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Evaluation of circulating IgG antibodies against Porphyromonas gingivalis or its gingipains as serological markers of periodontitis and carriage of the bacterium. 将针对牙龈卟啉单胞菌或其龈肽的循环 IgG 抗体作为牙周炎和细菌携带的血清学标志物进行评估。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-17 DOI: 10.1002/JPER.23-0766
Laura Massarenti, Claus Henrik Nielsen, Anne Katrine Danielsen, Peter Østrup Jensen, Christian Enevold, Christian Damgaard

Background: Increasing evidence indicates that periodontitis contributes to systemic low-grade inflammation. Porphyromonas gingivalis is strongly associated with periodontitis, and antibodies against the bacterium may be used as a serological proxy to account for periodontal status, when studying diseases associated with periodontitis. The aim of the present study is to identify an easily accessible and reliable serological biomarker for determination of periodontal status and oral carriage of the bacterium.

Methods: Saliva and serum samples were collected from periodontally healthy controls (n = 27), and patients with periodontitis stage II (n = 12) or stages III or IV (n = 44). Serum levels of immunoglobulin G (IgG) antibodies against intact and fragmented P. gingivalis, recombinant gingipains (RgpA and RgpB), and the bacteria Escherichia coli and Capnocytophaga ochracea as controls were quantified with a multiplex bead-based assay. P. gingivalis was identified in saliva using quantitative polymerase chain reaction (qPCR).

Results: Serum IgG antibodies against P. gingivalis whole bacteria were good indicators of periodontitis (area under the curve [AUC]: 0.75, 95% confidence interval [CI]: 0.64-0.85). The same was observed for levels of antibodies against P. gingivalis fragments (AUC: 0.78, 95% CI: 0.68-0.88). Likewise, levels of antibodies against P. gingivalis whole bacteria or P. gingivalis fragments were good indicators of oral carriage of P. gingivalis (AUC: 0.92, 95% CI: 0.86-0.98 and AUC: 0.96, 95% CI: 0.92-1, respectively). Conversely, antibodies against recombinant RgpA and RgpB were not good indicators of periodontitis or oral carriage of the bacterium. None of the antibody levels differed significantly between stage II and stage III or IV periodontitis.

Conclusion: Serum IgG antibody levels against heat-inactivated whole P. gingivalis proved to be the preferable biomarker for periodontitis and oral carriage of the bacterium.

背景:越来越多的证据表明,牙周炎会导致全身性低度炎症。牙龈卟啉单胞菌(Porphyromonas gingivalis)与牙周炎密切相关,在研究与牙周炎相关的疾病时,针对牙龈卟啉单胞菌的抗体可作为一种血清学替代物来说明牙周状况。本研究的目的是确定一种易于获得且可靠的血清学生物标志物,用于确定牙周状况和该细菌的口腔携带情况:方法:从牙周健康的对照组(27 人)和牙周炎 II 期(12 人)、III 期或 IV 期(44 人)患者中采集唾液和血清样本。采用基于多聚酶珠的检测方法对血清中针对完整和片段牙龈脓杆菌、重组牙龈肽(RgpA 和 RgpB)以及作为对照的大肠杆菌和嗜口荚膜梭菌的免疫球蛋白 G (IgG) 抗体水平进行量化。使用定量聚合酶链反应(qPCR)鉴定唾液中的牙龈脓疱疮杆菌:结果:血清中针对牙龈脓疱病菌的 IgG 抗体是牙周炎的良好指标(曲线下面积 [AUC]:0.75,95% 置信区间 [CI]:0.64-0.85)。针对牙龈片段的抗体水平也是如此(AUC:0.78,95% 置信区间:0.68-0.88)。同样,针对牙龈脓杆菌全菌或牙龈脓杆菌片段的抗体水平也是牙龈脓杆菌口腔携带的良好指标(AUC:0.92,95% CI:0.86-0.98;AUC:0.96,95% CI:0.92-1)。相反,针对重组 RgpA 和 RgpB 的抗体不是牙周炎或口腔带菌的良好指标。II期牙周炎与III期或IV期牙周炎的抗体水平均无明显差异:结论:针对热灭活全牙龈脓毒性杆菌的血清 IgG 抗体水平被证明是牙周炎和口腔带菌的理想生物标志物。
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引用次数: 0
Effect of alveolar ridge preservation at periodontally compromised molar extraction sockets: A retrospective cohort study. 牙周受损的臼齿拔牙窝的牙槽嵴保留效果:回顾性队列研究
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-17 DOI: 10.1002/JPER.24-0064
Anna Dai, Hao-Yu Li, Sen Kang, Renjie Lin, Jia-Ping Huang, Feifei Mao, Pei-Hui Ding

Background: To date, the clinical evidence regarding the effectiveness of alveolar ridge preservation (ARP) in restricting alveolar bone height and width change after extraction at periodontally compromised molar extraction sockets still remains controversial. This retrospective cohort study aims to evaluate the effect of ARP in molars extracted for periodontal reasons.

Methods: Retrospective data were collected from patient electronic records from January 2019 to December 2023. Patients with Stage III/IV periodontitis who underwent extraction of molars for periodontal reasons were screened for eligibility. The outcomes included the horizontal and vertical dimensions of alveolar bone. The need for additional augmentation procedure during implantation was also evaluated. A linear regression model was used to adjust for known confounders.

