Journal of Periodontal and Implant Science最新文献

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: Current bone grafting materials often lack inherent osteoinductive properties, underscoring the need for new therapeutic agents that promote regeneration. In this study, we evaluated the effects of QG3030, a novel osteoinductive derivative of lappaconitine, on the proliferation and osteogenic differentiation of rat bone marrow-derived stem cells (BMSCs) in vitro. Furthermore, we examined its influence on bone regeneration in vivo using a rat calvarial critical-sized defect model.

Methods: The effects of QG3030 on BMSC proliferation and osteogenic differentiation were assessed in vitro using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the alkaline phosphatase (ALP) activity assay, and alizarin red S staining. For in vivo evaluation, 18 Sprague-Dawley rats with 8-mm critical-sized calvarial defects were randomly assigned to 3 groups (n=6 per group): deproteinized bovine bone mineral (DBBM; Bio-Oss) alone (B0, control), DBBM combined with 100 mg/mL QG3030 (B100), and DBBM combined with 300 mg/mL QG3030 (B300). Bone regeneration was analyzed after 8 weeks by micro-computed tomography (micro-CT), histology, and histomorphometry.

Results: In vitro, QG3030 improved BMSC viability, significantly increased ALP activity, and promoted matrix mineralization within the tested non-cytotoxic range. On in vivo micro-CT analysis, the B100 group exhibited significantly higher bone mineral density and new bone volume fraction (new bone volume/total volume) than the B0 group (P=0.043 for both). Furthermore, histomorphometry revealed significantly greater new bone area (P=0.046) and percentage of new bone (P=0.032) in the B300 group compared to the B0 group.

Conclusions: Combining QG3030 with DBBM significantly enhanced bone regeneration in a rat calvarial critical-sized defect model, with QG3030 demonstrating distinct osteogenic effects both in vitro and in vivo. Accordingly, the combination of QG3030 and DBBM represents a promising therapeutic approach for bone regeneration strategies, especially in periodontology and implant dentistry, and warrants further investigation.

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.

The morphogenesis of peri-implant soft tissues following surgical trauma, along with the nature, topography, and design of implant-prosthetic material surfaces, leads to peri-implant tissues that exhibit unique histological and morphological characteristics. It has been shown that mucosal phenotypes with a mucosal thickness of at least 2 mm and a keratinised mucosa width of at least 2 mm promote proper integration and a biological seal at the mucosa-implant interface. This seal prevents pathogen penetration, protects the underlying peri-implant bone, and reduces susceptibility to inflammatory peri-implant diseases (IPDs). Furthermore, even under ideal conditions, peri-implant soft tissues demonstrate less mechanical resistance, stability, and hermeticity compared to periodontal tissues. These deficiencies are directly associated with both the onset and progression of IPDs such as peri-implant mucositis (PM) and peri-implantitis (PI). Over recent decades, the prevalence of PM and PI has risen, making them the primary causes of implant failure. Given that the characteristics of peri-implant mucosa are closely linked to the progression of these diseases, a deep understanding of the biology of peri-implant soft tissues is crucial for developing strategies to either avoid or minimise the impact of IPDs on implant therapy outcomes. This comprehensive review of the literature aims to provide a precise and detailed description of the structure, biology, and function of peri-implant soft tissues, starting from their formation process and linking their morphogenic characteristics to the establishment and evolution of IPDs. Additionally, the composition of the microbiome and the most relevant anti/pro-inflammatory mediators involved in the development of IPDs are summarised.

Purpose: This retrospective study aimed to evaluate the long-term survival rate and marginal bone loss (MBL) of tapered-straight-tapered dental implants, considering various associated factors, over an observational period of ≥5 years.

Methods: This study included 186 patients who underwent tapered-straight-tapered dental implant placement at Seoul National University Dental Hospital from 2014 to 2019. Digital panoramic radiographic images and dental records were examined. We evaluated multiple variables, such as sex, age, diabetes mellitus (DM), smoking status, placement region, jaw type (maxilla and mandible), implant diameter, implant length, staged surgery, immediate placement, splinted prosthesis, and implant placement depth (IPD). We first determined the implant survival rate using Kaplan-Meier analysis and analyzed potential risk factors for implant survival using mixed-effects Cox proportional hazards regression. Next, the Mann-Whitney and Kruskal-Wallis tests were used to examine differences in MBL across variables. Linear mixed-effects models with backward stepwise selection were used to identify associations between risk factors and MBL.

Results: This study included 316 implants in 186 patients, monitored over a follow-up period of 7.0±1.36 years. The cumulative survival rate of the implants was 98.1%. The average mesial and distal MBLs were 0.59±1.36 mm and 0.68±1.36 mm, respectively. Linear mixed-effects models indicated that MBL exhibited statistically significant positive correlations with DM (Coeff.=0.614, P=0.026) and staged surgery (Coeff.=0.410, P=0.002). Additionally, greater mesial IPD was associated with reduced MBL (Coeff.=-0.143, P=0.046), and a similar trend was observed for distal IPD (Coeff.=-0.316, P=0.068).

Conclusions: This study demonstrated a high cumulative survival rate for tapered-straight-tapered dental implants over a 5-year period. DM, staged surgery, and IPD showed strong associations with increased MBL. The results suggest that tapered-straight-tapered implants offer advantages in terms of peri-implant MBL and consistent clinical outcomes. These findings underscore the importance of considering these variables in clinical decision-making to optimize implant outcomes.