Journal of Clinical Periodontology最新文献

{"title":"Management of Dental Biofilm‐Induced Gingivitis: Oral Hygiene Instruction, Behavioural Strategies and Self‐Performed Mechanical Oral Hygiene—A Systematic Review and Meta‐Analysis","authors":"J. Suvan, G. A. Van der Weijden, D. E. Slot, C. Valkenburg, D. Marletta, S. Culshaw, F. D'Aiuto","doi":"10.1111/jcpe.70192","DOIUrl":"https://doi.org/10.1111/jcpe.70192","url":null,"abstract":"Background Effective self‐performed oral hygiene is fundamental to the prevention and control of dental biofilm‐induced gingivitis. While reinforcement strategies and behavioural interventions (including technologies/digital adjuncts) may improve adherence, advances in oral hygiene devices may enhance the mechanical efficacy of plaque removal. This systematic review evaluated the effects of (1) enhanced oral hygiene instruction, (2) behavioural/motivational/technology interventions and (3) oral hygiene devices on gingival inflammation in adults with gingivitis. Materials and Methods Electronic searches identified randomised controlled trials comparing enhanced versus standard oral hygiene instruction (PICOS 1), behavioural/motivational/technological adjuncts versus standard instruction (PICOS 2) and power versus manual toothbrush devices (PICOS 3). Primary outcome was bleeding on probing (BoP) at a minimum of 3 months. Risk of bias was assessed using the Cochrane RoB 2 tool. Random‐effects meta‐analyses and, where appropriate, network meta‐analyses were performed. Results Thirty‐seven randomised controlled trials (RCTs) were included (PICOS 1: <jats:italic>n</jats:italic> = 7, PICOS 2: <jats:italic>n</jats:italic> = 9, PICOS 3: <jats:italic>n</jats:italic> = 21). Enhanced oral hygiene instruction produced a statistically significant but modest reduction in gingival bleeding compared with standard instruction. Behavioural/motivational/technological interventions yielded small but statistically significant and consistent benefits, with low‐to‐moderate heterogeneity. In contrast, powered toothbrushes demonstrated substantially greater reductions in gingival bleeding and plaque compared with manual brushing. Network meta‐analysis ranked oscillating‐rotating and high‐frequency sonic powered toothbrushes as the most effective interventions, with large effect sizes and consistent findings across studies. Conclusions Reinforced instruction and behavioural interventions produce meaningful improvements in gingival inflammation. Powered toothbrushes consistently provide improvements in gingival health over manual toothbrushes. While effective powered devices have a strong influence on gingival therapeutic outcomes, the foundation of long‐term oral health lies in well‐instructed, consistent self‐care.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"38 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149086759","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":"Zinc Inversely Associates With Periodontitis Risk: An Exploratory Multi‐Omics Study Integrating Metallomics, Transcriptomics and Cellular Analyses","authors":"Yichen Lin, Liuhui Su, Huanhuan Liu, Xixi Dong, Han Yang, Baochang He, Jing Zhang, Lan Luo, Fuhua Yan, Yanfen Li, Fa Chen","doi":"10.1111/jcpe.70207","DOIUrl":"https://doi.org/10.1111/jcpe.70207","url":null,"abstract":"Aim To examine the association between metal profiles in plasma and periodontitis and explore zinc's role in inflammatory pathways using multi‐omics and cellular approaches. Materials and Methods A case–control study including 424 individuals was conducted. Plasma levels of 35 metals were measured by inductively coupled plasma mass spectrometry. Logistic regression, Bayesian kernel machine regression, weighted quantile sum regression and quantile g‐computation were used to assess single‐ and mixed‐metal associations. Transcriptomics, network pharmacology and virtual knockout analyses explored inflammatory pathways related to reduced zinc. Cellular experiments using TPEN in hPDLFs provided exploratory biological context. Results Zinc showed the strongest inverse association with periodontitis (OR = 0.299, 95% CI: 0.185–0.446). Multi‐metal models consistently identified zinc as the primary inversely associated element (WQS weight = 0.690; g‐computation weight = −0.622). Multi‐omics analyses indicated enrichment of the NF‐κB/NLRP3 inflammasome pathway. Zinc chelation was associated with increased expression of <jats:italic>IL1B</jats:italic> , <jats:italic>IL18</jats:italic> , <jats:italic>NLRP3</jats:italic> , <jats:italic>CASP1</jats:italic> and <jats:italic>RELA</jats:italic> in vitro. Virtual knockout analyses suggested the involvement of cytoskeleton regulation, integrin signalling and fibroblast transition. Conclusion This exploratory study supports an inverse association between plasma zinc and periodontitis in a multi‐metal context. Multi‐omics and cellular results are hypothesis‐generating only, and causal or preventive implications require confirmation from prospective and experimental studies.