Christina L Pappe, Beeke Peters, Olga Pivovarova-Ramich, Robert Schremmer, Aysegül Adam, Kirstin Vach, Henrik Dommisch, Johan P Woelber
{"title":"Effects of a 4-week free-sugar avoidance during periodontal therapy: An explorative randomized controlled clinical trial.","authors":"Christina L Pappe, Beeke Peters, Olga Pivovarova-Ramich, Robert Schremmer, Aysegül Adam, Kirstin Vach, Henrik Dommisch, Johan P Woelber","doi":"10.1002/JPER.24-0208","DOIUrl":"https://doi.org/10.1002/JPER.24-0208","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effect of a 4-week free-sugar avoidance on periodontal parameters during periodontal therapy.</p><p><strong>Methods: </strong>Twenty-one patients with untreated periodontitis and daily free-sugar intake were allocated to a sugar avoidance group (SAG) and a control group (CG). The SAG received a 45-min dietary consultation and was instructed to avoid free sugars during the following 4 weeks after subgingival instrumentation, while the CG continued with their regular diet. Bleeding on probing (BOP), plaque control record, body weight (BW), visceral fat (FATv), and a food frequency questionnaire (FFQ) were collected at baseline (T1), 4 weeks (T2), and 8 weeks (T3) after subgingival instrumentation.</p><p><strong>Results: </strong>The main outcome parameter BOP was significantly reduced at T2 by 40.3% ± 15.54 in the SAG and 34% ± 12.47 in the CG (intra-p value both <0.001, inter-p value 0.361). A linear regression analysis of changes at patient level adjusted for age and FATv revealed a significant group difference for BOP (regression coefficient = -6.8; p = 0.019). Significant reductions were observed in BW, FATv and mean daily intake of free sugars (-14.4 g/day), and a significant increase of vitamin C derived from fruits (75.89 mg/day) at T2 in the SAG only.</p><p><strong>Conclusion: </strong>This study may indicate additional beneficial effects of a sugar avoidance on periodontal and metabolic parameters, and nutritional intake during periodontal therapy. German Clinical Trials Register (DRKS00026699).</p><p><strong>Plain language summary: </strong>The current widespread free-sugar consumption is linked to an increasing incidence of chronic non-communicable diseases. Data indicate a relationship between sugar intake and a higher prevalence of periodontitis and increased gingival inflammation. This study showed that free-sugar avoidance after periodontal therapy had additional beneficial effects on periodontal and metabolic parameters in 10 test and 11 control patients. After 4 weeks of avoiding free sugars like sweets, processed white flour, juice, and so forth, periodontal bleeding was significantly reduced in both groups (-40.3% test group, -34% control group). Further regression analysis revealed a significant difference between groups favoring the intervention. Additionally, body weight and visceral fat were significantly reduced in the intervention group, only. To avoid sugar, patients were allowed to replace it with whole fruit, which led to increased levels of micronutrients such as vitamin C. Therefore, free-sugar avoidance may be of therapeutic benefit in addition to periodontal therapy. Further research is needed to investigate this effect in larger cohorts.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Henny J A Meijer, Kirsten W Slagter, Barzi Gareb, Diederik F M Hentenaar, Arjan Vissink, Gerry M Raghoebar
{"title":"Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.","authors":"Henny J A Meijer, Kirsten W Slagter, Barzi Gareb, Diederik F M Hentenaar, Arjan Vissink, Gerry M Raghoebar","doi":"10.1002/JPER.24-0251","DOIUrl":"https://doi.org/10.1002/JPER.24-0251","url":null,"abstract":"<p><strong>Background: </strong>It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5 mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation.</p><p><strong>Methods: </strong>Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5 mm after an extraction were randomly assigned to immediate (Immediate Group, n = 20) or delayed (Delayed Group, n = 20) implant placement. The second-stage surgery and provisional restoration placement occurred 3 months after implant placement in both groups, followed by definitive restorations 3 months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded.</p><p><strong>Results: </strong>The mean marginal bone level change was -0.71 ± 0.59 mm and -0.36 ± 0.39 mm in the Immediate Group and the Delayed Group after 10 years (p = 0.063), respectively. The secondary outcomes were not significantly different between both groups.