Journal of Periodontal and Implant Science最新文献

Purpose: The aim of this exploratory randomized controlled clinical trial was to compare profilometric and radiographic changes following early implant placement in sites treated with alveolar ridge preservation versus spontaneous healing (SH). Additionally, the study aimed to investigate clinical parameters of the implants up to 3 years following crown insertion.

Methods: Thirty-five patients exhibiting either intact buccal bone plates or buccal dehiscence of up to 50% after single-tooth extraction of incisors, canines, or premolars were enrolled. Participants were randomly assigned to 1 of 3 groups: 1) deproteinized bovine bone mineral with 10% collagen covered by a collagen matrix (DBBM-C/CM), 2) deproteinized bovine bone mineral with 10% collagen alone (DBBM-C), or 3) SH. Implant placement occurred 8 weeks post-extraction. Profilometric analyses were performed utilizing impressions and digital scans. Patients underwent follow-up assessments for up to 3 years (FU-3Y) after the final crown insertion (fixed dental prosthesis insertion, FDPi).

Results: The median contour changes between FDPi and FU-3Y were -0.23 mm for DBBM-C/CM, -0.21 mm for DBBM-C, and -0.33 mm for SH, demonstrating a statistically significant reduction over 3 years in all 3 groups (P<0.05). Median radiographic changes observed up to FU-3Y were 0.02 mm for DBBM-C/CM, -0.5 mm for DBBM-C, and -0.18 mm for SH. These radiographic changes were neither statistically significant within groups nor between groups over time (P>0.05). Clinical parameters remained stable throughout the study period in all groups.

Conclusions: The FU-3Y of this randomized clinical trial revealed stable clinical parameters and marginal bone levels in all evaluated groups. Although minor contour reductions were noted in all groups, these changes were deemed clinically acceptable.

Trial registration: German Clinical Trials Register Identifier: DRKS00009496.

Purpose: Recent studies have reported a high long-term success rate of dental implants however, various complications have also been observed, including proximal contact loss (PCL) between the implant and the adjacent teeth. PCL is frequently observed clinically and can potentially harm both the implant and adjacent teeth. This study examined the prevalence of PCL between implants that had functioned for more than 10 years and adjacent teeth in Korean patients, particularly those with a history of periodontal disease.

Methods: Fixed dental implants placed at the Department of Periodontics, Pusan National University Dental Hospital, were selected for this study. All implants selected had been functioning for more than 10 years, with at least 1 adjacent natural tooth in the mesial or distal position. Patient-, implant-, and tooth-related factors were evaluated. The chi-square test and Fisher exact test were used to assess the associations of PCL with these factors, with all statistical analyses performed using SPSS 29.0 and a significance level of 0.05.

Results: This study included 142 implants and 188 adjacent teeth from 101 patients. The overall PCL rate was 53.7%, with 65.6% occurring on the mesial aspect, and 28.3% on the distal aspect. Among the factors analyzed in relation to PCL, implant placement in the molar region and several adjacent tooth-related factors namely plaque accumulation, mobility, bleeding on probing, and pocket depth of 4mm or greater were significantly associated with PCL (P<0.05).

Conclusions: Dental implants functioning for more than 10 years exhibited a high incidence of PCL, exceeding 50%, which occurred more frequently on the mesial side than on the distal side. Additionally, implant positioning in the posterior region and poor periodontal condition of the adjacent teeth were significantly correlated with PCL.

Purpose: Periodontitis is a chronic disease that ultimately leads to tooth loss. This study aimed to investigate the inflammatory effects of short-chain fatty acids (SCFAs) on human periodontal ligament cells (hPDLCs).

Methods: Immunofluorescence was employed to assess the expression of G protein-coupled receptors (GPRs) in hPDLCs. The Cell Counting Kit-8 and enzyme-linked immunosorbent assay kits were utilized to examine the regulatory effects of SCFAs on both the proliferation and secretion of pro-inflammatory factors in hPDLCs. Western blot analysis was performed to investigate the potential inflammatory responses in hPDLCs induced by SCFAs.

Results: GPR41 was expressed on the surface of hPDLCs. The viability of hPDLCs was significantly reduced after exposure to both 7 mM butyric acid and 10 mM propionic acid. Additionally, a combination of 10 mM butyric acid and 10 mM propionic acid significantly increased the production of interleukin (IL)-6, IL-1β, and tumor necrosis factor-α in hPDLCs. Treatment with both 7 mM butyric acid and 10 mM propionic acid led to a significant increase in p65 phosphorylation in hPDLCs. There was no statistical difference in proliferation and pro-inflammatory effects after the addition of a GPR41 receptor inhibitor compared to the phosphate-buffered saline control.

Conclusions: Butyric acid and propionic acid exhibited a synergistic effect in inhibiting the proliferation of hPDLCs and enhancing their pro-inflammatory responses. This may be mediated through the activation of GPR41. Additionally, these acids could synergistically activate the nuclear factor-κB signaling pathway via GPR41 in hPDLCs.

