Journal of periodontology最新文献_第9页

Periodontists and stem cell-based therapy for alveolar bone regeneration: A national survey 牙周病医生与干细胞牙槽骨再生疗法：全国调查。

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2024-01-09 DOI: 10.1002/JPER.23-0506

Darnell Kaigler, Jonathan Misch, Abdusalam Alrmali, Marita R. Inglehart

Background

Stem cell-based therapy for bone regeneration has received attention in medical settings but has not yet been used in clinical practice for treating alveolar bone defects. The objectives of this study were to explore whether periodontists had heard about this approach, and if so how, how interested they were to learn about it, which attitudes and behavioral intentions they had related to using stem cell-based grafting, and what they would like to know before using this approach.

Methods

Anonymous survey data were collected from 481 members of the American Academy of Periodontology (response rate: 19.41%).

Results

Responses showed 35.3% had heard about stem cell-based therapy, mostly from publications (9.6%) and meetings (8.3%); 76.1% wanted to learn about it through in-person continuing education (CE) courses, 68.6% in online CE courses, and 57.1% from manuals; 73% considered this approach promising; and 54.9% preferred it to traditional approaches. It was important to them that it would result in more bone volume (93%), better bone quality (90.4%), and accelerated healing (83.2%). Also, 60.1% considered it likely/very likely that they would adopt this approach, 54% that patients would prefer it, and 62.1% that it would benefit their practice. When asked what they would like to know about this approach, information about short- and long-term outcomes, cost, and logistical considerations were most frequently named.

Conclusions

These findings provide the basis to develop educational interventions for periodontists about this novel approach and inform future research activities aimed to translate this approach to clinical practice.

背景：以干细胞为基础的骨再生疗法在医学领域受到关注，但尚未用于临床实践，治疗牙槽骨缺损。本研究的目的是探讨牙周病学家是否听说过这种方法，如果听说过，是如何听说的，他们对了解这种方法有多大兴趣，他们对使用干细胞移植有哪些态度和行为意向，以及他们在使用这种方法之前想了解什么：从美国牙周病学会的481名会员中收集了匿名调查数据（回复率：19.41%）：调查结果显示，35.3%的人听说过干细胞疗法，大部分是从出版物（9.6%）和会议（8.3%）上了解到的；76.1%的人希望通过现场继续教育（CE）课程了解干细胞疗法，68.6%的人希望通过在线继续教育课程了解干细胞疗法，57.1%的人希望从手册上了解干细胞疗法；73%的人认为干细胞疗法很有前景；54.9%的人认为干细胞疗法优于传统疗法。对他们来说，重要的是这种方法能带来更多的骨量（93%）、更好的骨质（90.4%）和更快的愈合（83.2%）。此外，60.1% 的人认为他们很有可能/非常有可能采用这种方法，54% 的人认为患者会更喜欢这种方法，62.1% 的人认为这种方法会使他们的临床实践受益。当被问及他们希望了解有关这种方法的哪些信息时，最常提到的是有关短期和长期结果、成本和后勤考虑因素的信息：这些发现为牙周病医生制定有关这种新方法的教育干预措施提供了依据，也为今后旨在将这种方法转化为临床实践的研究活动提供了信息。

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引用次数: 0

Impact of dietary inflammatory index on gingival health 饮食炎症指数对牙龈健康的影响。

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-28 DOI: 10.1002/JPER.23-0292

Roberta Andrade Reis, Camila Schmidt Stolf, Helena Alves de Carvalho Sampaio, Bruna Yhang da Costa Silva, Tuğçe Özlü, Emre Batuhan Kenger, Manuela Maria Vianal Miguel, Mauro Pedrine Santamaria, Mabelle de Freitas Monteiro, Marcio Zaffalon Casati, Renato Corrêa Viana Casarin

Background

Periodontal disease is a biofilm-dependent chronic inflammatory condition triggered by a host response. Several factors impact systemic inflammation and could lead to changes in disease pathogenesis. Recently, studies have assessed the influence of nutritional patterns on the development of periodontitis. In the present cross-sectional study, we evaluated the dietary inflammatory profile on periodontal conditions, focusing on clinical, subgingival microbial, and cytokine assessment of individuals with periodontal health or gingivitis.

