Madeline Yon, Elena Calciolari, Nikos Mardas, Anton Sculean, Nikolaos Donos
Soft tissue grafts (STG) are used in a wide range of clinical situations including volume augmentation, keratinized tissue increase, and recession coverage around teeth and implants. Each STG, produced from different sources and processed with various techniques, possesses unique material properties and interaction with the host tissues, which ultimately impacts healing and clinical outcome. Certain STG material characteristics may be considered ideal depending on specific clinical requirements, such as mechanical strength, volume stability, and angiogenicity. Hybrid materials and graft engineering may further improve STG properties and provide new graft options. This scoping review evaluates the ideal characteristics of STG in periodontal and peri‐implant applications.
{"title":"Ideal soft tissue graft in periodontal and peri‐implant applications: A scoping review","authors":"Madeline Yon, Elena Calciolari, Nikos Mardas, Anton Sculean, Nikolaos Donos","doi":"10.1111/prd.70010","DOIUrl":"https://doi.org/10.1111/prd.70010","url":null,"abstract":"Soft tissue grafts (STG) are used in a wide range of clinical situations including volume augmentation, keratinized tissue increase, and recession coverage around teeth and implants. Each STG, produced from different sources and processed with various techniques, possesses unique material properties and interaction with the host tissues, which ultimately impacts healing and clinical outcome. Certain STG material characteristics may be considered ideal depending on specific clinical requirements, such as mechanical strength, volume stability, and angiogenicity. Hybrid materials and graft engineering may further improve STG properties and provide new graft options. This scoping review evaluates the ideal characteristics of STG in periodontal and peri‐implant applications.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"24 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Negin Soghli,Aminollah Khormali,Darius Mahboubi,Aimin Peng,Patricia A Miguez
Oral cancer is a major global health burden, ranking sixth in prevalence, with oral squamous cell carcinoma (OSCC) being the most common type. Importantly, OSCC is often diagnosed at late stages, underscoring the need for innovative methods for early detection. The oral microbiome, an active microbial community within the oral cavity, holds promise as a biomarker for the prediction and progression of cancer. Emerging computational techniques in the artificial intelligence (AI) field have enabled the analysis of complex microbiome data sets to unravel the association between oral microbiome composition and oral cancer. This review provides a comprehensive overview of learning-based algorithms applied to oral microbiome data for cancer prediction. In particular, this work discusses how typical machine learning (ML) algorithms, such as logistic regression, random forests, and artificial neural networks, identify the unique microbial patterns associated with oral cancer and other malignancies. A search was conducted in Pubmed covering a 10-year period. The goal was to identify previous studies focused on the role of the oral microbiome in oral cancer prediction using AI-powered tools. The search strategy identified 3382 records in total, of which 44 studies met the inclusion criteria. While AI has shown a transformative power in understanding and revealing the oral microbiome's role in cancer studies, its application in clinical settings requires further efforts on standardization of protocols, curation of diverse cohorts, and validation through large-scale multi-centric and longitudinal studies. The integration of AI with oral microbiome analysis holds significant promise for improving early detection, risk stratification, and personalized treatment strategies for OSCC. By identifying unique microbial patterns associated with cancer, AI-driven models offer a noninvasive, cost-effective tool to predict disease progression and guide clinical decision-making. However, translating these advancements into routine clinical practice requires standardized protocols, diverse patient cohorts, and validation through large-scale, longitudinal studies. Once implemented, this approach could transform oral cancer management, enabling timely interventions and improving patient outcomes.
