Background: The clinical evidence about alveolar ridge changes following molar extraction and how the alveolar bone morphology influences the ridge dimensional changes remains limited.
Methods: A total of 192 patients with 199 molar extractions were included in this retrospective study. Cone-beam computed tomography (CBCT) images of patients were obtained 0-3 months pre extraction and 6-12 months post extraction. Outcome variables included the change rate in ridge height and width. The effect of morphology on the outcomes was explored by single-factor analysis, correlation analysis, and a multiple linear regression model.
Results: Significant resorption of alveolar bone occurred vertically and horizontally after molar extraction. Jaw, furcation involvement, number of roots, number of bone wall defects, extraction reasons, overall relative bone loss (RBL), bone height of the furcation region, thickness of the lingual/palatal wall, and height difference between buccal and lingual/palatal walls (|HB-HL|) were significantly correlated with the change in the height of the central alveolar bone (HC). The number of bone wall defects, overall RBL, and |HB-HL| were significantly correlated with horizontal width change. HC resorption was higher in sockets with |HB-HL| > 2.5 mm and overall RBL > 50%.
Conclusions: The alveolar bone presented significant resorption after extraction. Anatomical characteristics affected the dimensions of the alveolar bone after molar extraction. When the initial overall RBL was severe or |HB-HL| was larger, the loss of alveolar bone dimensions was even more.
Plain language summary: In recent years, it has been demonstrated that the local anatomical morphology of extraction sites may influence the process of alveolar bone remodeling. However, most studies have focused on the anterior teeth, with fewer investigations addressing molar extraction sites. Therefore, we aimed to describe ridge changes following molar extraction and investigate how alveolar bone morphology influences ridge dimensional changes. In this retrospective study, we included a total of 199 alveolar sockets from 192 patients with molar extractions and obtained the corresponding cone-beam computed tomography (CBCT) images 0-3 months pre extraction and 6-12 months post extraction. The results showed significant resorption of the alveolar bone following molar extraction. We found that anatomical characteristics significantly affect the dimensions of the alveolar bone after molar extraction. Specifically, the loss of alveolar bone dimensions was greater when the initial overall relative bone loss (RBL) was severe or when the difference between buccal and lingual/palatal walls was greater.
{"title":"Effect of initial bone morphology on alveolar bone remodeling following molar extraction: A retrospective study.","authors":"Ren-Jie Lin, Anna Dai, Jia-Ping Huang, Meng Wang, Wen-Tao He, Pei-Hui Ding","doi":"10.1002/JPER.24-0342","DOIUrl":"https://doi.org/10.1002/JPER.24-0342","url":null,"abstract":"<p><strong>Background: </strong>The clinical evidence about alveolar ridge changes following molar extraction and how the alveolar bone morphology influences the ridge dimensional changes remains limited.</p><p><strong>Methods: </strong>A total of 192 patients with 199 molar extractions were included in this retrospective study. Cone-beam computed tomography (CBCT) images of patients were obtained 0-3 months pre extraction and 6-12 months post extraction. Outcome variables included the change rate in ridge height and width. The effect of morphology on the outcomes was explored by single-factor analysis, correlation analysis, and a multiple linear regression model.</p><p><strong>Results: </strong>Significant resorption of alveolar bone occurred vertically and horizontally after molar extraction. Jaw, furcation involvement, number of roots, number of bone wall defects, extraction reasons, overall relative bone loss (RBL), bone height of the furcation region, thickness of the lingual/palatal wall, and height difference between buccal and lingual/palatal walls (|HB-HL|) were significantly correlated with the change in the height of the central alveolar bone (HC). The number of bone wall defects, overall RBL, and |HB-HL| were significantly correlated with horizontal width change. HC resorption was higher in sockets with |HB-HL| > 2.5 mm and overall RBL > 50%.</p><p><strong>Conclusions: </strong>The alveolar bone presented significant resorption after extraction. Anatomical characteristics affected the dimensions of the alveolar bone after molar extraction. When the initial overall RBL was severe or |HB-HL| was larger, the loss of alveolar bone dimensions was even more.</p><p><strong>Plain language summary: </strong>In recent years, it has been demonstrated that the local anatomical morphology of extraction sites may influence the process of alveolar bone remodeling. However, most studies have focused on the anterior teeth, with fewer investigations addressing molar extraction sites. Therefore, we aimed to describe ridge changes following molar extraction and investigate how alveolar bone morphology influences ridge dimensional changes. In this retrospective study, we included a total of 199 alveolar sockets from 192 patients with molar extractions and obtained the corresponding cone-beam computed tomography (CBCT) images 0-3 months pre extraction and 6-12 months post extraction. The results showed significant resorption of the alveolar bone following molar extraction. We found that anatomical characteristics significantly affect the dimensions of the alveolar bone after molar extraction. Specifically, the loss of alveolar bone dimensions was greater when the initial overall relative bone loss (RBL) was severe or when the difference between buccal and lingual/palatal walls was greater.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047113","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}
Anna Kinugawa, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Misuzu Sato, Megumi Maeda, Fumiko Murata, Ken Osaka, Haruhisa Fukuda
BackgroundTo investigate the differences in health care expenditure (HCE) due to the comorbidity status of periodontal disease (PD) and diabetes mellitus (DM).MethodsThis cohort study used health care claims and oral health screening data to identify participants with PD or DM and followed them for 1 year to assess their HCE. PD and DM were determined based on PD screening and medical claims data, respectively. The study participants were divided into four groups: participants without PD and DM (PD−/DM−), participants with PD and without DM (PD+/DM−), participants without PD and with DM (PD−/DM+), and participants with PD and DM (PD+/DM+). Covariates included age, sex, smoking status, and Charlson Comorbidity Index (CCI) score. A generalized linear model (GLM) with a gamma distribution and log link function was used to examine the association between comorbidity and annual HCE, and a two‐part model was used to assess the differences in annual HCE.ResultsIn total, 790 participants (mean age: 63.1, 30.3% male) were included. Compared with the PD−/DM− group, the