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Methods for 3D evaluation and quantification of gingival recessions and gingival margin changes: Advancements from conventional techniques. 牙龈凹陷和龈缘变化的三维评估和量化方法:传统技术的进步。
IF 17.5 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-17 DOI: 10.1111/prd.12615
Nikolaos Gkantidis, Konstantinos Dritsas, Mohammed Ghamri, Demetrios Halazonetis, Anton Sculean

In an era of increasing life expectancy and growing patient demands towards lifelong natural tooth retention, accurate assessment of gingival recessions is crucial for diagnosing periodontal diseases, planning preventive or restorative interventions, and evaluating their outcomes. The traditional two-dimensional (2D) methods, while useful, often fall short in capturing the complex topography of gingival tissue margins and their changes over time. By examining relevant published studies, this review highlights the transition from 2D to 3D techniques, analyzing the limitations of widely used 2D approaches, while emphasizing the potential of novel 3D tools and techniques. It discusses their comparative effectiveness, accuracy, and application challenges in clinical and research settings. Advancements in three-dimensional (3D) imaging regarding methodologies for the precise evaluation and quantification of free gingival margin changes and gingival recessions are explored and critically evaluated. The review underscores the potential for these technologies to enhance patient outcomes through more precise diagnosis and data generation. It also identifies gaps in current research and suggests directions for future investigation. Overall, this review provides a comprehensive overview of the state of the art in 3D evaluation methods for gingival recessions and gingival margin changes, offering valuable insights for clinicians and researchers.

在预期寿命不断延长、患者对终生保留天然牙齿的要求不断提高的时代,准确评估牙龈凹陷对于诊断牙周疾病、规划预防或修复干预措施以及评估其效果至关重要。传统的二维(2D)方法虽然有用,但往往无法捕捉牙龈组织边缘复杂的地形及其随时间的变化。通过研究已发表的相关研究,本综述强调了从二维到三维技术的过渡,分析了广泛使用的二维方法的局限性,同时强调了新型三维工具和技术的潜力。文章讨论了这些工具和技术的比较效果、准确性以及在临床和研究环境中的应用挑战。探讨了三维成像在精确评估和量化游离龈缘变化和牙龈凹陷的方法方面的进展,并对其进行了批判性评价。综述强调了这些技术通过更精确的诊断和数据生成来提高患者治疗效果的潜力。综述还指出了当前研究的不足,并提出了未来研究的方向。总之,这篇综述全面概述了牙龈凹陷和龈缘变化三维评估方法的最新进展,为临床医生和研究人员提供了宝贵的见解。
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引用次数: 0
Periodontal and orthodontic management of impacted canines. 牙周和正畸治疗撞击的犬齿。
IF 17.5 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-11-16 DOI: 10.1111/prd.12618
Mohammad Qali, Chenshuang Li, Chun-Hsi Chung, Nipul Tanna

The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contributes toward functional as well as neuromuscular stability, harmony, esthetics, and dentofacial balance. When an aberration is noted with the normal eruptive and development process, early diagnosis with strategic intervention is critical and may often require a multidisciplinary approach. A proper diagnosis, risk assessment, and management of the soft tissues, hard tissues, and adjacent structures are vital for a successful outcome. This review highlights the diagnostic and treatment modalities that require consideration for the orthodontic as well as the periodontal management of impacted canines. The reader is guided through the etiology, diagnosis, prevention, and intervention of clinical cases that were managed with different approaches.

上颌和下颌犬齿被许多临床医生称为牙弓的 "基石"。当处于最佳位置时,它们在提供平衡的咬合方案中发挥着关键作用,有助于实现功能和神经肌肉的稳定、和谐、美观和颌面平衡。当发现正常的萌出和发育过程出现异常时,早期诊断和策略性干预是至关重要的,通常需要采取多学科方法。正确的诊断、风险评估以及对软组织、硬组织和邻近结构的管理对于取得成功至关重要。这篇综述重点介绍了影响性犬齿的正畸和牙周管理中需要考虑的诊断和治疗方法。读者将在不同方法的指导下了解病因、诊断、预防和干预的临床案例。
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引用次数: 0
Osteoinduction and osteoimmunology: Emerging concepts. 骨诱导和骨免疫学:新概念。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-09-01 DOI: 10.1111/prd.12519
Richard J Miron, Marc Bohner, Yufeng Zhang, Dieter D Bosshardt

