The alveolar bone and femur were evaluated by micro-CT. Glucose metabolism was determined. Tumor necrosis factor (TNF-α) and receptor activator of nuclear factor kappa-B ligand (RANKL) levels in alveolar bone lysates were quantified using ELISA, and serum cytokines were quantified using flow cytometry. A three-point bending test was performed in the femur, and RANKL levels were measured in femur lysates using ELISA.

Results: Functional inhibition of LCN-2 in T2D-periodontitis mice decreased alveolar bone loss in buccal and palatal surfaces and preserved the microarchitecture of the remaining bone, decreased TNF-α and RANKL in alveolar bone, reduced hyperglycemia, glucose intolerance, and insulin resistance, and increased insulin production through improving the functionality of pancreatic β cells. Furthermore, this inhibition increased serum free-glycerol levels, decreased serum interleukin (IL)-6, increased serum IL-4, and reduced femur fragility and RANKL expression in the femur.

Conclusions: LCN-2 participates in periodontitis associated with T2D. Inhibiting its function in mice with T2D and periodontitis improves pancreatic β-cell function, and glucose metabolism and decreases inflammatory cytokines and bone-RANKL levels, which results in the preservation of femoral and alveolar bone microarchitecture.

Plain language summary: In this study, we explored the role of a bone protein known as lipocalin-2 (LCN-2) in the connection between periodontitis and type 2 diabetes (T2D). Periodontitis is a destructive gum and alveolar bone disease. LCN-2 levels are increased in both T2D and periodontitis. Using a mouse model of T2D with periodontitis, we examined how blocking LCN-2 function affected various aspects of these two diseases. We found that this inhibition led to significant improvements. First, it reduced alveolar bone loss and preserved bone structure by decreasing local inflammation and bone resorption. Second, it improved glucose and lipid metabolism, leading to better blood-sugar control and decreased insulin resistance. Blocking the functions of LCN-2 also decreased systemic inflammation throughout the body and strengthened bone integrity. Overall, our results suggest that LCN-2 plays a crucial role in the periodontitis associated