{"title":"Recent advancements in artificial intelligence-powered cancer prediction from oral microbiome.","authors":"Negin Soghli,Aminollah Khormali,Darius Mahboubi,Aimin Peng,Patricia A Miguez","doi":"10.1111/prd.70000","DOIUrl":"https://doi.org/10.1111/prd.70000","url":null,"abstract":"Oral cancer is a major global health burden, ranking sixth in prevalence, with oral squamous cell carcinoma (OSCC) being the most common type. Importantly, OSCC is often diagnosed at late stages, underscoring the need for innovative methods for early detection. The oral microbiome, an active microbial community within the oral cavity, holds promise as a biomarker for the prediction and progression of cancer. Emerging computational techniques in the artificial intelligence (AI) field have enabled the analysis of complex microbiome data sets to unravel the association between oral microbiome composition and oral cancer. This review provides a comprehensive overview of learning-based algorithms applied to oral microbiome data for cancer prediction. In particular, this work discusses how typical machine learning (ML) algorithms, such as logistic regression, random forests, and artificial neural networks, identify the unique microbial patterns associated with oral cancer and other malignancies. A search was conducted in Pubmed covering a 10-year period. The goal was to identify previous studies focused on the role of the oral microbiome in oral cancer prediction using AI-powered tools. The search strategy identified 3382 records in total, of which 44 studies met the inclusion criteria. While AI has shown a transformative power in understanding and revealing the oral microbiome's role in cancer studies, its application in clinical settings requires further efforts on standardization of protocols, curation of diverse cohorts, and validation through large-scale multi-centric and longitudinal studies. The integration of AI with oral microbiome analysis holds significant promise for improving early detection, risk stratification, and personalized treatment strategies for OSCC. By identifying unique microbial patterns associated with cancer, AI-driven models offer a noninvasive, cost-effective tool to predict disease progression and guide clinical decision-making. However, translating these advancements into routine clinical practice requires standardized protocols, diverse patient cohorts, and validation through large-scale, longitudinal studies. Once implemented, this approach could transform oral cancer management, enabling timely interventions and improving patient outcomes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"24 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hom-Lay Wang,Parham Hazrati,Javier Calatrava,Muhammad S Saleh,Abdusalam E Alrmali
This systematic review and meta-analysis aimed to evaluate the long-term clinical outcomes of regenerative procedures compared with access flap surgery for the treatment of intrabony defects, with a minimum follow-up period of 5 years. A systematic review protocol following PRISMA guidelines was conducted. Both electronic and manual searches were conducted to identify randomized clinical trials (RCTs) on regenerative treatment of deep intrabony defects (≥3 mm) with a follow-up of at least 5 years. Primary outcome variables were probing depth (PD) reduction, clinical attachment level (CAL) gain, recession depth (REC) and tooth loss. Meta-analyses and meta-regressions were performed using random-effects models. Seventeen RCTs published from 2004 to 2022, accounting for 501 defects, with follow-ups ranging from 5 to 20 years, were included. Thirteen studies with some concerns and four with high risks of bias were identified. Meta-analyses revealed that after ≥5 years of follow-up, guided tissue regeneration (GTR) on the intrabony defect resulted in significant CAL gain (3.27 mm; 95% CI: 2.90-3.65) and PD reduction (4.04 mm; 95% CI: 3.69-4.38) compared with baseline. After ≥5 years, regenerative procedures with biologics, bone grafts, or both showed significant improvements in CAL gain (3.21 mm; 95% CI: 2.72-3.70) and PD reduction (3.92 mm; 95% CI: 3.39-4.44). GTR on the intrabony defects obtained higher long-term CAL gain (1.52 mm; 95% CI: 0.06-3.10) and PD reduction (0.89 mm; 95% CI: 0.22-1.99) than OFD (open flap debridement); however, none of the outcomes reached statistical significance (p = 0.06; p = 0.115). Meta-regression identified significant associations between outcomes and factors, such as follow-up time, surgical technique, membrane type, and baseline measurements. The certainty of evidence was low for CAL and PD outcomes, but high for REC. Long-term studies indicate that regenerative procedures for the intrabony defects, particularly GTR, provide significant improvements in clinical parameters compared with baseline. However, the evidence does not conclusively demonstrate the superiority of regenerative approaches over OFD in the long term.