Results: A total of 80 sockets were included in this study, of which 27 sockets received ARP therapy after extraction while 53 sockets experienced natural healing (NH). ARP resulted in significantly less bone height change in the periodontally compromised molar sites compared to the NH group (p < 0.001). In sockets displaying a height disparity of >2 mm between the buccal and palatal/lingual walls, the ARP group exhibited advantageous outcomes in terms of ridge width change, surpassing the NH group (p = 0.004). Moreover, the percentage for additional augmentation was significantly reduced in the ARP compared to the NH group (p = 0.006). Age, sex, smoking, jaw, location, and buccal wall thickness did not show any significant effect on bone height change.

Conclusion: ARP had benefits on limiting ridge resorption subsequent to molar extraction for periodontal reasons.

背景:迄今为止,关于牙槽嵴保留(ARP)在牙周受损的磨牙拔牙窝拔牙后限制牙槽骨高度和宽度变化的有效性的临床证据仍然存在争议。这项回顾性队列研究旨在评估因牙周原因拔除的磨牙的牙槽嵴保留效果:从 2019 年 1 月至 2023 年 12 月的患者电子记录中收集回顾性数据。筛选出因牙周原因拔除磨牙的 III/IV 期牙周炎患者。研究结果包括牙槽骨的水平和垂直尺寸。此外,还评估了在种植过程中是否需要进行额外的增量手术。采用线性回归模型对已知的混杂因素进行调整:本研究共纳入了 80 个基台,其中 27 个基台在拔牙后接受了 ARP 治疗,53 个基台经历了自然愈合(NH)。与自然愈合组相比,ARP 使牙周受损的磨牙部位的骨高度变化明显较小(P = 2 mm),ARP 组在牙脊宽度变化方面表现出优势,超过了自然愈合组(P = 0.004)。此外,与 NH 组相比,ARP 组的额外增量比例明显降低(p = 0.006)。年龄、性别、吸烟、颌骨、位置和颊壁厚度对骨高度变化没有明显影响:结论:ARP对限制因牙周原因拔除臼齿后的牙脊吸收有好处。
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引用次数: 0
Impact of surface chemical treatment in surgical regenerative treatment of ligature-induced peri-implantitis: A canine study 表面化学处理对结扎引起的种植体周围炎手术再生治疗的影响:犬类研究
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-16 DOI: 10.1002/JPER.23-0634
Shu-Jiao Qian, Yi-Wen Tsai, Theofilos Koutouzis, Hong-Chang Lai, Shi-Chong Qiao, Georgios A. Kotsakis

Background

Implant surface decontamination is a critical step in peri-implantitis treatment. The aim of this study was to assess the effect chemotherapeutic agents have on reosseointegration after treatment on ligature-inducted peri-implantitis.

Methods

Six male canines had 36 implants placed and ligatures were placed around them for 28 weeks to establish peri-implantitis. The peri-implant defects were randomly treated by 1 of 3 methods: 0.12% chlorhexidine (CHX test group), 1.5% sodium hypochlorite (NaOCl test group), or saline (Control group). Sites treated with NaOCl and CHX were grafted with autogenous bone, and all sites then either received a collagen membrane or not. Histology sections were obtained at 6 months postsurgery to assess percentage of reosseointegration.

Results

Thirty-five implants were analyzed (CHX: 13; NaOCl: 14; Control:8). NaOCl-treated sites demonstrated reosseointegration with direct bone-to-implant-contact on the previously contaminated surfaces (42% mean reosseointegration), which was significantly higher than Controls (p < 0.05). Correspondingly, clinical improvement was noted with a significant reduction in probing depth from 5.50 ± 1.24 mm at baseline to 4.46 ± 1.70 mm at 6-months postsurgery (p = 0.006). CHX-treated sites demonstrated a nonsignificant reosseointegration of 26% (p > 0.05); however, in the majority of cases, the new bone growth was at a distance from the implant surface without contact. Probing depths did not improve in the CHX group. The use of membrane did not influence reosseointegration or probing depths (all p > 0.05).

Conclusion

Titanium implants with peri-implantitis have the capacity to reosseointegrate following regenerative surgery. However, treatment response is contingent upon the chemotherapeutic agent selection. Additional chemical treatment with 1.5% NaOCl lead to the most favorable results in terms of changes in defect depth and percentage of reosseointegration as compared to CHX, which may hinder reosseointegration.