The recognition and importance of immune cells during bone regeneration, including around bone biomaterials, has led to the development of an entire field termed "osteoimmunology," which focuses on the connection and interplay between the skeletal system and immune cells. Most studies have focused on the "osteogenic" capacity of various types of bone biomaterials, and much less focus has been placed on immune cells despite being the first cell type in contact with implantable devices. Thus, the amount of literature generated to date on this topic makes it challenging to extract needed information. This review article serves as a guide highlighting advancements made in the field of osteoimmunology emphasizing the role of the osteoimmunomodulatory properties of biomaterials and their impact on osteoinduction. First, the various immune cell types involved in bone biomaterial integration are discussed, including the prominent role of osteal macrophages (OsteoMacs) during bone regeneration. Thereafter, key biomaterial properties, including topography, wettability, surface charge, and adsorption of cytokines, growth factors, ions, and other bioactive molecules, are discussed in terms of their impact on immune responses. These findings highlight and recognize the importance of the immune system and osteoimmunology, leading to a shift in the traditional models used to understand and evaluate biomaterials for bone regeneration.

免疫细胞在骨再生(包括骨生物材料周围)过程中的作用和重要性得到了认可,并由此发展出了一个名为 "骨免疫学 "的完整领域,其研究重点是骨骼系统与免疫细胞之间的联系和相互作用。大多数研究都集中在各类骨生物材料的 "成骨 "能力上,而对免疫细胞的关注则少得多,尽管免疫细胞是最先与植入设备接触的细胞类型。因此,迄今为止有关这一主题的文献数量之多,使得提取所需信息变得十分困难。这篇综述文章重点介绍了骨免疫学领域的研究进展,强调了生物材料的骨免疫调节特性及其对骨质诱导的影响。首先,讨论了参与骨生物材料整合的各种免疫细胞类型,包括骨膜巨噬细胞(OsteoMacs)在骨再生过程中的突出作用。随后,讨论了生物材料的关键特性,包括形貌、润湿性、表面电荷以及细胞因子、生长因子、离子和其他生物活性分子的吸附性,这些特性对免疫反应的影响。这些发现强调并认识到了免疫系统和骨免疫学的重要性,从而改变了用于了解和评估骨再生生物材料的传统模式。
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引用次数: 0
Extended platelet-rich fibrin. 扩展的富血小板纤维蛋白。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-11-20 DOI: 10.1111/prd.12537
Richard J Miron, Michael A Pikos, Nathan E Estrin, Masako Kobayashi-Fujioka, Alan Rene Espinoza, Hussein Basma, Yufeng Zhang

Platelet-rich fibrin (PRF) has been characterized as a regenerative biomaterial that is fully resorbed within a typical 2-3 week period. Very recently, however, a novel heating process was shown to extend the working properties of PRP/PRF from a standard 2-3 week period toward a duration of 4-6 months. Numerous clinicians have now utilized this extended-PRF (e-PRF) membrane as a substitute for collagen barrier membranes in various clinical applications, such as guided tissue/bone regeneration. This review article summarizes the scientific work to date on this novel technology, including its current and future applications in periodontology, implant dentistry, orthopedics and facial aesthetics. A systematic review was conducted investigating key terms including "Bio-Heat," "albumin gel," "albumin-PRF," "Alb-PRF," "extended-PRF," "e-PRF," "activated plasma albumin gel," and "APAG" by searching databases such as MEDLINE, EMBASE and PubMed. Findings from preclinical studies demonstrate that following a simple 10-min heating process, the transformation of the liquid plasma albumin layer into a gel-like injectable albumin gel extends the resorption properties to at least 4 months according to ISO standard 10 993 (subcutaneous animal model). Several clinical studies have now demonstrated the use of e-PRF membranes as a replacement for collagen membranes in GTR/GBR procedures, closing lateral windows in sinus grafting procedures, for extraction site management, and as a stable biological membrane during recession coverage procedures. Furthermore, Alb-PRF may also be injected as a regenerative biological filler that lasts extended periods with advantages in joint injections, osteoarthritis and in the field of facial aesthetics. This article highlights the marked improvement in the stability and degradation properties of the novel Alb-PRF/e-PRF technology with its widespread future potential use as a potential replacement for collagen membranes with indications including extraction site management, GBR procedures, lateral sinus window closure, recession coverage among others, and further highlights its use as a biological regenerative filler for joint injections and facial aesthetics. It is hoped that this review will pioneer future opportunities and research development in the field, leading to further progression toward more natural and less costly biomaterials for use in medicine and dentistry.