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"41 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070947","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":"Efficacy of Local Application of a Combined Metronidazole and Minocycline Ointment in the Non‐Surgical Treatment of Peri‐Implantitis: A Preclinical In Vivo Study","authors":"Jin‐Young Park, Seung‐Hyun Park, Chang‐Sung Kim","doi":"10.1111/jcpe.70203","DOIUrl":"https://doi.org/10.1111/jcpe.70203","url":null,"abstract":"Aim To evaluate the adjunctive effect of locally delivered metronidazole–minocycline (Met/Mc) versus minocycline (Mc) ointment and mechanical debridement alone in non‐surgical treatment of peri‐implantitis. Materials and Methods Peri‐implantitis was induced through ligature in a canine model. Implants were allocated to mechanical debridement (control), Mc or Met/Mc. Probing depth (PD), bleeding on probing (BOP), marginal bone levels (MBLs) and immunohistochemical parameters (CD3, CD20, IgG) were assessed over 12 weeks. Results Both Met/Mc and Mc showed significantly greater PD reductions than control (Δ −5.33 ± 1.35 mm and −3.67 ± 1.89 mm vs. −0.04 ± 1.80 mm; <jats:italic>p</jats:italic> &lt; 0.0001 and <jats:italic>p</jats:italic> = 0.0004). BOP and MBL reductions were significantly greater in Met/Mc than Mc and control (BOP: Δ −5.67 ± 0.71 vs. −3.22 ± 2.54 vs. −0.78 ± 1.99, <jats:italic>p</jats:italic> = 0.020; MBL: Δ −2.41 ± 1.21 vs. −0.80 ± 0.21 vs. +0.64 ± 0.93 mm, <jats:italic>p</jats:italic> = 0.0035). Met/Mc showed significantly lower CD3, CD20 and IgG than the control and lower CD20 and IgG than Mc (all <jats:italic>p</jats:italic> &lt; 0.05). Conclusion In this preclinical model, adjunctive Met/Mc ointment yielded greater clinical and radiographic improvements than both comparators, accompanied by reduced B‐cell and plasma‐cell infiltration. These findings provide preclinical proof of concept, however, warranting clinical confirmation.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070948","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":"Hyaluronic Acid Modulates IL1β ‐Induced Cytokine Profile of Gingival Mesenchymal Stem Cells","authors":"Sema S. Hakki, Darko Božić, Anton Sculean, Serife Buket Bozkurt","doi":"10.1111/jcpe.70205","DOIUrl":"https://doi.org/10.1111/jcpe.70205","url":null,"abstract":"Aim Hyaluronic acid (HA) possesses anti‐inflammatory properties critical for periodontal wound healing. In this study, we aimed to evaluate the role of cross‐linked high‐molecular‐weight (HMW) HA on cytokine mRNA expression, cell viability and migration in IL‐1β‐stimulated gingival mesenchymal stem cells (gMSCs). Materials and Methods gMSCs were treated with IL‐1β (1 ng/mL), HA dilutions (1:2 and 1:4) or both. Cell viability was determined using the MTT assay at 24 h. Cell migration was assessed at 24 h using a wound‐healing assay. RNA was isolated on days 1 and 7, and mRNA expressions of IL‐1β, IL‐6, IL‐8, IL‐1 and IL‐17 were evaluated via RT‐PCR. Results IL‐1β significantly reduced cell viability ( <jats:italic>p</jats:italic> &lt; 0.01), while HA co‐treatment restored it to control levels ( <jats:italic>p</jats:italic> &lt; 0.05) and increased wound closure after 8 h ( <jats:italic>p</jats:italic> &lt; 0.05). IL‐1β, IL‐6 and IL‐8 mRNA expressions were up‐regulated by IL‐1β; HA significantly decreased their expression on days 1 and 7 ( <jats:italic>p</jats:italic> &lt; 0.01), enhanced IL‐10 and suppressed IL‐17 ( <jats:italic>p</jats:italic> &lt; 0.01). Conclusions HA suppressed pro‐inflammatory cytokines (IL‐1β, IL‐6, IL‐8 and IL‐17) while up‐regulating IL‐10 in IL‐1β‐exposed gMSCs, restoring cell viability and accelerating wound closure under inflammatory conditions. These findings support the rationale for HA's clinical use in periodontal therapy.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149033075","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":"Context‐Dependent Regulation of Epithelial Cell Behaviour by Palatal Connective Tissue Graft‐Derived Fibroblasts via\u0000 EGF\u0000 and\u0000 HB\u0000 ‐\u0000 EGF\u0000 Signalling","authors":"Xiaoqing Song,Cristina Nica,Alexandra Stähli,Anton Sculean,Maria B. Asparuhova","doi":"10.1111/jcpe.70202","DOIUrl":"https://doi.org/10.1111/jcpe.70202","url":null,"abstract":"ABSTRACT Aim To investigate how human palatal fibroblasts (HPFs) from anterior (A) or posterior (P) subepithelial connective tissue grafts (CTGs) regulate oral epithelial cell behaviour, focusing on epidermal growth factor (EGF) and heparin‐binding EGF‐like growth factor (HB‐EGF). Materials and Methods