背景:种植体表面净化是治疗种植体周围炎的关键步骤。本研究的目的是评估化疗药物对结扎引起的种植体周围炎治疗后的再骨结合的影响:方法:六颗雄性犬牙植入了36颗种植体,并在种植体周围植入结扎带28周,以建立种植体周围炎。种植体周围缺损随机采用三种方法中的一种进行治疗:0.12% 洗必泰(CHX 试验组)、1.5% 次氯酸钠(NaOCl 试验组)或生理盐水(对照组)。用 NaOCl 和 CHX 处理过的部位会移植自体骨,然后所有部位都会接受或不接受胶原蛋白膜。术后 6 个月时进行组织学切片检查,以评估再骨合的百分比:对 35 个种植体进行了分析(CHX:13 个;NaOCl:14 个;对照组:8 个)。经 NaOCl 处理过的部位显示,在先前污染的表面上,骨与种植体直接接触,实现了再骨结合(平均再骨结合率为 42%),明显高于对照组(P 0.05);但在大多数情况下,新骨生长与种植体表面有一定距离,没有接触。CHX 组的探查深度没有改善。膜的使用对再骨结合或探诊深度没有影响(均 p > 0.05):结论:患有种植体周围炎的钛种植体有能力在再生手术后重新骨结合。然而,治疗反应取决于化疗药物的选择。与可能阻碍再结合的 CHX 相比,使用 1.5% NaOCl 进行额外的化学处理在缺损深度变化和再结合百分比方面取得了最理想的效果。
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引用次数: 0
Survival analysis of teeth following clinical crown lengthening and crown insertion procedures up to 14 years: A retrospective cohort study. 长达 14 年的临床牙冠延长术和牙冠植入术后牙齿的存活率分析:回顾性队列研究。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-14 DOI: 10.1002/JPER.24-0118
Se-Lim Oh, Jiaxin Hu, Kee Hyun Kwak, Man-Kyo Chung

Background: The purpose of this study was to conduct survival analysis of teeth following clinical crown lengthening procedures (CLPs) and crown insertions via a retrospective cohort study.

Methods: Patient- and tooth-related data were collected from 268 participants who received CLPs from 2009 to 2015. The Kaplan-Meier curve and the log-rank tests were used to estimate the probability of survival and compare the survival probabilities among different variables. A Cox multivariate proportional hazard regression model was used to investigate the collective effects of root canal treatment (RCT) and the types of opposing dentition.

Results: The rate of tooth loss was 21.6% during the observation period from 1 to 14 years, with 58 teeth extracted. The most attributable reason for tooth extraction was coronal tooth fracture, followed by endodontic failure such as root fracture. The survival probability was 0.87 at 5 years and 0.7 at 10 years. No significant differences in the survival probabilities were found among different providers and locations, the presence of a post, and the types of crowns. The hazard ratio for tooth loss was 6.3, 95% confidence interval (CI) [2.6 to 20.9] in the teeth with RCT (p < 0.001) and 2.4, 95% CI [1.1 to 4.8] in the teeth occluding implant-retained prostheses (p = 0.016).

Conclusions: Tooth loss following CLPs and crown insertions appeared least among the teeth without RCT when occluding natural teeth, while tooth loss was most among the teeth with RCT when occluding implants.

背景:本研究旨在通过回顾性队列研究对临床牙冠延长术(CLP)和牙冠植入术后的牙齿进行存活率分析:本研究旨在通过一项回顾性队列研究,对临床牙冠延长术(CLP)和牙冠植入术后的牙齿进行存活率分析:方法: 收集了 2009 年至 2015 年期间接受临床牙冠延长术的 268 名参与者的患者和牙齿相关数据。采用卡普兰-梅耶曲线和对数秩检验估算生存概率,并比较不同变量之间的生存概率。采用 Cox 多变量比例危险回归模型来研究根管治疗(RCT)和对牙类型的共同影响:结果:在1至14年的观察期内,牙齿脱落率为21.6%,共拔除58颗牙齿。最常见的拔牙原因是牙冠折断,其次是牙髓治疗失败,如牙根折断。5 年的存活概率为 0.87,10 年的存活概率为 0.7。不同的医疗机构和地点、是否存在牙柱以及牙冠类型在存活概率上没有明显差异。在使用 RCT 的牙齿中,牙齿脱落的危险比为 6.3,95% 置信区间 (CI) [2.6 至 20.9](p 结论:在使用 RCT 的牙齿中,牙齿脱落的危险比为 6.3,95% 置信区间 (CI) [2.6 至 20.9]:在咬合天然牙时,无 RCT 的牙齿在植入 CLP 和牙冠后的牙齿缺失最少,而在咬合种植体时,有 RCT 的牙齿缺失最多。
{"title":"Survival analysis of teeth following clinical crown lengthening and crown insertion procedures up to 14 years: A retrospective cohort study.","authors":"Se-Lim Oh, Jiaxin Hu, Kee Hyun Kwak, Man-Kyo Chung","doi":"10.1002/JPER.24-0118","DOIUrl":"https://doi.org/10.1002/JPER.24-0118","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to conduct survival analysis of teeth following clinical crown lengthening procedures (CLPs) and crown insertions via a retrospective cohort study.</p><p><strong>Methods: </strong>Patient- and tooth-related data were collected from 268 participants who received CLPs from 2009 to 2015. The Kaplan-Meier curve and the log-rank tests were used to estimate the probability of survival and compare the survival probabilities among different variables. A Cox multivariate proportional hazard regression model was used to investigate the collective effects of root canal treatment (RCT) and the types of opposing dentition.</p><p><strong>Results: </strong>The rate of tooth loss was 21.6% during the observation period from 1 to 14 years, with 58 teeth extracted. The most attributable reason for tooth extraction was coronal tooth fracture, followed by endodontic failure such as root fracture. The survival probability was 0.87 at 5 years and 0.7 at 10 years. No significant differences in the survival probabilities were found among different providers and locations, the presence of a post, and the types of crowns. The hazard ratio for tooth loss was 6.3, 95% confidence interval (CI) [2.6 to 20.9] in the teeth with RCT (p < 0.001) and 2.4, 95% CI [1.1 to 4.8] in the teeth occluding implant-retained prostheses (p = 0.016).</p><p><strong>Conclusions: </strong>Tooth loss following CLPs and crown insertions appeared least among the teeth without RCT when occluding natural teeth, while tooth loss was most among the teeth with RCT when occluding implants.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317593","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
Preclinical comparison study of experimental peri-implantitis between alveolar ridge preservation and spontaneous healing sites in infected and noninfected tooth: a randomized blinded in vivo study 在受感染和未受感染的牙槽嵴保留区和自发愈合区进行实验性种植体周围炎的临床前比较研究:一项随机盲法体内研究。
IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-12 DOI: 10.1002/JPER.23-0617
Young-Chang Ko, Dongseob Lee, Obin Kwon, Yang-Jo Seol, Ki-Tae Koo, Yong-Moo Lee, Jungwon Lee