Methods

One hundred patients with periodontal health or gingivitis were included. Plaque index (PI), Bleeding on probing (BoP), the probing depth (PD), and the clinical attachment level (CAL) for each patient were assessed. Nutritional data and the Dietary Inflammatory Index (DII) were recorded by two 24-h food recalls on non-consecutive days. Biofilm and gingival crevicular fluid (GCF) to assess the microbiome profile and inflammatory biomarkers were collected. Multiple regressions focused on the DII, age, and sex as predictors of periodontal conditions were done.

Results

Age and moderate DII scores increased the risk of gingivitis by 1.64 and 3.94 times, respectively. Males with an elevated DII score had 27.15 times higher odds of being diagnosed with gingivitis and BoP (β = 6.54; p = 0.03). Elderly patients with a moderate or high DII score were less prone to gingivitis and increased BoP (p < 0.04) compared with younger subjects. Considering the DII, there were no differences in microbial alpha and beta diversity; however, distinct species abundance and a higher concentration of monocyte-chemoattractant protein-1 and interleukin 33 were seen in patients with a higher DII.

Conclusion

A pro-inflammatory diet significantly contributes to periodontal inflammation, modulating inflammatory biomarkers and affecting the subgingival microbial community in healthy individuals.

背景：牙周病是一种由宿主反应引发的生物膜依赖性慢性炎症。多种因素会影响全身炎症，并导致疾病发病机制的改变。最近，有研究评估了营养模式对牙周炎发展的影响。在本横断面研究中，我们评估了饮食对牙周状况的炎症影响，重点是对牙周健康或牙龈炎患者的临床、龈下微生物和细胞因子进行评估：方法：纳入 100 名牙周健康或牙龈炎患者。对每位患者的牙菌斑指数（PI）、探诊出血量（BoP）、探诊深度（PD）和临床附着水平（CAL）进行评估。营养数据和膳食炎症指数（DII）通过非连续两天的 24 小时食物回顾进行记录。还收集了生物膜和龈沟液（GCF），以评估微生物组概况和炎症生物标志物。以 DII、年龄和性别作为牙周状况的预测因素，进行了多元回归：结果：年龄和中度 DII 分数分别使患牙龈炎的风险增加了 1.64 倍和 3.94 倍。DII 分值较高的男性被诊断为牙龈炎和 BoP 的几率要高出 27.15 倍（β = 6.54；P = 0.03）。中度或高度 DII 评分的老年患者不易患牙龈炎和 BoP 增高（p 结论：DII 评分越高，牙龈炎和 BoP 增高的几率越小：促炎性饮食会明显导致牙周炎症，调节炎症生物标志物并影响健康人的龈下微生物群落。

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引用次数: 0

Association of active oxygen-releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study 活性氧释放凝胶与光动力疗法在治疗 2 型糖尿病患者残余牙周袋中的结合：随机对照临床研究。

IF 4.3 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-19 DOI: 10.1002/JPER.23-0125

Marina M. Cláudio, Valdir G. Garcia, Rubens M. Freitas, João Victor S. Rodrigues, Mark Wainwright, Renato C. V. Casarin, Cristiane Duque, Leticia H. Theodoro

Background

The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2).

Methods

Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)—subgingival instrumentation in a single session; BM (n = 17)—SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)—SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%).

Results

A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments.

Conclusion

The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.

研究背景本研究的目的是评估活性氧释放凝胶作为一种辅助剂，在使用或不使用抗菌光动力疗法（aPDT）的情况下，治疗2型糖尿病（DM2）牙周病患者残留牙周袋的效果：将探诊深度（PD）≥4 毫米且探诊出血（BOP）的残余牙周袋患者分为以下几组：方法：将探诊深度（PD）≥4 mm且探诊出血（BOP）的残余牙周袋患者分为以下几组：SI组（n = 17）--一次性龈下器械治疗；BM组（n = 17）--SI组，随后在牙周袋内局部涂抹活性氧释放凝胶3分钟；BM + aPDT组（n = 17）--SI组，随后涂抹BM 3分钟并用亚甲蓝冲洗牙周袋，再用100 mW的660 nm二极管激光照射50 s。所有数据均进行了统计分析（α = 5%）：结果：90 天和 180 天后，BM + aPDT 组的 BOP 明显减少。在 90 天时，BM + aPDT 组和 BM 组 PD ≥ 4 mm 的部位百分比显著降低，而在 180 天后，只有 BM 组显著降低。在 BM + aPDT 组中，肿瘤坏死因子 α 的水平在 90 天时显著降低。两种治疗方法之间没有差异：结论：在治疗控制不佳的 DM2 患者的残余牙周袋时，使用辅助活性氧释放凝胶（无论是否使用 aPDT）与使用 SI 具有相同的临床疗效。

