José Nart,Cristina Valles,Javi Vilarrasa,Federica Romano,Giacomo Baima,Mario Aimetti
The aim of this systematic review was to assess the performance of soft tissue augmentation (STA) procedures, with or without a modification of the prosthetic rehabilitation, for the treatment of buccal peri-implant soft tissue dehiscence (PSTD) in terms of esthetics and patient-reported outcomes. A systematic review protocol was developed following the PRISMA checklist. Electronic and hand searches were conducted to identify randomized clinical trials (RCTs) and prospective studies on the treatment of buccal PSTD in implants without peri-implantitis, with a follow-up of at least 6 months. Professional assessment of esthetics and self-reported patient satisfaction were considered the primary outcomes, while clinical variables were considered secondary outcomes. Meta-analysis was carried out when possible using a fixed- or random-effect model. Eight publications reporting on five studies (two RCTs and three prospective studies), published from 2013 to 2024 and including a total of 87 patients, were included in this systematic review. All studies evaluated a coronally advanced flap (CAF) with connective tissue graft (CTG) or substitutes, whereas one arm of an RCT employed a tunnel procedure. Two studies included changing of the prosthetic component. Three studies were rated at low risk of bias. A total of 10 meta-analyses were performed. STA using CAF achieved a final professional esthetic score of 7.7 on a 0-10 scale (95% CI: 6.63; 8.83) and showed improvements in terms of patient-reported esthetics on a 0-100 visual analogue scale (60.8; 95% CI: 46.56; 75.01), with moderate-to-high heterogeneity. The estimated reduction in PSTD depth was 2.2 mm (95% CI: 1.76; 2.69), with an estimated rate of complete PSTD coverage of 71% (95% CI: 59; 82). Based on limited evidence, it can be concluded that STA procedures around implants affected by buccal PSTD appear to positively influence both professional and patient-reported esthetics outcomes.
{"title":"Impact of soft tissue augmentation procedures on esthetics and patient satisfaction in the treatment of peri-implant buccal soft tissue dehiscences: A systematic review and meta-analysis.","authors":"José Nart,Cristina Valles,Javi Vilarrasa,Federica Romano,Giacomo Baima,Mario Aimetti","doi":"10.1111/prd.12633","DOIUrl":"https://doi.org/10.1111/prd.12633","url":null,"abstract":"The aim of this systematic review was to assess the performance of soft tissue augmentation (STA) procedures, with or without a modification of the prosthetic rehabilitation, for the treatment of buccal peri-implant soft tissue dehiscence (PSTD) in terms of esthetics and patient-reported outcomes. A systematic review protocol was developed following the PRISMA checklist. Electronic and hand searches were conducted to identify randomized clinical trials (RCTs) and prospective studies on the treatment of buccal PSTD in implants without peri-implantitis, with a follow-up of at least 6 months. Professional assessment of esthetics and self-reported patient satisfaction were considered the primary outcomes, while clinical variables were considered secondary outcomes. Meta-analysis was carried out when possible using a fixed- or random-effect model. Eight publications reporting on five studies (two RCTs and three prospective studies), published from 2013 to 2024 and including a total of 87 patients, were included in this systematic review. All studies evaluated a coronally advanced flap (CAF) with connective tissue graft (CTG) or substitutes, whereas one arm of an RCT employed a tunnel procedure. Two studies included changing of the prosthetic component. Three studies were rated at low risk of bias. A total of 10 meta-analyses were performed. STA using CAF achieved a final professional esthetic score of 7.7 on a 0-10 scale (95% CI: 6.63; 8.83) and showed improvements in terms of patient-reported esthetics on a 0-100 visual analogue scale (60.8; 95% CI: 46.56; 75.01), with moderate-to-high heterogeneity. The estimated reduction in PSTD depth was 2.2 mm (95% CI: 1.76; 2.69), with an estimated rate of complete PSTD coverage of 71% (95% CI: 59; 82). Based on limited evidence, it can be concluded that STA procedures around implants affected by buccal PSTD appear to positively influence both professional and patient-reported esthetics outcomes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"16 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645921","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}
Zhaozhao Chen,Lan-Lin Chiou,Javier Calatrava,Hom-Lay Wang
Antibiotics are commonly prescribed in periodontal and implant surgeries, either before, during or after surgery, to prevent postoperative infection and reduce early implant failure. However, the potential benefits may be undermined by the risks of resistance and sensitization, thus requiring a strict indication for prescription. There are controversial views regarding the indication, dosage, duration, and timing of antibiotic medication in periodontal and implant surgery. Therefore, the aim of this review is to address the benefits and concerns regarding the efficacy of using preventive antibiotic therapy in Periodontology and Implant Dentistry. Specifically, various types of procedures were comprehensively explored, and recommendations were given accordingly. The available evidence indicates that preventive antibiotic therapy is not warranted for periodontal surgeries, including conventional, plastic, and regenerative procedures. While antibiotic prophylaxis has shown effectiveness in preventing early implant failures in straightforward implant placements, postoperative coverage does not appear to be justified. Furthermore, antibiotic administration has not proven to significantly reduce early implant failure rates in implant placements involving simultaneous guided bone regeneration. There remains insufficient evidence to support or oppose the use of preventive antibiotic therapy for reducing infection rates after ridge or sinus augmentation procedures, nor is there evidence favoring any specific protocol over others.