{"title":"Long-term clinical outcomes of periodontal regeneration of intrabony defects: A systematic review and meta-analysis.","authors":"Hom-Lay Wang,Parham Hazrati,Javier Calatrava,Muhammad S Saleh,Abdusalam E Alrmali","doi":"10.1111/prd.70002","DOIUrl":"https://doi.org/10.1111/prd.70002","url":null,"abstract":"This systematic review and meta-analysis aimed to evaluate the long-term clinical outcomes of regenerative procedures compared with access flap surgery for the treatment of intrabony defects, with a minimum follow-up period of 5 years. A systematic review protocol following PRISMA guidelines was conducted. Both electronic and manual searches were conducted to identify randomized clinical trials (RCTs) on regenerative treatment of deep intrabony defects (≥3 mm) with a follow-up of at least 5 years. Primary outcome variables were probing depth (PD) reduction, clinical attachment level (CAL) gain, recession depth (REC) and tooth loss. Meta-analyses and meta-regressions were performed using random-effects models. Seventeen RCTs published from 2004 to 2022, accounting for 501 defects, with follow-ups ranging from 5 to 20 years, were included. Thirteen studies with some concerns and four with high risks of bias were identified. Meta-analyses revealed that after ≥5 years of follow-up, guided tissue regeneration (GTR) on the intrabony defect resulted in significant CAL gain (3.27 mm; 95% CI: 2.90-3.65) and PD reduction (4.04 mm; 95% CI: 3.69-4.38) compared with baseline. After ≥5 years, regenerative procedures with biologics, bone grafts, or both showed significant improvements in CAL gain (3.21 mm; 95% CI: 2.72-3.70) and PD reduction (3.92 mm; 95% CI: 3.39-4.44). GTR on the intrabony defects obtained higher long-term CAL gain (1.52 mm; 95% CI: 0.06-3.10) and PD reduction (0.89 mm; 95% CI: 0.22-1.99) than OFD (open flap debridement); however, none of the outcomes reached statistical significance (p = 0.06; p = 0.115). Meta-regression identified significant associations between outcomes and factors, such as follow-up time, surgical technique, membrane type, and baseline measurements. The certainty of evidence was low for CAL and PD outcomes, but high for REC. Long-term studies indicate that regenerative procedures for the intrabony defects, particularly GTR, provide significant improvements in clinical parameters compared with baseline. However, the evidence does not conclusively demonstrate the superiority of regenerative approaches over OFD in the long term.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"67 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sandra H Stuhr,Muhammad H A Saleh,Tiziano Testori,Hom-Lay Wang,Ann M Decker
Transcrestal sinus augmentation has emerged as a minimally invasive alternative to lateral window techniques for vertical bone augmentation in the edentulous maxilla. Since its early introduction and modification over the last several decades, this technique has demonstrated predictable outcomes for implant placement in regions with limited bone height. This narrative review examines the current understanding and evolution of transcrestal sinus floor elevation (TSFE), focusing on factors related to long-term stability. We evaluate the procedure's foundational principles, including osteotome-mediated bone condensation and controlled fracture of the sinus floor, which contribute to enhanced primary implant stability. The review addresses critical aspects of treatment planning, surgical execution, and postoperative management while examining potential complications and their resolution. Special attention is given to emerging technologies and materials that may influence treatment outcomes. By synthesizing current evidence and clinical experience, this review aims to provide clinicians with a comprehensive framework for optimizing TSFE procedures and managing potential complications, ultimately working toward a standardized approach through a proposed clinical checklist. Finally, we provide a standardized checklist for TSFE outcome reporting in research studies to facilitate more consistent, reproducible, and comprehensive documentation of surgical procedures, complications, and long-term stability.
{"title":"Long-term stability of transcrestal sinus augmentation.","authors":"Sandra H Stuhr,Muhammad H A Saleh,Tiziano Testori,Hom-Lay Wang,Ann M Decker","doi":"10.1111/prd.70009","DOIUrl":"https://doi.org/10.1111/prd.70009","url":null,"abstract":"Transcrestal sinus augmentation has emerged as a minimally invasive alternative to lateral window techniques for vertical bone augmentation in the edentulous maxilla. Since its early introduction and modification over the last several decades, this technique has demonstrated predictable outcomes for implant placement in regions with limited bone height. This narrative review examines the current understanding and evolution of transcrestal sinus floor elevation (TSFE), focusing on factors related to long-term stability. We evaluate the procedure's foundational principles, including osteotome-mediated bone condensation and controlled fracture of the sinus floor, which contribute to enhanced primary implant stability. The review addresses critical aspects of treatment planning, surgical execution, and postoperative management while examining potential complications and their resolution. Special attention is given to emerging technologies and materials that may influence treatment outcomes. By synthesizing current evidence and clinical experience, this review aims to provide clinicians with a comprehensive framework for optimizing TSFE procedures and managing potential complications, ultimately working toward a standardized approach through a proposed clinical checklist. Finally, we provide a standardized checklist for TSFE outcome reporting in research studies to facilitate more consistent, reproducible, and comprehensive documentation of surgical procedures, complications, and long-term stability.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"57 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guo-Hao Lin,April Martinez,Vincent Li,Eric Lee,Kang-Wei Tu,Richard Kao,Hom-Lay Wang
BACKGROUNDFurcation involvement (FI) in multi-rooted teeth poses significant challenges in periodontal therapy due to complex anatomy and difficulty in achieving effective maintenance. FI is associated with increased periodontal destruction, especially in sites with narrow furcation entrances and deep root concavities. These features hinder effective debridement and compromise the efficacy of periodontal treatments.MATERIALS AND METHODSThis narrative review examines non-regenerative treatment approaches for managing FI, focusing on clinical outcomes and failure rates associated with flap procedures, biologic root reshaping, root amputation, root separation, and root tunneling.RESULTSNon-regenerative procedures show variable outcomes. Reported failure rates include 20.1% for root amputation (range: 0%-61.1%), 18.8% for root separation (range: 2.9%-38%), and 20.9% for root tunneling (range: 7.1%-42.9%). These variations are influenced by factors such as FI severity, root morphology, and patient hygiene.CONCLUSIONEffective management of FI requires accurate diagnosis, appropriate treatment selection, and individualized maintenance protocols. Long-term success is closely tied to case selection and the patient's commitment to ongoing periodontal maintenance care.CLINICAL RELEVANCEUnderstanding the therapeutic prognosis and limitations of non-regenerative approaches in FI cases is essential for optimizing long-term treatment outcomes. Clinicians should emphasize maintenance strategies and consider anatomical challenges when selecting treatment modalities.