背景:脂联素-2(LCN-2)是一种骨生成素,可抑制食欲、刺激胰岛素分泌、调节骨重塑,并由促炎细胞因子诱导。本研究旨在通过评估牙槽骨损失、血糖控制、炎症和股骨脆性,研究 LCN-2 在与 2 型糖尿病(T2D)相关的牙周炎中的参与情况:方法:使用了一种伴有 T2D 和 LCN-2 浓度升高的小鼠牙周炎模型。使用抗 LCN-2 多克隆抗体抑制 LCN-2 的功能,并使用同种型免疫球蛋白 G 作为对照。通过显微 CT 对牙槽骨和股骨进行评估。测定葡萄糖代谢。采用酶联免疫吸附法对肺泡骨裂解液中的肿瘤坏死因子(TNF-α)和核因子卡巴-B配体受体激活剂(RANKL)水平进行量化,并采用流式细胞术对血清细胞因子进行量化。在股骨中进行了三点弯曲试验,并用酶联免疫吸附法测定了股骨裂解物中的 RANKL 水平:结果:在T2D-牙周炎小鼠体内对LCN-2进行功能性抑制,可减少颊面和腭面的牙槽骨损失,并保护剩余骨的微观结构,减少牙槽骨中的TNF-α和RANKL,降低高血糖、葡萄糖不耐受和胰岛素抵抗,并通过改善胰腺β细胞的功能增加胰岛素分泌。此外,这种抑制还能提高血清游离甘油水平,降低血清白细胞介素(IL)-6,增加血清IL-4,降低股骨脆性和股骨中RANKL的表达:结论:LCN-2参与了与T2D相关的牙周炎。在患有 T2D 和牙周炎的小鼠体内抑制其功能,可改善胰腺 β 细胞功能和葡萄糖代谢,降低炎性细胞因子和骨 RANKL 水平,从而保护股骨和牙槽骨的微结构。牙周炎是一种破坏性牙龈和牙槽骨疾病。在 T2D 和牙周炎中,LCN-2 的水平都会升高。我们利用小鼠 T2D 和牙周炎模型,研究了阻断 LCN-2 功能对这两种疾病各方面的影响。我们发现,这种抑制作用带来了显著的改善。首先,它通过减少局部炎症和骨吸收,减少了牙槽骨流失并保护了骨结构。其次,它改善了葡萄糖和脂质代谢,从而改善了血糖控制并降低了胰岛素抵抗。阻断 LCN-2 的功能还能减少全身炎症,增强骨的完整性。总之,我们的研究结果表明,LCN-2 在与 T2D 相关的牙周炎中起着至关重要的作用。通过抑制 LCN-2 的功能,我们能够改善胰腺功能、改善葡萄糖代谢、减少炎症并增强骨骼健康。以 LCN-2 为靶点可能是解决 T2D 和牙周炎有害影响的一种有前途的策略。
{"title":"Lipocalin-2 as a fundamental protein in type 2 diabetes and periodontitis in mice.","authors":"Diana Laura Sólis-Suarez, Saúl Ernesto Cifuentes-Mendiola, Patricia González-Alva, Adriana Patricia Rodríguez-Hernández, Arnulfo Martínez-Dávalos, Fulgencio Eduardo Llamosas-Hernandez, Marycarmen Godínez-Victoria, Ana Lilia García-Hernández","doi":"10.1002/JPER.24-0215","DOIUrl":"https://doi.org/10.1002/JPER.24-0215","url":null,"abstract":"<p><strong>Background: </strong>Lipocalin-2 (LCN-2) is an osteokine that suppresses appetite, stimulates insulin secretion, regulates bone remodeling, and is induced by proinflammatory cytokines. The aim of this work was to investigate the participation of LCN-2 in periodontitis associated with type 2 diabetes (T2D) by evaluating alveolar bone loss, glycemic control, inflammation, and femur fragility.</p><p><strong>Methods: </strong>A murine model of periodontitis with T2D and elevated LCN-2 concentration was used. Functional LCN-2 inhibition was achieved using an anti-LCN-2 polyclonal antibody, and isotype immunoglobulin G was used as a control. The alveolar bone and femur were evaluated by micro-CT. Glucose metabolism was determined. Tumor necrosis factor (TNF-α) and receptor activator of nuclear factor kappa-B ligand (RANKL) levels in alveolar bone lysates were quantified using ELISA, and serum cytokines were quantified using flow cytometry. A three-point bending test was performed in the femur, and RANKL levels were measured in femur lysates using ELISA.</p><p><strong>Results: </strong>Functional inhibition of LCN-2 in T2D-periodontitis mice decreased alveolar bone loss in buccal and palatal surfaces and preserved the microarchitecture of the remaining bone, decreased TNF-α and RANKL in alveolar bone, reduced hyperglycemia, glucose intolerance, and insulin resistance, and increased insulin production through improving the functionality of pancreatic β cells. Furthermore, this inhibition increased serum free-glycerol levels, decreased serum interleukin (IL)-6, increased serum IL-4, and reduced femur fragility and RANKL expression in the femur.</p><p><strong>Conclusions: </strong>LCN-2 participates in periodontitis associated with T2D. Inhibiting its function in mice with T2D and periodontitis improves pancreatic β-cell function, and glucose metabolism and decreases inflammatory cytokines and bone-RANKL levels, which results in the preservation of femoral and alveolar bone microarchitecture.</p><p><strong>Plain language summary: </strong>In this study, we explored the role of a bone protein known as lipocalin-2 (LCN-2) in the connection between periodontitis and type 2 diabetes (T2D). Periodontitis is a destructive gum and alveolar bone disease. LCN-2 levels are increased in both T2D and periodontitis. Using a mouse model of T2D with periodontitis, we examined how blocking LCN-2 function affected various aspects of these two diseases. We found that this inhibition led to significant improvements. First, it reduced alveolar bone loss and preserved bone structure by decreasing local inflammation and bone resorption. Second, it improved glucose and lipid metabolism, leading to better blood-sugar control and decreased insulin resistance. Blocking the functions of LCN-2 also decreased systemic inflammation throughout the body and strengthened bone integrity. Overall, our results suggest that LCN-2 plays a crucial role in the periodontitis associated","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073067","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}
引用次数: 0
Histological and immunohistochemical soft-tissue response to cylindrical and concave abutments: Multicenter randomized clinical trial. 组织学和免疫组化软组织对圆柱形和凹形基台的反应:多中心随机临床试验。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-26 DOI: 10.1002/JPER.24-0250
Fabio Camacho-Alonso, Juan Carlos Bernabeu-Mira, Joaquín Sánchez, Antonio Julián Buendía, Ana María Mercado-Díaz, Mario Pérez-Sayáns, Alba Pérez-Jardón, José Manuel Somoza Martín, Javier Montero, Cristina Gomez-Polo, Norberto Quispe-López, David Peñarrocha-Oltra

Background: This study aimed to analyze the influence of concave and cylindrical abutments on peri-implant soft tissue. Dimensions, collagen fiber orientation, and immunohistochemical data were assessed.

Methods: A multicenter, split-mouth, double-blind randomized clinical trial was conducted. Two groups were analyzed: cylindrical abutments and concave abutments. After a 12-week healing period, peri-implant soft tissue samples were collected, processed, and evaluated for dimensions, collagen fiber orientation, and immunohistochemical data. Inflammatory infiltration and vascularization were assessed, and the abutment surfaces were analyzed using scanning electron microscopy. The statistical analysis was performed using the SPSS version 20.0 statistical package.

Results: A total of 74 samples in 37 patients were evaluated. Histological evaluation of peri-implant soft tissue dimensions revealed significant differences between concave and cylindrical abutments. Concave abutments exhibited greater total height (concave: 3.57 ± 0.28 - cylindrical: 2.95 ± 0.27) and barrier epithelium extension (concave: 2.46 ± 0.17 - cylindrical: 1.89 ± 0.21) (p < 0.05), while the supracrestal connective tissue extension (concave: 1.11 ± 0.17 - cylindrical: 1.03 ± 0.16) was slightly greater (p > 0.05). Collagen fiber orientation favored concave abutments (23.76 ± 5.86), with significantly more transverse/perpendicular fibers than for cylindrical abutments (15.68 ± 4.57). The immunohistochemical analysis evidenced greater inflammatory and vascular intensity in the lower portion for both abutments, though concave abutments showed lower overall intensity (concave: 1.05 ± 0.78 - cylindrical: 1.97 ± 0.68) (p < 0.05). The abutment surface analysis demonstrated a higher percentage of tissue remnants on concave abutments (42.47 ± 1.32; 45.12 ± 3.03) (p < 0.05).