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引用次数: 0

Influence of residual pockets on periodontal tooth loss: A retrospective analysis 残留牙周袋对牙周牙齿脱落的影响：回顾性分析。

IF 4.3 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-19 DOI: 10.1002/JPER.23-0448

Muhammad H. A. Saleh, Debora R. Dias, Obada Mandil, Ricardo P. de Oliveira, Abdusalam Alrmali, Maurício G. Araújo, Hom-Lay Wang, Zoltan Barath, Istvan A. Urban

Background

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.

Methods

Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.

Results

Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.

Conclusion

Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.

背景：接受支持性牙周治疗（SPT）的患者仍有可能因牙周炎（TLP）而导致牙齿脱落。关于残余牙周袋（RPc）的影响以及将患者的情况设定为 TLP 高风险的 "阈值"，文献中的证据很有限。因此，本研究旨在评估RPc对TLP的影响，并确定RPc与牙周炎分期和分级相比对TLP风险的预后效果：这项回顾性研究评估了168名牙周炎患者（3869颗牙齿）接受SPT治疗至少10年的临床数据。收集了每位患者的TLP和RPc≥5毫米或≥6毫米的部位百分比。采用多层次考克斯比例危险回归模型将RPc的预后表现与TLP的疾病分期和分级进行比较：在中位 25 年的随访中，13.7% 的牙齿脱落，其中 4.6% 是由于牙周炎造成的。大多数TLP患者有≥1个部位的RPc≥5毫米（90.8%）或≥6毫米（77.6%）。多变量多层次Cox回归显示，与RPc≤4毫米/A级相比，RPc≥5毫米的部位>15%的患者的危险比为2.34，C级的TLP危险比为4.6：结论：RPc≥5 mm的患者，>15%的部位有牙齿脱落的风险。分级和 RPc ≥5 mm 对 TLP 有很好的预测能力。

{"title":"Influence of residual pockets on periodontal tooth loss: A retrospective analysis","authors":"Muhammad H. A. Saleh, Debora R. Dias, Obada Mandil, Ricardo P. de Oliveira, Abdusalam Alrmali, Maurício G. Araújo, Hom-Lay Wang, Zoltan Barath, Istvan A. Urban","doi":"10.1002/JPER.23-0448","DOIUrl":"10.1002/JPER.23-0448","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals enrolled in supportive periodontal therapy (<span>SPT</span>) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined “threshold” at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc ≥ 5 mm or ≥6 mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5 mm (90.8%) or ≥6 mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5 mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4 mm/grade A. Grading exhibited the best discrimination and model fit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with RPc ≥5 mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5 mm displayed very good predictive capability of TLP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"95 5","pages":"444-455"},"PeriodicalIF":4.3,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/JPER.23-0448","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805315","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

Human gingival fibroblasts are a source of B cell-activating factor during periodontal inflammation 人牙龈成纤维细胞是牙周炎症期间 B 细胞活化因子的来源之一

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-13 DOI: 10.1002/JPER.23-0543

Ahed Dyab, Ava Emnegard, Magnus Wänman, Filippa Sjöström, Elin Kindstedt

Background

Host-modulating therapy is a possible treatment for individuals that respond poorly to conventional periodontal therapy. B cells, abundant in periodontitis lesions, require the cytokines B cell-activating factor (BAFF) and A proliferation-inducing ligand (APRIL) for survival and maturation. Although mRNA levels of BAFF and APRIL are increased in tissue from periodontitis lesions, it is unknown if periodontal resident cells express BAFF and/or APRIL during periodontal inflammation. In this study, we aim to analyze the expression of BAFF and APRIL in human gingival fibroblasts after stimulation with proinflammatory cytokines. Furthermore, we perform protein analysis in tissues and serum from periodontitis patients and healthy controls.