{"title":"The role of antibiotics in preventing surgical complications in periodontology and implant dentistry.","authors":"Zhaozhao Chen,Lan-Lin Chiou,Javier Calatrava,Hom-Lay Wang","doi":"10.1111/prd.12636","DOIUrl":"https://doi.org/10.1111/prd.12636","url":null,"abstract":"Antibiotics are commonly prescribed in periodontal and implant surgeries, either before, during or after surgery, to prevent postoperative infection and reduce early implant failure. However, the potential benefits may be undermined by the risks of resistance and sensitization, thus requiring a strict indication for prescription. There are controversial views regarding the indication, dosage, duration, and timing of antibiotic medication in periodontal and implant surgery. Therefore, the aim of this review is to address the benefits and concerns regarding the efficacy of using preventive antibiotic therapy in Periodontology and Implant Dentistry. Specifically, various types of procedures were comprehensively explored, and recommendations were given accordingly. The available evidence indicates that preventive antibiotic therapy is not warranted for periodontal surgeries, including conventional, plastic, and regenerative procedures. While antibiotic prophylaxis has shown effectiveness in preventing early implant failures in straightforward implant placements, postoperative coverage does not appear to be justified. Furthermore, antibiotic administration has not proven to significantly reduce early implant failure rates in implant placements involving simultaneous guided bone regeneration. There remains insufficient evidence to support or oppose the use of preventive antibiotic therapy for reducing infection rates after ridge or sinus augmentation procedures, nor is there evidence favoring any specific protocol over others.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"10 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639950","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}
Yi Te Lin, Chenshuang Li, Jonathan Korostoff, Joseph P. Fiorellini, Jie Yang, Yu‐Cheng Chang
3D digital evaluation of the periodontal and peri‐implant tissue, including CBCT, intraoral scanning, optical surface scanning, and ultrasonography, is being used in the clinical arena with increasing frequency. Thus, to validate the utilization of 3D digital analysis for this purpose, a critical evaluation of the reliability of digital approaches relative to conventional methodologies is necessary. Therefore, the goal of the present review is to provide a summary of the existing literature addressing the use of CBCT and intraoral scanning to evaluate the periodontal and peri‐implant tissues, highlighting both the advantages and disadvantages of 3D digital methodologies versus conventional approaches. A synopsis of currently available hardware and software is provided. Finally, the review discusses the implications of artificial intelligence in the future development of digital technology for assessing the structures of the periodontal and peri‐implant tissue. This review provides a foundation for understanding current 3D digital analysis approaches for the evaluation of periodontal and peri‐implant phenotype. While current CBCT and intraoral scanning technologies provide accurate quantitative measurements comparable to conventional methods, the full potential of 3D digital clinical data has not been undermined. Future advancement requires a fundamental shift in how we conceptualize and analyze periodontal and peri‐implant tissue relationships in three‐dimensional space, moving beyond conventional evaluation protocols. Integration of artificial intelligence and deep learning tools with these comprehensive 3D datasets in the future will enable more precise diagnosis and treatment outcome assessment, revolutionizing how we evaluate periodontal and peri‐implant phenotypes.