Oral epithelial cells were cocultured with either A‐HPFs or P‐HPFs under indirect and direct conditions. Proliferation and differentiation were assessed by BrdU, qRT‐PCR and immunofluorescence. Growth factor signalling was analysed by ELISA, inhibition/neutralisation experiments, siRNA knockdown and immunoblotting. Results A‐HPFs promoted epithelial proliferation but not differentiation under indirect conditions. In contrast, direct contact triggered epithelial differentiation and AP‐1 gene induction. EGF mediated proliferation via the EGF receptor (EGFR), whereas HB‐EGF induced differentiation via the ErbB4 receptor. HB‐EGF knockdown selectively impaired expression of differentiation‐associated and AP‐1 genes without affecting proliferation. Distinct intracellular signalling was observed, with Erk1/2 activation predominating in indirect coculture and Akt and Stat5 activation in direct coculture. Conclusion This mechanistic in vitro study supports a model in which A‐CTG‐derived fibroblasts regulate epithelial responses through a transition from paracrine EGF–EGFR to juxtacrine HB‐EGF–ErbB4 signalling during wound healing. These findings provide a biological basis for personalised strategies to optimise graft selection and biomaterial functionalisation in periodontal and peri‐implant therapy.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"18 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020377","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":"Regional Disparities in the Prevalence of Probing Depths and Tooth Loss in Germany—Results From the German National Cohort ( NAKO )","authors":"Jana Gortschakow, Katrin Borof, Dominic Sasunna, Kathrin Kuhr, Ghazal Aarabi, Sebastian‐Edgar Baumeister, Antonio Ciardo, Karin Halina Greiser, Daniel Hagenfeld, Katrin Hertrampf, Ti‐Sun Kim, Jan Kühnisch, Tobias Pischon, Stefan L. Reckelkamm, Stefanie Samietz, Martin Wojciechowsky, Asma'a Alselwi, Yvonne Kemmling, Lilian Krist, Michael Leitzmann, Claudia Meinke‐Franze, Rafael Mikolajczyk, Nadia Obi, Regina Pickford, Nicole Pischon, Wolfgang Rathmann, Matthias B. Schulze, Sabine Schipf, Börge Schmidt, Stefan N. Willich, Stefan Rach, A. Rainer Jordan, Henry Völzke, Thomas Kocher, Philipp Kanzow, Alexander Welk, Stefan Rupf, Birte Holtfreter","doi":"10.1111/jcpe.70201","DOIUrl":"https://doi.org/10.1111/jcpe.70201","url":null,"abstract":"Aim To evaluate regional disparities in the prevalence, severity and extent of probing depths (PDs) as well as tooth loss in German adults aged 19–74, using data from the baseline study of the German National Cohort (NAKO; 2014–2019). Methods Dental examinations were recorded at two levels: Level 1 (18/18 centres; <jats:italic>N</jats:italic> = 184,871; tooth counts including third molars and dental interview) and Level 2 (8/18 centres, not geographically representative; <jats:italic>N</jats:italic> = 18,389; recording of PDs). We evaluated differences by sex, age and study region. All data were survey‐weighted. For individuals aged 65–74, we supplemented tooth loss data from the Fifth German Oral Health Study and the Study of Health in Pomerania. Results Among Level 1 participants, the prevalence of edentulism was 1.7% (95% confidence interval: 1.6–1.9). The average mean PD was 1.89 mm (1.87–1.91). Both edentulism and PDs increased with increasing age. There were clear regional disparities, with the lowest prevalence of both in Augsburg/Regensburg in the south (1.3% and 1.64 mm) and the highest in Neubrandenburg in the north‐east (2.3% and 2.31 mm). Conclusion Clear regional disparities emerged. In light of demographic changes, these results highlight the importance of incorporating region‐specific oral health burdens into future healthcare planning and treatment concepts.","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"87 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148993733","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":"Dimensional Changes of the Peri-Implant Mucosa Applying a Suture-Free Wound Closure Using a Healing Abutment Attachment: A Randomised Controlled Clinical Trial.","authors":"Seulbin Im, Young Woo Song, Seung-Hyun Park, Jin-Young Park, Daniel S Thoma, Ronald E Jung, Jae-Kook Cha, Ui-Won Jung","doi":"10.1111/jcpe.70200","DOIUrl":"https://doi.org/10.1111/jcpe.70200","url":null,"abstract":"<p><strong>Aim: </strong>To compare peri-implant soft-tissue dimensional changes following wound closure using a suture-free healing abutment attachment (HAA) compared to conventional suturing during implant surgery.</p><p><strong>Materials and methods: </strong>Thirty patients who were randomly allocated to the HAA group (15 patients, 20 implants) or the suture group (15 patients, 15 implants) were analysed. Clinical parameters including keratinised tissue width (KTW), buccal supracrestal tissue height (STH) and surgery time (seconds) were recorded at posterior maxillary and mandibular implant sites during surgery and over a 6-month follow-up period.