Journal of Clinical Periodontology最新文献

{"title":"Alpha-Ketoglutarate Alleviates Systemic Lupus Erythematosus-Associated Periodontitis in a Novel Murine Model.","authors":"Chuanyuan Mao, Weijun Yu, Lu Lin, Ruhan Yang, Shucheng Hu, Guanglong Li, Yuting Gu, Min Jin, Eryi Lu","doi":"10.1111/jcpe.14080","DOIUrl":"https://doi.org/10.1111/jcpe.14080","url":null,"abstract":"<p><strong>Aim: </strong>To establish a reproducible experimental animal model for systemic lupus erythematosus (SLE)-associated periodontitis (PD), investigate the effects of SLE on PD and assess the therapeutic potential of alpha-ketoglutarate (αKG) for SLE-PD treatment.</p><p><strong>Materials and methods: </strong>An SLE-PD murine model was established via ligature-induced PD in MRL-lpr strain, with MRL/MpJ strain as a non-SLE control. The periodontal state was assessed using micro-CT, real-time PCR, histology, immunofluorescence and flow cytometry assays. αKG levels were analysed, and a thermoresponsive gel was designed as a periodontal dimethyl (DM)-αKG delivery system. αKG levels were analysed in gingival crevicular fluid (GCF) of PD patients with or without SLE.</p><p><strong>Results: </strong>SLE significantly increased the periodontal inflammation and bone resorption in the SLE-PD model. αKG levels in GCF were lower in PD patients with SLE than in PD patients without SLE. Decreased αKG levels in the gingiva and macrophage M1/M2 imbalance were observed in SLE-PD mice. However, DM-αKG thermoresponsive gel effectively alleviated the periodontal inflammation, bone resorption and macrophage M1/M2 imbalance in SLE-PD mice.</p><p><strong>Conclusions: </strong>Our study established, for the first time, a novel SLE-PD murine model and revealed that SLE increases the severity of PD in vivo. Our findings highlight the therapeutic potential of αKG for SLE-associated PD.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647504","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}

{"title":"EXPRESSION OF CONCERN: Role of Cytokines in Development of Pre-Eclampsia Associated with Periodontal Disease-Cohort Study.","authors":"","doi":"10.1111/jcpe.14088","DOIUrl":"https://doi.org/10.1111/jcpe.14088","url":null,"abstract":"","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647526","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}

{"title":"Identifying Undiagnosed Diabetes and Prediabetes in the Dental Setting in an Asian Population—A Clinical Risk Model","authors":"Hoe Kit Chee, Frank Abbas, Arie Jan van Winkelhoff, Geerten Has Tjakkes, Hla Myint Htoon, Huihua Li, Yvonne de Waal, Arjan Vissink, Chaminda Jayampath Seneviratne","doi":"10.1111/jcpe.14090","DOIUrl":"https://doi.org/10.1111/jcpe.14090","url":null,"abstract":"AimTo assess the glycaemic status of Asian patients in a tertiary care dental setting and develop a risk model for undiagnosed diabetes mellitus (DM).Material and MethodsA total of 1074 participants completed a diabetes risk test questionnaire, full‐mouth periodontal examination and a point‐of‐care HbA1c finger‐prick blood test. Univariable logistic regression was performed to assess the effect of potential factors to predict DM, with confirmed diabetes as the outcome. Subsequently, multivariable logistic regression analysis with stepwise variable selection was employed to develop the final models for predicting DM.ResultsSixty‐five (6.1%) and 83 (7.7%) of the 1074 participants were medically confirmed with T2DM and prediabetes, respectively. The ‘best’ predictive risk model for DM included body mass index (BMI), family history of diabetes, smoking and a diagnosis of Stage III/IV or severe periodontitis with an area under the curve (AUC) of 0.717 (95% confidence interval, CI [0.689–0.744]) and 0.721 (95% CI [0.693–0.748]), respectively. Including the oral health measure marginally increased the AUC.ConclusionsDental patients clinically diagnosed with advanced periodontitis in combination with high BMI, positive family history of DM and smoking are potentially at high risk for DM and should be screened for DM and referred for medical confirmation and management.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"13 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610404","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}