Methods

Human gingival fibroblasts were cultured and stimulated with the proinflammatory cytokines’ tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β). The mRNA expression of BAFF and APRIL was analyzed by real-time quantitative polymerase chain reaction (qPCR), and the protein was detected in tissue sections using immune staining. Serum levels of BAFF were analyzed with enzyme-linked immunosorbent assay (ELISA).

Results

In gingival fibroblasts, TNF-α upregulated BAFF mRNA, but APRIL was unaffected. IL-1β affected neither BAFF nor APRIL expression. BAFF protein was detected in the oral epithelium and in cells of the underlying connective tissue in periodontitis tissue, and BAFF protein was increased in the serum of periodontitis patients.

Conclusion

Periodontal resident cells express BAFF during periodontal inflammation and participate in providing a favorable milieu for the survival and action of B cells.

宿主调节疗法是对常规牙周治疗反应差的个体的一种可能的治疗方法。在牙周炎病变中大量存在的B细胞需要细胞因子B细胞活化因子(BAFF)和A增殖诱导配体(APRIL)来存活和成熟。虽然在牙周炎病变组织中BAFF和APRIL的mRNA水平升高，但尚不清楚牙周驻留细胞是否在牙周炎症期间表达BAFF和/或APRIL。本研究旨在分析促炎因子刺激后人牙龈成纤维细胞中BAFF和APRIL的表达情况。此外，我们在牙周炎患者和健康对照者的组织和血清中进行蛋白质分析。

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引用次数: 0

Harvest graft substitute for soft tissue volume augmentation around existing implants: A randomized, controlled and blinded multicenter trial 用于现有种植体周围软组织体积增大的收获移植替代物：随机、对照和盲法多中心试验

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-09 DOI: 10.1002/JPER.23-0305

Donald S. Clem, Pamela K. McClain, Michael K. McGuire, Chris R. Richardson, Greg A. Santarelli, Rachel A. Schallhorn, E. Todd Scheyer, John C. Gunsolley, Thiago Morelli

Background

Using a single-blind, randomized, controlled, multicenter, practice-based clinical trial, a volume-stable collagen matrix (VCMX) was compared with connective tissue graft (CTG) for soft tissue augmentation around existing dental implants.

Methods

Sixty patients (31 VCMX and 31 CTG) were included. The primary outcome was a soft tissue thickness change 3 mm below the gingival margin (GM). Secondary outcomes included clinical measures, such as keratinized tissue widths (KTw), probing pocket depths, and pink esthetic scores, and patient-reported outcomes (PRO).

Results

There were no significant differences between test and control patient demographics or clinical measures throughout the 1-year study. VCMX “grafts” were by design larger than CTG, and surgery time was less (27% less, p = 0.0005). Three millimeters below the GM (primary endpoint), tissue thickness increase was noninferior for VCMX compared with CTG (0.93 ± 0.80 mm vs. 1.10 ± 0.51 mm, respectively), inferior (by 0.25 mm) at 1 mm, and noninferior at 5 mm. Postoperative pain was significantly less for VCMX patients (p < 0.0001), but all other PRO measures, including esthetics and satisfaction, improved similarly for both therapies.

Conclusions

Given the inclusion criteria for this study, namely soft tissue augmentation around existing implants with some evidence of KTw and minimal recession, VCMX provided soft tissue thickness and volume increases similar (noninferior) to CTG. Clinical measures and PRO were similar between therapies—site sensitivity and esthetics improved similarly for both therapies—but surgery time and pain following surgery were significantly less for VCMX.

通过一项单盲、随机、对照、多中心、基于实践的临床试验，比较了体积稳定胶原基质（VCMX）和结缔组织移植（CTG）在现有牙科种植体周围软组织增量方面的效果。

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引用次数: 0

Melatonin supports nonsurgical periodontal treatment in patients with Type 2 diabetes mellitus and periodontitis: A randomized clinical trial 褪黑素支持2型糖尿病和牙周炎患者的非手术牙周治疗:一项随机临床试验

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-06 DOI: 10.1002/JPER.23-0335

Yagmur Sarac Gul, Oguz Kose, Ahmet Altin, Hatice Yemenoglu, Hatice Arslan, Kerimali Akyildiz, Adnan Yilmaz

Background

Diabetes mellitus (DM)-associated hyperinflammatory host response significantly provokes periodontal tissue destruction. In this context, the support of nonsurgical periodontal therapy in diabetics with host modulation agents is a current field of study. This clinical study aims to investigate the clinical efficacy of melatonin supplementation and discuss its possible biological mechanisms in nonsurgical periodontal treatment in patients with DM and periodontitis through some fundamental markers.