Background

This study compared the progression of experimental peri-implantitis between alveolar ridge preservation (ARP) and spontaneous healing (SH) sites in infected (IT) and noninfected tooth (NIT).

Methods

Bilateral mandibular third or fourth premolars of six beagle dogs were randomly assigned to IT and NIT groups. Before extraction, chronic dehiscence defects were created at the mesial root of mid-buccal area in IT group. Four weeks later, the mesial roots of the third and fourth premolars were extracted in all groups.ARP procedure was randomly conducted on one side of the extraction sockets using collagenated bovine bone substitutes and resorbable collagen membrane, and contralateral side was allowded spontaneous healing. After 12 weeks of healing, bone-level implants (ϕ 3.6 × 8.0 mm) were placed at the extraction sockets. Three months of ligature induced peri-implantitis and three months of spontaneous progression were allowed, with radiographs taken at each phase. Biopsies were retrieved at the implant site for histomorphometric, immunohistochemical, and polarized light-microscopic analyses.

Results

Radiography demonstrated that the changes in the marginal bone level during the spontaneous progression period showed no significant differences between ARP and SH sites. Only small and/or nonsignificant differences in the progression of peri-implantitis were observed between ARP and SH sites in histomorphometric, immunohistochemical, and polarized light microscopic analyses. Additionally, the IT and NIT groups exhibited similar outcomes for most parameters.

Conclusion

ARP with xenogenic bone substitutes might provide similarly robust results as SH sites regarding the progression of experimental peri-implantitis, irrespective of the infected or noninfected nature of the site before tooth extraction.

背景:本研究比较了感染牙(IT)和非感染牙(NIT)的牙槽嵴保留(ARP)和自发愈合(SH)部位的实验性种植体周围炎的进展情况:方法:将 6 只猎犬的双侧下颌第三或第四前臼齿随机分配到 IT 组和 NIT 组。拔牙前,在 IT 组颊面中部的中根创建慢性开裂缺损。四周后,所有组别均拔除第三和第四前臼齿的中侧根。使用胶原牛骨替代物和可吸收胶原膜,在一侧拔牙窝随机进行 ARP 手术,对侧允许自发愈合。12 周愈合后,在拔牙窝植入骨水平种植体(ϕ 3.6 × 8.0 毫米)。三个月的结扎诱导种植体周围炎和三个月的自发进展期,每个阶段都要拍摄X光片。在种植部位取活体组织进行组织形态学、免疫组织化学和偏振光显微镜分析:结果:X 光片显示,在自发进展期,ARP 和 SH 植入部位的边缘骨水平变化无明显差异。在组织形态计量学、免疫组化和偏振光显微镜分析中,ARP和SH部位的种植体周围炎的进展仅存在微小和/或不显著的差异。此外,IT 组和 NIT 组在大多数参数上表现出相似的结果:结论:在实验性种植体周围炎的进展方面,使用异种骨替代物的 ARP 可提供与 SH 位点类似的稳健结果,而与拔牙前该位点的感染或非感染性质无关。
{"title":"Preclinical comparison study of experimental peri-implantitis between alveolar ridge preservation and spontaneous healing sites in infected and noninfected tooth: a randomized blinded in vivo study","authors":"Young-Chang Ko,&nbsp;Dongseob Lee,&nbsp;Obin Kwon,&nbsp;Yang-Jo Seol,&nbsp;Ki-Tae Koo,&nbsp;Yong-Moo Lee,&nbsp;Jungwon Lee","doi":"10.1002/JPER.23-0617","DOIUrl":"10.1002/JPER.23-0617","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compared the progression of experimental peri-implantitis between alveolar ridge preservation (ARP) and spontaneous healing (SH) sites in infected (IT) and noninfected tooth (NIT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Bilateral mandibular third or fourth premolars of six beagle dogs were randomly assigned to IT and NIT groups. Before extraction, chronic dehiscence defects were created at the mesial root of mid-buccal area in IT group. Four weeks later, the mesial roots of the third and fourth premolars were extracted in all groups.ARP procedure was randomly conducted on one side of the extraction sockets using collagenated bovine bone substitutes and resorbable collagen membrane, and contralateral side was allowded spontaneous healing. After 12 weeks of healing, bone-level implants (ϕ 3.6 × 8.0 mm) were placed at the extraction sockets. Three months of ligature induced peri-implantitis and three months of spontaneous progression were allowed, with radiographs taken at each phase. Biopsies were retrieved at the implant site for histomorphometric, immunohistochemical, and polarized light-microscopic analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Radiography demonstrated that the changes in the marginal bone level during the spontaneous progression period showed no significant differences between ARP and SH sites. Only small and/or nonsignificant differences in the progression of peri-implantitis were observed between ARP and SH sites in histomorphometric, immunohistochemical, and polarized light microscopic analyses. Additionally, the IT and NIT groups exhibited similar outcomes for most parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ARP with xenogenic bone substitutes might provide similarly robust results as SH sites regarding the progression of experimental peri-implantitis, irrespective of the infected or noninfected nature of the site before tooth extraction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"95 10","pages":"977-990"},"PeriodicalIF":4.2,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/JPER.23-0617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The mediating role of sugar and lipid metabolism and systemic inflammation in the association between breakfast skipping and periodontitis: A population-based study. 不吃早餐与牙周炎之间的关系中,糖和脂质代谢及全身炎症的中介作用:一项基于人群的研究。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-08 DOI: 10.1002/JPER.24-0079
Zhikang Wang, Rui Pu, Jing Zhang, Guoli Yang