富血小板纤维蛋白(PRF)是一种可再生的生物材料,在典型的2-3周内被完全吸收。然而,最近,一种新的加热工艺被证明可以将PRP/PRF的工作性能从标准的2-3周延长到4-6个月。许多临床医生现在已经在各种临床应用中使用这种扩展prf (e-PRF)膜作为胶原屏障膜的替代品,例如引导组织/骨再生。本文综述了该新技术在牙周病学、种植牙科、骨科和面部美学等方面的应用现状和前景。通过检索MEDLINE、EMBASE和PubMed等数据库,对“Bio-Heat”、“白蛋白凝胶”、“白蛋白prf”、“Alb-PRF”、“extended-PRF”、“e-PRF”、“活化血浆白蛋白凝胶”和“APAG”等关键词进行系统综述。临床前研究结果表明,经过简单的10分钟加热过程,液体血浆白蛋白层转化为凝胶状可注射白蛋白凝胶,根据ISO标准10 993(皮下动物模型),吸收特性延长至少4个月。一些临床研究已经证明了e-PRF膜在GTR/GBR手术中作为胶原膜的替代品,在鼻窦移植手术中关闭侧窗,用于提取部位管理,以及在退行性覆盖手术中作为稳定的生物膜。此外,Alb-PRF也可以作为一种可再生的生物填充物注射,其持续时间更长,在关节注射、骨关节炎和面部美学领域具有优势。本文重点介绍了新型Alb-PRF/e-PRF技术在稳定性和降解性能方面的显著改善,以及其作为胶原膜潜在替代品的广泛应用前景,适应症包括提取部位管理、GBR手术、侧窦窗口关闭、退行性覆盖等,并进一步强调了其作为关节注射和面部美容的生物再生填充剂的用途。希望这篇综述将开拓该领域未来的机会和研究发展,从而进一步发展更天然、更便宜的生物材料,用于医学和牙科。
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引用次数: 0
Ten years of injectable platelet-rich fibrin. 十年注射富血小板纤维蛋白。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-11-30 DOI: 10.1111/prd.12538
Richard J Miron, Reinhard Gruber, Nima Farshidfar, Anton Sculean, Yufeng Zhang

The use of platelet-rich fibrin (PRF) has seen widespread advantages over platelet-rich plasma (PRP) in many fields of medicine. However, until 2014, PRF remained clinically available only in its solid clotted form. Modifications to centrifugation protocols and tube technology have led to the development of a liquid injectable version of PRF (i-PRF). This narrative review takes a look back at the technological developments made throughout the past decade and further elaborates on their future clinical applications. Topics covered include improvements in isolation techniques and protocols, ways to further concentrate i-PRF, and the clinical impact and relevance of cooling i-PRF. Next, various uses of i-PRF are discussed, including its use in regenerative periodontology, implantology, endodontics, temporomandibular joint injections, and orthodontic tooth movement. Furthermore, various indications in medicine are also covered, including its use in sports injuries and osteoarthritis of various joints, treatment of diabetic ulcers/wound care, and facial esthetics and hair regrowth. Finally, future applications are discussed, mainly its use as a drug delivery vehicle for small biomolecules, such as growth factors, antibiotics, exosomes, and other medications that may benefit from the controlled and gradual release of biomolecules over time.

在许多医学领域,富血小板纤维蛋白(PRF)比富血小板血浆(PRP)具有广泛的优势。然而,直到2014年,PRF仍仅以固体凝块形式在临床上可用。对离心方案和试管技术的修改导致了液体注射型PRF (i-PRF)的发展。这篇叙述性的综述回顾了过去十年的技术发展,并进一步阐述了它们未来的临床应用。所涉及的主题包括分离技术和方案的改进,进一步浓缩i-PRF的方法,以及冷却i-PRF的临床影响和相关性。接下来,讨论了i-PRF的各种用途,包括其在再生牙周病学、种植学、牙髓学、颞下颌关节注射和正畸牙齿运动中的应用。此外,还涵盖了各种医学适应症,包括在运动损伤和各种关节骨关节炎中的应用,糖尿病溃疡/伤口护理的治疗,面部美容和头发再生。最后,讨论了其未来的应用,主要是作为小生物分子的药物递送载体,如生长因子、抗生素、外泌体和其他可能受益于生物分子随时间的控制和逐渐释放的药物。
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引用次数: 0
Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis. 长基牙修复骨水平植入物周围的边缘骨丢失较少:一项系统综述和荟萃分析。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-09-28 DOI: 10.1111/prd.12534
Péter Tajti, Eleonora Solyom, Szilárd Váncsa, Péter Mátrai, Péter Hegyi, Gábor Varga, Péter Hermann, Judit Borbély, Anton Sculean, Krisztina Mikulás

The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing.