{"title":"Long-term stability of conventional non-regenerative periodontal treatment for furcation defects.","authors":"Guo-Hao Lin,April Martinez,Vincent Li,Eric Lee,Kang-Wei Tu,Richard Kao,Hom-Lay Wang","doi":"10.1111/prd.70007","DOIUrl":"https://doi.org/10.1111/prd.70007","url":null,"abstract":"BACKGROUNDFurcation involvement (FI) in multi-rooted teeth poses significant challenges in periodontal therapy due to complex anatomy and difficulty in achieving effective maintenance. FI is associated with increased periodontal destruction, especially in sites with narrow furcation entrances and deep root concavities. These features hinder effective debridement and compromise the efficacy of periodontal treatments.MATERIALS AND METHODSThis narrative review examines non-regenerative treatment approaches for managing FI, focusing on clinical outcomes and failure rates associated with flap procedures, biologic root reshaping, root amputation, root separation, and root tunneling.RESULTSNon-regenerative procedures show variable outcomes. Reported failure rates include 20.1% for root amputation (range: 0%-61.1%), 18.8% for root separation (range: 2.9%-38%), and 20.9% for root tunneling (range: 7.1%-42.9%). These variations are influenced by factors such as FI severity, root morphology, and patient hygiene.CONCLUSIONEffective management of FI requires accurate diagnosis, appropriate treatment selection, and individualized maintenance protocols. Long-term success is closely tied to case selection and the patient's commitment to ongoing periodontal maintenance care.CLINICAL RELEVANCEUnderstanding the therapeutic prognosis and limitations of non-regenerative approaches in FI cases is essential for optimizing long-term treatment outcomes. Clinicians should emphasize maintenance strategies and consider anatomical challenges when selecting treatment modalities.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"34 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Pilloni, Yoshinori Shirakata, Lorenzo Marini, Darko Božić, Richard J Miron, Roberto Rotundo, Andreas Stavropoulos, Anton Sculean
<p><strong>Background: </strong>Although hyaluronic acid (HA) has long been used for many medical applications, only in recent years has it gained greater popularity in the field of periodontics because of its biological effects during wound healing. Even today, most clinicians are not aware that more than one type of HA exists and that the extent of its biological functions may vary depending upon the particular characteristics of the biomolecule itself.</p><p><strong>Aim: </strong>To review and synthesize the current preclinical and clinical evidence on the biological effects and therapeutic applications of HA in periodontology, with a focus on its role in wound healing and regeneration.</p><p><strong>Materials and methods: </strong>The origin and chemical structure of HA are discussed first, with a focus on the importance of its molecular weight and the possibility of modifying its structure and form. The main biological properties of HA followed by its effects on the cells of periodontal tissues are summarized and followed by the presentation of the results from preclinical studies in animals which have evaluated the effects of HA in various types of defects. Subsequently, the data from clinical studies evaluating the application of HA in nonsurgical periodontal therapy, regenerative periodontal surgery, and mucogingival surgery are summarized, and recommendations for the clinicians are provided.</p><p><strong>Results: </strong>The preclinical and clinical evidence indicates that HA accelerates the wound healing process through inflammatory mechanisms and enhances blood clot stability when applied to the root surface. It also influences the expression of both mineralized tissue markers and cementoblast-specific genes, suggesting a potential role in cementum regeneration. HA strongly promotes osteoprogenitor growth while maintaining stemness, potentially regulating the balance between self-renewal and differentiation during bone regeneration. Additionally, HA enhances periodontal ligament (PDL) cell adhesion and proliferation. It has been shown to improve the proliferative and migratory abilities of cells while inducing the expression of collagen type III alpha 1 (COL3A1) and TGFβ-3 genes, which are characteristic of scarless fetal wound healing. Certain HA formulations upregulate the expression of genes encoding platelet-derived growth factor B (PDGFB), fibroblast growth factor 2 (FGF-2), and epidermal growth factor (EGF), all of which play crucial roles in the healing process. Histologic evidence from animal studies suggests that HA may promote periodontal regeneration when applied both non-surgically and surgically-particularly in intrabony defects, gingival recessions, and, to some extent, in furcation defects. The data from clinical studies revealed that HA leads to statistically significant and clinically relevant improvements of probing depths and clinical attachment levels when used in conjunction with nonsurgical periodontal therapy a