Background: This study investigated the association between breakfast skipping and periodontitis and the mediating role of sugar and lipid metabolism and systemic inflammation in this association using data from the Korea National Health and Nutrition Examination Survey 2016-2018.

Methods: This study included 11,953 participants, representing an estimated 33.9 million people. Complex sample logistic regression was used to assess the independent association between breakfast skipping and periodontitis. Subgroup analysis was conducted with modifiers including age, sex, body mass index (BMI), urban residence, education level, marital status, and diabetes. Structural equation modeling assessed potential mediation by biomarkers related to glucose and lipid metabolism along with systemic inflammation.

Results: The fully adjusted logistic regression model indicated a positive association between breakfast skipping and periodontitis (odds ratio [OR] = 1.234 (1.026-1.483), p = 0.025). This association was highlighted in middle-aged (40-60 years), female, highly educated, married individuals with BMI < 25 kg/m2, and those in urban areas without diabetes. Blood glucose (β ± SE = 0.006 ± 0.002, p = 0.014), triglycerides (β ± SE = 0.004 ± 0.002, p = 0.033), and white blood cell count (β ± SE = 0.011 ± 0.003, p = 0.003) were identified as partial mediators.

Conclusions: A new, independent association between breakfast skipping, and periodontitis has been discovered, which is partially mediated by sugar and lipid metabolism, and systemic inflammation. The findings provide new insights into the benefits of chrononutrition for periodontal health.

研究背景本研究利用2016-2018年韩国国民健康与营养调查的数据,调查了不吃早餐与牙周炎之间的关联,以及糖、脂代谢和全身炎症在这一关联中的中介作用:这项研究包括 11953 名参与者,估计代表了 3390 万人。采用复杂样本逻辑回归评估不吃早餐与牙周炎之间的独立关联。对年龄、性别、体重指数(BMI)、城市居住地、教育水平、婚姻状况和糖尿病等修饰因素进行了分组分析。结构方程模型评估了与葡萄糖和脂质代谢以及全身炎症有关的生物标志物的潜在中介作用:完全调整后的逻辑回归模型表明,不吃早餐与牙周炎之间存在正相关(几率比 [OR] = 1.234 (1.026-1.483),P = 0.025)。这种关联在中年(40-60 岁)、女性、受过高等教育、已婚、体重指数(BMI)为 2 和城市地区无糖尿病的人群中尤为突出。血糖(β±SE = 0.006 ± 0.002,p = 0.014)、甘油三酯(β±SE = 0.004 ± 0.002,p = 0.033)和白细胞计数(β±SE = 0.011 ± 0.003,p = 0.003)被认为是部分中介因素:结论:不吃早餐与牙周炎之间发现了一种新的、独立的关联,这种关联部分由糖、脂代谢和全身炎症介导。这些发现为慢性营养对牙周健康的益处提供了新的见解。
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引用次数: 0
Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial. 气流作为牙周炎的辅助治疗方法:随机对照试验
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-03 DOI: 10.1002/JPER.24-0099
Salem Alsuwaidi, Aisha Almatrooshi, Maanas Shah, Abeer Hakam, Andrew Tawse-Smith, Nabeel H M Alsabeeha, Momen A Atieh

Backgound: The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis.

Methods: Twenty-six participants with Stage III/IV periodontitis requiring nonsurgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3 and 6 months posttreatment. A visual analogue scale was used to evaluate postoperative participants' perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months.

Results: A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5 mm at the 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF: 14.3 ± 14.1, SI alone: 19.2 ± 20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03).

Conclusions: Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.