本研究的目的是根据“一次一个基牙”方案,研究用长基牙和短基牙修复骨水平植入物的生物学结果。截至2023年1月14日,在MEDLINE(PubMed)、EMBASE、Web of Science、Scopus和CENTRAL五个数据库中进行了系统搜索,用于随机对照试验。两位评审员收集了边缘骨丢失、探查出血和探查袋深度的数据。作为效应大小测量、平均差(MD)和风险比(RR)用于连续和分类结果,R统计软件用于进行统计分析。对于质量和确定性评估,使用了偏差风险工具2、ROBINS-I和GRADE方法。搜索得到4055条记录,没有任何重复。经过标题、摘要和全文分析,发现有八篇文章符合入选条件。骨水平和平台转换植入物在6个月后表现出较少的边缘骨损失 月和1 年,当使用长基牙时(MD 0.63,95%CI:[-0.16;1.42])和(MD 0.26,95%CI:-0.02;0.53])。然而,亚组分析显示,当使用“一次一个基牙”方案时,边缘骨损失没有差异(p = 0.973)。在两组中,探查出血和探查袋深度表现出类似的良好结果,几乎没有任何差异(RR 0.97,95%CI:[0.76;1.23])和(MD-0.05,95%CI:[1-111;1.01])。无论连接时间如何,骨水平植入物上较长的基牙似乎是减少早期边缘骨损失的有利选择。
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引用次数: 0
Antimicrobial effect of platelet-rich fibrin: A systematic review of in vitro evidence-based studies. 富含血小板的纤维蛋白的抗菌作用:体外循证研究的系统综述。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-09-22 DOI: 10.1111/prd.12529
Vittorio Moraschini, Richard J Miron, Carlos Fernando de Almeida Barros Mourão, Rafael Seabra Louro, Anton Sculean, Luiz Afonso Morgenstern da Fonseca, Monica Diuana Calasans Maia, Jamil Awad Shibli

This systematic review (SR) aimed to evaluate the antimicrobial potential of different types of platelet-rich fibrin (PRF) often used in regenerative treatments. An electronic search was performed in four databases and in Gray literature for articles published until January, 2023. The eligibility criteria comprised in vitro studies that evaluated the antimicrobial effect of different types of PRF. For the analysis of the risk of bias within studies, the modified OHAT (Office of Health Assessment and Translation) tool was used. For the evaluation of the results, a qualitative critical analysis was carried out in the synthesis of the results of the primary studies. Sixteen studies published between 2013 and 2021 were included in this SR. The antimicrobial effects of PRF variations (PRF, injectable PRF [I-PRF], PRF with silver nanoparticles [agNP-PRF], and horizontal PRF [H-PRF]), were analyzed against 16 types of bacteria from the oral, periodontal, and endodontic environments. All types of PRF showed significant antimicrobial action, with the antibacterial efficacy being more expressive than the fungal one. The I-PRF, H-PRF, and agNP-PRF subtypes improve antimicrobial activity. According to the OHAT analysis, no study was classified as having a high risk of bias. Evidence suggests that PRF variations have significant antimicrobial activity, with bacterial action being greater than fungal. Evolutions such as I-PRF, H-PRF, and agNP-PRF improve antimicrobial activity. Future studies analyzing the clinical effect of these platelets are fundamental. This SR was registered in INPLASY under number INPLASY202340016.