</p><p><strong>Conclusions: </strong>Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5 mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone.</p><p><strong>Plain language summary: </strong>Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gingival phenotype classification by visual and probe visibility assessments: Relationship with thickness and probe design.","authors":"Burak Fatih Uysal, Timur Köse, Ali Gürkan","doi":"10.1002/JPER.24-0172","DOIUrl":"https://doi.org/10.1002/JPER.24-0172","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the agreement among dentists in classifying gingival phenotype (GP) through periodontal probe visibility (PPV) assessment with various probe types and the visual method. Additionally, the relationship between GP classifications and gingival thickness (GT) was evaluated.</p><p><strong>Methods: </strong>Photographs were taken with standard periodontal probe (SPP), color-coded periodontal probe (CCPP) tips in white, green, and blue, as well as metal phenotype probe (MPP) tips in gray and black. Evaluators (periodontist, periodontics resident, endodontics resident, dental student) assessed the photographs and classified the GPs. GT was measured by trans gingival probing.</p><p><strong>Results: </strong>Visual method showed poor to fair agreement to classify GP. The lowest agreement regarding PPV was noted with white-tipped CCPP. The highest agreement in singular PPV was observed with CCPP blue (κ = 0.932), followed by CCPP green (κ = 0.791), MPP black (κ = 0.783), SPP (κ = 0.730), and MPP gray (κ = 0.690). Combined PPV data revealed fair to moderate agreement with CCPP and moderate to substantial agreement with MPP in GP classification. The corresponding GT to different GP classifications based on combined PPV were comparable. The agreement between SPP and CCPP in classifying non-thin phenotypes was 89.8%, while the agreement between SPP and MPP was 75.4%. Based on PPV, no significant GT cutoff value was found to distinguish between thin and non-thin phenotypes.</p><p><strong>Conclusion: </strong>Determining a precise GT that guarantees the visibility of a given probe can be difficult when evaluating GP. Regardless of the type of probe, the PPV method has a high potential for misclassifying GP, despite having an acceptable agreement.</p><p><strong>Plain language summary: </strong>Gingival phenotype (GP) is constituted by thickness of the gums and width of keratinized tissue around teeth. Direct visual evaluation or evaluating a periodontal probe's visibility beneath gums are established techniques to classify gingival phenotype. This study investigated how dentists classify GP using visual assessments and different types of periodontal probes, while also exploring the relationship between GP classifications and gingival thickness. Results showed varied agreement among dentists in classifying GP, with lower agreement observed when using certain types of probes, notably the white-tipped phenotype probe. The highest agreement was found with the blue phenotype probe. Data from periodontal probe visibility assessments indicated fair to moderate agreement with certain probes, suggesting some inconsistency in classification methods. Interestingly, GP classification with visual assessments or probes did not correlate with gingival thickness, which may highlight the importance of considering both factors in clinical practice. These findings underline the need for attention when relying solely on visual a","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"U-shaped association between pan-immune-inflammation value and periodontitis: NHANES 2009-2014.","authors":"Huan Zhou, Shusen Zhang, Di Miao, Ruoyan Cao","doi":"10.1002/JPER.24-0318","DOIUrl":"https://doi.org/10.1002/JPER.24-0318","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the relationship between the pan-immune-inflammation value (PIV) and periodontitis based on a large national survey.</p><p><strong>Methods: </strong>In the present cross-sectional study, data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, which included a total of 10,300 participants. The categorization of periodontitis was based on the 2017 classification scheme. The PIV was determined using the formula: (neutrophils count × monocyte count × platelet count)/lymphocytes count. Restricted cubic spline and weighted multivariable logistic regression analyses were employed to evaluate the associations between the PIV with periodontitis.