{"title":"Hyaluronic acid: A novel approach in regenerative/reconstructive periodontal therapy?","authors":"Andrea Pilloni, Yoshinori Shirakata, Lorenzo Marini, Darko Božić, Richard J Miron, Roberto Rotundo, Andreas Stavropoulos, Anton Sculean","doi":"10.1111/prd.12644","DOIUrl":"https://doi.org/10.1111/prd.12644","url":null,"abstract":"<p><strong>Background: </strong>Although hyaluronic acid (HA) has long been used for many medical applications, only in recent years has it gained greater popularity in the field of periodontics because of its biological effects during wound healing. Even today, most clinicians are not aware that more than one type of HA exists and that the extent of its biological functions may vary depending upon the particular characteristics of the biomolecule itself.</p><p><strong>Aim: </strong>To review and synthesize the current preclinical and clinical evidence on the biological effects and therapeutic applications of HA in periodontology, with a focus on its role in wound healing and regeneration.</p><p><strong>Materials and methods: </strong>The origin and chemical structure of HA are discussed first, with a focus on the importance of its molecular weight and the possibility of modifying its structure and form. The main biological properties of HA followed by its effects on the cells of periodontal tissues are summarized and followed by the presentation of the results from preclinical studies in animals which have evaluated the effects of HA in various types of defects. Subsequently, the data from clinical studies evaluating the application of HA in nonsurgical periodontal therapy, regenerative periodontal surgery, and mucogingival surgery are summarized, and recommendations for the clinicians are provided.</p><p><strong>Results: </strong>The preclinical and clinical evidence indicates that HA accelerates the wound healing process through inflammatory mechanisms and enhances blood clot stability when applied to the root surface. It also influences the expression of both mineralized tissue markers and cementoblast-specific genes, suggesting a potential role in cementum regeneration. HA strongly promotes osteoprogenitor growth while maintaining stemness, potentially regulating the balance between self-renewal and differentiation during bone regeneration. Additionally, HA enhances periodontal ligament (PDL) cell adhesion and proliferation. It has been shown to improve the proliferative and migratory abilities of cells while inducing the expression of collagen type III alpha 1 (COL3A1) and TGFβ-3 genes, which are characteristic of scarless fetal wound healing. Certain HA formulations upregulate the expression of genes encoding platelet-derived growth factor B (PDGFB), fibroblast growth factor 2 (FGF-2), and epidermal growth factor (EGF), all of which play crucial roles in the healing process. Histologic evidence from animal studies suggests that HA may promote periodontal regeneration when applied both non-surgically and surgically-particularly in intrabony defects, gingival recessions, and, to some extent, in furcation defects. The data from clinical studies revealed that HA leads to statistically significant and clinically relevant improvements of probing depths and clinical attachment levels when used in conjunction with nonsurgical periodontal therapy a","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
France Lambert,Eduardo Montero,Isabelle Laleman,Ana Carrillo de Albornoz,Haitam Yousfi,Ignacio Sanz-Sánchez
To explore the impact of soft tissue augmentation procedures during immediate implant placement (IIP) on clinician-assessed esthetic outcomes and patient-reported outcome measures (PROMs). A systematic literature search was conducted in PubMed, Cochrane Library, and Embase until March 2024. Two independent reviewers selected randomized and controlled clinical trials with ≥12 months follow-up, evaluating IIP in the premolar-to-premolar area with or without STA. Primary outcomes included esthetic assessments by clinicians (Pink Aesthetic Score, Implant Crown Aesthetic Index and mid-facial soft tissue recession) as well as PROMs. Secondary outcomes comprised post-operative morbidity, soft tissue stability, and interproximal bone changes. Data extraction was done by two independent reviewers, and the risk of bias was assessed using RoB 2.0 or ROBINS-I. Sixteen publications were included. The only relevant finding was that soft tissue augmentation significantly reduced midfacial soft tissue recession (n = 4, WMD = 0.38; 95% CI (0.15, 0.61)). No significant differences could be found between grafting and no grafting regarding the other clinician-assessed esthetic outcomes or for PROMs. Soft tissue augmentation during IIP reduces midfacial soft tissue recession. However, no other effects could be found based on clinician-assessed or patient-reported esthetic outcomes.