背景:这项随机对照试验的目的是评估龈下器械治疗(SI)与单独使用赤藓糖醇气流(EAF)治疗牙周炎相比的临床和患者报告结果:26名患有III/IV期牙周炎、需要进行非手术牙周治疗的患者被随机分配到两个治疗组:SI联合EAF或单独SI。在基线、治疗后 3 个月和 6 个月记录探诊袋深度(PPD)≥5 毫米的百分比、全口出血和牙菌斑评分(FMBS 和 FMPS)以及 PPD 值等临床参数。采用视觉模拟量表评估术后参与者对疼痛、肿胀、出血、瘀伤和牙根敏感性的感受。使用口腔健康综合评估指数(GOHAI)评估牙周治疗对6个月后生活质量的影响:共有 26 名 III/IV 期牙周炎患者完成了为期 6 个月的随访。在 3 个月和 6 个月的随访中,无论是否使用 EAF,SI 都能显著降低 FMBS、FMPS、PPD 和 PPD ≥5 mm 的百分比。在任何时间间隔内,两个治疗组之间的差异均无统计学意义。在 3 个月(SI/EAF:19.4 ± 11.9,单用 SI:30.1 ± 20.5;P = 0.12)和 6 个月(SI/EAF:14.3 ± 9.6,单用 SI:24.5 ± 18.2;P = 0.09)时,接受 SI/EAF 治疗的参与者与单用 SI 治疗组的参与者相比,FMBS 的减少幅度更大。在 3 个月时(SI/EAF:14.3 ± 14.1,SI 单独:19.2 ± 20.3;P = 0.48)和 6 个月时(SI/EAF:8.3 ± 10.0,SI 单独:15.4 ± 17.4;P = 0.22),SI/EAF 组与 SI 单独组相比,深部 PPD(≥5 mm)的部位比例也较低。患者报告的结果显示,除了在6个月时GOHAI的心理社会领域有利于SI/EAF组(P = 0.03)外,两个治疗组之间没有显著差异:在研究的局限性范围内,在治疗III/IV期牙周炎时,除SI外辅助使用EAF并不能显著改善临床参数。在使用 EAF 的同时,患者的生活质量也得到了有限的改善。
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引用次数: 0
The effect of an antioxidant gel compared to chlorhexidine during the soft tissue healing process: An animal study. 软组织愈合过程中抗氧化凝胶与洗必泰的效果比较:一项动物研究。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-03 DOI: 10.1002/JPER.23-0794
Kelechi Ukaegbu, Deborah Foyle, Xianghong Luan, Emet Schneiderman, Edward P Allen, Jacqueline Plemons, Kathy K H Svoboda

Background: Prolonged inflammation and oxidative stress can impede healing. To enhance healing efficiency, many solutions have been employed. This is an in vivo study comparing chlorhexidine (CHX) to a commercial antioxidant gel (AO).

Methods: Envelope flaps were created in the lower incisor gingival region of 60 Sprague-Dawley rats, and acellular dermal matrix (ADM) was inserted. Animals were randomly assigned to postsurgical treatment application of AO gel or 0.12% CHX twice daily. A control group received no postsurgical treatment. Data collected (before surgery, 24 h, and 72 h) included surgical images, tissue samples, and weights. Blinded scorers assessed images using a wound healing scale. Real-time polymerase chain reaction (RT-PCR) was used for gene expression of tumor necrosis factor-alpha (TNFα), interleukin-1 (IL-1), myeloperoxidase (MPO), and superoxide dismutase (SOD).

Results: The AO group scored higher than the CHX and control groups in clinical evaluation (p < 0.05). At 24 h, TNFα expression was upregulated in the AO group compared to CHX (p = 0.027) and controls (p = 0.018). The AO group had significantly higher expression of antioxidant enzyme (SOD) at 24 h compared to CHX (p = 0.021). All animals lost weight in the first 24 h. Animals treated with AO or CHX regained more weight at 72 h than control animals (p = 0.034 and 0.003, respectively).

Conclusion: Animals treated with AO healed faster. AO led to earlier upregulation of TNFα and antioxidant enzyme SOD. We hypothesized that AO promoted an earlier inflammatory process while counteracting oxidative stress by increasing antioxidant responses via SOD.