Conclusions: Within the limitations of this study, concave abutments presented significantly greater peri-implant tissue height, linked to an extended barrier epithelium, versus cylindrical abutments in thick tissue phenotype. This enhanced soft tissue sealing, favoring a greater percentage of transversely oriented collagen fibers. The concave design reduced chronic inflammatory exudation with T and B cells, thus minimizing the risk of chronic inflammation.

Plain language summary: This study looked at how 2 different shapes of dental implant abutments (the parts that connect the implant to the crown), specifically concave and cylindrical, affect the soft tissue around the implants. We wanted to see how these shapes influenced the tissue's size, structure, and health. We conducted a clinical trial with 37 patients, comparing the 2 types of abutments in the same mouth over 12 weeks. Our findings showed that the concave abutments led to a taller and more extensive layer of protective tissue around the implant comp

背景:本研究旨在分析凹基台和圆柱基台对种植体周围软组织的影响。对尺寸、胶原纤维方向和免疫组化数据进行了评估:进行了一项多中心、分口、双盲随机临床试验。分析对象分为两组:圆柱基台和凹基台。经过 12 周的愈合期后,收集、处理种植体周围软组织样本,并对其尺寸、胶原纤维方向和免疫组化数据进行评估。对炎症浸润和血管化进行评估,并使用扫描电子显微镜对基台表面进行分析。统计分析使用 SPSS 20.0 版统计软件包进行:结果:共对 37 名患者的 74 个样本进行了评估。对种植体周围软组织尺寸的组织学评估显示,凹基台和圆柱基台之间存在显著差异。凹形基台的总高度(凹形:3.57 ± 0.28 - 圆柱形:2.95 ± 0.27)和屏障上皮的扩展(凹形:2.46 ± 0.17 - 圆柱形:1.89 ± 0.21)更大(P 0.05)。凹形基台的胶原纤维取向更佳(23.76 ± 5.86),横向/垂直纤维明显多于圆柱形基台(15.68 ± 4.57)。免疫组化分析表明,两种基台下部的炎症和血管强度都较高,但凹面基台的总体强度较低(凹面:1.05 ± 0.78 - 圆柱面:1.97 ± 0.68)(p 结论:凹面基台和圆柱面基台的炎症和血管强度都较高:在本研究的限制条件下,凹基台与圆柱基台相比,在厚组织表型中,凹基台的种植体周围组织高度明显更高,这与扩展的屏障上皮有关。这增强了软组织的密封性,有利于增加横向胶原纤维的比例。凹形设计减少了T细胞和B细胞的慢性炎症渗出,从而将慢性炎症的风险降至最低。白话摘要:本研究观察了两种不同形状的种植体基台(连接种植体和牙冠的部分),特别是凹形和圆柱形基台对种植体周围软组织的影响。我们想知道这些形状对组织的大小、结构和健康有什么影响。我们对 37 名患者进行了临床试验,在 12 周内对同一口腔中的两种基台进行了比较。我们的研究结果表明,与圆柱形基台相比,凹形基台能在种植体周围形成更高更广泛的保护组织层。这种保护组织具有更有利的胶原纤维取向,这对组织的强度和健康非常重要。此外,凹基台的炎症更少,组织整合性更好。总之,凹基台可以为种植牙周围的软组织提供更好的支持和健康,降低慢性炎症的风险,并有可能为种植牙患者带来更好的长期疗效。
{"title":"Histological and immunohistochemical soft-tissue response to cylindrical and concave abutments: Multicenter randomized clinical trial.","authors":"Fabio Camacho-Alonso, Juan Carlos Bernabeu-Mira, Joaquín Sánchez, Antonio Julián Buendía, Ana María Mercado-Díaz, Mario Pérez-Sayáns, Alba Pérez-Jardón, José Manuel Somoza Martín, Javier Montero, Cristina Gomez-Polo, Norberto Quispe-López, David Peñarrocha-Oltra","doi":"10.1002/JPER.24-0250","DOIUrl":"https://doi.org/10.1002/JPER.24-0250","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to analyze the influence of concave and cylindrical abutments on peri-implant soft tissue. Dimensions, collagen fiber orientation, and immunohistochemical data were assessed.</p><p><strong>Methods: </strong>A multicenter, split-mouth, double-blind randomized clinical trial was conducted. Two groups were analyzed: cylindrical abutments and concave abutments. After a 12-week healing period, peri-implant soft tissue samples were collected, processed, and evaluated for dimensions, collagen fiber orientation, and immunohistochemical data. Inflammatory infiltration and vascularization were assessed, and the abutment surfaces were analyzed using scanning electron microscopy. The statistical analysis was performed using the SPSS version 20.0 statistical package.</p><p><strong>Results: </strong>A total of 74 samples in 37 patients were evaluated. Histological evaluation of peri-implant soft tissue dimensions revealed significant differences between concave and cylindrical abutments. Concave abutments exhibited greater total height (concave: 3.57 ± 0.28 - cylindrical: 2.95 ± 0.27) and barrier epithelium extension (concave: 2.46 ± 0.17 - cylindrical: 1.89 ± 0.21) (p < 0.05), while the supracrestal connective tissue extension (concave: 1.11 ± 0.17 - cylindrical: 1.03 ± 0.16) was slightly greater (p > 0.05). Collagen fiber orientation favored concave abutments (23.76 ± 5.86), with significantly more transverse/perpendicular fibers than for cylindrical abutments (15.68 ± 4.57). The immunohistochemical analysis evidenced greater inflammatory and vascular intensity in the lower portion for both abutments, though concave abutments showed lower overall intensity (concave: 1.05 ± 0.78 - cylindrical: 1.97 ± 0.68) (p < 0.05). The abutment surface analysis demonstrated a higher percentage of tissue remnants on concave abutments (42.47 ± 1.32; 45.12 ± 3.03) (p < 0.05).</p><p><strong>Conclusions: </strong>Within the limitations of this study, concave abutments presented significantly greater peri-implant tissue height, linked to an extended barrier epithelium, versus cylindrical abutments in thick tissue phenotype. This enhanced soft tissue sealing, favoring a greater percentage of transversely oriented collagen fibers. The concave design reduced chronic inflammatory exudation with T and B cells, thus minimizing the risk of chronic inflammation.</p><p><strong>Plain language summary: </strong>This study looked at how 2 different shapes of dental implant abutments (the parts that connect the implant to the crown), specifically concave and cylindrical, affect the soft tissue around the implants. We wanted to see how these shapes influenced the tissue's size, structure, and health. We conducted a clinical trial with 37 patients, comparing the 2 types of abutments in the same mouth over 12 weeks. Our findings showed that the concave abutments led to a taller and more extensive layer of protective tissue around the implant comp","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055884","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}
引用次数: 0
Diagnostic reproducibility of the 2018 Classification of Gingival Recessions: Comparing photographic and in-person diagnoses. 2018 年牙龈凹陷分类的诊断重现性:比较照相诊断和当面诊断。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-26 DOI: 10.1002/JPER.24-0173
Riccardo Di Gianfilippo, GiovanPaolo Pini Prato, Debora Franceschi, Walter Castelluzzo, Luigi Barbato, Alessandra Bandel, Maria Di Martino, Claudio M Pannuti, Leandro Chambrone, Francesco Cairo