本系统综述(SR)旨在评估再生治疗中常用的不同类型富含血小板的纤维蛋白(PRF)的抗菌潜力。在四个数据库和格雷文献中对2023年1月之前发表的文章进行了电子搜索。合格标准包括评估不同类型PRF抗菌效果的体外研究。为了分析研究中的偏倚风险,使用了改良的OHAT(健康评估和翻译办公室)工具。为了评估结果,在综合初步研究结果的过程中进行了定性批判性分析。2013年至2021年间发表的16项研究包括在本SR中。分析了PRF变体(PRF、可注射PRF[I-PRF]、含银纳米颗粒的PRF[agNP-PRF]和水平PRF[H-PRF])对口腔、牙周和牙髓环境中的16种细菌的抗菌作用。所有类型的PRF都表现出显著的抗菌作用,抗菌效果比真菌更具表现力。I-PRF、H-PRF和agNP-PRF亚型提高了抗菌活性。根据OHAT的分析,没有任何研究被归类为具有高偏倚风险。有证据表明,PRF变异具有显著的抗菌活性,细菌的作用大于真菌。I-PRF、H-PRF和agNP-PRF等进化产物可提高抗菌活性。未来分析这些血小板的临床效果的研究是基础。该SR在INPLASY注册,编号为INPLASY202340016。
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引用次数: 0
Optimization of platelet-rich fibrin. 优化富血小板纤维蛋白。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-09-08 DOI: 10.1111/prd.12521
Richard J Miron, Masako Fujioka-Kobayashi, Anton Sculean, Yufeng Zhang

The use of platelet-rich fibrin (PRF) has gained tremendous popularity in recent years owing to its ability to speed wound healing postsurgery. However, to date, many clinicians are unaware of methods designed to optimize the technology. This overview article will discuss the advancements and improvements made over the years aimed at maximizing cell and growth factor concentrations. First, a general understanding explaining the differences between RPM and RCF (g-force) is introduced. Then, the low-speed centrifugation concept, fixed angle versus horizontal centrifugation, and methods to maximize platelet concentrations using optimized protocols will be discussed in detail. Thereafter, the importance of chemically modified PRF tubes without the addition of chemical additives, as well as regulation of temperature to induce/delay clotting, will be thoroughly described. This article is a first of its kind summarizing all recent literature on PRF designed to optimize PRF production for clinical treatment.

近年来,由于富血小板纤维蛋白(PRF)能够加快术后伤口愈合,其使用已大受欢迎。然而,迄今为止,许多临床医生还不了解旨在优化该技术的方法。本综述文章将讨论多年来为最大限度地提高细胞和生长因子浓度而取得的进步和改进。首先,介绍对转速和离心力(g-force)之间差异的一般理解。然后,将详细讨论低速离心概念、固定角度与水平离心,以及使用优化方案最大限度提高血小板浓度的方法。随后,将详细介绍不添加化学添加剂的化学修饰 PRF 管的重要性,以及调节温度以诱导/延缓凝血的方法。这篇文章首次总结了有关 PRF 的所有最新文献,旨在优化 PRF 生产,以用于临床治疗。
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引用次数: 0
Optimized bone grafting. 优化骨移植。
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-08-23 DOI: 10.1111/prd.12517
Richard J Miron

Bone grafting is routinely performed in periodontology and oral surgery to fill bone voids. While autogenous bone is considered the gold standard because of its regenerative properties, allografts and xenografts have more commonly been utilized owing to their availability as well as their differential regenerative/biomechanical properties. In particular, xenografts are sintered at high temperatures, which allows for their slower degradation and resorption rates and/or nonresorbable features. As a result, clinicians have combined xenografts with other classes of bone grafts (most notably allografts and autografts in various ratios) for procedures requiring better long-term stability, such as contour grafting, sinus elevation procedures, and vertical bone augmentations. This review addresses the regenerative properties of each class of bone grafts and then highlights the importance of understanding each of their biomechanical and regenerative properties for clinical applications, including extraction site management, contour augmentation, sinus grafting, and horizontal and vertical augmentation procedures. Thereafter, an introduction toward the novel production of nonresorbable bone allografts (NRBAs) via high-temperature sintering is presented. These NRBAs not only pose the advantage of being more biocompatible than xenografts owing to their origin (human vs. animal bone) but also display nonresorbable properties similar to those of xenografts. Thus, while packaging allografts with xenografts in premixtures specific to various clinical indications has never been permitted owing to cross-species contamination and FDA/CE requirements, the discovery and production of NRBAs allows premixing with standard allografts in various ratios without regulatory restrictions. Therefore, premixtures of allografts with NRBAs can be produced in various ratios for specific indications (e.g., a 1:1 ratio similar to an allograft/xenograft mixture for sinus grafting) without the need for purchasing separate classes of bone grafts. This optimized form of bone grafting could theoretically provide clinicians more precise ratios without the need to purchase separate bone grafts. This review highlights the future potential for simplified and optimized bone grafting in periodontology and implant dentistry.