</p><p><strong>Results: </strong>The associations between PIV and stage III/IV periodontitis followed a U-shaped pattern (P<sub>non-linearity</sub> < 0.001). The risk of developing stage III/IV periodontitis showed an increasing trend among participants in the first quartile (odds ratio [OR] = 1.21; 95% confidence interval [CI]: 1.01-1.46), third quartile (OR = 1.34; 95% CI: 1.11-1.61), and fourth quartile (OR = 1.47; 95% CI: 1.25-1.73) compared to those in the second quartile. Subgroup analysis indicated stronger associations of PIV with periodontitis in males (OR<sub>Q4vs2</sub> = 1.72, 95% CI: 1.36-2.18) and individuals with hypertension (OR<sub>Q4vs2</sub> = 1.78, 95% CI: 1.38-2.28) with significant interactions (P<sub>interaction</sub> < 0.05).</p><p><strong>Conclusions: </strong>There is a U-shaped association between PIV and stage III/IV periodontitis, which suggests a potential adjunctive treatment strategy for periodontitis. Higher PIV values were found to have a stronger correlation with stage III/IV periodontitis in males and individuals with hypertension. Further prospective trials are needed to confirm the validity of our results.</p><p><strong>Plain language summary: </strong>A U-shaped association exists between the pan-immune inflammation value and periodontitis in US adults, suggesting that maintaining a moderate immune inflammation response is crucial for periodontal health.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cheol-Min Kim, Jong-Bin Lee, Heung-Sik Um, Jae-Kwan Lee
{"title":"Risk factors for the failure of re-implanted dental implants: A 20-year retrospective study.","authors":"Cheol-Min Kim, Jong-Bin Lee, Heung-Sik Um, Jae-Kwan Lee","doi":"10.1002/JPER.24-0198","DOIUrl":"https://doi.org/10.1002/JPER.24-0198","url":null,"abstract":"<p><strong>Background: </strong>Re-implantation of failed implants is common to maintain the original prosthetic plan; however, it may not always be ideal due to various factors. Few studies have thoroughly investigated the outcomes of re-implanted implants, while considering factors that can enhance their survival rates. Therefore, this study aimed to identify the risk factors that may contribute to the refailure of implants placed the second time by analyzing previously failed implants and evaluating their survival.</p><p><strong>Methods: </strong>Of 10,666 dental implants placed in 4063 patients at the Department of Periodontics of the Gangneung-Wonju National University Dental Hospital between December 1999 and March 2021, 259 failed implants in 170 patients were evaluated through clinical and radiographic records for patient-, surgical-, implant-, and prosthesis-related factors; survival analysis was conducted for implants that met the inclusion criteria.</p><p><strong>Results: </strong>Of the 259 failed implants, 80 second-time-placed implants met the inclusion criteria. Survival analysis showed that the 1-year survival rate of second-time-placed implants was 88.1%. Smoking (hazard ratio [HR] = 5.066, p = 0.081), implant surface (HR = 18.776, p < 0.01), and timing of reimplantation (HR = 0.086, p < 0.01) were identified as risk factors influencing the refailure of second-time-placed implants.</p><p><strong>Conclusions: </strong>The survival rate of second-time-placed implants was lower than that of first-time-placed implants. The risk factors for second-time-placed implant failure were smoking, implant surface, and timing of reimplantation. To prevent further failure, previous failure factors should be analyzed and modifiable risk factors must be controlled before reimplantation.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to \"Salivary cytokine expression after nonsurgical periodontal therapy in smokers: 12-month follow-up\".","authors":"","doi":"10.1002/jper.11256","DOIUrl":"https://doi.org/10.1002/jper.11256","url":null,"abstract":"","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeong-Hwa Seon, Na-Yeong Kim, Ji-Eun Kim, Choong-Ho Choi, Ki-Ho Chung