relative cost ratio (RCR) for the PD+/DM+, PD−/DM+, PD+/DM− groups were 1.31 (95% confidence interval [CI]: 1.06–1.62), 1.27 (95% CI: 0.99–1.64), 1.01 (95% CI: 0.89–1.14) times higher, respectively. The adjusted mean annual HCE for the PD+/DM+, PD−/DM+, PD+/DM− groups were ¥59,328 (95% CI: 14,171–104,484), ¥50,228 (95% CI: −15,801–116,256), ¥‐2,162 (95% CI: −24,598–20,274) higher than the PD−/DM− group, respectively.ConclusionThis study provides a significant contribution of PD to the increase in HCE, particularly in individuals with DM.Plain Language SummaryThe association between periodontal disease (PD) and diabetes mellitus (DM) has commonly been described in previous literature, but the health expenditure incurred when PD and DM coexist is not clear. This study investigates the differences in health care expenditure (HCE) due to the comorbidity status of PD and DM. HCE is calculated from medical, dental, and pharmacy‐dispensing expenditures from the claims data. PD was defined by periodontal pocket scores, and DM was determined based on medical records. Study participants were divided into four groups based on whether they had PD, DM, both, or neither. The results showed that people with both PD and DM had higher HCE compared with those without PD and DM. These findings may suggest the importance of cooperation between medical and dental professionals in the treatment of DM in terms of HCE.
{"title":"Differences in health care expenditure due to the comorbidity status of periodontal disease and diabetes mellitus","authors":"Anna Kinugawa, Kenji Takeuchi, Yudai Tamada, Taro Kusama, Misuzu Sato, Megumi Maeda, Fumiko Murata, Ken Osaka, Haruhisa Fukuda","doi":"10.1002/jper.24-0496","DOIUrl":"https://doi.org/10.1002/jper.24-0496","url":null,"abstract":"BackgroundTo investigate the differences in health care expenditure (HCE) due to the comorbidity status of periodontal disease (PD) and diabetes mellitus (DM).MethodsThis cohort study used health care claims and oral health screening data to identify participants with PD or DM and followed them for 1 year to assess their HCE. PD and DM were determined based on PD screening and medical claims data, respectively. The study participants were divided into four groups: participants without PD and DM (PD−/DM−), participants with PD and without DM (PD+/DM−), participants without PD and with DM (PD−/DM+), and participants with PD and DM (PD+/DM+). Covariates included age, sex, smoking status, and Charlson Comorbidity Index (CCI) score. A generalized linear model (GLM) with a gamma distribution and log link function was used to examine the association between comorbidity and annual HCE, and a two‐part model was used to assess the differences in annual HCE.ResultsIn total, 790 participants (mean age: 63.1, 30.3% male) were included. Compared with the PD−/DM− group, the relative cost ratio (RCR) for the PD+/DM+, PD−/DM+, PD+/DM− groups were 1.31 (95% confidence interval [CI]: 1.06–1.62), 1.27 (95% CI: 0.99–1.64), 1.01 (95% CI: 0.89–1.14) times higher, respectively. The adjusted mean annual HCE for the PD+/DM+, PD−/DM+, PD+/DM− groups were ¥59,328 (95% CI: 14,171–104,484), ¥50,228 (95% CI: −15,801–116,256), ¥‐2,162 (95% CI: −24,598–20,274) higher than the PD−/DM− group, respectively.ConclusionThis study provides a significant contribution of PD to the increase in HCE, particularly in individuals with DM.Plain Language SummaryThe association between periodontal disease (PD) and diabetes mellitus (DM) has commonly been described in previous literature, but the health expenditure incurred when PD and DM coexist is not clear. This study investigates the differences in health care expenditure (HCE) due to the comorbidity status of PD and DM. HCE is calculated from medical, dental, and pharmacy‐dispensing expenditures from the claims data. PD was defined by periodontal pocket scores, and DM was determined based on medical records. Study participants were divided into four groups based on whether they had PD, DM, both, or neither. The results showed that people with both PD and DM had higher HCE compared with those without PD and DM. These findings may suggest the importance of cooperation between medical and dental professionals in the treatment of DM in terms of HCE.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"20 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988542","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}
Anna Liss, Kajsa H. Abrahamsson, Maria Welander, Cristiano Tomasi
BackgroundThe study aims to analyze the effectiveness of nonsurgical re‐instrumentation of residual pockets as step 3 of periodontal therapy and the stability of treatment outcomes at 18 months.MethodsThe study sample consisted of 489 patients diagnosed and treated nonsurgically for periodontitis. After a 6‐month evaluation, residual pockets (≥5 mm) were re‐instrumented. A final examination was performed at 18 months. Participants were categorized by treatment outcome at 6 months: (A) No residual pockets ≥5 mm, (B) Residual pockets 5–6 mm, or (C) Residual pockets ≥7 mm. The primary outcome was pocket closure (≤4 mm). Logistic regression models were built to evaluate the effectiveness of re‐instrumentation and stability of initial outcomes at 18 months.ResultsRe‐instrumentation of pockets 5 to 6 mm resulted in pocket closure of around 39% in groups B and C. The corresponding result at sites with deeper residual pocketing (probing pocket depth [PPD] ≥7 mm) was 28%. Combining hand and ultrasonic instrumentation was more effective than each alone. Healed sites (6 months) were more likely to remain closed in group A (80%) than in groups B (50%) and C (40%). The logistic regression revealed that the stability of outcomes of step 1 and step 2 therapy was influenced by PPD at baseline, tobacco smoking, age, and type of tooth.ConclusionsAt step 3, nonsurgical re‐instrumentation can effectively improve periodontal health conditions. Treatment decisions after nonsurgical therapy should be based on residual probing depth, overall healing response, and patient behavior. The stability of clinical results was influenced by disease severity and the effectiveness of step 2 therapy.Plain Language SummaryThis study examined the effectiveness of nonsurgical re‐treatment of residual pockets (periodontal pockets not healed) after initial therapy and the stability of treatment outcomes to 18 months. The study involved 489 patients with periodontitis (loss of tooth‐supporting structures) treated in general dental practice. Residual pockets were re‐treated after examination at 6 months. A final examination was performed at 18 months. Treatment of residual gingival pockets was more successful in moderately diseased pockets compared with the most severely diseased pockets. Clinical results achieved in patients with a mild form of periodontitis were better in terms of stability compared with patients suffering from moderate and severe periodontitis. The success of nonsurgical periodontal treatment was influenced by the severity of periodontitis at the study start, the type of tooth affected, the age of the patient, and whether the patient was a smoker or not.