骨移植是牙周病学和口腔外科的常规手术,用于填补骨空隙。虽然自体骨因其再生特性而被认为是黄金标准,但异体骨和异种骨因其可获得性以及不同的再生/生物力学特性而更常被使用。特别是,异种移植物是在高温下烧结而成的,因此降解和吸收速度较慢,而且/或者具有不可吸收的特性。因此,临床医生已将异种移植物与其他类别的骨移植物(最主要的是不同比例的异种移植物和自体移植物)结合起来,用于需要更好的长期稳定性的手术,如轮廓移植、上颌窦提升手术和垂直骨增量手术。本综述探讨了各类骨移植物的再生特性,然后强调了了解其生物力学和再生特性对临床应用的重要性,包括拔牙部位管理、轮廓增高、上颌窦移植以及水平和垂直增高手术。随后,介绍了通过高温烧结生产不可吸收骨异体移植物(NRBAs)的新方法。这些 NRBAs 不仅因其来源(人类骨与动物骨)而比异种移植物更具生物相容性,而且还具有与异种移植物类似的不可吸收特性。因此,虽然由于跨物种污染和 FDA/CE 的要求,一直以来都不允许将异种移植物与异种移植物包装成适用于各种临床适应症的预混合物,但 NRBA 的发现和生产允许以各种比例与标准异种移植物进行预混合,而不受监管限制。因此,异体移植物与 NRBA 的预混合物可以针对特定适应症以不同比例生产(例如,1:1 的比例类似于用于上颌窦移植的异体移植物/异种移植物混合物),而无需购买单独类别的骨移植物。理论上,这种优化的骨移植形式可以为临床医生提供更精确的比例,而无需购买单独的骨移植物。这篇综述强调了简化和优化骨移植在牙周病学和种植牙学中的未来潜力。
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引用次数: 0
Can vitamins improve periodontal wound healing/regeneration? 维生素能改善牙周伤口愈合/再生吗?
IF 18.6 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 Epub Date: 2023-08-17 DOI: 10.1111/prd.12513
Karim M Fawzy El-Sayed, Raluca Cosgarea, Anton Sculean, Christof Doerfer

Periodontitis is a complex inflammatory disorder of the tooth supporting structures, associated with microbial dysbiosis, and linked to a number if systemic conditions. Untreated it can result in an irreversible damage to the periodontal structures and eventually teeth loss. Regeneration of the lost periodontium requires an orchestration of a number of biological events on cellular and molecular level. In this context, a set of vitamins have been advocated, relying their beneficial physiological effects, to endorse the biological regenerative events of the periodontium on cellular and molecular levels. The aim of the present article is to elaborate on the question whether or not vitamins improve wound healing/regeneration, summarizing the current evidence from in vitro, animal and clinical studies, thereby shedding light on the knowledge gap in this field and highlighting future research needs. Although the present review demonstrates the current heterogeneity in the available evidence and knowledge gaps, findings suggest that vitamins, especially A, B, E, and CoQ10, as well as vitamin combinations, could exert positive attributes on the periodontal outcomes in adjunct to surgical or nonsurgical periodontal therapy.

牙周炎是牙齿支持结构的一种复杂炎症性疾病,与微生物菌群失调有关,并与多种全身性疾病相关。如不及时治疗,会对牙周结构造成不可逆转的损害,最终导致牙齿脱落。失去的牙周的再生需要细胞和分子水平上一系列生物事件的协调。在这种情况下,人们主张使用一系列维生素,依靠其有益的生理作用,在细胞和分子水平上支持牙周的生物再生事件。本文旨在阐述维生素是否能改善伤口愈合/再生的问题,总结体外、动物和临床研究的现有证据,从而揭示该领域的知识差距,并强调未来的研究需求。尽管本综述显示了目前现有证据的不一致性和知识差距,但研究结果表明,维生素,尤其是 A、B、E 和 CoQ10,以及维生素组合,在辅助手术或非手术牙周治疗时,可对牙周疗效产生积极影响。
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引用次数: 0
期刊
Periodontology 2000
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