Journal of Clinical Periodontology最新文献

{"title":"TREM-1 Pathway Biomarkers for Classification of Periodontal Diseases and Monitoring of Treatment Response in Grade B and C Periodontitis","authors":"Angelika Silbereisen,&nbsp;Ronaldo Lira-Junior,&nbsp;Beral Afacan,&nbsp;Ozgen-Veli Özturk,&nbsp;Gülnur Emingil,&nbsp;Nagihan Bostanci","doi":"10.1111/jcpe.14195","DOIUrl":"10.1111/jcpe.14195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated the diagnostic potential of salivary triggering receptor expressed on myeloid cells (TREM)-1, peptidoglycan recognition protein 1 (PGLYRP1) and interleukin (IL)-1β for periodontitis patients and their ability to predict treatment outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systemically healthy, non-smokers with gingivitis (<i>n</i> = 31), stage III periodontitis (34 grade B: <i>n</i> = 34, grade C: <i>n</i> = 24) and healthy controls (<i>n</i> = 34) were recruited. Periodontitis patients (<i>n</i> = 42) underwent non-surgical periodontal treatment. Saliva was collected at baseline (T0) and post-treatment (T1, T3, T6). Biomarkers were measured using immunoassays. Periodontitis patients were categorised into responders (<i>n</i> = 19) and non-responders (<i>n</i> = 23) based on the number of residual pockets ≥ 5 mm with bleeding on probing at T6.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TREM-1 was higher in periodontitis than in gingivitis and health, and in periodontitis grade B than in gingivitis (<i>p</i> &lt; 0.05). PGLYRP1 and IL-1β were higher in periodontitis and gingivitis compared to controls (<i>p</i> &lt; 0.01). All biomarkers discriminated periodontitis from health (AUC ≥ 0.9) with high sensitivity (82.1%–92.8%) and specificity (83.3%–88.9%). TREM-1 differentiated periodontitis from gingivitis (AUC = 0.72) with high sensitivity (92.8%) but low specificity (58.1%). Baseline biomarkers did not predict treatment outcome (AUC ≤ 0.61), while T1 levels showed moderate potential (AUC ≥ 0.71).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Salivary TREM-1 pathway biomarkers offer diagnostic value for periodontitis, are modulated by therapy but show limited ability to predict treatment outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Registration</h3>\u0000 \u0000 <p>The study has been registered in ClinicalTrials.gov (ID: NCT06715176, 4 December 2024).</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1288-1297"},"PeriodicalIF":6.8,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311417","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":"Aesthetics and Patient-Reported Outcomes in Periodontology and Implant Dentistry: Consensus Report","authors":"Maurizio Tonetti,&nbsp;Mariano Sanz,&nbsp;Francesco Cairo,&nbsp;Jose Nart,&nbsp;Iain Chapple,&nbsp;Mario Aimetti,&nbsp;Sofia Aroca,&nbsp;Gustavo Avila-Ortiz,&nbsp;Juan Blanco,&nbsp;Antonio Bujaldón,&nbsp;Raffaele Cavalcanti,&nbsp;Pierpaolo Cortellini,&nbsp;Jan Cosyn,&nbsp;Monique Danser,&nbsp;Massimo de Sanctis,&nbsp;Jan Derks,&nbsp;Henrik Dommisch,&nbsp;Elena Figuero,&nbsp;Rodolfo Gianserra,&nbsp;Filippo Graziani,&nbsp;Søren Jepsen,&nbsp;Moritz Kebschull,&nbsp;France Lambert,&nbsp;Eduardo Montero,&nbsp;Nadja Naenni,&nbsp;Ian Needleman,&nbsp;Andrea Pilloni,&nbsp;Ausra Ramanauskaite,&nbsp;Mario Roccuzzo,&nbsp;Ignacio Sanz-Martín,&nbsp;Ignacio Sanz-Sánchez,&nbsp;Frank Schwarz,&nbsp;Anton Sculean,&nbsp;Martina Stefanini,&nbsp;Daniel Thoma,&nbsp;Leonardo Trombelli,&nbsp;Cristina Valles,&nbsp;Nicola West,&nbsp;Giovanni Zucchelli,&nbsp;Otto Zuhr,&nbsp;David Herrera","doi":"10.1111/jcpe.14182","DOIUrl":"10.1111/jcpe.14182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aesthetics and patient-reported experiences (PREs) and outcomes (PROs) influence treatment choices, but have been largely overlooked in periodontology and implant dentistry. This consensus conference evaluated these factors by focusing on gingival recession defects (GRDs), immediate or early/delayed implant placement and peri-implant buccal soft-tissue dehiscences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The workshop discussions were informed by five specifically commissioned systematic reviews covering PREs, PROs and clinician-reported outcomes (CROs), including effectiveness, aesthetics and other concerns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following