Background: To assess how the diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects (GRD) could be applied when comparing in-person chairside measurements with photographic measurements.

Methods: Thirty-four GRD were photographed and evaluated by 4 masked operators. For each case, the operators measured twice recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento-enamel junction (CEJ), and presence of root steps (RSs), chairside, and on photographs. Intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) was calculated for RD and KTW; Kappa with 95% CI was used for GT, CEJ, and RS; quadratic weighted Kappa with 95% CI was used for RT.

Results: RD, KTW, and RT showed excellent overall intra-operator agreement (> 0.93), and from good to excellent overall inter-operator agreement (> 0.80), for both clinical and photographic measurements. Agreements were lower for GT, CEJ, and RS. Overall clinical and photographic agreements were within 0.1 difference for every variable, except for inter-operator agreement for RS which was 0.72 for clinical measurements and 0.45 for photographic measurements. The lowest overall agreement between clinical versus photographic measurements existed for CEJ (0.28) and RS (0.35).

Conclusions: Variables composing the 2018 Classification of GRD are reproducible, both clinically and on photographs, with comparable agreements. The overall agreement was higher for KTW, RD, and RT, and lower for GT, CEJ, and RS, for both clinical and photographic measurements. The comparison between chairside and photographic evaluations indicated fair to excellent agreement for most variables, with CEJ and RS showing fair agreement.

Plain language summary: As digital diagnostics evolve to facilitate clinical diagnostic measurement, we aimed to assess the effectiveness of intraoral photography for diagnosing gingival recession defects (GRD) according to the 2018 Classification of GRD, compared to traditional clinical examination. Standardized photographs of thirty-four GRD cases were captured. Four masked operators evaluated the same gingival recessions twice in a clinical setting and twice using photographs. Measurement repeatability within and between operators was calculated for both clinical and photographic settings, and the two settings were compared. Continuous measurements such as recession depth and keratinized tissue width, as well as the evaluation of interproximal attachment height (recession type), showed excellent agreement both clinically and photographically. Agreement was lower for gingival thickness and the detectability of tooth anatomical landmarks, such as the cemento-enamel junction and the presence of root steps. Overall, the agreement between chairside and photographic evaluations was gener