{"title":"Three‐dimensional digital quantitative analysis of periodontal and peri‐implant phenotype—A narrative review","authors":"Yi Te Lin, Chenshuang Li, Jonathan Korostoff, Joseph P. Fiorellini, Jie Yang, Yu‐Cheng Chang","doi":"10.1111/prd.12639","DOIUrl":"https://doi.org/10.1111/prd.12639","url":null,"abstract":"3D digital evaluation of the periodontal and peri‐implant tissue, including CBCT, intraoral scanning, optical surface scanning, and ultrasonography, is being used in the clinical arena with increasing frequency. Thus, to validate the utilization of 3D digital analysis for this purpose, a critical evaluation of the reliability of digital approaches relative to conventional methodologies is necessary. Therefore, the goal of the present review is to provide a summary of the existing literature addressing the use of CBCT and intraoral scanning to evaluate the periodontal and peri‐implant tissues, highlighting both the advantages and disadvantages of 3D digital methodologies versus conventional approaches. A synopsis of currently available hardware and software is provided. Finally, the review discusses the implications of artificial intelligence in the future development of digital technology for assessing the structures of the periodontal and peri‐implant tissue. This review provides a foundation for understanding current 3D digital analysis approaches for the evaluation of periodontal and peri‐implant phenotype. While current CBCT and intraoral scanning technologies provide accurate quantitative measurements comparable to conventional methods, the full potential of 3D digital clinical data has not been undermined. Future advancement requires a fundamental shift in how we conceptualize and analyze periodontal and peri‐implant tissue relationships in three‐dimensional space, moving beyond conventional evaluation protocols. Integration of artificial intelligence and deep learning tools with these comprehensive 3D datasets in the future will enable more precise diagnosis and treatment outcome assessment, revolutionizing how we evaluate periodontal and peri‐implant phenotypes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"21 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144603084","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}
João Gabriel S Souza,Bruna E Nagay,Rodrigo Martins,Martinna Bertolini,Jamil A Shibli,Conrado Aparicio,Magda Feres,Valentim A R Barão
When exposed to the oral environment, dental implants, like natural surfaces, become substrates for microbial adhesion and accumulation, often leading to implant-related infections-one of the main causes of implant failure. These failures impose significant costs on patients, clinicians, and healthcare systems. Despite extensive research, there is no consensus on the most effective protocol for managing peri-implantitis. Biomedical engineering has aimed to address this challenge by developing biocompatible implants with surface properties designed to enhance biological responses and reduce polymicrobial accumulation. Due to the complexity of interactions between implants and biological systems, no single material property can drive these processes. Instead, a combination of physical, chemical, and mechanical properties is required to ensure a safe and effective response. Antimicrobial coatings are developed either by incorporating antimicrobial agents onto surfaces or modifying the material's physicochemical properties. These coatings utilize a range of compounds for contact-killing or as drug-delivery systems. While biomaterials science has advanced rapidly in enhancing implant surfaces, these bioengineering techniques have progressed more rapidly than our understanding of the pathogenesis of implant infections. To bridge this gap, biomedical engineering must address emerging knowledge about implant infections, focusing on controlling microbial accumulation while simultaneously managing inflammatory responses to support tissue healing. This review critically evaluates current evidence on implant infection pathogenesis, antimicrobial coating technologies, and systematically assesses their in vivo (animal and human evidence) efficacy to guide future advancements in implant infection mitigation.