treatments such as coronally advanced flaps (CAFs) with a connective tissue graft (CTG) for root coverage (RC), a positive correlation was noted between clinician-reported aesthetic scores and RC measures for GRDs. However, a corresponding correlation for patient-reported aesthetic perceptions was not evident. In dental implant procedures, the addition of a CTG immediately after implant placement significantly mitigated the apical shift in the mid-facial mucosal level. However, clinician- and patient-reported aesthetic scores were not reflective of these changes. Neither set of scores captured the impact of grafting on improving peri-implant soft-tissue volume. In the treatment of peri-implant dehiscences, soft-tissue augmentation (STA), using CTG beneath CAF, resulted in favourable outcomes in clinician- and patient-perceived aesthetics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinician and patient views provide complementary perspectives for evidence-based clinical decision making. They need to be integrated into select interventions. Specific trials are needed encompassing PREs, PROs and CROs and reporting benefits and harms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1222-1244"},"PeriodicalIF":6.8,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266279","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":"Risk Factors for Early Implant Failure Following Sinus Augmentation: A Multi-Centre Nested Case–Control Study","authors":"Björn Bonsmann,&nbsp;Mohamed Abughalia,&nbsp;Constantin von See,&nbsp;Thomas Dietrich","doi":"10.1111/jcpe.14191","DOIUrl":"10.1111/jcpe.14191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the determinants of early implant failure after sinus augmentation (SA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We conducted a nested case–control study of implants placed after SA between 2016 and 2021 in eight centres across Germany. We included a total of 129 implants that were lost within 12 months after placement (cases) and 273 implants that were not lost within 12 months (controls). Multivariable logistic regression models were fitted to estimate odds ratios (ORs) and 95% confidence intervals for the association of various clinical and radiographic parameters with the risk of early implant failure, independent of confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Marked associations with early failure risk were found for male sex (OR 1.6, 95% CI: 1.1–2.5), current smoking (OR 1.9, 95% CI: 1.0–3.6), history of severe periodontitis (OR 7.5, 95% CI: 2.4–23), number of missing teeth (OR 1.4, 95% CI: 1.2–1.6), residual bone height of 3 to &lt; 5 mm (OR 2.4, 95% CI: 1.4–4.2) and &lt; 3 mm (OR 3.8, 95% CI: 2.2–6.8) and insertion torque &lt; 8 Ncm (OR 5.8, 95% CI 1.3–26).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Male sex, current smoking, low residual bone height, very low insertion torque, a history of severe periodontitis and number of missing teeth are associated with early implant failure after SA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1306-1313"},"PeriodicalIF":6.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225600","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":"Effect of Tooth Splinting on Clinical Outcomes following Periodontal Regenerative Therapy in Teeth with Mobility Degree 1 or 0: A Propensity Score-Matched Analysis","authors":"Risako Mikami,&nbsp;Miho Ishimaru,&nbsp;Koji Mizutani,&nbsp;Hidehiro Shioyama,&nbsp;Takanori Matsuura,&nbsp;Norio Aoyama,&nbsp;Tomonari Suda,&nbsp;Yukako Kusunoki,&nbsp;Kohei Takeda,&nbsp;Tatsuhiko Anzai,&nbsp;Kunihiko Takahashi,&nbsp;Koichiro Matsuo,&nbsp;Jun Aida,&nbsp;Yuichi Izumi,&nbsp;Akira Aoki,&nbsp;Takanori Iwata","doi":"10.1111/jcpe.14190","DOIUrl":"10.1111/jcpe.14190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The evidence for tooth splinting during periodontal regenerative therapy is limited. We aimed to investigate the adjunctive benefits of tooth splinting on clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>In total, 194 intrabony defects in 126 participants were prospectively evaluated over three years following periodontal regenerative therapy with an enamel matrix derivative. Clinical attachment level (CAL), probing depth (PD) and radiographic bone defect depth (RBD) were assessed. Propensity