背景:目的:评估在比较亲自椅旁测量和照片测量时,如何应用2018年牙龈退缩缺陷(GRD)分类的诊断重现性:由 4 名蒙面操作员对 34 个 GRD 进行拍照和评估。对于每个病例,操作员都在椅旁和照片上测量了两次退缩类型(RT)、退缩深度(RD)、角化组织宽度(KTW)、牙龈厚度(GT)、牙龈-釉质交界处(CEJ)的可探测性以及根台阶(RS)的存在。对 RD 和 KTW 计算了带 95% 置信区间 (CI) 的类内相关系数 (ICC);对 GT、CEJ 和 RS 使用了带 95% CI 的 Kappa;对 RT 使用了带 95% CI 的二次加权 Kappa:RD、KTW 和 RT 的临床和摄影测量结果显示出极佳的整体操作者内一致性(> 0.93),以及良好到极佳的整体操作者间一致性(> 0.80)。GT、CEJ 和 RS 的一致性较低。除 RS 的操作者间一致性(临床测量为 0.72,摄影测量为 0.45)外,每个变量的临床测量和摄影测量的总体一致性均在 0.1 的差值范围内。CEJ(0.28)和RS(0.35)的临床测量与摄影测量的总体一致性最低:构成 2018 年 GRD 分类的变量在临床和照片上都具有可重复性,且一致性相当。在临床和照片测量中,KTW、RD和RT的总体一致性较高,而GT、CEJ和RS的一致性较低。椅旁评估和照片评估之间的比较表明,大多数变量的一致性为一般到优秀,CEJ和RS的一致性为一般。原文摘要:随着数字诊断技术的发展,促进了临床诊断测量,我们的目的是根据2018年牙龈退缩缺损分类,评估口内摄影与传统临床检查相比诊断牙龈退缩缺损(GRD)的有效性。我们拍摄了 34 例 GRD 的标准化照片。四名蒙面操作员对相同的牙龈退缩进行了两次临床评估和两次照片评估。计算了临床和照片两种设置下操作员内部和操作员之间的测量重复性,并对两种设置进行了比较。退缩深度和角化组织宽度等连续测量值以及近端间附着高度(退缩类型)的评估在临床和照片上都显示出极好的一致性。在牙龈厚度和牙齿解剖标志(如牙本质-釉质交界处和牙根台阶的存在)的可探测性方面,两者的一致性较低。总体而言,椅旁评价和照片评价之间的一致性普遍较好,但在评价牙齿解剖标志时一致性较低。构成 2018 年 GRD 分类的变量在临床和照相环境中都具有可重复性,一致性水平相当。然而,牙龈厚度和评估牙齿解剖标志时的一致性一直较差。
{"title":"Diagnostic reproducibility of the 2018 Classification of Gingival Recessions: Comparing photographic and in-person diagnoses.","authors":"Riccardo Di Gianfilippo, GiovanPaolo Pini Prato, Debora Franceschi, Walter Castelluzzo, Luigi Barbato, Alessandra Bandel, Maria Di Martino, Claudio M Pannuti, Leandro Chambrone, Francesco Cairo","doi":"10.1002/JPER.24-0173","DOIUrl":"https://doi.org/10.1002/JPER.24-0173","url":null,"abstract":"<p><strong>Background: </strong>To assess how the diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects (GRD) could be applied when comparing in-person chairside measurements with photographic measurements.</p><p><strong>Methods: </strong>Thirty-four GRD were photographed and evaluated by 4 masked operators. For each case, the operators measured twice recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento-enamel junction (CEJ), and presence of root steps (RSs), chairside, and on photographs. Intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) was calculated for RD and KTW; Kappa with 95% CI was used for GT, CEJ, and RS; quadratic weighted Kappa with 95% CI was used for RT.</p><p><strong>Results: </strong>RD, KTW, and RT showed excellent overall intra-operator agreement (> 0.93), and from good to excellent overall inter-operator agreement (> 0.80), for both clinical and photographic measurements. Agreements were lower for GT, CEJ, and RS. Overall clinical and photographic agreements were within 0.1 difference for every variable, except for inter-operator agreement for RS which was 0.72 for clinical measurements and 0.45 for photographic measurements. The lowest overall agreement between clinical versus photographic measurements existed for CEJ (0.28) and RS (0.35).</p><p><strong>Conclusions: </strong>Variables composing the 2018 Classification of GRD are reproducible, both clinically and on photographs, with comparable agreements. The overall agreement was higher for KTW, RD, and RT, and lower for GT, CEJ, and RS, for both clinical and photographic measurements. The comparison between chairside and photographic evaluations indicated fair to excellent agreement for most variables, with CEJ and RS showing fair agreement.</p><p><strong>Plain language summary: </strong>As digital diagnostics evolve to facilitate clinical diagnostic measurement, we aimed to assess the effectiveness of intraoral photography for diagnosing gingival recession defects (GRD) according to the 2018 Classification of GRD, compared to traditional clinical examination. Standardized photographs of thirty-four GRD cases were captured. Four masked operators evaluated the same gingival recessions twice in a clinical setting and twice using photographs. Measurement repeatability within and between operators was calculated for both clinical and photographic settings, and the two settings were compared. Continuous measurements such as recession depth and keratinized tissue width, as well as the evaluation of interproximal attachment height (recession type), showed excellent agreement both clinically and photographically. Agreement was lower for gingival thickness and the detectability of tooth anatomical landmarks, such as the cemento-enamel junction and the presence of root steps. Overall, the agreement between chairside and photographic evaluations was gener","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055882","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}
引用次数: 0
Effects of a 4-week free-sugar avoidance during periodontal therapy: An explorative randomized controlled clinical trial. 牙周治疗期间 4 周无糖忌口的效果:一项探索性随机对照临床试验。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-26 DOI: 10.1002/JPER.24-0208
Christina L Pappe, Beeke Peters, Olga Pivovarova-Ramich, Robert Schremmer, Aysegül Adam, Kirstin Vach, Henrik Dommisch, Johan P Woelber

Background: This study investigated the effect of a 4-week free-sugar avoidance on periodontal parameters during periodontal therapy.

Methods: Twenty-one patients with untreated periodontitis and daily free-sugar intake were allocated to a sugar avoidance group (SAG) and a control group (CG). The SAG received a 45-min dietary consultation and was instructed to avoid free sugars during the following 4 weeks after subgingival instrumentation, while the CG continued with their regular diet. Bleeding on probing (BOP), plaque control record, body weight (BW), visceral fat (FATv), and a food frequency questionnaire (FFQ) were collected at baseline (T1), 4 weeks (T2), and 8 weeks (T3) after subgingival instrumentation.