{"title":"Proteomic Insights Into Gingival Crevicular Extracellular Vesicles in Periodontitis and Gestational Diabetes: An Exploratory Study","authors":"María Luisa Mizgier, Gino Nardocci, Valeria Ramírez, María José Bendek, Marcela Hernández, Carolina Rojas, David Herrera, Alpdogan Kantarci, Matthew W. Kemp, Sebastián E. Illanes, Alejandra Chaparro","doi":"10.1111/jcpe.14083","DOIUrl":"https://doi.org/10.1111/jcpe.14083","url":null,"abstract":"AimTo characterize the gingival crevicular fluid (GCF) and plasma extracellular vesicles (EVs) and explore their proteomic cargo in healthy pregnant women compared to those with gestational diabetes mellitus (GDM) and periodontitis.MethodsOne‐hundred and four pregnant women were recruited at 24–30 gestation weeks. GDM was diagnosed by an oral glucose tolerance test. GCF and plasma samples were obtained to isolate EVs and characterized by nanoparticle tracking, immunoassays, electron microscopy and mass spectrometry.ResultsOf the recruits,17.3% women were healthy, 50% had periodontitis and 32.7% had both GDM and periodontitis. Probing depth, clinical attachment loss and bleeding on probing were more severe in GDM and periodontitis pregnancies (<jats:italic>p</jats:italic> &lt; 0.0001). Additionally, this group showed an increase concentration of total, small and large GCF‐EVs (<jats:italic>p =</jats:italic> 0.0015, <jats:italic>p =</jats:italic> 0.0011 and <jats:italic>p =</jats:italic> 0.0008, respectively), with decreased expression of CD9, CD81 and CD81/CD63 ratio (<jats:italic>p =</jats:italic> 0.0461, <jats:italic>p =</jats:italic> 0.0164 and <jats:italic>p =</jats:italic> 0.0005, respectively). No differences were observed in plasmatic EVs concentration or markers expression. Proteomic analysis of GCF‐EVs showed peptides of both host and bacterial origin. Gene ontology analysis revealed that proteins of GCF‐EVs participate in immune inflammatory responses, glucose metabolism and insulin response mechanisms.ConclusionGCF‐EVs were increased in both GDM and periodontitis, and their proteomic cargo suggest their involvement in immune inflammatory response, glucose metabolism and insulin pathways during pregnancy.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"162 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610403","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}

{"title":"A Study Into Systemic and Oral Levels of Proinflammatory Biomarkers Associated With Endpoints After Active Non‐Surgical Periodontal Therapy","authors":"Nils Werner, Iris Frasheri, Katrin Heck, Carla Scalia, Vinay Pitchika, Burkhard Summer, Christina Ern, Richard Heym, Falk Schwendicke, Caspar Victor Bumm, Matthias Folwaczny","doi":"10.1111/jcpe.14089","DOIUrl":"https://doi.org/10.1111/jcpe.14089","url":null,"abstract":"AimTo analyse whether some selected inflammatory biomarkers collected from venous blood and gingival crevicular fluid (GCF) were associated with the outcome of non‐surgical periodontal therapy.Materials and MethodsTwo‐hundred and nine patients affected by periodontitis were enrolled in the study, who had undergone steps I and II therapy as well as a non‐surgical re‐instrumentation (NSRI) of periodontal pockets after 6 months. Serum (SE), plasma (PL) and GCF samples were quantitatively analysed for the following inflammatory biomarkers: active matrix metalloproteinase‐8 (aMMP‐8), prostaglandin E2 (PGE2) and surfactant protein D (SP‐D). Therapy outcomes were evaluated using a ‘treat‐to‐target’ endpoint (T2T) at the patient level, defined as ≤ 4 sites with pocket depth ≥ 5 mm.ResultsPatients presented with 23 ± 6 teeth (mean ± SD) at baseline. After steps I and II therapy, 41.6% of the patients reached T2T and after NSRI 47.4%. Univariate analysis identified a potential association between high levels of PL‐SP‐D and more favourable treatment outcomes. Multivariate binary logistic regression adjusted for sex, mean baseline probing depth, diabetes and current smoking status confirmed an independent relationship between baseline PL‐SP‐D and the T2T after steps I and II therapy (aOR 0.432, <jats:italic>p</jats:italic> = 0.011), implying that a higher level PL‐SP‐D at baseline is associated with a &gt; 50% reduced risk of failing T2T. However, no such association was found for PL‐SP‐D and NSRI.ConclusionHigher baseline PL‐SP‐D levels might be associated with more favourable treatment outcomes after steps I and II therapy. This may be due to its role in the regulation of neutrophil function. However, further investigation is required to confirm this hypothesis. If proven, PL‐SP‐D could play a role as a biomarker for identifying individuals who respond differentially to primary therapy.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"70 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597980","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}