{"title":"Effectiveness of nonsurgical re‐instrumentation of residual pockets as step 3 of periodontal therapy: A field study","authors":"Anna Liss, Kajsa H. Abrahamsson, Maria Welander, Cristiano Tomasi","doi":"10.1002/jper.24-0532","DOIUrl":"https://doi.org/10.1002/jper.24-0532","url":null,"abstract":"BackgroundThe study aims to analyze the effectiveness of nonsurgical re‐instrumentation of residual pockets as step 3 of periodontal therapy and the stability of treatment outcomes at 18 months.MethodsThe study sample consisted of 489 patients diagnosed and treated nonsurgically for periodontitis. After a 6‐month evaluation, residual pockets (≥5 mm) were re‐instrumented. A final examination was performed at 18 months. Participants were categorized by treatment outcome at 6 months: (A) No residual pockets ≥5 mm, (B) Residual pockets 5–6 mm, or (C) Residual pockets ≥7 mm. The primary outcome was pocket closure (≤4 mm). Logistic regression models were built to evaluate the effectiveness of re‐instrumentation and stability of initial outcomes at 18 months.ResultsRe‐instrumentation of pockets 5 to 6 mm resulted in pocket closure of around 39% in groups B and C. The corresponding result at sites with deeper residual pocketing (probing pocket depth [PPD] ≥7 mm) was 28%. Combining hand and ultrasonic instrumentation was more effective than each alone. Healed sites (6 months) were more likely to remain closed in group A (80%) than in groups B (50%) and C (40%). The logistic regression revealed that the stability of outcomes of step 1 and step 2 therapy was influenced by PPD at baseline, tobacco smoking, age, and type of tooth.ConclusionsAt step 3, nonsurgical re‐instrumentation can effectively improve periodontal health conditions. Treatment decisions after nonsurgical therapy should be based on residual probing depth, overall healing response, and patient behavior. The stability of clinical results was influenced by disease severity and the effectiveness of step 2 therapy.Plain Language SummaryThis study examined the effectiveness of nonsurgical re‐treatment of residual pockets (periodontal pockets not healed) after initial therapy and the stability of treatment outcomes to 18 months. The study involved 489 patients with periodontitis (loss of tooth‐supporting structures) treated in general dental practice. Residual pockets were re‐treated after examination at 6 months. A final examination was performed at 18 months. Treatment of residual gingival pockets was more successful in moderately diseased pockets compared with the most severely diseased pockets. Clinical results achieved in patients with a mild form of periodontitis were better in terms of stability compared with patients suffering from moderate and severe periodontitis. The success of nonsurgical periodontal treatment was influenced by the severity of periodontitis at the study start, the type of tooth affected, the age of the patient, and whether the patient was a smoker or not.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"30 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988543","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}
Mohamed Ahmed Hassan, Guilherme Castro Lima Silva do Amaral, Luciana Saraiva, Marinella Holzhausen, Fausto Medeiros Mendes, Claudio Mendes Pannuti, Bernal Stewart, Zilson M. Malheiros, Carlos Benítez, Laís Yumi Souza Nakao, Cristina Cunha Villar, Giuseppe Alexandre Romito
BackgroundGingivitis, a widely prevalent oral health condition, affects up to 80% of the population. Traditional assessment methods for gingivitis rely heavily on subjective clinical evaluation. This study seeks to explore the efficacy of interpreting the color metrics from intraoral scans to objectively differentiate between healthy and inflamed gingiva.MethodsThis study used the percentage of bleeding on probing (BOP%) as the clinical reference standard. Intraoral scans, obtained before and after gingivitis treatment using a scanner, were analyzed through a custom MATLAB script to quantify HSV (hue, saturation, value) and CIELAB (Commission Internationale de l'Eclairage L*a*b*) color coordinates. The region of interest was a 2‐mm‐wide gingival strip along the buccal margin of the maxillary anterior teeth. Linear regression analysis was performed to evaluate the relationship between photometric outcomes and continuous, dichotomous, and categorical BOP data. Diagnostic accuracy was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), as well as sensitivity and specificity measures.ResultsThe analysis included clinical and digital color data from 110 scans, adhering to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. The multilevel linear regression analysis underscored a significant correlation between the BOP% and digital color metrics, specifically the CIELAB a* (red‐green chroma), CIELAB b* (yellow‐blue chroma), and color saturation, with AUC performances of 70%, 79.5%, and 80.8%, respectively.ConclusionDigital color analysis of intraoral scans has demonstrated a range of performance from acceptable to excellent in distinguishing sites with BOP. This innovative approach presents a promising tool for dentists and researchers in the accurate diagnosis, screening, and management of gingivitis.Plain Language SummaryOur study focuses on finding a better way to detect gingivitis, a common gum disease affecting many people. Traditional methods rely on the dentist's visual inspection, which can be subjective. We explored the use of color measurements from digital intraoral scans to objectively identify healthy versus inflamed gums. We analyzed 110 scans from 55 participants, examining the color differences in the gums before and after treatment. By measuring specific color values, we achieved up to 80.8% accuracy in distinguishing between healthy and inflamed gums. This method could offer a more reliable tool for dentists and researchers to diagnose and manage gingivitis, leading to better oral health outcomes.