Purpose: The aim of this study was to clinically and radiographically investigate the effect of soft tissue grafting as an adjunct in the surgical treatment of ligature-induced peri-implantitis lesions in canines.

Methods: Seven Mongrel dogs received implant placements on both sides of the posterior mandible (3 fixtures per side). After inducing peri-implantitis via ligation with suture material, surgical treatment was performed on each implant according to randomly assigned groups: DI, implantoplasty only; DIB, implantoplasty followed by collagenated, deproteinized bovine bone mineral (DBBM-C) grafting; DIC, implantoplasty followed by autogenous connective tissue graft (CTG); DIV, implantoplasty followed by volume-stable collagen matrix (VCMX) grafting; DIBC, implantoplasty followed by DBBM-C grafting and CTG; and DIBV, implantoplasty followed by DBBM-C and VCMX grafting. Clinical and radiographic outcomes were evaluated. Composite treatment success was defined by the following criteria: absence of bleeding on probing at 12 weeks post-surgery; a reduction in probing depth (PD) or an increase of 1 mm or less in PD at 12 weeks post-surgery; and absence of additional bone loss ≥0.5 mm at 12 weeks post-surgery compared to radiographic baseline. Statistical significance was set at P<0.05.

Results: All groups exhibited clinical and radiographic improvement after surgery. Clinical parameters, radiographic bone levels, and mucosal thickness did not significantly differ among the groups. The DI and DIV groups demonstrated higher composite treatment success rates (71.4%) compared to the other 4 groups. Adjunctive soft tissue grafting resulted in fewer changes in peri-implant mucosa. The effect of hard tissue grafting on bone regeneration was minimal, and combining hard and soft tissue grafting did not yield better outcomes than implantoplasty alone.

Conclusions: The surgical treatment of peri-implantitis lesions remains challenging. Soft tissue grafting showed clinical benefits by reducing changes in the peri-implant mucosa. The effect of hard tissue grafting on bone regeneration was very limited.

Purpose: This study was conducted to compare the clinical efficacy and patient-reported outcomes of de-epithelialized gingival graft (DGG) alone versus DGG combined with leukocyte platelet-rich fibrin (L-PRF) for the treatment of multiple adjacent gingival recessions using a coronally advanced flap technique.

Methods: In this split-mouth randomized controlled trial, 15 patients with multiple gingival recessions affecting at least 3 adjacent teeth were treated on one side with DGG only (termed the DGG group) and on the contralateral side with DGG and L-PRF (the DGG+PRF group). Clinical parameters-recession depth, recession width, probing depth, clinical attachment level, keratinized tissue width, gingival thickness, and percentage of root coverage (RC%)-were recorded at 1 month, 3 months, and 6 months postoperatively. Patient-reported outcome measures, including Oral Health Impact Profile-14 scores, postoperative pain, bleeding, discomfort, and analgesic consumption, were also assessed.

Results: At T6, the mean RC% was 93.30%±6.97% in the DGG group and 95.28%±4.99% in the DGG+PRF group, with no statistically significant difference observed. Patients receiving DGG+PRF reported significantly lower discomfort on days 2, 3, and 5 and reduced pain on days 6 and 7 relative to the DGG group.

Conclusions: Combining L-PRF with DGG achieves root coverage outcomes comparable to DGG alone, while significantly reducing early postoperative discomfort and morbidity.

Trial registration: ClinicalTrials.gov Identifier: NCT06509867.

Purpose: This pre-clinical study aimed to compare the efficacy of L-shaped, loosely packed soft block bone substitutes (BBS, LP group) with that of non-trimmed, compactly packed soft BBS (CP group), both covered with a non-fixed collagen membrane, on augmentation stability and new bone formation in chronic peri-implant dehiscence defects treated with guided bone regeneration (GBR).

Methods: In 4 mongrel dogs, 4 standardized box-shaped buccal defects were surgically created in each jaw. Following a 4-week period of spontaneous healing, a total of 32 dental implants were placed, with 2 implants inserted into each defect. Each defect was randomly assigned to either the LP or CP group. Statistical comparisons between groups were conducted using the Mann-Whitney U test. Bland-Altman and Spearman correlation analyses were also performed to evaluate the relationship and agreement between micro-computed tomography (micro-CT) and histomorphometric measurements.

Results: Micro-CT and histomorphometric analyses revealed no significant differences in bone width at any apical level between the LP and CP groups. Both groups exhibited similar increases in bone width, although bone retention in the coronal region remained limited. Additionally, micro-CT tended to slightly overestimate bone width (mean difference, 0.31 mm), but showed a strong correlation with histomorphometric analysis (r=0.971, P<0.001), supporting the reliability of radiographic methods for bone assessment.

Conclusions: Neither LP nor CP soft BBS effectively prevented morphological collapse in the coronal region of augmented sites when used without additional membrane fixation. These findings underscore the necessity of enhanced stabilization techniques to improve structural integrity and bone regeneration in GBR procedures.

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.