{"title":"Engineered surface strategies to manage dental implant-related infections.","authors":"João Gabriel S Souza,Bruna E Nagay,Rodrigo Martins,Martinna Bertolini,Jamil A Shibli,Conrado Aparicio,Magda Feres,Valentim A R Barão","doi":"10.1111/prd.12637","DOIUrl":"https://doi.org/10.1111/prd.12637","url":null,"abstract":"When exposed to the oral environment, dental implants, like natural surfaces, become substrates for microbial adhesion and accumulation, often leading to implant-related infections-one of the main causes of implant failure. These failures impose significant costs on patients, clinicians, and healthcare systems. Despite extensive research, there is no consensus on the most effective protocol for managing peri-implantitis. Biomedical engineering has aimed to address this challenge by developing biocompatible implants with surface properties designed to enhance biological responses and reduce polymicrobial accumulation. Due to the complexity of interactions between implants and biological systems, no single material property can drive these processes. Instead, a combination of physical, chemical, and mechanical properties is required to ensure a safe and effective response. Antimicrobial coatings are developed either by incorporating antimicrobial agents onto surfaces or modifying the material's physicochemical properties. These coatings utilize a range of compounds for contact-killing or as drug-delivery systems. While biomaterials science has advanced rapidly in enhancing implant surfaces, these bioengineering techniques have progressed more rapidly than our understanding of the pathogenesis of implant infections. To bridge this gap, biomedical engineering must address emerging knowledge about implant infections, focusing on controlling microbial accumulation while simultaneously managing inflammatory responses to support tissue healing. This review critically evaluates current evidence on implant infection pathogenesis, antimicrobial coating technologies, and systematically assesses their in vivo (animal and human evidence) efficacy to guide future advancements in implant infection mitigation.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"9 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578582","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}
G Avila-Ortiz,E Couso-Queiruga,S Stuhr,L Chambrone
This systematic review analyzed the long-term outcomes of alveolar ridge preservation (ARP) and alveolar ridge reconstruction (ARR) before delayed implant placement. Eight studies were included (one non-randomized clinical trial, one prospective case series, four retrospective comparative studies, and two retrospective case series). Risk of bias assessment, using a modified Newcastle-Ottawa Scale, revealed one high-quality study, four medium-quality studies, and three with low methodological quality. In total, 333 patients underwent ARP or ARR, with the most common approach involving xenogeneic bone grafting and socket sealing with a collagen membrane, matrix, or dressing. Follow-up ranged from 5 to 10 years. Due to methodological heterogeneity and limited data, quantitative analysis was not feasible. The implant survival rate was the most frequently reported outcome, followed by peri-implant marginal bone level changes and peri-implant disease incidence. Despite limited evidence, ARP and ARR appear to support favorable long-term outcomes, particularly in implant survival and bone stability. Further well-designed, large-scale studies comparing different ARP and ARR modalities with other therapies are needed to guide clinical decision-making.
{"title":"Long-term outcomes of post-extraction alveolar ridge preservation and alveolar ridge reconstruction followed by delayed implant placement: A systematic review.","authors":"G Avila-Ortiz,E Couso-Queiruga,S Stuhr,L Chambrone","doi":"10.1111/prd.12642","DOIUrl":"https://doi.org/10.1111/prd.12642","url":null,"abstract":"This systematic review analyzed the long-term outcomes of alveolar ridge preservation (ARP) and alveolar ridge reconstruction (ARR) before delayed implant placement. Eight studies were included (one non-randomized clinical trial, one prospective case series, four retrospective comparative studies, and two retrospective case series). Risk of bias assessment, using a modified Newcastle-Ottawa Scale, revealed one high-quality study, four medium-quality studies, and three with low methodological quality. In total, 333 patients underwent ARP or ARR, with the most common approach involving xenogeneic bone grafting and socket sealing with a collagen membrane, matrix, or dressing. Follow-up ranged from 5 to 10 years. Due to methodological heterogeneity and limited data, quantitative analysis was not feasible. The implant survival rate was the most frequently reported outcome, followed by peri-implant marginal bone level changes and peri-implant disease incidence. Despite limited evidence, ARP and ARR appear to support favorable long-term outcomes, particularly in implant survival and bone stability. Further well-designed, large-scale studies comparing different ARP and ARR modalities with other therapies are needed to guide clinical decision-making.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"20 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547856","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}
Tali Chackartchi, David Polak, Ayala Stabholz, Stela Chaushu
This paper examines the complex interplay between orthodontic intervention and periodontal conditions in individuals with periodontitis. It outlines diagnostic and treatment approaches for adolescents and adults, considering their distinct periodontal, dental, and behavioral needs. Furthermore, the paper highlights the detrimental effects of orthodontic tooth movement in the presence of periodontal disease, emphasizing the critical importance of maintaining periodontal health throughout treatment. A comprehensive treatment strategy is presented, including the treatment sequence and periodontal maintenance during orthodontic tooth movement.