牙龈炎是一种广泛流行的口腔健康状况，影响着多达80%的人口。传统的牙龈炎评估方法严重依赖主观临床评价。本研究旨在探讨解释口腔内扫描的颜色指标的有效性，以客观区分健康和发炎的牙龈。方法以探查出血百分率（BOP%）作为临床参考标准。使用扫描仪在牙龈炎治疗前后获得口腔内扫描，通过定制的MATLAB脚本进行分析，以量化HSV（色调、饱和度、值）和CIELAB （Commission Internationale de l’eclairage l *a*b*）颜色坐标。所研究的区域是沿上颌前牙颊缘的一条2毫米宽的龈带。采用线性回归分析来评估光度测量结果与连续、二分类和分类BOP数据之间的关系。采用受试者工作特征（ROC）曲线下面积（AUC）以及敏感性和特异性测量来评估诊断准确性。结果：根据STROBE（加强流行病学观察性研究报告）指南，分析包括来自110次扫描的临床和数字彩色数据。多层线性回归分析强调了BOP%与数字色彩指标之间的显著相关性，特别是CIELAB a*（红绿色度），CIELAB b*（黄蓝色度）和色彩饱和度，AUC性能分别为70%，79.5%和80.8%。结论口内扫描的数字颜色分析显示，在与BOP区分部位方面具有从可接受到优秀的性能。这种创新的方法为牙医和研究人员在牙龈炎的准确诊断、筛查和管理方面提供了一个有前途的工具。你的研究重点是寻找一种更好的方法来检测牙龈炎，这是一种影响许多人的常见牙龈疾病。传统的方法依赖于牙医的视觉检查，这可能是主观的。我们探索了使用数字口内扫描的颜色测量来客观地识别健康的牙龈和发炎的牙龈。我们分析了55名参与者的110张扫描图，检查了治疗前后牙龈的颜色差异。通过测量特定的颜色值，我们在区分健康牙龈和发炎牙龈方面达到了80.8%的准确率。这种方法可以为牙医和研究人员提供更可靠的工具来诊断和治疗牙龈炎，从而获得更好的口腔健康结果。
{"title":"Colorimetric analysis of intraoral scans: A novel approach for detecting gingival inflammation","authors":"Mohamed Ahmed Hassan, Guilherme Castro Lima Silva do Amaral, Luciana Saraiva, Marinella Holzhausen, Fausto Medeiros Mendes, Claudio Mendes Pannuti, Bernal Stewart, Zilson M. Malheiros, Carlos Benítez, Laís Yumi Souza Nakao, Cristina Cunha Villar, Giuseppe Alexandre Romito","doi":"10.1002/jper.24-0389","DOIUrl":"https://doi.org/10.1002/jper.24-0389","url":null,"abstract":"BackgroundGingivitis, a widely prevalent oral health condition, affects up to 80% of the population. Traditional assessment methods for gingivitis rely heavily on subjective clinical evaluation. This study seeks to explore the efficacy of interpreting the color metrics from intraoral scans to objectively differentiate between healthy and inflamed gingiva.MethodsThis study used the percentage of bleeding on probing (BOP%) as the clinical reference standard. Intraoral scans, obtained before and after gingivitis treatment using a scanner, were analyzed through a custom MATLAB script to quantify HSV (hue, saturation, value) and CIELAB (Commission Internationale de l'Eclairage L*a*b*) color coordinates. The region of interest was a 2‐mm‐wide gingival strip along the buccal margin of the maxillary anterior teeth. Linear regression analysis was performed to evaluate the relationship between photometric outcomes and continuous, dichotomous, and categorical BOP data. Diagnostic accuracy was assessed using the area under the receiver operating characteristic (ROC) curve (AUC), as well as sensitivity and specificity measures.ResultsThe analysis included clinical and digital color data from 110 scans, adhering to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. The multilevel linear regression analysis underscored a significant correlation between the BOP% and digital color metrics, specifically the CIELAB a* (red‐green chroma), CIELAB b* (yellow‐blue chroma), and color saturation, with AUC performances of 70%, 79.5%, and 80.8%, respectively.ConclusionDigital color analysis of intraoral scans has demonstrated a range of performance from acceptable to excellent in distinguishing sites with BOP. This innovative approach presents a promising tool for dentists and researchers in the accurate diagnosis, screening, and management of gingivitis.Plain Language SummaryOur study focuses on finding a better way to detect gingivitis, a common gum disease affecting many people. Traditional methods rely on the dentist's visual inspection, which can be subjective. We explored the use of color measurements from digital intraoral scans to objectively identify healthy versus inflamed gums. We analyzed 110 scans from 55 participants, examining the color differences in the gums before and after treatment. By measuring specific color values, we achieved up to 80.8% accuracy in distinguishing between healthy and inflamed gums. This method could offer a more reliable tool for dentists and researchers to diagnose and manage gingivitis, leading to better oral health outcomes.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"37 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142988604","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}