{"title":"Attempts to Modify Periodontal Screening Models Based on a Self‐Reported Oral Health Questionnaire in the Medical Care Setting","authors":"N. Nijland, N. Su, V. E. A. Gerdes, B. G. Loos","doi":"10.1111/jcpe.14069","DOIUrl":"https://doi.org/10.1111/jcpe.14069","url":null,"abstract":"AimPeriodontal disease (PD) screening models based on a self‐reported questionnaire were previously established and externally validated. The aim of the present study is to explore whether the screening models could be modified to improve prediction performance; this methodology is called ‘updating’.MethodsUpdating the models for ‘total’ and ‘severe’ PD was performed using two datasets. One dataset from a previous study (<jats:italic>n</jats:italic> = 155) was used to explore the updating, and a second (<jats:italic>n</jats:italic> = 187, built for the current study) was used to validate whether updating improved performance. Updating was based on different statistical approaches, including model recalibration and revision. Discrimination and calibration were assessed after updating.ResultsFor ‘total’ PD, the update based on model revision improved its performance. However, still low AUCs were found: 0.64 (0.56–0.73) and 0.61 (0.53–0.69) with corresponding O:E ratios 1.00 (0.80–1.23) and 0.92 (0.75–1.13) in the update and validation cohorts, respectively. For ‘severe’ PD, performance of the original model without update performed still the best; AUCs were 0.72 (0.61–0.83) and 0.75 (0.66–0.84) in the update and validation cohorts, respectively, with corresponding O:E ratios 0.60 (0.38–0.84) and 0.62 (0.42–0.87).ConclusionsThe updating methodology did not further improve the performance of the original ‘severe’ PD screening model; it performed satisfactorily in the medical care setting. Despite updating attempts, the screening model for ‘total’ PD remained sub‐optimal. Screening for ‘severe’ PD can now be implemented in the medical care setting.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596797","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}

{"title":"Periodontitis Is Associated With Arterial Stiffness as Measured by Serial Cardio-Ankle Vascular Index (CAVI): A 10-Year Cohort Study.","authors":"Bantita Kanpittaya, Attawood Lertpimonchai, Sanutm Mongkornkarn, Lakshman Samaranayake, Nisakorn Thongmung, Thosaphol Limpijankit, Orawan Charatkulangkun","doi":"10.1111/jcpe.14086","DOIUrl":"https://doi.org/10.1111/jcpe.14086","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the effect of periodontitis on the long-term changes of the cardio-ankle vascular index (CAVI).</p><p><strong>Materials and methods: </strong>A 10-year retrospective cohort study of 3842 Thai participants (range 25-76 years) with normal CAVI at the study initiation was undertaken. Full-mouth periodontal examination was performed by calibrated periodontists, and the extent and severity of periodontitis were determined at 5-year intervals. Serial CAVI measurements were used to examine the incidence of high CAVI (≥ 9.0) and changes in CAVI over time (ΔCAVI).</p><p><strong>Results: </strong>Participants with a higher extent or severity of periodontitis were found to have a significantly higher mean ΔCAVI. The incidence of high CAVI was also observed to be higher in those with periodontitis compared to those without it. The adjusted risk ratios for developing high CAVI were 1.309 and 1.513 for localized and generalized periodontitis, respectively. Participants with severe periodontitis had a 37% higher likelihood of developing CAVI ≥ 9.0 compared to individuals with no/mild periodontitis. This risk was consistent with a significant change in ΔCAVI of 0.054-0.140.</p><p><strong>Conclusions: </strong>Periodontitis, both in terms of extent and severity, was found to have a significant dose-dependent effect on the risk of developing high CAVI over a 10-year period, suggesting a causal relationship between these two parameters.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590834","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}

{"title":"Hypoxic Responses in Periodontal Tissues: Influence of Smoking and Periodontitis.","authors":"Bejna Bozyel, Özlem Doğan, Serenay Elgün, Burcu Özdemir","doi":"10.1111/jcpe.14087","DOIUrl":"https://doi.org/10.1111/jcpe.14087","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to investigate the hypoxic changes in periodontal tissues resulting from smoking and periodontitis by assessing levels of hypoxia-inducible factors (HIF-1α, HIF-2α, HIF-3α) and vascular endothelial growth factor (VEGF) in gingival crevicular fluid (GCF).</p><p><strong>Materials and methods: </strong>The study comprised 22 periodontally healthy non-smokers (Group H), 22 periodontally healthy smokers (Group HS), 22 non-smokers with periodontitis (Group P) and 22 smokers with periodontitis (Group PS). Clinical periodontal parameters were documented, and GCF samples were collected and analysed using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>Significantly elevated levels of HIF-1α, HIF-3α and VEGF were observed in Groups HS, P and PS compared to Group H (p < 0.05). Moreover, higher HIF-2α levels were detected in the Groups HS and P compared to Group H (p < 0.05). Significant correlations were detected between all evaluated hypoxia biomarkers in the Group P (p < 0.05) except HIF-2α and HIF-3α. However, in the PS group, significant correlation appeared only between HIF-1α and HIF-2α (p < 0.05).</p><p><strong>Conclusion: </strong>Our findings indicate that smoking and periodontitis induce comparable hypoxic effects in periodontal tissues, as evidenced by the evaluated biomarkers. Further research is warranted to gain a deeper understanding of the mechanisms underlying hypoxia in periodontal tissues.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568799","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}