score matching (PSM) was employed to assign surgical sites to splinting and non-splinting groups, and multilevel regression was used to analyse the impact of tooth splinting on clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using PSM, 37 sites each from 32 and 30 participants in the splinting and non-splinting groups, respectively, were matched using the propensity score. Both groups included 26 and 11 sites with tooth mobility degrees 0 and 1, respectively. Significant improvements in CAL, PD and RBD were observed in both groups compared to baseline over the 3-year period. However, there were no significant differences among these parameters between the groups at the 1- and 3-year follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No statistically significant adjunctive benefits of tooth splinting were observed in this study. However, further research with a larger sample size may be required to detect smaller but potentially clinically relevant effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1254-1262"},"PeriodicalIF":6.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234290","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":"Microbial Complexes in Subgingival Plaque: A Bacterial Meta-Taxonomic Study","authors":"Julien Santi-Rocca,&nbsp;David F. Martín-García,&nbsp;Iván Lorca-Alonso,&nbsp;Sandra la González-de la Fuente,&nbsp;Begoña Aguado,&nbsp;Mark Bonner,&nbsp;Véronique Amard,&nbsp;Pierre Amiot,&nbsp;Charlotte Bar,&nbsp;Vincent Berbon,&nbsp;Nefissa Berkani,&nbsp;Alix Burke,&nbsp;Ivonne Cartagena,&nbsp;Jean-Michel Chatard,&nbsp;Céline Coutayar,&nbsp;Guillaume Depraz,&nbsp;Isabel Morales,&nbsp;Narcisa Popa,&nbsp;Stéphane Regniers,&nbsp;Thomas Rissoan,&nbsp;Catherine Robert,&nbsp;Arnaud Tremoureux,&nbsp;Marion Verdy,&nbsp;Manuel Fresno Escudero,&nbsp;Núria Gironès Pujol","doi":"10.1111/jcpe.14138","DOIUrl":"10.1111/jcpe.14138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To leverage technological advances to propose a more accurate representation of subgingival microbiota diversity and dynamics across health and disease, 25 years after the seminal and still authoritative contribution of Socransky and his colleagues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Subgingival plaque from 135 patients (41 healthy, 47 gingivitis, 47 periodontitis) was analysed by V3–V4 16S rRNA sequencing. Sequences were probabilistically assigned to unambiguous taxon groups (UTGs) using advanced bioinformatics. Beyond univariate analyses across health groups, samples were re-classified into microbiota patterns using unsupervised clustering. Bacterial community ordination was performed via correlation analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 394 fully characterized UTGs were detected with a confidence level of at least 98% in all samples, with an average of 157 in each sample and 162 representing more than 95% of the bacteriome. Hierarchical clustering identified 10 UTG complexes, with 1 particularly associated with health (Complex 6) and 1 with disease (Complex 10). Complex 10 corresponded to 29 taxa, among which the three species from Socransky's red complex and additional 8 <i>Treponema</i> UTGs, as well as species from the orange complex. Complex 6 comprised species from Socransky's green, yellow and purple complexes. While gingivitis appeared as an intermediate state between health and periodontitis, k-clustering revealed five microbiota patterns related to disease progression, and with specific contributions of bacterial complexes, evidencing alternative pathophysiological routes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These 10 new complexes offer an entry point to understanding plaque ecology, beyond the complexity of microbial dynamics in the periodontal microenvironments revealed by the variability within these groups and the existence of ‘boundary taxa’ linking them. These microbial complexes co-exist in specific microenvironments, and shifts in their relative abundance mark the transition from a healthy microbiota to a diseased microbiota, with intermediary patterns in between. We propose to use these patterns as indicators for the classification of periodontal diseases along a microbial risk scale to complement the current staging and grading system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 7","pages":"983-998"},"PeriodicalIF":5.