<p><strong>Background: </strong>Previous research has indicated a potential connection between smoking and tooth loss, but it remains unclear how the metabolites of nicotine, cotinine (COT) and trans-3'-hydroxycotinine (HC), and the nicotine metabolite ratio (NMR) affect the occurrence and progress of tooth loss. In this study, we aimed to investigate the relationship between tooth loss and smoking metabolites, then verify how the systemic immunoinflammatory index (SII) or monocyte to high-density lipoprotein cholesterol ratio (MHR) levels mediate this process.</p><p><strong>Methods: </strong>The cross-sectional study data were collected from the National Health and Nutrition Examination Survey (NHANES). After screening and comparing the baseline data, regression models were utilized to evaluate the relationship between serum COT + HC level and tooth loss, as well as COT + HC and SII/MHR and tooth loss. Furthermore, bootstrapping was applied to test the mediation effect of SII and MHR in the association between COT + HC and tooth loss.</p><p><strong>Results: </strong>A total of 9036 subjects were included in the study, with 2795 individuals in the COT/HC- group and 6241 in the COT/HC+ group. In the models with covariates adjusted, COT + HC level was found to be positively correlated with tooth loss (Model 3: odds ratio [OR] = 1.001, 95% CI = 1.001-1.001), especially in the fourth quartile (Q4) of COT + HC level (Model 3: OR = 2.647, 95% CI = 2.645-2.649) as compared to Q1. Furthermore, NMR was found to be negatively associated with tooth loss after adjustments (Model 3: OR = 0.803, 95% CI = 0.802-0.803). For mediation analysis, COT + HC level was significantly correlated with SII score, and SII was proved to be positively associated with tooth loss; meanwhile, COT + HC level was significantly correlated with MHR, and MHR was positively associated with tooth loss. SII and MHR played a partial mediating role in the association between COT + HC and tooth loss, and the indirect effect was 0.0001 (SII; 95% CI = 0.0000-0.0002) and 0.0002 (MHR; 95% CI = 0.0001-0.0004), respectively. The mediating effect of both SII and MHR was 0.0003 (95% CI = 0.0001-0.0004).</p><p><strong>Conclusions: </strong>This study revealed that the level of nicotine metabolites (COT + HC) was a risk factor, while higher NMR was a protective factor for tooth loss, and further demonstrated the partial mediating role of SII and MHR in the association between COT + HC and tooth loss.</p><p><strong>Plain language summary: </strong>Prior studies have suggested a possible link between smoking and tooth loss, but how certain nicotine byproducts and their ratios impact tooth loss is unclear. This research aimed to explore how these smoking metabolites influence tooth loss. Data from national health surveys were used for a cross-sectional study to assess the connection between cotinine levels in the blood and tooth loss, as well as to understand if immune and cholesterol markers mediate t
背景：以往的研究表明吸烟与牙齿脱落有潜在的联系，但尼古丁、可替宁（COT）和反式-3′-羟基可替宁（HC）的代谢物以及尼古丁代谢物比率（NMR）如何影响牙齿脱落的发生和进展尚不清楚。在本研究中，我们旨在研究牙齿脱落与吸烟代谢物之间的关系，然后验证全身免疫炎症指数（SII）或单核细胞与高密度脂蛋白胆固醇比（MHR）水平如何介导这一过程。方法：横断面研究数据收集自国家健康与营养检查调查（NHANES）。筛选比较基线数据后，采用回归模型评价血清COT + HC水平与牙齿脱落、COT + HC和SII/MHR与牙齿脱落的关系。此外，采用自举法检验SII和MHR在COT + HC与牙齿脱落之间的中介作用。结果：共纳入9036例受试者，其中COT/HC-组2795例，COT/HC+组6241例。在协变量调整后的模型中，COT + HC水平与牙齿脱落呈正相关（模型3：比值比[OR] = 1.001, 95% CI = 1.001-1.001），特别是COT + HC水平的第四分位数（Q4）与Q1相比（模型3:OR = 2.647, 95% CI = 2.645-2.649）。此外，NMR被发现与调整后牙齿脱落呈负相关（模型3:OR = 0.803, 95% CI = 0.802-0.803）。在中介分析中，COT + HC水平与SII评分显著相关，SII与牙齿脱落呈正相关；同时，COT + HC水平与MHR显著相关，MHR与牙齿脱落呈正相关。SII和MHR在COT + HC与牙齿脱落的关联中起部分中介作用，间接效应为0.0001 (SII；95% CI = 0.000 -0.0002)和0.0002 (MHR；95% CI = 0.0001-0.0004)。SII和MHR的中介效应均为0.0003 （95% CI = 0.0001 ~ 0.0004）。结论：本研究揭示了尼古丁代谢物（COT + HC）水平是牙齿脱落的危险因素，而高NMR是牙齿脱落的保护因素，并进一步证明了SII和MHR在COT + HC与牙齿脱落之间的部分中介作用。简单的语言总结：先前的研究表明吸烟和牙齿脱落之间可能存在联系，但某些尼古丁副产品及其比例如何影响牙齿脱落尚不清楚。这项研究旨在探索这些吸烟代谢物如何影响牙齿脱落。来自全国健康调查的数据被用于一项横断面研究，以评估血液中可替宁水平与牙齿脱落之间的联系，并了解免疫和胆固醇标志物是否介导吸烟代谢物与牙齿脱落之间的联系。结果显示，可替宁水平与牙齿脱落呈正相关。免疫和胆固醇标记物被发现部分介导吸烟代谢物与牙齿脱落之间的关系。高水平的尼古丁副产品与牙齿脱落的风险增加有关。
{"title":"Cotinine, trans-3'-hydroxycotinine, and nicotine metabolite ratio indicate association between smoking and tooth loss.","authors":"Yuwei Zhang, Yue Jia, Changjie Sun, Yifei Zhang, Yuxin Liao, Huizhe Liu, Rui Zou, Lin Niu, Shaojie Dong","doi":"10.1002/JPER.24-0249","DOIUrl":"https://doi.org/10.1002/JPER.24-0249","url":null,"abstract":"<p><strong>Background: </strong>Previous research has indicated a potential connection between smoking and tooth loss, but it remains unclear how the metabolites of nicotine, cotinine (COT) and trans-3'-hydroxycotinine (HC), and the nicotine metabolite ratio (NMR) affect the occurrence and progress of tooth loss. In this study, we aimed to investigate the relationship between tooth loss and smoking metabolites, then verify how the systemic immunoinflammatory index (SII) or monocyte to high-density lipoprotein cholesterol ratio (MHR) levels mediate this process.