{"title":"Esthetic and patient-reported outcomes in immediate implants with adjunctive surgical procedures to increase soft tissue thickness/height: A systematic review.","authors":"France Lambert,Eduardo Montero,Isabelle Laleman,Ana Carrillo de Albornoz,Haitam Yousfi,Ignacio Sanz-Sánchez","doi":"10.1111/prd.70003","DOIUrl":"https://doi.org/10.1111/prd.70003","url":null,"abstract":"To explore the impact of soft tissue augmentation procedures during immediate implant placement (IIP) on clinician-assessed esthetic outcomes and patient-reported outcome measures (PROMs). A systematic literature search was conducted in PubMed, Cochrane Library, and Embase until March 2024. Two independent reviewers selected randomized and controlled clinical trials with ≥12 months follow-up, evaluating IIP in the premolar-to-premolar area with or without STA. Primary outcomes included esthetic assessments by clinicians (Pink Aesthetic Score, Implant Crown Aesthetic Index and mid-facial soft tissue recession) as well as PROMs. Secondary outcomes comprised post-operative morbidity, soft tissue stability, and interproximal bone changes. Data extraction was done by two independent reviewers, and the risk of bias was assessed using RoB 2.0 or ROBINS-I. Sixteen publications were included. The only relevant finding was that soft tissue augmentation significantly reduced midfacial soft tissue recession (n = 4, WMD = 0.38; 95% CI (0.15, 0.61)). No significant differences could be found between grafting and no grafting regarding the other clinician-assessed esthetic outcomes or for PROMs. Soft tissue augmentation during IIP reduces midfacial soft tissue recession. However, no other effects could be found based on clinician-assessed or patient-reported esthetic outcomes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"27 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For decades, osseous resective surgery along with apically positioned flap procedure has been advocated as a predictable treatment option to reduce residual pockets and minimize periodontal complications during supportive periodontal care. More recently, Fiber Retention Osseous Resective Surgery (FibReORS) has been suggested to reduce the amount of resected bone during flap surgery. The present review is aimed at assessing the potential advantages of FibReORS in terms of clinical and patient-related outcomes, thus focusing on the role of resective periodontal surgery in a modern clinical scenario.