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219224","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":"Shotgun Metagenomics Identifies in a Cross-Sectional Setting Improved Plaque Microbiome Biomarkers for Peri-Implant Diseases","authors":"Paolo Ghensi,&nbsp;Vitor Heidrich,&nbsp;Davide Bazzani,&nbsp;Francesco Asnicar,&nbsp;Federica Armanini,&nbsp;Alberto Bertelle,&nbsp;Federico Dell'Acqua,&nbsp;Ester Dellasega,&nbsp;Romina Waldner,&nbsp;Daniela Vicentini,&nbsp;Mattia Bolzan,&nbsp;Lorenzo Trevisiol,&nbsp;Cristiano Tomasi,&nbsp;Edoardo Pasolli,&nbsp;Nicola Segata","doi":"10.1111/jcpe.14121","DOIUrl":"10.1111/jcpe.14121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This observational study aimed to verify and improve the predictive value of plaque microbiome of patients with dental implant for peri-implant diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients were included in one of the following study groups according to the health status of their dental implants: (a) healthy, (b) affected by mucositis and (c) affected by peri-implantitis. From each patient, submucosal plaque microbiome samples were collected from the considered dental implant and from a contralateral healthy implant/tooth. After shotgun metagenomic sequencing, the plaque microbiome was profiled taxonomically and functionally with MetaPhlAn 4 and HUMAnN 3, respectively. Taxonomic and functional profiles were fed into machine-learning models, which were then evaluated with cross-validation to assess the extent to which the plaque microbiome could be used to pinpoint peri-implant diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Shotgun metagenomics sequencing was performed for a total of 158 samples spanning 102 individuals. Four-hundred and forty-seven prokaryotic species were identified as part of the peri-implant microbiome, 34% of which were currently uncharacterized species. At the community level, the peri-implant microbiome differed according to the health status of the implant (<i>p</i> ≤ 0.006 for all pairwise comparisons) but this was site-specific, as healthy contralateral sites showed no discriminating microbiome features. Peri-implantitis microbiomes further showed lower inter-subject variability than healthy plaque microbiomes (<i>p</i> &lt; 0.001), while mucositis-associated microbiomes were in the middle of the continuum between health and peri-implantitis. Each health condition was associated with a strong signature of taxonomic and functional microbiome biomarkers (log₁₀ LDA score ≥ 2.5), 30% and 13% of which represented uncharacterized microbial functions and unknown species, respectively. Distinct \u0000 <i>Fusobacterium nucleatum</i>\u0000 clades were associated with implant status, highlighting the subspecies \u0000 <i>F. nucleatum</i>′s functional and phenotypic diversity. Machine-learning models trained on taxonomic or functional plaque microbiome profiles were highly accurate in differentiating clinical groups (AUC = 0.78–0.96) and highlighted the extent to which the peri-implant microbiome is associated with peri-implant clinical parameters (AUC = 0.79–0.87).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 7","pages":"999-1010"},"PeriodicalIF":5.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219228","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":"Clinical and Patient-Reported Outcomes in Grade III Furcations: A Randomized Feasibility Trial With SMART Design","authors":"Priya Bahal,&nbsp;Pasquale Santamaria,&nbsp;Zainab Malaki,&nbsp;Jeremy Redman,&nbsp;Luigi Nibali","doi":"10.1111/jcpe.14134","DOIUrl":"10.1111/jcpe.14134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the feasibility of applying sequential, multiple assignment, randomized trial (SMART) design in periodontology and to assess the response of grade III furcation-involved molars to various treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A member of the public served as a co-investigator. Twenty participants with at least one grade III furcation-involved molar tooth were randomized to either non-surgical periodontal treatment (NSPT) or open-flap debridement (OFD). They were reassessed 6 months later, where ‘successful response’ to therapy was defined with a ‘combined outcome’ incorporating