</p><p><strong>Methods: </strong>The cross-sectional study data were collected from the National Health and Nutrition Examination Survey (NHANES). After screening and comparing the baseline data, regression models were utilized to evaluate the relationship between serum COT + HC level and tooth loss, as well as COT + HC and SII/MHR and tooth loss. Furthermore, bootstrapping was applied to test the mediation effect of SII and MHR in the association between COT + HC and tooth loss.</p><p><strong>Results: </strong>A total of 9036 subjects were included in the study, with 2795 individuals in the COT/HC- group and 6241 in the COT/HC+ group. In the models with covariates adjusted, COT + HC level was found to be positively correlated with tooth loss (Model 3: odds ratio [OR] = 1.001, 95% CI = 1.001-1.001), especially in the fourth quartile (Q4) of COT + HC level (Model 3: OR = 2.647, 95% CI = 2.645-2.649) as compared to Q1. Furthermore, NMR was found to be negatively associated with tooth loss after adjustments (Model 3: OR = 0.803, 95% CI = 0.802-0.803). For mediation analysis, COT + HC level was significantly correlated with SII score, and SII was proved to be positively associated with tooth loss; meanwhile, COT + HC level was significantly correlated with MHR, and MHR was positively associated with tooth loss. SII and MHR played a partial mediating role in the association between COT + HC and tooth loss, and the indirect effect was 0.0001 (SII; 95% CI = 0.0000-0.0002) and 0.0002 (MHR; 95% CI = 0.0001-0.0004), respectively. The mediating effect of both SII and MHR was 0.0003 (95% CI = 0.0001-0.0004).</p><p><strong>Conclusions: </strong>This study revealed that the level of nicotine metabolites (COT + HC) was a risk factor, while higher NMR was a protective factor for tooth loss, and further demonstrated the partial mediating role of SII and MHR in the association between COT + HC and tooth loss.</p><p><strong>Plain language summary: </strong>Prior studies have suggested a possible link between smoking and tooth loss, but how certain nicotine byproducts and their ratios impact tooth loss is unclear. This research aimed to explore how these smoking metabolites influence tooth loss. Data from national health surveys were used for a cross-sectional study to assess the connection between cotinine levels in the blood and tooth loss, as well as to understand if immune and cholesterol markers mediate t","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983499","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}
{"title":"Research Forum Poster Session and Competition: Finalists and Posters","authors":"","doi":"10.1002/jper.24-0266","DOIUrl":"https://doi.org/10.1002/jper.24-0266","url":null,"abstract":"","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"36 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981347","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}
Hamzeh Almashni, Era Kakar, Paolo Nava, Hom-Lay Wang, Muhammad H A Saleh
Background: To investigate the effect of rheumatoid arthritis (RA) on the incidence of peri-implantitis (PI) and peri-implant mucositis (PIM).
Methods: Radiographic and clinical chart reviews were conducted to measure the probing depth (PD), bleeding on probing, and marginal bone loss (MBL) around the implants to diagnose peri-implant diseases based on the 2017 workshop classification. Values were recorded at the baseline (T0) to the last available chart and radiograph (T1). Maintenance compliance was evaluated. Cases were followed longitudinally to detect the incidence of PI and PIM. Various potential confounders were controlled, including the total radiographic follow-up time, chart-based follow-up time, number of maintenance visits, implant dimensions, history of periodontitis, bone graft, restoration angle, emergence, smoking, and diabetes mellitus. Chi-square and Mann-Whitney tests evaluated categorical and continuous differences. Generalized estimating equations with a Tweedie distribution were applied. Binary logistic regression ascertained the odds ratio for binary outcomes.
Results: A total of 101 patients (50 RA and 51 non-RA) with 124 implants were investigated. The mean follow-up period for the implants was 5.38 ± 2.22 years. Implant survival rate was high at 96%. The RA group demonstrated a significantly higher PI (p = 0.024), while the non-RA group showed a significantly higher PIM (p < 0.001). No significant differences were observed between both groups in implant survival and MBL.