{"title":"Orthodontic treatment in periodontitis patients.","authors":"Tali Chackartchi, David Polak, Ayala Stabholz, Stela Chaushu","doi":"10.1111/prd.12634","DOIUrl":"https://doi.org/10.1111/prd.12634","url":null,"abstract":"<p><p>This paper examines the complex interplay between orthodontic intervention and periodontal conditions in individuals with periodontitis. It outlines diagnostic and treatment approaches for adolescents and adults, considering their distinct periodontal, dental, and behavioral needs. Furthermore, the paper highlights the detrimental effects of orthodontic tooth movement in the presence of periodontal disease, emphasizing the critical importance of maintaining periodontal health throughout treatment. A comprehensive treatment strategy is presented, including the treatment sequence and periodontal maintenance during orthodontic tooth movement.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497614","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,Ettore Amerio,Irene Mallor,Conrado Aparicio
Peri-implant diseases are dysbiosis-mediated inflammatory disorders that occur in susceptible hosts. Antimicrobials and immunomodulatory agents therefore might be pertinent as adjunctive measures in the treatment of such disorders. The aim of this narrative review was to examine the existing evidence and assess the effectiveness of emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. An electronic search in the PubMed library was carried out to identify traditional and emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. A narrative review was conducted to shed light on the role of these approaches to prevent and treat peri-implant diseases. The use of traditional locally delivered antimicrobials as an adjunct to the nonsurgical or surgical treatment of peri-implant diseases has been shown to be safe and effective to a certain extent. Nevertheless, the body of evidence is limited, which precludes the drawing of firm conclusions/recommendations on their daily use for the treatment of these disorders. Likewise, the existing evidence on traditional immunomodulatory approaches is scarce, and so firm conclusions/recommendations on their daily use for the treatment of these disorders cannot be made. Among the emerging antimicrobials and immunomodulatory strategies, argon plasma and lasers seem to offer benefits for the prevention and treatment of peri-implant diseases, respectively. Significant advances have been made in the understanding and potential of novel locally delivered and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. Nevertheless, their clinical application is still limited by a lack of control over the bioactivity afforded by the known delivery systems and the scarcity of consistent nonclinical and clinical data. Awareness must be raised on the part of the industry to develop feasible agents/tools to enhance the efficacy of preventive and therapeutic strategies.
{"title":"Emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases.","authors":"Alberto Monje,Ettore Amerio,Irene Mallor,Conrado Aparicio","doi":"10.1111/prd.12638","DOIUrl":"https://doi.org/10.1111/prd.12638","url":null,"abstract":"Peri-implant diseases are dysbiosis-mediated inflammatory disorders that occur in susceptible hosts. Antimicrobials and immunomodulatory agents therefore might be pertinent as adjunctive measures in the treatment of such disorders. The aim of this narrative review was to examine the existing evidence and assess the effectiveness of emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. An electronic search in the PubMed library was carried out to identify traditional and emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. A narrative review was conducted to shed light on the role of these approaches to prevent and treat peri-implant diseases. The use of traditional locally delivered antimicrobials as an adjunct to the nonsurgical or surgical treatment of peri-implant diseases has been shown to be safe and effective to a certain extent. Nevertheless, the body of evidence is limited, which precludes the drawing of firm conclusions/recommendations on their daily use for the treatment of these disorders. Likewise, the existing evidence on traditional immunomodulatory approaches is scarce, and so firm conclusions/recommendations on their daily use for the treatment of these disorders cannot be made. Among the emerging antimicrobials and immunomodulatory strategies, argon plasma and lasers seem to offer benefits for the prevention and treatment of peri-implant diseases, respectively. Significant advances have been made in the understanding and potential of novel locally delivered and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. Nevertheless, their clinical application is still limited by a lack of control over the bioactivity afforded by the known delivery systems and the scarcity of consistent nonclinical and clinical data. Awareness must be raised on the part of the industry to develop feasible agents/tools to enhance the efficacy of preventive and therapeutic strategies.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"242 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370368","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}