背景:长期的炎症和氧化应激会阻碍伤口愈合。为了提高愈合效率,人们采用了许多解决方案。这是一项比较洗必泰(CHX)和商用抗氧化凝胶(AO)的体内研究:方法:在 60 只 Sprague-Dawley 大鼠的下门牙牙龈区域制作包膜瓣,并插入非细胞真皮基质 (ADM)。动物被随机分配到手术后使用 AO 凝胶或 0.12% CHX 的治疗组,每天两次。对照组不接受术后治疗。收集的数据(手术前、24 小时和 72 小时)包括手术图像、组织样本和体重。双盲评分员使用伤口愈合量表对图像进行评估。实时聚合酶链反应(RT-PCR)用于检测肿瘤坏死因子-α(TNFα)、白细胞介素-1(IL-1)、髓过氧化物酶(MPO)和超氧化物歧化酶(SOD)的基因表达:在临床评估中,AO 组的得分高于 CHX 组和对照组(p 结论:用 AO 治疗的动物痊愈了:接受 AO 治疗的动物痊愈得更快。AO 导致 TNFα 和抗氧化酶 SOD 提前上调。我们推测,AO 在通过 SOD 增加抗氧化反应来抵消氧化应激的同时,还促进了炎症进程的提前。
{"title":"The effect of an antioxidant gel compared to chlorhexidine during the soft tissue healing process: An animal study.","authors":"Kelechi Ukaegbu, Deborah Foyle, Xianghong Luan, Emet Schneiderman, Edward P Allen, Jacqueline Plemons, Kathy K H Svoboda","doi":"10.1002/JPER.23-0794","DOIUrl":"https://doi.org/10.1002/JPER.23-0794","url":null,"abstract":"<p><strong>Background: </strong>Prolonged inflammation and oxidative stress can impede healing. To enhance healing efficiency, many solutions have been employed. This is an in vivo study comparing chlorhexidine (CHX) to a commercial antioxidant gel (AO).</p><p><strong>Methods: </strong>Envelope flaps were created in the lower incisor gingival region of 60 Sprague-Dawley rats, and acellular dermal matrix (ADM) was inserted. Animals were randomly assigned to postsurgical treatment application of AO gel or 0.12% CHX twice daily. A control group received no postsurgical treatment. Data collected (before surgery, 24 h, and 72 h) included surgical images, tissue samples, and weights. Blinded scorers assessed images using a wound healing scale. Real-time polymerase chain reaction (RT-PCR) was used for gene expression of tumor necrosis factor-alpha (TNFα), interleukin-1 (IL-1), myeloperoxidase (MPO), and superoxide dismutase (SOD).</p><p><strong>Results: </strong>The AO group scored higher than the CHX and control groups in clinical evaluation (p < 0.05). At 24 h, TNFα expression was upregulated in the AO group compared to CHX (p = 0.027) and controls (p = 0.018). The AO group had significantly higher expression of antioxidant enzyme (SOD) at 24 h compared to CHX (p = 0.021). All animals lost weight in the first 24 h. Animals treated with AO or CHX regained more weight at 72 h than control animals (p = 0.034 and 0.003, respectively).</p><p><strong>Conclusion: </strong>Animals treated with AO healed faster. AO led to earlier upregulation of TNFα and antioxidant enzyme SOD. We hypothesized that AO promoted an earlier inflammatory process while counteracting oxidative stress by increasing antioxidant responses via SOD.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237681","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
Tunnel technique and subepithelial connective tissue graft, with or without cross-linked hyaluronic acid, in the treatment of multiple gingival recessions: 12-month outcomes of a randomized clinical trial. 隧道技术和上皮下结缔组织移植(含或不含交联透明质酸)治疗多发性牙龈凹陷:随机临床试验的 12 个月结果。
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-29 DOI: 10.1002/JPER.24-0093
Izabela Skierska, Bartłomiej Górski, Łukasz Fus

Background: This study evaluated the influence of the adjunctive application of a cross-linked hyaluronic acid (HA) in the treatment of multiple gingival recessions, using a modified coronally advanced tunnel (MCAT) technique and subepithelial connective tissue graft (SCTG) (MCAT+SCTG±HA).

Methods: A randomized, split-mouth, double-masked comparison of the effects of MCAT+HA+SCTG (test) versus MCAT+SCTG (control) in the treatment of multiple, contralateral gingival recessions with clinical, esthetic, and histological evaluations was carried out. All samples were stained with hematoxylin and eosin, Masson's trichrome, Verhoeff-Van Gieson, and Alcian blue stain for semiquantitative evaluation. The primary outcome variable was 12-month mean root coverage (MRC).

Results: Twenty-four patients with 266 gingival recessions received both control and test treatments (133 recessions per group). 12-month MRC of the MCAT+HA+SCTG group was not significantly different from the MCAT+SCTG group with 84.32%±  34.46% and 85.71%±  36.43%, respectively (p = 0.991). Both treatment modes produced favorable esthetic outcomes (root coverage esthetic score [RES] 9.51±  1.01 tests vs. 9.26±  1.10 controls, p = 0.7292). However, the application of HA improved soft tissue texture (p = 0.0091). The remaining end point measures did not differ significantly between groups. Histological evaluation showed a significantly greater number of elastic fibers and a moderate increase in collagen fiber density in biopsy samples taken from the test sides when compared to the control sides (p = 0.0419 and p = 0.300, respectively).

Conclusions: MCAT+SCTG is an effective procedure in the treatment of multiple recession Type 1 (RT1) and RT2 recessions. There were no statistically significant differences in evaluated clinical treatment outcomes in the MCAT+HA+SCTG group compared to the MCAT+SCTG group within a period of 12 months. The application of HA increased collagen and elastic fiber density.