Conclusion: Compared to the non-RA group, RA patients demonstrated a similar incidence of MBL and implant survival rates and a significantly lower incidence of PIM; however, there was a significantly higher incidence of PI.
Plain language summary: In this study, we investigated the condition of dental implants in 50 patients with rheumatoid arthritis (RA) compared to 51 healthy controls over 5 years. Assessments from initial treatment to the last follow-up visit included reviewing patient records and radiographs for signs of bleeding, probing depth, and bone loss. These measures helped diagnose peri-implantitis (PI) and peri-implant mucositis (PIM) based on the 2017 periodontal disease classification. The findings revealed a high implant survival rate in both groups (96%) with no significant difference in bone loss. However, the RA group showed a significantly higher incidence of PI than the healthy group that demonstrated PIM.
背景：研究类风湿关节炎（RA）对种植体周围炎（PI）和种植体周围粘膜炎（PIM）发病率的影响：目的：研究类风湿性关节炎（RA）对种植体周围炎（PI）和种植体周围粘膜炎（PIM）发病率的影响：根据2017年研讨会的分类，对种植体周围的探诊深度（PD）、探诊出血量和边缘骨量（MBL）进行测量，以诊断种植体周围疾病。从基线值（T0）到最后一次可用的病历和X光片（T1）均有记录。对维护依从性进行评估。对病例进行纵向随访，以检测 PI 和 PIM 的发生率。对各种潜在的混杂因素进行了控制，包括总的影像学随访时间、基于图表的随访时间、维护次数、种植体尺寸、牙周炎病史、植骨、修复角度、出牙期、吸烟和糖尿病。卡方检验（Chi-square）和曼惠特尼检验（Mann-Whitney）对分类和连续性差异进行了评估。应用了特威迪分布的广义估计方程。二元逻辑回归确定了二元结果的几率比例：共调查了 101 名患者（50 名 RA 患者和 51 名非 RA 患者）的 124 例植入物。种植体的平均随访时间为 5.38 ± 2.22 年。种植体存活率高达 96%。RA 组的 PI 明显更高（P = 0.024），而非 RA 组的 PIM 明显更高（P = 0.024）：与非 RA 组相比，RA 患者的 MBL 发生率和种植体存活率相似，PIM 发生率明显较低；但 PI 发生率明显较高。白话摘要：在这项研究中，我们调查了 50 名类风湿性关节炎（RA）患者与 51 名健康对照组患者 5 年来的牙科种植体状况。从初始治疗到最后一次随访的评估包括查看患者记录和X光片，以了解出血迹象、探查深度和骨质流失情况。根据2017年牙周病分类，这些措施有助于诊断种植体周围炎（PI）和种植体周围粘膜炎（PIM）。研究结果显示，两组患者的种植体存活率都很高（96%），骨质流失方面没有明显差异。不过，RA 组的 PI 发生率明显高于显示出 PIM 的健康组。
{"title":"Influence of rheumatoid arthritis on peri-implant diseases: A longitudinal retrospective clinical and radiographic evaluation.","authors":"Hamzeh Almashni, Era Kakar, Paolo Nava, Hom-Lay Wang, Muhammad H A Saleh","doi":"10.1002/JPER.24-0376","DOIUrl":"https://doi.org/10.1002/JPER.24-0376","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effect of rheumatoid arthritis (RA) on the incidence of peri-implantitis (PI) and peri-implant mucositis (PIM).</p><p><strong>Methods: </strong>Radiographic and clinical chart reviews were conducted to measure the probing depth (PD), bleeding on probing, and marginal bone loss (MBL) around the implants to diagnose peri-implant diseases based on the 2017 workshop classification. Values were recorded at the baseline (T0) to the last available chart and radiograph (T1). Maintenance compliance was evaluated. Cases were followed longitudinally to detect the incidence of PI and PIM. Various potential confounders were controlled, including the total radiographic follow-up time, chart-based follow-up time, number of maintenance visits, implant dimensions, history of periodontitis, bone graft, restoration angle, emergence, smoking, and diabetes mellitus. Chi-square and Mann-Whitney tests evaluated categorical and continuous differences. Generalized estimating equations with a Tweedie distribution were applied. Binary logistic regression ascertained the odds ratio for binary outcomes.</p><p><strong>Results: </strong>A total of 101 patients (50 RA and 51 non-RA) with 124 implants were investigated. The mean follow-up period for the implants was 5.38 ± 2.22 years. Implant survival rate was high at 96%. The RA group demonstrated a significantly higher PI (p = 0.024), while the non-RA group showed a significantly higher PIM (p < 0.001). No significant differences were observed between both groups in implant survival and MBL.</p><p><strong>Conclusion: </strong>Compared to the non-RA group, RA patients demonstrated a similar incidence of MBL and implant survival rates and a significantly lower incidence of PIM; however, there was a significantly higher incidence of PI.</p><p><strong>Plain language summary: </strong>In this study, we investigated the condition of dental implants in 50 patients with rheumatoid arthritis (RA) compared to 51 healthy controls over 5 years. Assessments from initial treatment to the last follow-up visit included reviewing patient records and radiographs for signs of bleeding, probing depth, and bone loss. These measures helped diagnose peri-implantitis (PI) and peri-implant mucositis (PIM) based on the 2017 periodontal disease classification. The findings revealed a high implant survival rate in both groups (96%) with no significant difference in bone loss. However, the RA group showed a significantly higher incidence of PI than the healthy group that demonstrated PIM.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983635","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}
{"title":"Research Forum Poster Session and Competition: Finalists and Posters.","authors":"","doi":"10.1002/JPER.24-0369","DOIUrl":"https://doi.org/10.1002/JPER.24-0369","url":null,"abstract":"","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983637","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}
Marco Montevecchi, Leoluca Valeriani, Maria Francesca Salvadori, Martina Stefanini, Giovanni Zucchelli