BackgroundThe primary goal of periodontology is to prevent tooth loss and reduce the risk of focal infections. Periodontitis lesions can harbor hundreds of thousands of active cytomegaloviruses (virions), which can easily enter the systemic circulation and potentially infect the fetus of a mother with compromised immunity. The healthy, non‐inflamed periodontium contains no PCR‐detectable cytomegalovirus. Maternal cytomegalovirus may be linked to cleft lip and cleft palate, prepubertal and juvenile periodontitis, and systemic diseases.AimThis article presents an anti‐cytomegalovirus periodontal therapy aimed at preventing congenital cytomegalovirus disorders.Materials and MethodsImmunodeficient and periodontitis‐affected women in the pre‐gestational period or the first trimester of pregnancy are prime candidates for periodontal treatment. The periodontal diagnosis and drug treatment ought to be performed by well‐informed dentists (periodontists). Treatment consists of a one‐time valacyclovir regimen (1 g BID on days 1 and 2, and 500 mg BID on days 3–7), subgingival and supragingival ultrasonic scaling using a 0.1%–0.2% sodium hypochlorite cooling solution, individually tailored oral hygiene instructions, and patient‐administered daily subgingival irrigation with a 0.1%–0.2% sodium hypochlorite solution.ResultsCytomegalovirus in maternal periodontitis likely serves as a critical nidus for fetal infection. The combined treatment of valacyclovir, ultrasonic scaling, and sodium hypochlorite rinses markedly reduces or eliminates the mother’s periodontal cytomegaloviruses.Clinical relevanceThe proposed noninvasive anti‐cytomegalovirus periodontal therapy is highly safe for the pregnant mother and the fetus. The anti‐cytomegalovirus periodontal treatment is expected to control the mother’s periodontal cytomegalovirus load and, consequently, part of the baby’s congenital disease risk. Research is encouraged on the relationship between periodontal cytomegalovirus and congenital diseases.
{"title":"The relationship between maternal periodontitis and congenital cytomegalovirus: A hypothetical model and therapeutic implications","authors":"Jørgen Slots","doi":"10.1111/prd.12632","DOIUrl":"https://doi.org/10.1111/prd.12632","url":null,"abstract":"BackgroundThe primary goal of periodontology is to prevent tooth loss and reduce the risk of focal infections. Periodontitis lesions can harbor hundreds of thousands of active cytomegaloviruses (virions), which can easily enter the systemic circulation and potentially infect the fetus of a mother with compromised immunity. The healthy, non‐inflamed periodontium contains no PCR‐detectable cytomegalovirus. Maternal cytomegalovirus may be linked to cleft lip and cleft palate, prepubertal and juvenile periodontitis, and systemic diseases.AimThis article presents an anti‐cytomegalovirus periodontal therapy aimed at preventing congenital cytomegalovirus disorders.Materials and MethodsImmunodeficient and periodontitis‐affected women in the pre‐gestational period or the first trimester of pregnancy are prime candidates for periodontal treatment. The periodontal diagnosis and drug treatment ought to be performed by well‐informed dentists (periodontists). Treatment consists of a one‐time valacyclovir regimen (1 g BID on days 1 and 2, and 500 mg BID on days 3–7), subgingival and supragingival ultrasonic scaling using a 0.1%–0.2% sodium hypochlorite cooling solution, individually tailored oral hygiene instructions, and patient‐administered daily subgingival irrigation with a 0.1%–0.2% sodium hypochlorite solution.ResultsCytomegalovirus in maternal periodontitis likely serves as a critical nidus for fetal infection. The combined treatment of valacyclovir, ultrasonic scaling, and sodium hypochlorite rinses markedly reduces or eliminates the mother’s periodontal cytomegaloviruses.Clinical relevanceThe proposed noninvasive anti‐cytomegalovirus periodontal therapy is highly safe for the pregnant mother and the fetus. The anti‐cytomegalovirus periodontal treatment is expected to control the mother’s periodontal cytomegalovirus load and, consequently, part of the baby’s congenital disease risk. Research is encouraged on the relationship between periodontal cytomegalovirus and congenital diseases.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"51 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328498","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}
Richard J. Miron, Yoshinori Shirakata, Paras Ahmad, Mario Romandini, Nathan E. Estrin, Nima Farshidfar, Dieter D. Bosshardt, Anton Sculean
The use of growth factors (GFs) has become a cornerstone of modern regenerative periodontology. While the extent to which GFs enhance tissue regeneration compared to other biomaterials was initially uncertain, it is now well established that GFs play a critical role in the regeneration of various tissue types. In the context of periodontal regeneration, enamel matrix derivative (EMD/Emdogain) has been a key biomaterial for over 30 years. Pioneering work by Lars Hammarström in the mid‐1990s led to a wealth of publications on the clinical concept of mimicking tooth development to promote periodontal regeneration. This approach has been shown to induce the formation of new cementum, with functionally oriented periodontal ligament fibers and new alveolar bone. This review begins with an overview of the biological basis of EMD, highlighting its role as a protein (primarily amelogenins) and growth factor complex that initiates and mimics tooth development. Subsequently, histological evidence from animal and human studies using EMD is presented, alongside a discussion of ongoing research avenues. Clinical outcomes are then narratively reviewed, focusing on EMD safety, early wound healing properties, and applications in various scenarios, including non‐surgical periodontal therapy, intra‐bony and furcation defects, periodontal regeneration, and as an adjunct to soft‐tissue grafting. The use of EMD has gained tremendous evidence over the past 30 years as a GF capable of enhancing both hard and soft tissue regeneration in periodontal therapy.