Results: The main outcome parameter BOP was significantly reduced at T2 by 40.3% ± 15.54 in the SAG and 34% ± 12.47 in the CG (intra-p value both <0.001, inter-p value 0.361). A linear regression analysis of changes at patient level adjusted for age and FATv revealed a significant group difference for BOP (regression coefficient = -6.8; p = 0.019). Significant reductions were observed in BW, FATv and mean daily intake of free sugars (-14.4 g/day), and a significant increase of vitamin C derived from fruits (75.89 mg/day) at T2 in the SAG only.

Conclusion: This study may indicate additional beneficial effects of a sugar avoidance on periodontal and metabolic parameters, and nutritional intake during periodontal therapy. German Clinical Trials Register (DRKS00026699).

Plain language summary: The current widespread free-sugar consumption is linked to an increasing incidence of chronic non-communicable diseases. Data indicate a relationship between sugar intake and a higher prevalence of periodontitis and increased gingival inflammation. This study showed that free-sugar avoidance after periodontal therapy had additional beneficial effects on periodontal and metabolic parameters in 10 test and 11 control patients. After 4 weeks of avoiding free sugars like sweets, processed white flour, juice, and so forth, periodontal bleeding was significantly reduced in both groups (-40.3% test group, -34% control group). Further regression analysis revealed a significant difference between groups favoring the intervention. Additionally, body weight and visceral fat were significantly reduced in the intervention group, only. To avoid sugar, patients were allowed to replace it with whole fruit, which led to increased levels of micronutrients such as vitamin C. Therefore, free-sugar avoidance may be of therapeutic benefit in addition to periodontal therapy. Further research is needed to investigate this effect in larger cohorts.

背景:本研究探讨了在牙周治疗过程中,4周无糖饮食对牙周参数的影响:本研究探讨了在牙周治疗过程中,为期 4 周的无糖忌口对牙周参数的影响:21名牙周炎未经治疗且每天摄入游离糖的患者被分配到忌糖组(SAG)和对照组(CG)。龈下器械治疗后的 4 周内,SAG 组接受 45 分钟的饮食咨询,并接受避免摄入游离糖的指导,而 CG 组则继续正常饮食。分别在龈下器械治疗后的基线(T1)、4周(T2)和8周(T3)收集探诊出血量(BOP)、牙菌斑控制记录、体重(BW)、内脏脂肪(FATv)和食物频率问卷(FFQ):结果:主要结果参数 BOP 在 T2 显著降低,SAG 降低了 40.3% ± 15.54,CG 降低了 34% ± 12.47(均为 P 值内):这项研究可能表明,在牙周治疗期间,避免摄入糖分对牙周和代谢参数以及营养摄入有额外的益处。德国临床试验注册(DRKS00026699).纯语言摘要:目前广泛的免费糖消费与慢性非传染性疾病发病率的增加有关。有数据表明,糖的摄入量与牙周炎的高发率和牙龈炎症的增加有关。这项研究表明,在 10 名试验患者和 11 名对照组患者中,牙周治疗后避免摄入游离糖对牙周和代谢参数有额外的益处。在避免食用甜食、加工白面、果汁等游离糖 4 周后,两组患者的牙周出血量均显著减少(试验组-40.3%,对照组-34%)。进一步的回归分析表明,两组之间存在明显差异,有利于干预措施。此外,只有干预组的体重和内脏脂肪明显减少。因此,除了牙周治疗外,避免摄入游离糖可能也有治疗效果。还需要在更大的群体中进一步研究这种效果。
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引用次数: 0
Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis. 在牙周炎的非手术治疗中联合应用 Er:YAG 激光和低强度激光。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-26 DOI: 10.1002/JPER.24-0128
Zhexian Cheng, Wei Li, Jitian Wang, Xuan Huang, Xingyuan Jia, Xuan Zhou

Background: To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment.

Methods: In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months.

Results: For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups.

Conclusion: The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets.

Plain language summary: To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low

