Journal of periodontology最新文献

Background: Gingivitis is a common inflammatory condition affecting the gingival tissues, often serving as a precursor to periodontitis. Ultra-high frequency ultrasonography (UHFUS) has emerged as a promising imaging modality capable of providing high-resolution visualization of superficial soft tissues. This cross-sectional study explores the application of UHFUS to the evaluation of gingival tissues, aiming to compare its findings in cases of gingivitis versus gingival health. In particular, the focus is on identifying and characterizing the ultrastructural changes associated with inflammation.

Methods: Twenty participants affected by generalized gingivitis and twenty healthy controls were enrolled. All study participants underwent UHFUS scans (70 MHz) of gingival tissues on three areas per dental arch (anterior, middle right, middle left) using a standardized acquisition technique. Gingival thickness, echogenicity, and vascularization parameters (peak systolic velocity, time averaged peak velocity, resistive index, and pulsatility index) were evaluated and compared.

Results: No differences in terms of age and sex distribution were noticed between study groups. Participants affected by gingivitis exhibited significantly reduced gingival thickness (p < 0.05) and echogenicity (p < 0.001) at soft tissue level. All vascular parameters indicated the presence of increased blood flow associated to higher vascular resistance, with resistive index values consistently > 0.8 compared with healthy study participants, who showed values between 0.6 and 0.7.

Conclusions: Ultrasonography highlighted the presence of structural modifications in the presence of gingivitis compared with healthy study participants. Further assessment is advised to better address the modifications occurring following the development of gingival inflammation.

Plain language summary: This study aimed to characterize the ultrastructural and vascular modifications in gingival tissue associated with inflammation using UHFUS. A cross-sectional clinical investigation compared 20 participants with generalized gingivitis to 20 periodontally healthy controls. Standardized UHFUS (70 MHz) imaging of designated gingival sites was performed to objectively quantify tissue thickness, echogenicity (textural echointensity), and key vascularization parameters via Doppler analysis. The results demonstrated significant morphofunctional alterations in inflamed gingiva. The objective UHFUS-derived metrics indicated that gingival inflammation involves not only increased perfusion but also substantive underlying architectural changes. The findings provide a foundational reference for detecting subclinical tissue changes and offer a potential objective framework for monitoring therapeutic outcomes in periodontal research and clinical trials.

Background: Periodontitis, a chronic inflammatory disease, is linked to systemic conditions such as cardiovascular and kidney disease. Serum α-Klotho, an anti-aging protein with anti-inflammatory properties, has been associated with systemic diseases, but its role in periodontitis is unclear. This study evaluated the relationship between serum α-Klotho levels and periodontitis severity while accounting for confounders.

Methods: In this cross-sectional study, data from 961 participants in the National Health and Nutrition Examination Survey (NHANES) database were analyzed. Periodontitis was classified into stages (I-IV) and grades (A-C) using the ACES (Application of the 2018 periodontal status Classification to Epidemiological Survey data) guidelines. Serum α-Klotho levels were measured via enzyme-linked immunosorbent assay (ELISA). Ordinal logistic regression assessed associations between α-Klotho levels and periodontitis, adjusting for confounders such as age, smoking, comorbidities, and oral hygiene. The number of lost teeth was analyzed as a secondary outcome.

Results: In both adjusted and unadjusted regression models, no significant association was found between α-Klotho levels and periodontitis. Particularly, adjusted models revealed no significant association between α-Klotho levels and periodontitis stage (OR = 1.0001, p = 0.547, 95% CI: 0.9997-1.0006) or grade (OR = 0.9996, p = 0.144, 95% CI: 0.9991-1.0001). Age, smoking, and comorbidities significantly predicted severity. Despite a weak negative correlation between α-Klotho and tooth loss (r = -0.07, p = 0.023), this association was no longer significant after adjustment.

Conclusion: No significant association was found between serum α-Klotho levels and periodontitis severity. Age, smoking, and comorbidities were key predictors, highlighting the multifactorial nature of periodontitis. Further longitudinal and mechanistic studies are needed to clarify whether α-Klotho has a value as a biomarker of periodontal inflammation or disease progression.

Background: A simple tool for predicting the risk of tooth loss is considered valuable for the implementation of early preventive measures in community settings. This study aimed to establish a simple predictive model for tooth loss in a community-dwelling Japanese population.

Methods: This longitudinal study included 1755 participants aged 40-79 years who underwent dental examinations between 2007 and 2012. Incident tooth loss was defined as losing ≥2 teeth over a 5-year period, corresponding to the highest quartile of the number of teeth lost. Logistic regression analysis was employed for developing multivariate prediction models with and without dental examination data. The developed models were translated into simplified scoring systems based on the beta coefficients. The discrimination of the model was assessed using the Hosmer-Lemeshow test, and the calibration was assessed using a calibration plot.

Results: The incidence of tooth loss was 24.1%. The multivariable model without dental examination data, which included age, current smoking, diabetes, periodontal treatment, number of teeth present, and occupational status as predictors, demonstrated good discrimination and calibration. The multivariable model with dental examination parameters (periodontitis stage and untreated decayed teeth) as predictors demonstrated better predictive performance. The simplified scores, which were developed based on multivariable models, demonstrated predictive performances comparable to that of their respective multivariable models.

Conclusion: The prediction model, even the model without dental examination data can be used to identify individuals at high risk for tooth loss. The simple scoring tool for predicting tooth loss can be readily implemented in the community.

Plain language summary: We developed a multivariable risk prediction model and simplified scoring system for predicting tooth loss, which may help in the identification of individuals at a high risk of tooth loss in a community.

Background: This randomized controlled trial aims to evaluate alveolar ridge preservation (ARP) with or without a biologically active amnion-chorion membrane (BACM).

Methods: Thirty patients requiring tooth extraction in the esthetic zone were randomly assigned to 2 groups. Both groups underwent tooth extraction and collagenated bovine bone grafting, while the test sites received an additional BACM. Cone-beam computed tomography (CBCT) and intraoral scans (IOS) were performed before extraction and at 4 months post-extraction. Patient-reported outcomes (PROs) were assessed. The primary endpoint was the change in vertical and horizontal hard and soft tissue dimensions as measured by CBCT and clinically.

Results: All patients completed implant placement. CBCT measurements at 2 mm demonstrated that control and test groups exhibited reductions in horizontal ridge width with median decreases of 1.19 mm and 2.41 mm, respectively, with no significant differences (p = 0.126). For vertical height changes, the control and test groups experienced mean reductions of 0.99 ± 1.08 mm and 1.33 ± 0.73 mm, respectively, with no significant differences (p = 0.250). IOS analyses showed that mean soft tissue thickness at the alveolar crest was 2.67 ± 0.699 mm (p = 0.370) in the control versus 2.13 ± 0.807 mm (p = 0.846) in the test group, with no significant differences (p = 0.325).

Conclusion: The addition of a BACM did not improve the mean horizontal or vertical bone dimentional changes or have a measurable effect on the soft tissue outcome during ARP.