{"title":"30 years of enamel matrix derivative: Mimicking tooth development as a clinical concept","authors":"Richard J. Miron, Yoshinori Shirakata, Paras Ahmad, Mario Romandini, Nathan E. Estrin, Nima Farshidfar, Dieter D. Bosshardt, Anton Sculean","doi":"10.1111/prd.12635","DOIUrl":"https://doi.org/10.1111/prd.12635","url":null,"abstract":"The use of growth factors (GFs) has become a cornerstone of modern regenerative periodontology. While the extent to which GFs enhance tissue regeneration compared to other biomaterials was initially uncertain, it is now well established that GFs play a critical role in the regeneration of various tissue types. In the context of periodontal regeneration, enamel matrix derivative (EMD/Emdogain) has been a key biomaterial for over 30 years. Pioneering work by Lars Hammarström in the mid‐1990s led to a wealth of publications on the clinical concept of mimicking tooth development to promote periodontal regeneration. This approach has been shown to induce the formation of new cementum, with functionally oriented periodontal ligament fibers and new alveolar bone. This review begins with an overview of the biological basis of EMD, highlighting its role as a protein (primarily amelogenins) and growth factor complex that initiates and mimics tooth development. Subsequently, histological evidence from animal and human studies using EMD is presented, alongside a discussion of ongoing research avenues. Clinical outcomes are then narratively reviewed, focusing on EMD safety, early wound healing properties, and applications in various scenarios, including non‐surgical periodontal therapy, intra‐bony and furcation defects, periodontal regeneration, and as an adjunct to soft‐tissue grafting. The use of EMD has gained tremendous evidence over the past 30 years as a GF capable of enhancing both hard and soft tissue regeneration in periodontal therapy.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"7 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201441","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}
Pub Date : 2025-06-01Epub Date: 2024-03-19DOI: 10.1111/prd.12559
Eleanor Fleming, George W Taylor, Harold Woody Neighbors
Racial disparities in the prevalence of periodontal disease are consistent and persistent. The epidemiology of periodontal disease demonstrates racial inequities: non-Hispanic Black (14.7%), Mexican American (13.4%), and other Hispanic adults (7.8%) experience a higher prevalence of severe periodontal disease than non-Hispanic White adults (5.9%). Epidemiologic and clinical research on periodontal health suffers from the same problem that has plagued the health equity movement, an over emphasis on describing racial inequities coupled with few interventions that reduce racial health inequity. Over the decades that racial inequities in periodontal disease have been observed, many have argued that systemic racism is the fundamental driver of racial health inequity. This paper interrogates the roles of systemic racism, dental education, clinical treatment, and patient behavior in periodontal disease. We describe how, together, these mechanisms contribute to racial disparities in periodontal outcomes. However, it is insufficient for oral health equity scientists to only describe and discuss the negative effects of systemic racism. The imperative is to create antiracist strategies designed to eliminate systemic racism. Health equity scientists must also specify how dental systems operate in a racist manner and create effective clinical strategies designed to reduce racial disparities in periodontal disease.
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