背景:比较Er:YAG激光(ERL)和低强度激光疗法(LLLT)联合治疗与单一激光应用以及洗牙和根面平整(SRP)用于非手术牙周治疗的疗效:在一项随机对照试验中,招募了 25 名非吸烟的二期或三期牙周炎患者。口内四个象限被随机分配到四种不同的治疗方法中:(1)ERL+SRP+LLLT联合应用;(2)ERL+SRP;(3)SRP+LLLT;(4)SRP。我们在基线、3 个月和 6 个月时评估了牙周指标,包括探诊深度 (PD)、临床附着水平 (CAL)、出血指数 (BI) 和牙菌斑指数 (PLI),以及龈沟液中的三种细胞因子(IL-1β、TNF-α、IL-10)和龈下牙菌斑中的红色复合病原体:对于最初的中度牙周袋(4 mm ≤ PD ≤ 6 mm),与对照组(SRP)相比,ERL+SRP+LLLT、ERL+SRP 和 SRP+LLLT 治疗的象限在 3 个月的随访中显示出更大的 PD 改善(1.25 ± 1.06、1.23 ± 1.12、1.00 ± 1.21 vs. 0.98 ± 1.21 mm)和 6 个月随访(1.35 ± 1.06、1.23 ± 1.17、1.35 ± 0.98 vs. 0.98 ± 1.23 mm)(p = 0.002)。在 3 个月随访(0.96 ± 1.42、0.61 ± 1.39 vs. 0.55 ± 1.57 mm)和 6 个月随访(0.84 ± 1.54、0.89 ± 1.49 vs. 0.48 ± 1.68 mm)时,接受 ERL+SRP+LLLT 和 SRP+LLLT 治疗的象限比对照象限显示出更多的 CAL 增益(p = 0.008)。对于最初的深袋(PD ≥ 7 mm),ERL+SRP+LLLT象限与对照象限相比,在随访时有更多的PD改善和CAL增加。四组之间在BI、PLI、炎症细胞因子和牙周病原体方面没有明显差异:白话摘要:比较联合使用 Er:YAG 激光(ERL)和低水平激光治疗(LLLT)与单一使用激光和传统牙周治疗(SRP)的治疗效果。共有 25 名不吸烟的牙周炎患者参与了这项研究,他们的口腔被分为四个部分,每个部分都接受了不同的治疗:分别接受 ERL+SRP+LLLT、ERL+SRP、SRP+LLLT 和 SRP 治疗。分别在基线、3 个月和 6 个月时对临床指标和实验室指标进行评估。6 个月后,对于初期中度牙周袋,联合激光组和单一激光组在减少牙周袋深度和增加附着水平方面的改善效果优于传统组。但对于初期的深牙周袋,只有联合激光组比传统组有更好的改善。各组在出血、牙菌斑、炎症或有害细菌水平方面没有明显差异。这些研究结果表明,将 Er:YAG 激光和低水平激光疗法整合到标准牙周治疗中可能会提高治疗效果,减少牙周袋深度,尤其是对于严重的情况。
{"title":"Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis.","authors":"Zhexian Cheng, Wei Li, Jitian Wang, Xuan Huang, Xingyuan Jia, Xuan Zhou","doi":"10.1002/JPER.24-0128","DOIUrl":"https://doi.org/10.1002/JPER.24-0128","url":null,"abstract":"<p><strong>Background: </strong>To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment.</p><p><strong>Methods: </strong>In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months.</p><p><strong>Results: </strong>For initial moderate pockets (4 mm ≤ PD ≤ 6 mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25 ± 1.06, 1.23 ± 1.12, 1.00 ± 1.21 vs. 0.98 ± 1.21 mm) and the 6-month follow-up (1.35 ± 1.06, 1.23 ± 1.17, 1.35 ± 0.98 vs. 0.98 ± 1.23 mm) (p = 0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96 ± 1.42, 0.61 ± 1.39 vs. 0.55 ± 1.57 mm) and the 6-month follow-up (0.84 ± 1.54, 0.89 ± 1.49 vs. 0.48 ± 1.68 mm) (p = 0.008). For initial deep pockets (PD ≥ 7 mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups.</p><p><strong>Conclusion: </strong>The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets.</p><p><strong>Plain language summary: </strong>To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 non smoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and low","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055881","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}
引用次数: 0
Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial. 骨缺损部位的即刻单牙种植:为期 10 年的随机对照试验。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-11 DOI: 10.1002/JPER.24-0251
Henny J A Meijer, Kirsten W Slagter, Barzi Gareb, Diederik F M Hentenaar, Arjan Vissink, Gerry M Raghoebar

Background: It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation.

Methods: Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded.

Results: The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups.

Conclusions: Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone.

Plain language summary: Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

背景:目前还不清楚完整的颊骨板是否是在拔牙后牙槽骨中即刻植入种植体的先决条件。这项为期 10 年的随机对照试验旨在比较种植体周围软组织和硬组织参数、患者对拔牙后牙槽骨美学区颊骨缺损≥5 毫米的即刻种植体植入的美学评价和满意度,以及牙槽嵴保留后的延迟种植体植入的美学评价和满意度:方法:将拔牙后美观区有一颗失败牙且颊骨缺损≥5 mm的患者随机分配为即刻种植(即刻组,n = 20)或延迟种植(延迟组,n = 20)。两组患者均在种植体植入后 3 个月进行第二阶段手术和临时修复体植入,之后 3 个月进行最终修复体植入。在为期 10 年的随访期间,记录了边缘骨水平(主要结果)、颊骨厚度、软组织参数、美观度和患者报告的满意度:结果:10 年后,即刻组和延迟组的平均边缘骨水平变化分别为 -0.71 ± 0.59 毫米和 -0.36 ± 0.39 毫米(p = 0.063)。两组的次要结果无明显差异:即刻种植结合骨增量术植入颊骨缺损≥5 毫米的拔牙后牙槽窝后,边缘骨水平变化、颊骨厚度、临床效果、美学效果和患者满意度与在美学区保留牙脊后延迟植入种植体后的结果无统计学差异。问题是即刻种植是否需要完整的颊骨壁。在一项为期 10 年的研究中,20 名上颌额部牙齿缺损的患者接受了即刻种植治疗,并与 20 名采用更传统治疗策略的患者进行了比较,后者首先拔除缺损的牙齿,恢复骨间隙,然后再植入种植体。经过 10 年的随访,种植体周围的骨质非常稳定,牙龈健康,患者对效果非常满意。两种治疗方法没有任何区别。这样的结果意味着专业人员可以与患者讨论治疗程序,并根据个人喜好进行选择。
{"title":"Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.","authors":"Henny J A Meijer, Kirsten W Slagter, Barzi Gareb, Diederik F M Hentenaar, Arjan Vissink, Gerry M Raghoebar","doi":"10.1002/JPER.24-0251","DOIUrl":"https://doi.org/10.1002/JPER.24-0251","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation.</p><p><strong>Methods: </strong>Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded.</p><p><strong>Results: </strong>The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups.</p><p><strong>Conclusions: </strong>Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone.</p><p><strong>Plain language summary: </strong>Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916918","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}
引用次数: 0
Gingival phenotype classification by visual and probe visibility assessments: Relationship with thickness and probe design. 通过目测和探针可见度评估进行牙龈表型分类:与厚度和探针设计的关系
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-08-09 DOI: 10.1002/JPER.24-0172
Burak Fatih Uysal, Timur Köse, Ali Gürkan

Background: This study investigated the agreement among dentists in classifying gingival phenotype (GP) through periodontal probe visibility (PPV) assessment with various probe types and the visual method. Additionally, the relationship between GP classifications and gingival thickness (GT) was evaluated.