</p><p><strong>Results: </strong>The HAA group demonstrated significantly less decrease in KTW compared to the suture group (-0.46 ± 0.71 mm vs. -1.23 ± 0.95 mm at implant level, p < 0.05). The extent of STH increase over 6 months was numerically higher in the HAA group than in the suture group (0.95 ± 0.47 vs. 0.59 ± 0.67 mm), and the difference was statistically significant (p < 0.05). The time required for flap stabilisation was significantly shorter in the HAA group (43.73 s vs. 198.27 s, p < 0.001).</p><p><strong>Conclusion: </strong>Applying the suture-free HAA was more time-efficient and could reduce buccal keratinised tissue shrinkage compared to the traditional wound closure by suturing.</p>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990011","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":"Local and Systemic Risk Factors of Dental Biofilm-Induced Gingivitis and Their Control: A Systematic Review.","authors":"M Gosset, E Chatzopoulou, L Detzen, K Jepsen, P-M Jervøe-Storm, S Jepsen, R Cosgarea","doi":"10.1111/jcpe.70189","DOIUrl":"https://doi.org/10.1111/jcpe.70189","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To identify local and systemic risk factors/indicators for dental biofilm-induced gingivitis (DB-GI) and to summarize evidence for their control.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic review was undertaken following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and divided into PECOTS and PICOTS questions, respectively, related to risk factors/indicators and intervention studies. Only longitudinal studies with at least 3 months duration or studies using the experimental gingivitis protocol were included. Literature search was performed on electronic databases PubMed in Medline, Ovid in EMBASE and SCOPUS. The protocol was registered in PROSPERO.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From an initial screening of 11,529 entries, 71 papers were eventually included, 55 for PECOTS (39 for local factors, 16 for systemic factors) and 16 for PICOTS (11 for local factors, 5 for systemic factors). Local factors: most studies addressed fixed orthodontic appliances as a factor in plaque retention, whereas only a few studies investigated the effects of tooth malalignment/severe crowding on DB-GI. Some studies found higher GI at sites with defective, overhanging or subgingival margins. The removal of fixed orthodontic appliances led consistently to a significant reduction of DB-GI, whereas the evidence for an effect of orthodontic tooth correction on DB-GI in patients with malalignment/severe crowding was rather limited. Systemic factors: adherence to a pro-inflammatory or high-sugar diet increased the risk of DB-GI, whereas an anti-inflammatory/low-sugar diet and dietary advice could reduce it. In patients with pre-existing gingivitis, menstrual cycle hormone fluctuations and gonadotropin-induced ovarian stimulation were associated with increased DB-GI independent of plaque levels. No convincing evidence was found that overweight/obesity increases the risk for DB-GI due to a lack of studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DB-GI may be influenced by local and systemic factors, although the certainty of the evidence varies. Fixed orthodontic appliances consistently increase gingival inflammation through plaque retention, an effect that is generally reversible after appliance removal. Evidence regarding the impact of orthodontic correction of malalignment or severe crowding remains limited. Dietary patterns may influence gingival inflammation, with some preliminary evidence suggesting benefits of anti-inflammatory or low-sugar diets. Hormonal fluctuations and exogenous sex steroid use may increase gingival inflammation in patients with pre-existing gingivitis. Evidence is currently insufficient to support overweight or obesity as risk factors for gingival inflammation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical significance: &lt;/strong&gt;Dental biofilm-induced gingivitis is increased by some predisposing local factors and modifying local and systemic factors. Oral hygiene instructions and professional mechanic","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990026","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":"Clinical Outcomes of a Digital Companion in Periodontal Care: A Randomised Controlled Trial","authors":"Bettina Dannewitz,&nbsp;James Deschner,&nbsp;Christof Dörfer,&nbsp;Henrik Dommisch,&nbsp;Peter Eickholz,&nbsp;Lukas Förster,&nbsp;Lukasz Jablonowski,&nbsp;Neelam Lingwal,&nbsp;Stefan Listl,&nbsp;Maurice Rütters,&nbsp;Lina Weinert,&nbsp;Nihad El Sayed,&nbsp;the Paro-ComPas Collaborators","doi":"10.1111/jcpe.70181","DOIUrl":"10.1111/jcpe.