Journal of Periodontal and Implant Science最新文献

Purpose: The identification of specific target molecules and their appropriate cut-off values is crucial for the successful development of in vitro diagnostics. Salivary biomarkers, such as interleukin-1β (IL-1β) and matrix metalloproteinase-8 (MMP-8), have been investigated for their potential in diagnosing periodontal disease. This study aimed to evaluate the efficacy of IL-1β and MMP-8 as diagnostic tools and to establish their cut-off values for distinguishing active types of periodontal disease from healthy conditions.

Methods: We conducted a prospective cohort study involving 47 participants, who were divided into 2 groups: the control group consisted of 24 individuals with healthy or mild periodontal conditions (stages I-II of periodontal disease), and the periodontal group comprised 23 individuals with moderate to severe periodontal disease (stages III-IV). Saliva samples were collected from all participants, followed by an oral examination, periodontal charting, and radiographic assessments. The salivary concentrations of IL-1β and MMP-8 were quantified using enzyme-linked immunosorbent assays.

Results: Significant differences in salivary levels of IL-1β and MMP-8 were observed between the control group and those with periodontal disease. However, after adjusting for age and sex, these differences were not statistically significant for IL-1β. In contrast, the differences remained significant for MMP-8 in participants classified as having an active type of periodontal disease, specifically those in the periodontal group with more than 10% bleeding on probing. By setting a cut-off value of 200 ng/mL for salivary MMP-8, the sensitivity and specificity for diagnosing active periodontal disease were determined to be 70% and 86.5%, respectively.

Conclusions: Our findings indicate that salivary MMP-8, using a cut-off value of 200 ng/mL, serves as a reliable biomarker for identifying active periodontal disease. This biomarker holds potential for further development into a diagnostic tool in in vitro settings, which could improve the early detection and management of periodontal disease.

This comprehensive narrative review provides an overview of the current scientific evidence regarding maxillary sinus hypoplasia (MSH). This review highlights several variants of MSH that are relevant to implant planning and treatment in daily clinical practice. MSH is characterized by a reduction in sinus volume, which contrasts with maxillary sinus pneumatization, a condition that has received more clinical attention. Nevertheless, certain types of MSH can significantly impact implant surgery and the management of associated complications. The maxillary sinus volume can be affected by factors such as infection, trauma, genetic predispositions, and changes within the sinus or adjacent anatomical structures, including the nasal cavity and the ethmoid sinus. In cases of MSH, the maxillary sinus floor is positioned more cranially than the nasal floor, and the distance between the lamina papyracea of the eye and the middle meatus antrostomy point increases horizontally. Several variants of MSH potentially affect implant therapy. Chronic maxillary sinus atelectasis, which results from persistent ostium blockage, may have clinical implications, particularly when implant-related infections occur in the MS. Inferior meatus pneumatization involves a lateral expansion of the nasal cavity, requiring a nasal floor elevation procedure when placing implants in the posterior maxilla. Additionally, the formation of an ethmomaxillary sinus may create a septum-like structure in the distal area of the maxillary sinus, necessitating two separate bone access windows during the sinus floor elevation procedure. Given these considerations, it is crucial for clinicians to be aware of MSH. Accurate diagnosis of MSH requires the use of 3-dimensional radiography techniques, such as cone-beam computed tomography.

Purpose: The aim of this study was to evaluate the diagnostic and classification performance of a deep learning (DL) model for peri-implantitis-related bone defects using panoramic radiographs, focusing on defect morphology and severity.

Methods: A dataset comprising 1,075 panoramic radiographs from 426 patients with peri-implantitis was analyzed. A total of 2,250 implant sites were annotated and categorized based on defect morphology (intraosseous [class I], supracrestal/horizontal [class II], or combined [class III]) and severity (slight, moderate, or severe). The ensemble-based YOLOv8 DL model was trained on 80% of the dataset, with the remaining 20% reserved for testing. Performance was assessed using classification metrics, including accuracy, precision, recall, and F1 score. The diagnostic accuracy of the DL model was also compared with that of 2 board-certified periodontal surgeons.

Results: The DL model achieved an overall accuracy of 85.33%, significantly outperforming the periodontal surgeons, who exhibited a mean accuracy of 75.6%. The DL model performed especially well for slight class II defects, with precision and recall values of 100% and 98%, respectively. In contrast, the periodontal surgeons demonstrated higher accuracy in severe cases, particularly for class II defects.

Conclusions: DL enables reliable and accurate detection of peri-implantitis bone defects. It outperformed periodontal surgeons in overall accuracy, demonstrating its potential as a valuable second-opinion tool to support clinical decision-making. Future research should focus on expanding datasets and incorporating multimodal imaging.

Purpose: This study aimed to evaluate and compare the responses of an artificial intelligence (AI)-powered chatbot and professional periodontists to patient queries in periodontology and implantology, using the Korean Academy of Periodontology's (KAP) online question and answer (Q&A) section.

Methods: In this comparative cross-sectional study, we analyzed 219 patient-submitted periodontal and implant knowledge questions from the KAP online Q&A section. A panel of 10 evaluators-5 periodontists and 5 laypersons-rated both the periodontist's and the AI chatbot's responses using standardized scales. We applied the t-test and Spearman correlation coefficients to compare response quality, empathy, consistency, and evaluator preferences.

Results: Ten evaluators judged the AI chatbot's responses to be significantly superior in quality and empathy compared to periodontist replies. A higher proportion of periodontist responses fell below acceptable quality ("very poor" or "poor") than chatbot responses (28.7% vs. 15.0%; P<0.001), and more chatbot replies were rated "empathetic" or "very empathetic" (62.5% vs. 42.8%; P<0.001). Overall response consistency was deemed satisfactory at 64.2%, with no significant difference in consistency or preference between periodontist and lay evaluators.