Methods

In this randomized controlled and single-blind study, 27 of 55 diabetic patients with periodontitis (stage III/IV and grade C) underwent full-mouth scaling and root planing (fmSRP) alone and 28 patients underwent melatonin administration (6 mg daily, 30 days) in addition to fmSRP (full-mouth scaling and root planing plus melatonin, fmSRP-mel). The potential therapeutic contribution of melatonin was evaluated clinically and biochemically (gingival crevicular fluid RANKL, OPG, MMP-8, and serum IL-1β levels) at 3rd and 6th months.

Results

Melatonin (tablet, 6 mg daily, 30 days) did not cause any local or systemic side effects. fmSRP alone resulted in significant reduction in serum IL-1β levels, pocket depths, gingival inflammation, and gingival crevicular fluid RANKL and MMP-8 levels (p < 0.05). Moreover, melatonin supplementation resulted in a more significant decrease in bleeding and pocket depth scores at probing, especially at 3 months (p < 0.05). Furthermore, RANKL and MMP-8 levels were significantly lower at 3 months and IL-1β levels at 6 months compared to the control group (p < 0.05). However, OPG levels were not affected significantly by the treatments (p > 0.05).

Conclusion

Melatonin, as a host modulation agent, significantly increases the clinical efficacy of fmSRP. The reduction in periodontal inflammation and pocket depths may be a result of marked suppression of RANKL-associated osteoclastogenesis and extracellular matrix damage by melatonin.

背景:糖尿病(DM)相关的高炎症宿主反应显著地引起牙周组织破坏。在这种情况下，支持使用宿主调节剂对糖尿病患者进行非手术牙周治疗是当前研究的一个领域。本临床研究旨在通过一些基础标志物探讨褪黑素在糖尿病合并牙周炎患者非手术牙周治疗中的临床疗效，并探讨其可能的生物学机制。方法:在这项随机对照单盲研究中，55名患有牙周炎的糖尿病患者(III/IV期和C级)中有27名患者单独接受了全口洗牙和牙根刨平(fmSRP)治疗，28名患者在fmSRP(全口洗牙和牙根刨平加褪黑素，fmSRP-mel)治疗的基础上接受了褪黑素治疗(每天6 mg, 30天)。在第3个月和第6个月对褪黑素的潜在治疗作用进行临床和生化评估(龈沟液RANKL、OPG、MMP-8和血清IL-1β水平)。结果:褪黑素(片剂，每日6毫克，30天)未引起任何局部或全身副作用。单用fmSRP可显著降低血清IL-1β水平、龈袋深度、牙龈炎症、龈沟液RANKL和MMP-8水平(p 0.05)。结论:褪黑素作为宿主调节剂，可显著提高fmSRP的临床疗效。牙周炎症和牙袋深度的减少可能是褪黑素显著抑制rankl相关的破骨细胞生成和细胞外基质损伤的结果。

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引用次数: 0

Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study 标准治疗后种植体周围粘膜炎的解决:一项前瞻性裂口研究。

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-12-02 DOI: 10.1002/JPER.23-0507

Mia Rakic, Zoran Tatic, Sandro Radovanovic, Aleksandra Petkovic-Curcin, Danilo Vojvodic, Alberto Monje

Background

Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors.

Methods

Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms.

Results

Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness.

Conclusion

AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.

背景:种植体周围粘膜炎(PIM)是种植体周围炎的病理前兆，但其转化为种植体周围炎的模式尚不清楚，临床上诊断复杂，而现有的方案均不能完全解决疾病。本研究的目的是在临床和生物标志物水平上评估PIM对标准抗感染机械治疗(AIMT)的反应性，并评估骨标志物作为替代终点和预测因子的诊断能力。方法:纳入系统健康门诊患者，其中一个种植体表现出软组织内炎症的临床症状(PIM)，另一个健康对照(HC)种植体位于非邻近位置。基线和机械治疗后6个月收集临床参数和种植体周围沟液样本，评估RANKL、OPG和IGFBP2水平。使用机器学习算法进行PIM聚类。结果:38例患者符合纳入标准。治疗导致所有临床和生物学指标降低，但与HC相比，各自的值仍显着较高。临床检查显示，在6个月的随访中，30%的疾病消退，而43%的患者骨吸收不活跃。OPG对治疗结果有积极的预后价值，而基于主动骨吸收的聚类在治疗效果方面没有差异。结论:AIMT能有效降低PIM的临床及生物学指标，但临床完全缓解的病例仅占30%。大约三分之一的PIM患者表现出活跃的骨吸收低于临床可检测性，这与疾病进展和治疗反应性差无关。