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the efficacy of a digital health companion app as an adjunct to systematic periodontal therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seven German university dental centres conducted this multi-centre randomised controlled trial. Adults with periodontitis (<i>n</i> = 194) were assigned to standard periodontal care with or without the Paro-ComPas app. The primary endpoint was the gingival bleeding index (GBI) at baseline, re-evaluation and during supportive periodontal care. Secondary outcomes included plaque and bleeding on probing. Confirmatory analyses used longitudinal mixed-effects regression. Exploratory analyses examined clinical outcomes by app usage cluster.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 180 participants, 148 completed the trial. Both groups showed substantial clinical improvements. The unadjusted between-group difference favoured the control group [7.70 pp (0.55; 14.85) at T0–T2]; the adjusted analysis showed no significant difference in the primary endpoint (1.56 pp; <i>p</i> = 0.352) or in secondary endpoints. Implementation fidelity was suboptimal. Exploratory analyses revealed that moderate app users achieved significantly greater plaque reductions compared to low users (−14.95 pp; <i>p</i> = 0.034).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This trial found no significant benefit of a digital companion app as an adjunct to systematic periodontal therapy. Low baseline inflammation, incomplete intervention delivery and inter-examiner variability likely limited detection of small effects. Exploratory findings suggest potential benefits among moderately engaged users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The study was registered in an international trial register (German Clinical Trial Register number DRKS00031263, registration date 19/06/2023, https://www.drks.de/search/de/trial/DRKS00031263/details)</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"53 10","pages":"1596-1609"},"PeriodicalIF":8.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630632","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}

{"title":"Methodological Quality of Prognostic Models for Periodontitis: A Systematic Review and Critical Appraisal","authors":"Maryia Karaban,&nbsp;Debora R. Dias,&nbsp;Giuseppe Troiano,&nbsp;Sahar Baniameri,&nbsp;Ishan Ahuja,&nbsp;Divya Joseph,&nbsp;Matteo Serroni,&nbsp;Andrea Ravidà","doi":"10.1111/jcpe.70180","DOIUrl":"10.1111/jcpe.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To critically appraise the methodological quality and historical evolution of prognostic models for periodontitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A systematic search was conducted in three databases. Eligible studies were classified as conceptual tools, category-based tools and data-driven models. Category-based and data-driven models were evaluated with PROBAST. Risk of bias (ROB) was compared across four domains: Participants, Predictors, Outcome and Analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-seven studies were included. Prognostic methods evolved from qualitative risk categories and expert-based classifications towards quantitative, individualised probability estimates generated through multivariable statistical and machine-learning models, alongside progressive improvements in outcome definition, prediction time and risk expression formats. Conceptual tools were not evaluable under PROBAST due to the absence of empirical data. Category-based tools showed limitations in predictor handling and validation rather than bias per se. Data-driven models demonstrated progressive refinement: earlier studies lacked consistent validation, whereas recent models more frequently report internal validation, calibration metrics and external validation. However, all studies except one were classified as high ROB. Domain-level assessment showed strengths in the Participants domain but persistent limitations in the Analysis domain. Methodological improvements after TRIPOD were modest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Prognostic models reflect distinct methodological profiles across design type. Conceptual and category-based frameworks remain clinically relevant historically, while data-driven models represent the contemporary standard but retain important methodological gaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO number: CRD42024525505</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"53 10","pages":"1513-1528"},"PeriodicalIF":8.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.70180","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669884","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}