Conclusions: AI-powered chatbots can deliver more accurate and empathetic answers than human periodontists, suggesting their potential role as consultation assistants merits further investigation. The high intraclass correlation coefficient values (0.79-0.93) indicate a high level of agreement among evaluators in both the periodontist and lay evaluator groups, thus confirming the reliability and robustness of the study's assessment methodology.

Purpose: Implant stability testing is crucial for verifying osseointegration before prosthetic loading. Several methods have been developed to assess osseointegration. Among these, damping capacity analysis (DCA) devices offer a user-friendly and non-invasive approach. In this study, we evaluated the accuracy and reliability of newly available DCA devices in assessing dental implant stability.

Methods: This study included 58 implants from 37 patients over a 1-month period. Three measurements per implant were obtained with healing abutments in place, following the manufacturers' guidelines, using the DCA-P (Periotest M, Medizintechnik Gulden), DCA-A (Anycheck, Neobiotech), and DCA-T (The Trust, Dentium) devices. Factors such as healing abutment height, time since placement, bone grafting, fixture diameter, and fixture length were evaluated. Accuracy was assessed using DCA-P as the reference, and reproducibility was statistically analyzed using 3 measurements per implant. Statistical analyses were performed with SPSS Statistics 23.0 (IBM Corp.).

Results: All implants that passed the stability tests using DCA devices were restored with definitive prostheses and showed no signs of early failure. The DCA-A value demonstrated a very strong correlation with the DCA-P value (DCAV-P), whereas the DCA-T value exhibited only a moderate correlation with DCAV-P. DCA-P also showed the highest reliability, followed by DCA-A and then DCA-T. The reliability of DCA-A and DCA-T was not significantly affected by any of the assessed factors; in contrast, DCA-P's reliability was significantly influenced by arch location and specific quadrant position.

Conclusions: With DCA-P as the reference, DCA-A demonstrated superior accuracy compared to DCA-T. Although DCA-P exhibited the highest reliability, its performance was significantly affected by the positional factors of the target implant.

Purpose: The aim of this study was to determine predictors of implant treatment failure after alveolar ridge preservation (ARP).

Methods: The study included patients who received implant treatment after ARP between 2014 and 2020. The demographic, clinical, and radiographic data of these patients were collected. Implant success was defined as the absence of pain or tenderness, no mobility, a change of <2 mm in marginal bone level, and no exudation. A Cox proportional hazards model with shared frailty was used to estimate hazard ratios (HRs) for the demographic, clinical, and radiographic factors contributing to implant failure.

Results: The study included 528 implants from 412 patients. The cumulative success rate over 3.5±1.8 years (mean ± standard deviation) was 89.0% (95% confidence interval [CI], 85.4%-92.8%), with 43 failed implants. The multiple Cox proportional hazards model with shared frailty indicated that a pristine bone engagement (PBE) of <1.1 mm was significantly associated with implant failure (HR, 2.50; 95% CI, 1.34-4.67; P=0.004).

Conclusions: PBE of at least 1.1 mm appears to decrease the probability of implant failure after ARP.

Purpose: This study investigated the potential effect of increasing systemic cholesterol sulfate (CS) levels by applying a non-steroidal inhibitor of steroid sulfatase (STS inhibitor) on the progression of periodontitis in osteoporosis-induced rats.

Methods: A total of 16 ovariectomized female Sprague-Dawley rats were used, and periodontitis was induced by placing non-resorbable suture material around the maxillary second molars bilaterally for 5 weeks. During this period, the animals received either STS inhibitor-mixed feed (high-CS group, n=8) or conventional feed (control group, n=8). At 5 weeks after periodontitis induction, histologic outcomes were statistically compared between the 2 groups (P<0.05).

Results: The high-CS group showed significantly shorter distances between the cemento-enamel junction (CEJ) and the apical location of the junctional epithelium at proximal sites (0.12 mm shorter on average) and between the CEJ and the alveolar bone crest at proximal sites (0.19 mm shorter on average) compared with the control group. The mean areal percentage of alveolar bone within the furcation area was also significantly higher in the high-CS group (11.82% higher on average) than in the control group.

Conclusions: Increasing systemic CS levels may suppress periodontal tissue destruction caused by periodontitis in ovariectomized rats.

Purpose: Immediate implant placement (IIP) offers several advantages, including minimizing hard and soft tissue deformation, reducing implant time and cost, and rapidly restoring tooth function. However, IIP is technically challenging due to the need to secure initial stability and limit functional loading during healing. Therefore, this study aimed to evaluate the clinical outcomes of a bone-level implant featuring a dual thread design-an upper U-shaped thread and a lower V-shaped thread-with an 11° internal hexagonal connection in IIP within the maxillary esthetic zone.

Methods: This study included 20 patients. Implants were inserted immediately after tooth extraction. Soft tissue changes were evaluated before tooth extraction (V0), after IIP (V1), at prosthesis delivery (V5), at a 3-month follow-up after prosthesis delivery (V6), and at a 1-year follow-up (V8). Bone dimensional changes were assessed at V1 and V8 using cone beam computed tomography, and the marginal bone level (MBL) was evaluated at V6 and V8 using 2-dimensional.

Results: Of the 20 patients, 3 dropped out due to osseointegration failure during the follow-up period. Although the horizontal dimensions of the soft and hard tissues decreased slightly, the gingival margin and MBL remained well maintained throughout the follow-up.

Conclusions: Within this limited dataset, the lower V-shaped thread enabled favorable initial stability in IIP, and the esthetic outcomes were positive-with minimal gingival recession and marginal bone loss. Long-term follow-up is required to fully assess the impact of thread design and connection on esthetics.

Trial registration: Clinical Research Information Service Identifier: KCT0008231.