{"title":"Resolution of peri-implant mucositis following standard treatment: A prospective split-mouth study","authors":"Mia Rakic, Zoran Tatic, Sandro Radovanovic, Aleksandra Petkovic-Curcin, Danilo Vojvodic, Alberto Monje","doi":"10.1002/JPER.23-0507","DOIUrl":"10.1002/JPER.23-0507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peri-implant mucositis (PIM) is a pathological precursor of peri-implantitis, but its pattern of conversion to peri-implantitis is unclear and complicated to diagnose clinically, while none of the available protocols yield complete disease resolution. The aim of this study was the evaluation of PIM responsiveness to standard anti-infective mechanical treatment (AIMT) at clinical and biomarker levels, and estimation of the diagnostic capacity of bone markers as surrogate endpoints and predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systemically healthy outpatients presenting one implant exhibiting clinical signs of inflammation confined within the soft tissue (PIM) and one healthy control (HC) implant at a non-adjacent position were included. Clinical parameters and peri-implant crevicular fluid samples were collected baseline and 6 months following mechanical therapy, to assess the levels of RANKL, OPG, and IGFBP2. PIM clustering was performed using machine learning algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 38 patients met the inclusion criteria. Therapy resulted in the reduction of all clinical and biological indicators, but respective values remained significantly higher compared to HC. Clinical examination noted 30% disease resolution at the 6-month follow-up, while 43% showed no active bone resorption. OPG showed positive prognostic value for treatment outcome, while the clustering based on active bone resorption did not differ in terms of therapeutic effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AIMT is effective in reducing the clinical and biological indicators of PIM, but complete clinical resolution was achieved in only 30% of the cases. Around one third of PIM patients exhibited active bone resorption bellow clinical detectability that was not associated with disease progression and poor treatment responsiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"95 9","pages":"842-852"},"PeriodicalIF":4.2,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/JPER.23-0507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470445","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

Assessment of bone defect morphology for the adjunctive use of bone grafting combined with enamel matrix derivative: A 3-year cohort study 牙釉质基质衍生物联合植骨辅助使用的骨缺损形态学评估:一项为期3年的队列研究

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-11-29 DOI: 10.1002/JPER.23-0538

Takanori Matsuura, Risako Mikami, Koji Mizutani, Hidehiro Shioyama, Norio Aoyama, Tomonari Suda, Yukako Kusunoki, Kohei Takeda, Yuichi Izumi, Jun Aida, Akira Aoki, Takanori Iwata

Background

There have been limited studies with statistically sufficient sample sizes for assessment of suitable bone defect morphology for combination therapy with enamel matrix derivative (EMD) and bone grafting. The aim of this study was to investigate the appropriate feature of intrabony defects, such as bone defect angle (DA) and the containment by bony wall, for yielding the additional benefit of bone grafting in combination with periodontal regenerative therapy using EMD.

Methods

Following periodontal regenerative therapy using EMD with or without autologous bone grafting, 282 intrabony defects of 177 participants were maintained for 3 years. Multilevel linear regression analysis was performed to evaluate the radiographic bony defect depth (RBD) reduction after adjusting for confounders.

Results

The baseline parameters, except for the proportion of contained bony defects and tooth mobility, did not differ significantly between the groups with and without bone grafts. There was no significant difference in the improvement of clinical parameters between the groups. The 1- and 3-year reduction of RBD showed significant inverse correlations with preoperative DA only in the group without bone graft. Furthermore, multivariate analysis showed a significant interaction between DA at baseline ≥40° and adjunctive bone grafting in the reduction of RBD, regardless of the number of bony walls.

Conclusion

Adjunctive autologous bone grafting with enamel matrix derivative might be significantly beneficial for defect depth improvement in the case of DA at baseline ≥40°.