{"title":"The European contribution to osseous resective surgery for the treatment of residual pockets and furcation defects.","authors":"Gianfranco Carnevale,Alberto Fonzar,Filippo Graziani,Francesco Cairo","doi":"10.1111/prd.70001","DOIUrl":"https://doi.org/10.1111/prd.70001","url":null,"abstract":"For decades, osseous resective surgery along with apically positioned flap procedure has been advocated as a predictable treatment option to reduce residual pockets and minimize periodontal complications during supportive periodontal care. More recently, Fiber Retention Osseous Resective Surgery (FibReORS) has been suggested to reduce the amount of resected bone during flap surgery. The present review is aimed at assessing the potential advantages of FibReORS in terms of clinical and patient-related outcomes, thus focusing on the role of resective periodontal surgery in a modern clinical scenario.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"35 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Cairo, Emilio Couso‐Queiruga, Luigi Barbato, Cosimo Rupe, Sandra Stuhr, Leandro Chambrone, Gustavo Avila‐Ortiz
To analyze the effect of root coverage surgical therapy for the treatment of single gingival recession defects (GRD) in terms of clinician‐ and patient‐reported outcomes (CROs and PROs), with an emphasis on esthetic perception. The protocol of this PRISMA 2020‐compliant systematic review was registered in PROSPERO (CRD517050). Relevant articles reporting the outcomes of randomized controlled trials (RCTs) were identified through a literature search. After final article selection, according to specific eligibility criteria, data were extracted and categorized. Primary outcomes were clinician‐reported root coverage esthetic scores (RES) and patient‐reported esthetic perception and satisfaction using different assessment methods, such as standardized visual analog scales (VAS). Data were analyzed and the risk of bias in all included studies was assessed. Fifty‐eight articles pertaining to 50 different RCTs were selected. A total of 1820 subjects presenting 2219 single GRDs were treated. Key findings derived from the pooled estimates indicated that root coverage and gingival phenotype modification therapy positively influenced both RES and patient‐reported esthetic perception and satisfaction values. Compared to the use of a coronally advanced flap (CAF) alone (i.e., monolaminar technique), the use of a CAF in conjunction with a subepithelial connective tissue graft (i.e., bilaminar technique) had a positive impact on both RES and VAS values, whereas CAF in conjunction with soft tissue substitutes only had a beneficial effect on VAS values. Surgical approaches based on lateral flap displacement were associated with superior mean RES values compared to techniques involving coronal flap displacement. Meta‐regression analyses revealed a statistically significant positive association between mean root coverage and RES (i.e., the greater the percentage of root coverage, the higher the RES). Conversely, the association between patient‐reported esthetic perception and MRC was not statistically significant. In addition, it was observed that dentinal hypersensitivity can be substantially reduced with surgical root coverage therapy, regardless of the treatment modality. Surgical therapy for the correction of single GRDs had a positive effect on both clinician‐reported esthetic scores and patient‐reported esthetic perception and satisfaction. Bilaminar techniques are generally associated with superior results.
{"title":"Clinician‐ and patient‐reported outcomes following the surgical treatment of single gingival recession defects: A systematic review","authors":"Francesco Cairo, Emilio Couso‐Queiruga, Luigi Barbato, Cosimo Rupe, Sandra Stuhr, Leandro Chambrone, Gustavo Avila‐Ortiz","doi":"10.1111/prd.12641","DOIUrl":"https://doi.org/10.1111/prd.12641","url":null,"abstract":"To analyze the effect of root coverage surgical therapy for the treatment of single gingival recession defects (GRD) in terms of clinician‐ and patient‐reported outcomes (CROs and PROs), with an emphasis on esthetic perception. The protocol of this PRISMA 2020‐compliant systematic review was registered in PROSPERO (CRD517050). Relevant articles reporting the outcomes of randomized controlled trials (RCTs) were identified through a literature search. After final article selection, according to specific eligibility criteria, data were extracted and categorized. Primary outcomes were clinician‐reported root coverage esthetic scores (RES) and patient‐reported esthetic perception and satisfaction using different assessment methods, such as standardized visual analog scales (VAS). Data were analyzed and the risk of bias in all included studies was assessed. Fifty‐eight articles pertaining to 50 different RCTs were selected. A total of 1820 subjects presenting 2219 single GRDs were treated. Key findings derived from the pooled estimates indicated that root coverage and gingival phenotype modification therapy positively influenced both RES and patient‐reported esthetic perception and satisfaction values. Compared to the use of a coronally advanced flap (CAF) alone (i.e., monolaminar technique), the use of a CAF in conjunction with a subepithelial connective tissue graft (i.e., bilaminar technique) had a positive impact on both RES and VAS values, whereas CAF in conjunction with soft tissue substitutes only had a beneficial effect on VAS values. Surgical approaches based on lateral flap displacement were associated with superior mean RES values compared to techniques involving coronal flap displacement. Meta‐regression analyses revealed a statistically significant positive association between mean root coverage and RES (i.e., the greater the percentage of root coverage, the higher the RES). Conversely, the association between patient‐reported esthetic perception and MRC was not statistically significant. In addition, it was observed that dentinal hypersensitivity can be substantially reduced with surgical root coverage therapy, regardless of the treatment modality. Surgical therapy for the correction of single GRDs had a positive effect on both clinician‐reported esthetic scores and patient‐reported esthetic perception and satisfaction. Bilaminar techniques are generally associated with superior results.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"27 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Monje,Ramon Pons,Ausra Ramanauskaite,Adriana Castro,Frank Schwarz,Leando Chambrone