背景:本研究评估了交联透明质酸(HA)辅助应用在治疗多发性牙龈凹陷中的影响,采用的是改良冠状前进隧道(MCAT)技术和上皮下结缔组织移植(SCTG)(MCAT+SCTG±HA):对 MCAT+HA+SCTG(试验)与 MCAT+SCTG(对照)治疗多发性对侧牙龈凹陷的效果进行了随机、分口、双掩蔽比较,并进行了临床、美学和组织学评估。所有样本均采用苏木精和伊红、马森三色染色、Verhoeff-Van Gieson 和阿尔新蓝染色进行半定量评估。主要结果变量是 12 个月的平均牙根覆盖率(MRC):24 名牙龈凹陷患者共 266 个牙龈凹陷,分别接受了对照组和测试组的治疗(每组 133 个凹陷)。MCAT+HA+SCTG组的12个月平均根面覆盖率为84.32%± 34.46%,MCAT+HA+SCTG组为85.71%± 36.43%,与MCAT+SCTG组无明显差异(p = 0.991)。两种治疗模式都产生了良好的美学效果(根覆盖美学评分 [RES] 9.51±1.01 试验组 vs. 9.26±1.10 对照组,p = 0.7292)。不过,HA 的应用改善了软组织质地(p = 0.0091)。其余终点指标在组间无明显差异。组织学评估显示,与对照组相比,试验侧活检样本中弹性纤维数量明显增加,胶原纤维密度适度增加(分别为 p = 0.0419 和 p = 0.300):结论:MCAT+SCTG 是治疗多发性 1 型(RT1)和 RT2 型凹陷的有效方法。与 MCAT+SCTG 组相比,MCAT+HA+SCTG 组在 12 个月内的临床治疗效果评估差异无统计学意义。应用 HA 增加了胶原蛋白和弹性纤维密度。
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引用次数: 0
Ultrasound-based jawbone surface quality evaluation after alveolar ridge preservation. 牙槽嵴保留术后基于超声波的颌骨表面质量评估
IF 4.3 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-05-14 DOI: 10.1002/JPER.23-0370
Amanda B Rodriguez, Oliver D Kripfgans, Kenneth M Kozloff, Ankita Samal, Jae-Man Woo, Mostafa Shehabeldin, Hsun-Liang Chan

Background: Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans.

Methods: A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard.

Results: Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm3; >0.45 mm3/mm3), questionable (1500-2200 mg/cm3; 0.4-0.45 mm3/mm3), and unfavorable (<1500 mg/cm3; <0.4 mm3/mm3). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV.

Conclusion: Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.

背景:通常在拔牙和牙槽嵴保留(ARP)后 3 到 6 个月之间的任意时间,通过二维射线照片和锥形束计算机断层扫描检查骨质/骨密度来评估种植体植入的骨准备情况。本研究旨在探讨高频超声波(US)是否能对人类的骨准备情况进行分类,并以显微计算机断层扫描(Micro-CT)作为参考标准,获得接受 ARP 治疗的愈合牙槽窝的骨矿密度(BMD)和骨体积分数(BVTV):方法:在种植手术过程中,从 24 名曾接受过 ARP 拔牙的患者身上共采集了 27 个骨核。种植手术前立即在与组织活检采集位置共同登记的部位拍摄 US 图像(使用专门设计的导板),然后根据 B 型图像标准将其分为 3 级:(1) 有利;(2) 有疑问;(3) 不利。作为金标准,骨矿密度(羟基磷灰石)和 BVTV 是通过显微 CT 获得的:在投射的 US 切片平面内对羟磷灰石和 BVTV 进行评估,并将阈值分为有利(>2200 mg/cm3;>0.45 mm3/mm3)、可疑(1500-2200 mg/cm3;0.4-0.45 mm3/mm3)和不利(3;3/mm3)。目前的 US B 型分类与 BMD 成反比。回归分析表明,US 分级与 BMD 和 BVTV 之间存在显著关系。T检验分析表明,US读者评分与金标准之间存在明显的相关性。在比较第一级与第二级和第三级的组合时,相对于平均 BMD,US 实现了显著的组别区分(p = 0.004,真阳性 66.7%,假阳性 0%,真阴性 100%,假阴性 33.3%,特异性 100%,灵敏度 66.7%,曲线下接收者操作特征面积 0.86)。结论:初步数据表明,US 可以对与 BMD/BVTV 相关的颌骨表面质量进行分级,并为将来开发基于 US 的 ARP 后牙槽骨愈合评估奠定基础。
{"title":"Ultrasound-based jawbone surface quality evaluation after alveolar ridge preservation.","authors":"Amanda B Rodriguez, Oliver D Kripfgans, Kenneth M Kozloff, Ankita Samal, Jae-Man Woo, Mostafa Shehabeldin, Hsun-Liang Chan","doi":"10.1002/JPER.23-0370","DOIUrl":"https://doi.org/10.1002/JPER.23-0370","url":null,"abstract":"<p><strong>Background: </strong>Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans.</p><p><strong>Methods: </strong>A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard.</p><p><strong>Results: </strong>Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm<sup>3</sup>; >0.45 mm<sup>3</sup>/mm<sup>3</sup>), questionable (1500-2200 mg/cm<sup>3</sup>; 0.4-0.45 mm<sup>3</sup>/mm<sup>3</sup>), and unfavorable (<1500 mg/cm<sup>3</sup>; <0.4 mm<sup>3</sup>/mm<sup>3</sup>). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV.</p><p><strong>Conclusion: </strong>Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922550","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
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Journal of periodontology
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