在评估牙釉质基质衍生物(EMD)和骨移植联合治疗的合适骨缺损形态方面，有统计学上足够样本量的有限研究。本研究的目的是探讨骨内缺损的适当特征，如骨缺损角(DA)和骨壁的遏制，以获得骨移植结合EMD牙周再生治疗的额外好处。

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引用次数: 0

Enhanced periodontal tissue healing via vascular endothelial growth factor expression following low-level erbium-doped: yttrium, aluminum, and garnet laser irradiation: In vitro and in vivo studies 低水平掺铒:钇、铝和石榴石激光照射后通过血管内皮生长因子表达增强牙周组织愈合:体外和体内研究

IF 4.2 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of periodontology

Pub Date : 2023-11-27 DOI: 10.1002/JPER.23-0458

Shu Takemura, Koji Mizutani, Risako Mikami, Keita Nakagawa, Masahiro Hakariya, Eri Sakaniwa, Natsumi Saito, Hiromi Kominato, Daisuke Kido, Kohei Takeda, Akira Aoki, Takanori Iwata

Background

This study aimed to investigate the effects of low-level erbium-doped: yttrium, aluminum, and garnet (Er:YAG) laser irradiation on periodontal tissue healing and regeneration through angiogenesis in vivo and in vitro studies.

Methods

Intrabony defects were surgically created in the bilateral maxilla molar of rats. The defects were treated by open flap debridement (OFD) with Er:YAG laser, including low-level laser irradiation (LLLI) to bone and blood clot surfaces, or conventional procedures. The mRNA expression of vascular endothelial growth factor (VEGF) in the surgical sites was quantified using real-time polymerase chain reaction. The decalcified specimens were prepared for histometric analysis. Also, LLLI was performed on human umbilical vein endothelial cells to evaluate the effects on angiogenesis. Cell proliferation, VEGF expression, and tube formation were assessed. In addition, capsazepine (CPZ), a selective inhibitor of transient receptor potential vanilloid 1 (TRPV1), treatment was performed before LLLI for the same assays.

Results

OFD using Er:YAG laser did not generate thermal damage on bone or root surfaces. LLLI accelerated hemostasis by coagulation of the superficial layers of blood clots in the laser-treated group. Postoperative healing was sound in all animals in both groups. VEGF expression and bone formation were significantly increased in the laser-treated group compared to those in the conventional treatment group. In vitro, cell proliferation and VEGF expression were significantly increased in the LLLI group compared to the control group. Tube-formation assays showed that LLLI significantly promoted angiogenesis. CPZ treatment significantly suppressed VEGF expression and tube formation following LLLI.

Conclusions

This study suggests that Er:YAG laser irradiation may promote periodontal tissue healing by enhancing angiogenetic effect of endothelial cells via TRPV1.

背景:本研究旨在探讨低水平掺铒:钇，铝和石榴石(Er:YAG)激光照射对牙周组织血管生成愈合和再生的影响。方法:对大鼠双侧上颌磨牙进行骨内缺损手术修复。缺损采用Er:YAG激光开瓣清创(OFD)治疗，包括低水平激光照射(LLLI)骨和血凝块表面，或常规手术。采用实时聚合酶链反应定量检测手术部位血管内皮生长因子(VEGF) mRNA表达。制备脱钙标本进行组织计量学分析。并对人脐静脉内皮细胞进行了LLLI实验，以评估其对血管生成的影响。评估细胞增殖、VEGF表达和管形成情况。此外，辣椒素(CPZ)是一种瞬时受体电位香草素1 (TRPV1)的选择性抑制剂，在LLLI之前进行了同样的检测。结果:Er:YAG激光OFD对骨和根表面均无热损伤。在激光治疗组中，LLLI通过凝固血凝块的浅层来加速止血。两组动物术后愈合良好。与常规治疗组相比，激光治疗组VEGF表达和骨形成明显增加。在体外，与对照组相比，LLLI组细胞增殖和VEGF表达明显增加。成管实验表明，LLLI显著促进血管生成。CPZ处理显著抑制血管内皮生长因子的表达和LLLI后的小管形成。结论:Er:YAG激光照射可能通过增强内皮细胞TRPV1血管生成作用促进牙周组织愈合。

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引用次数: 0