BACKGROUNDTo assess the long-term results of the surgical treatment of peri-implantitis by means of clinical, radiographic outcomes, and whenever possible, a composite definition of disease resolution. Furthermore, this review aimed at evaluating the prognostic indicators of long-term disease recurrence.METHODSA systematic screening was conducted to identify long-term clinical studies (≥5 years) on the surgical therapy of peri-implantitis. Data pertinent to study methodology, surgical intervention and clinical and radiographic outcomes were retrieved from the original studies. Qualitative assessment was performed.RESULTSOverall, 17 long-term studies were included in the qualitative synthesis. Due to the heterogeneity, quantitative analysis was not suggested. The mean disease resolution rate was 58.6%. The mean progressive bone loss arrestment (>1 mm) at the latest follow-up following therapy was reached in 69.6%. Resolution of bleeding on probing at the latest follow-up was achieved in 59.9%. The need for retreatment was deemed in 27.2% of the cases. Disease resolution following a second attempt was seldomly evaluated. The implant survival rate resulted in 88.6% (range: 75%-100%). The odds for disease recurrence following surgical treatment of peri-implantitis were ∼8× higher when residual pathogenic pockets were present during follow-up. Moreover, the extent of bone loss, the width (<2 mm) of keratinized mucosa following surgical treatment, and implant surface (modified) influenced disease recurrence.CONCLUSIONThe surgical treatment of peri-implantitis yields to favorable outcomes in the long-term. Data suggest that the long-term disease resolution is ∼60% under supportive peri-implant care, while ∼70% exhibit progressive bone loss arrestment. Hence, the need for retreatment is not infrequent. Residual pockets (≥6 mm) following surgical therapy and the advanced extent of bone loss imply a risk for disease recurrence.CLINICAL RELEVANCEThese findings suggest that the surgical treatment of peri-implantitis is effective in the long-term in patients enrolled in supportive peri-implant therapy. However, its predictability can be interfered in scenarios exhibiting advanced lesions or in those that display residual deep pockets following therapy.
{"title":"Long-term surgical treatment outcomes of peri-implantitis.","authors":"Alberto Monje,Ramon Pons,Ausra Ramanauskaite,Adriana Castro,Frank Schwarz,Leando Chambrone","doi":"10.1111/prd.12643","DOIUrl":"https://doi.org/10.1111/prd.12643","url":null,"abstract":"BACKGROUNDTo assess the long-term results of the surgical treatment of peri-implantitis by means of clinical, radiographic outcomes, and whenever possible, a composite definition of disease resolution. Furthermore, this review aimed at evaluating the prognostic indicators of long-term disease recurrence.METHODSA systematic screening was conducted to identify long-term clinical studies (≥5 years) on the surgical therapy of peri-implantitis. Data pertinent to study methodology, surgical intervention and clinical and radiographic outcomes were retrieved from the original studies. Qualitative assessment was performed.RESULTSOverall, 17 long-term studies were included in the qualitative synthesis. Due to the heterogeneity, quantitative analysis was not suggested. The mean disease resolution rate was 58.6%. The mean progressive bone loss arrestment (>1 mm) at the latest follow-up following therapy was reached in 69.6%. Resolution of bleeding on probing at the latest follow-up was achieved in 59.9%. The need for retreatment was deemed in 27.2% of the cases. Disease resolution following a second attempt was seldomly evaluated. The implant survival rate resulted in 88.6% (range: 75%-100%). The odds for disease recurrence following surgical treatment of peri-implantitis were ∼8× higher when residual pathogenic pockets were present during follow-up. Moreover, the extent of bone loss, the width (<2 mm) of keratinized mucosa following surgical treatment, and implant surface (modified) influenced disease recurrence.CONCLUSIONThe surgical treatment of peri-implantitis yields to favorable outcomes in the long-term. Data suggest that the long-term disease resolution is ∼60% under supportive peri-implant care, while ∼70% exhibit progressive bone loss arrestment. Hence, the need for retreatment is not infrequent. Residual pockets (≥6 mm) following surgical therapy and the advanced extent of bone loss imply a risk for disease recurrence.CLINICAL RELEVANCEThese findings suggest that the surgical treatment of peri-implantitis is effective in the long-term in patients enrolled in supportive peri-implant therapy. However, its predictability can be interfered in scenarios exhibiting advanced lesions or in those that display residual deep pockets following therapy.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"18 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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