patient-reported and clinical parameters. Based on SMART principles, non-responders underwent further treatment and were followed up to 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All study feasibility criteria were met, except ‘planned recruitment rate’, which was slower than expected. At the 6-month review, those who underwent OFD showed a greater reduction in probing pocket depth (PPD) compared to those who received NSPT (<i>p</i> = &lt; 0.01). ‘Success’ was reached by 6 out of 10 NSPT participants and by 7 out of 10 OFD participants. Non-responders were further randomized and followed up to 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This SMART design is feasible in periodontology trials. This study demonstrates its advantages and limitations along with clinical and patient-reported data of grade III furcations treated surgically or non-surgically.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 7","pages":"932-939"},"PeriodicalIF":5.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144219225","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":"Clinical Features Associated With Periodontal Case Misclassification by an Active Matrix Metalloproteinase-8 Point-of-Care Oral Rinse Test","authors":"Mengning Bi,&nbsp;Yu Xie,&nbsp;Xiaoyu Yu,&nbsp;Hairui Li,&nbsp;George Pelekos,&nbsp;Lijian Jin,&nbsp;Yuan Li,&nbsp;Maurizio S. Tonetti","doi":"10.1111/jcpe.14189","DOIUrl":"10.1111/jcpe.14189","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The diagnostic performance of active matrix metalloproteinase-8 (aMMP-8) point-of-care oral rinse test (POC-ORT) for periodontitis needs to be improved because of its relatively low sensitivity. This study attempted to identify the clinical features associated with the misclassification of periodontal cases by the test.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This work consisted of two cross-sectional diagnostic accuracy studies involving a representative cohort in Hong Kong, China, and a convenience sample of subjects in Shanghai, China. The outcomes of the aMMP-8 POC-ORT (index test) were compared to the case definitions of the 2017 World Workshop on the classification of periodontal health status (reference test). The analysis reports the diagnostic accuracy parameters, the Youden index and correlations between the aMMP-8 test outcomes and clinical features.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In this study, 384 and 390 subjects were enrolled in Hong Kong and Shanghai, respectively. The conventional 20 ng/mL threshold failed to detect more than 50% of early-stage (I/II) cases. The positive POC-ORT results were significantly correlated with the number of sites with bleeding on probing (BOP), probing pocket depth (PPD) ≥ 4 mm, PPD ≥ 5 mm, PPD ≥ 4 mm and BOP, PPD ≥ 5 mm and BOP and clinical attachment loss. The adjusted odds ratio (OR) for a positive test increased with the number of sites with PPD ≥ 5 mm: 1.092 (95% CI: 1.063–1.127, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) for the Hong Kong sample and 1.074 (95% CI: 1.050–1.100, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) for the Shanghai sample, suggesting a higher likelihood of a positive result with each additional pocket ≥ 5 mm. The same was observed for PPD ≥ 5 mm with BOP: 1.093 (95% CI: 1.064–1.129, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and 1.077 (95% CI: 1.052–1.105, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Notably, the false-negative cases were characterised by a significantly smaller number of periodontal pockets, BOP percentages and bleeding pockets than the true-positive ones.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The false-negative cases, which are responsible for the observed low sensitivity of the POC-ORT, showed more localised periodontal inflammation and pocketing. As the oral rinse test measures the overall level of aMMP-8 cleared by the gingival crevicular fluid from various lesions throughout the whole dentition, localised periodontitis appears more difficult to detect. Additional studies are needed to optimise the sampling strategy and set the cut-off value of a positive test.&lt;/p&gt;\u0000 ","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1276-1287"},"PeriodicalIF":6.