<p><strong>Background: </strong>Crown cementation is a common technique for implant-supported prosthodontics. However, for possible slipping of the cement below the mucosal margin, its thorough removal poses some issues. The objective of this study was to evaluate the presence of submucosal cement residues in patients with peri-implant disease by endoscopic visualization and to investigate the potential correlation between the pathological scenario and the spatial position of cement residues.</p><p><strong>Methods: </strong>The study sample comprised 46 consecutive patients exhibiting clinical and radiographic signs of peri-implant disease around cement-retained crowns. When at first visit bleeding on probing was the only pathological sign, the area was debrided and then treated with antiseptic agents for 30 days. Only those patients for whom bleeding was still found at re-evaluation were included in the study. All implants were therefore endoscopically evaluated to identify possible submucosal cement residues. For all implants showing residual cement, the spatial position of the residual cement was recorded with respect to predefined points.</p><p><strong>Results: </strong>Cement residues were detected in 80.4% of the patients and were predominantly located in the vestibular and lingual areas (88%). Analysis of the distances between the apical portion of the residues and anatomical landmarks revealed significant differences between mucositis and peri-implantitis patients (p = 0.001). In cases of peri-implantitis, the cement residue was more apically located than in mucositis.</p><p><strong>Conclusion: </strong>The presence of cement residue was associated with peri-implant disorders in the majority of patients. A potential correlation between the position of residues and the peri-implant disease scenario is here suggested.</p><p><strong>Plain language summary: </strong>A common method for fixing the crown on the dental implant is the use of specific cements. However, these products can slip below the gum line resulting in difficulties in their removal, which could cause peri-implant disease. This study aimed to evaluate the presence and location of residual cement hidden under the gums in patients with peri-implant disease, characterized by symptoms such as bleeding gums and, in some cases, bone loss around the dental implant. Using a small fiber-optic camera (endoscope), 46 patients were examined for any cement residue under the gums. The study showed that more than 80% of patients had cement residues, especially in the areas facing the cheeks and tongue. It was also found that in patients with a more severe form of inflammation (peri-implantitis), the cement was placed deeper than in those with a milder form (mucositis). This confirms that residual cement is common in patients with peri-implant disease, but also suggests that its location could influence the severity of the pathological manifestation. This finding highlights the importance of
{"title":"Excess cement and peri-implant disease: A cross-sectional clinical endoscopic study.","authors":"Marco Montevecchi, Leoluca Valeriani, Maria Francesca Salvadori, Martina Stefanini, Giovanni Zucchelli","doi":"10.1002/JPER.24-0510","DOIUrl":"https://doi.org/10.1002/JPER.24-0510","url":null,"abstract":"<p><strong>Background: </strong>Crown cementation is a common technique for implant-supported prosthodontics. However, for possible slipping of the cement below the mucosal margin, its thorough removal poses some issues. The objective of this study was to evaluate the presence of submucosal cement residues in patients with peri-implant disease by endoscopic visualization and to investigate the potential correlation between the pathological scenario and the spatial position of cement residues.</p><p><strong>Methods: </strong>The study sample comprised 46 consecutive patients exhibiting clinical and radiographic signs of peri-implant disease around cement-retained crowns. When at first visit bleeding on probing was the only pathological sign, the area was debrided and then treated with antiseptic agents for 30 days. Only those patients for whom bleeding was still found at re-evaluation were included in the study. All implants were therefore endoscopically evaluated to identify possible submucosal cement residues. For all implants showing residual cement, the spatial position of the residual cement was recorded with respect to predefined points.</p><p><strong>Results: </strong>Cement residues were detected in 80.4% of the patients and were predominantly located in the vestibular and lingual areas (88%). Analysis of the distances between the apical portion of the residues and anatomical landmarks revealed significant differences between mucositis and peri-implantitis patients (p = 0.001). In cases of peri-implantitis, the cement residue was more apically located than in mucositis.</p><p><strong>Conclusion: </strong>The presence of cement residue was associated with peri-implant disorders in the majority of patients. A potential correlation between the position of residues and the peri-implant disease scenario is here suggested.</p><p><strong>Plain language summary: </strong>A common method for fixing the crown on the dental implant is the use of specific cements. However, these products can slip below the gum line resulting in difficulties in their removal, which could cause peri-implant disease. This study aimed to evaluate the presence and location of residual cement hidden under the gums in patients with peri-implant disease, characterized by symptoms such as bleeding gums and, in some cases, bone loss around the dental implant. Using a small fiber-optic camera (endoscope), 46 patients were examined for any cement residue under the gums. The study showed that more than 80% of patients had cement residues, especially in the areas facing the cheeks and tongue. It was also found that in patients with a more severe form of inflammation (peri-implantitis), the cement was placed deeper than in those with a milder form (mucositis). This confirms that residual cement is common in patients with peri-implant disease, but also suggests that its location could influence the severity of the pathological manifestation. This finding highlights the importance of ","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983517","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}
{"title":"Research Forum Poster Session and Competition: Winners.","authors":"","doi":"10.1002/JPER.24-0373","DOIUrl":"https://doi.org/10.1002/JPER.24-0373","url":null,"abstract":"","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983558","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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