{"title":"The Clinical Efficacy and Safety of ErhBMP-2/BioCaP/β-TCP as a Novel Bone Substitute Using the Tooth-Extraction-Socket-Healing Model: A Proof-of-Concept Randomized Controlled Trial.","authors":"Lingfei Wei, Yuanyuan Sun, Dedong Yu, Herman Pieterse, Daniel Wismeijer, Yuelian Liu, Yiqun Wu","doi":"10.1111/jcpe.14084","DOIUrl":"https://doi.org/10.1111/jcpe.14084","url":null,"abstract":"<p><strong>Aim: </strong>This first randomized controlled trial in humans aimed to assess the efficacy and safety of low-dosage Escherichia coli-derived recombinant human bone morphogenetic protein 2 (ErhBMP-2)-incorporated biomimetic calcium phosphate coating-functionalized β-TCP (ErhBMP-2/BioCaP/β-TCP) as a novel bone substitute using the tooth-extraction-socket-healing model.</p><p><strong>Materials and methods: </strong>Forty patients requiring dental implants after single-root tooth extraction were enrolled in this study and randomly assigned into three groups: ErhBMP-2/BioCaP/β-TCP (N = 15), β-TCP (N = 15) and natural healing (N = 10). New bone volume density from histomorphometric analyses was evaluated 6 weeks post-operatively as the primary outcome, and other histomorphometric analyses, alveolar bone and soft-tissue changes were the secondary outcomes. Safety parameters included adverse events, soft-tissue healing, oral health impact profile, serum BMP-2 concentrations and other laboratory tests.</p><p><strong>Results: </strong>The findings revealed a significant increase in new bone volume density in patients treated with ErhBMP-2/BioCaP/β-TCP compared to those receiving β-TCP alone. The required bone augmentation procedures during implant placement surgery in the ErhBMP-2/BioCaP/β-TCP group were significantly less than in the natural healing group. There were no significant differences in safety parameters among the three groups.</p><p><strong>Conclusion: </strong>This clinical trial primarily proved the safety and efficacy of ErhBMP-2/BioCaP/β-TCP as a promising bone substitute.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545714","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}

{"title":"Continuing Professional Development (CPD) and Vocational Education and Training (VET) in Periodontology and Implant Dentistry","authors":"Joerg Meyle,&nbsp;France Lambert,&nbsp;Lewis Winning,&nbsp;Kristina Bertl,&nbsp;Corinna Bruckmann,&nbsp;Martin Biosse Duplan,&nbsp;Peter Harrison,&nbsp;Isabelle Laleman,&nbsp;Nikos Mattheos,&nbsp;Ana Molina,&nbsp;Andreas Stavropoulos,&nbsp;Yvonne C. M. de Waal,&nbsp;Haitam Yousfi,&nbsp;Henrik Dommisch,&nbsp;Ioannis Polyzois,&nbsp;Moritz Kebschull","doi":"10.1111/jcpe.14071","DOIUrl":"10.1111/jcpe.14071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To (i) evaluate structured postgraduate part-time programs in periodontology, including those addressing peri-implant diseases, among members of the European Federation of Periodontology (EFP), (ii) the impact of the 2018 classification scheme and EFP clinical practice guidelines and (iii) propose a framework for periodontal vocational education and training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A summary of relevant European guidelines for vocational education and training was compiled. In a survey and in a systematic review, current part-time programs in continuing professional education in periodontology as well as in prevention and management of peri-implant diseases were examined. The implementation and dissemination of the 2018 classification scheme and the EFP clinical practice guidelines were assessed by literature analysis. Based on these findings, a framework for periodontal vocational education and training was generated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Part-time programs for professional development in periodontology are established in nine EFP member countries. The systematic review identified lack of knowledge in prevention and management of peri-implant diseases among dental practitioners and hygienists. Continuing professional development was found to be important for education in prevention, classification and management of periodontal as well as peri-implant diseases. The proposed European framework consists of an escalator model with three levels (certificate, diploma and master).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Considering the identified variation in the national programs, there is a need to improve education in periodontal and peri-implant diseases. The proposed framework will help harmonize the national structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed framework for part-time professional development is expected to enhance professional qualification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"51 S27","pages":"91-116"},"PeriodicalIF":5.8,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}