Methods: Photographs were taken with standard periodontal probe (SPP), color-coded periodontal probe (CCPP) tips in white, green, and blue, as well as metal phenotype probe (MPP) tips in gray and black. Evaluators (periodontist, periodontics resident, endodontics resident, dental student) assessed the photographs and classified the GPs. GT was measured by trans gingival probing.

Results: Visual method showed poor to fair agreement to classify GP. The lowest agreement regarding PPV was noted with white-tipped CCPP. The highest agreement in singular PPV was observed with CCPP blue (κ = 0.932), followed by CCPP green (κ = 0.791), MPP black (κ = 0.783), SPP (κ = 0.730), and MPP gray (κ = 0.690). Combined PPV data revealed fair to moderate agreement with CCPP and moderate to substantial agreement with MPP in GP classification. The corresponding GT to different GP classifications based on combined PPV were comparable. The agreement between SPP and CCPP in classifying non-thin phenotypes was 89.8%, while the agreement between SPP and MPP was 75.4%. Based on PPV, no significant GT cutoff value was found to distinguish between thin and non-thin phenotypes.

Conclusion: Determining a precise GT that guarantees the visibility of a given probe can be difficult when evaluating GP. Regardless of the type of probe, the PPV method has a high potential for misclassifying GP, despite having an acceptable agreement.

Plain language summary: Gingival phenotype (GP) is constituted by thickness of the gums and width of keratinized tissue around teeth. Direct visual evaluation or evaluating a periodontal probe's visibility beneath gums are established techniques to classify gingival phenotype. This study investigated how dentists classify GP using visual assessments and different types of periodontal probes, while also exploring the relationship between GP classifications and gingival thickness. Results showed varied agreement among dentists in classifying GP, with lower agreement observed when using certain types of probes, notably the white-tipped phenotype probe. The highest agreement was found with the blue phenotype probe. Data from periodontal probe visibility assessments indicated fair to moderate agreement with certain probes, suggesting some inconsistency in classification methods. Interestingly, GP classification with visual assessments or probes did not correlate with gingival thickness, which may highlight the importance of considering both factors in clinical practice. These findings underline the need for attention when relying solely on visual a

背景:本研究调查了牙科医生通过使用不同类型的探针和目测法评估牙周探针可见度(PPV)来划分牙龈表型(GP)的一致性。此外,还评估了 GP 分类与牙龈厚度(GT)之间的关系:使用标准牙周探针(SPP)、白色、绿色和蓝色彩色编码牙周探针(CCPP)以及灰色和黑色金属表型探针(MPP)拍摄照片。评估人员(牙周病学家、牙周病学住院医师、牙髓病学住院医师、牙科学生)对照片进行评估,并对 GP 进行分类。GT通过经牙龈探针测量:结果:目测法对 GP 分类的一致性从较差到一般。白尖 CCPP 的 PPV 一致性最低。单个 PPV 的一致性最高的是蓝色 CCPP(κ = 0.932),其次是绿色 CCPP(κ = 0.791)、黑色 MPP(κ = 0.783)、SPP(κ = 0.730)和灰色 MPP(κ = 0.690)。综合 PPV 数据显示,在 GP 分类中,与 CCPP 的一致程度为一般到中等,与 MPP 的一致程度为中等到较高。基于综合 PPV 的不同 GP 分类的相应 GT 具有可比性。SPP 与 CCPP 在非瘦小表型分类方面的一致性为 89.8%,而 SPP 与 MPP 的一致性为 75.4%。根据PPV,没有发现明显的GT临界值可以区分消瘦和非消瘦表型:结论:在评估 GP 时,确定一个精确的 GT 值以保证特定探针的可见性是很困难的。无论探针的类型如何,PPV 方法尽管具有可接受的一致性,但误判 GP 的可能性很大。白话摘要:牙龈表型(GP)由牙龈的厚度和牙齿周围角化组织的宽度构成。直接目测或评估牙周探针在牙龈下的可见度是划分牙龈表型的成熟技术。本研究调查了牙医如何使用视觉评估和不同类型的牙周探针对 GP 进行分类,同时还探讨了 GP 分类与牙龈厚度之间的关系。结果显示,牙医在对 GP 进行分类时的一致性不尽相同,在使用某些类型的探针(尤其是白尖表型探针)时,一致性较低。蓝色表型探针的一致性最高。牙周探针可见度评估的数据显示,某些探针的一致性一般到中等,这表明分类方法存在一定的不一致性。有趣的是,用目测或探针进行的 GP 分类与牙龈厚度并不相关,这可能突出了在临床实践中考虑这两个因素的重要性。这些发现强调了在仅依赖视觉评估或特定探针类型进行准确的 GP 分类时需要注意的问题。
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引用次数: 0
期刊
Journal of periodontology
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