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215968","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":"Periosteal Fenestration Procedure in Apically Positioned Flap Increases the Attached Mucosal Width: An In Vivo Experimental Study","authors":"Inpyo Hong,&nbsp;Seungho Jeong,&nbsp;Hae Jee Shin,&nbsp;Daniel S. Thoma,&nbsp;Franz J. Strauss,&nbsp;Jung-Seok Lee","doi":"10.1111/jcpe.14188","DOIUrl":"10.1111/jcpe.14188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the efficacy of the apically positioned flap (APF) with periosteal fenestration in increasing the width of the masticatory mucosa (MM, including attached and keratinized mucosa) and to assess the histological properties of the MM gained through this technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Six mongrel dogs were treated using a split-mouth design, with APF alone (control) and APF with periosteal fenestration (test) applied from the first to the fourth maxillary premolars on both sides (total of 48 sites). Clinical MM width (cMW) and digitally scanned MM width (dMW) were measured at baseline, post-operatively, and after 8 weeks of healing. Histological observations included measuring the distance from the free gingival margin to the mucogingival junction (MGJ) and the width of non-keratinized attached mucosa (NKAM). A linear mixed model was employed to analyse changes in MM measurements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean gain of cMW was 3.17 mm (SD 1.63) in the control group and 4.27 mm (SD 1.91) in the fenestration group with a significant difference in favour of the fenestration group. The estimated mean difference was 1.45 mm (95% CI: 0.57–2.33; <i>p</i> = 0.002). Histologically, the increased mucosal width observed in the fenestration group, compared to the control group, was primarily characterized by non-keratinized epithelium.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>APF with periosteal fenestration enhances the attached mucosal width; however, this increase is predominantly composed of NKAM rather than orthokeratinized mucosa.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1362-1371"},"PeriodicalIF":6.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199177","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":"Long-Term Prognosis of Teeth With Class II Furcation Involvement: A Retrospective Cohort Study","authors":"P. Eickholz,&nbsp;T. Cordis,&nbsp;B. Dannewitz,&nbsp;B. Pretzl,&nbsp;M. Schröder,&nbsp;N. Lingwal,&nbsp;N. El Sayed","doi":"10.1111/jcpe.14186","DOIUrl":"10.1111/jcpe.14186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the survival of teeth with class II furcation involvement (FI) ≥ 5 years after active periodontal treatment (APT) and to identify the prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All charts of patients having undergone APT at the Department of Periodontology of Goethe-University Frankfurt, Germany, were screened for teeth with class II FI. APT had to be accomplished ≥ 5 years ago. Charts were analysed for data of class II FI teeth at baseline (T0), after APT (T1) and at the last supportive periodontal care (SPC/T2).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two-hundred and twenty-two patients (age: 56.5 ± 10.1 years; 118 females; 35 active smokers; 17 diabetics, 154 stage III, 68 stage IV, 94 grade B, 128 grade C) presented 543 teeth with class II FI. Sixty-one patients lost 93 teeth (17%), on average, over 108.4 ± 36.5 months of SPC. Logistic/Cox proportional hazards mixed-model regressions associated increased tooth loss with irregular SPC (<i>p</i> = 0.023/0.073), premolar versus molar (<i>p</i> = 0.041/0.017), root canal filling (RCF) (<i>p</i> &lt; 0.001) and multiple class II FI per tooth at T1 (<i>p</i> = 0.001/0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Of a total of 543 teeth with class II FI, 83% were retained for 108.6 ± 36.5 months. Multiple class II FI at T1, RCF, premolars and irregular SPC were found to compromise the long-term prognosis of teeth with class II FI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15380,"journal":{"name":"Journal of Clinical Periodontology","volume":"52 9","pages":"1298-1305"},"PeriodicalIF":6.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.14186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199176","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}