{"title":"Oxidative balance scores in Korean adults are associated with periodontitis.","authors":"Jeong-Hwa Seon, Na-Yeong Kim, Ji-Eun Kim, Choong-Ho Choi, Ki-Ho Chung","doi":"10.1002/JPER.24-0164","DOIUrl":"https://doi.org/10.1002/JPER.24-0164","url":null,"abstract":"<p><strong>Background: </strong>The Oxidative Balance Score (OBS) is a comprehensive metric that assesses the state of a person's oxidative balance. This study aimed to investigate the relationship between the oxidative balance score and moderate and severe periodontitis in a representative sample of Korean adults.</p><p><strong>Methods: </strong>Healthcare big data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018) was used, and 16,489 adults aged ≥19 years were included. Multivariate logistic regression analysis was performed to investigate the effect of sex-specific oxidative balance scores on periodontitis.</p><p><strong>Results: </strong>In comparison with participants with a lower oxidative balance score, those with a higher oxidative balance score had a lower incidence of moderate and severe periodontitis (p < 0.05). After adjusting for covariates, the oxidative balance score was negatively associated with moderate (odds ratio [OR] = 0.952; 95% confidence interval [CI]: 0.934-0.971) and severe (OR = 0.958; 95% CI: 0.931-0.986) periodontitis; however, the result was not significant for severe periodontitis in women's (OR = 0.975; 95% CI: 0.934-1.018). Our study showed a statistically significant association between OBS and moderate and severe periodontitis, the small effect size should be interpreted with caution.</p><p><strong>Conclusions: </strong>The oxidative balance score was associated with moderate and severe periodontitis in Korean adults. Therefore, managing this score may help reduce the risk of periodontitis.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aonjittra Phanrungsuwan, Michael B Chavez, Leena A Eltilib, Tamara N Kolli, Fatma F Mohamed, Michelle H Tan, Cristiane R Salmon, Francisco H Nociti, Brian L Foster
{"title":"Disparate effects of sclerostin deletion on alveolar bone and cellular cementum in mice.","authors":"Aonjittra Phanrungsuwan, Michael B Chavez, Leena A Eltilib, Tamara N Kolli, Fatma F Mohamed, Michelle H Tan, Cristiane R Salmon, Francisco H Nociti, Brian L Foster","doi":"10.1002/JPER.24-0025","DOIUrl":"https://doi.org/10.1002/JPER.24-0025","url":null,"abstract":"<p><strong>Background: </strong>Cellular cementum (CC) includes cementocytes, cells suspected to regulate CC formation or resorption as osteocytes do in bone. Sclerostin (SOST) is a secreted negative regulator of Wnt/β-catenin signaling expressed by osteocytes and cementocytes. Osteocyte SOST expression reduces bone formation. We investigated the functional importance of SOST in CC compared with alveolar bone (AB) using a Sost knockout (Sost<sup>-/-</sup>) mouse model to better understand the role of cementocytes in CC.</p><p><strong>Methods: </strong>Mandibles and femurs of Sost<sup>-/-</sup> and wild-type (WT) mice were analyzed at 42 and 120 days postnatal (dpn). Maxillary first molars were bilaterally extracted at 42 dpn and both AB healing (maxillary molar sockets) and CC apposition (mandibular first molars) were examined at 21 days post-procedure. Analyses included micro-computed tomography, histology, and immunohistochemistry.</p><p><strong>Results: </strong>Femur cortical and trabecular bone and mandibular bone volumes were similarly increased in Sost<sup>-/-</sup> versus WT mice at 42 and/or 120 dpn. In contrast to previous reports, CC was not increased by Sost<sup>-/-</sup> at either age. We conducted challenge experiments on AB and CC to explore tissue-specific responses. Post-extraction AB healing was improved by Sost deletion. In contrast, experimentally-induced apposition in molars failed to stimulate increased CC formation in Sost<sup>-/-</sup> versus WT mice. Wnt pathway markers AXIN2 and DKK1, which were increased in Sost<sup>-/-</sup> versus WT AB osteocytes, were unchanged in cementocytes.</p><p><strong>Conclusions: </strong>These data indicate CC is less responsive than AB to SOST deletion. Within the study limitations, these results do not support cementocytes as critical for directing increased CC formation.</p><p><strong>Plain language summary: </strong>Sclerostin is a protein known to inhibit bone formation, and removing sclerostin leads to more bone formation. Cementum is the thin layer that covers the surface of the tooth's root. Previous studies suggest that inhibiting sclerostin can similarly increase the amount of cementum. We wanted to compare the response of cementum and bone when sclerostin is absent to understand similarities and differences between these two tissues. In this study, we removed the Sost gene (the gene which produces sclerostin) in mice. We found that mice without sclerostin have more bone in their legs and jaws. Moreover, mice without sclerostin also healed better after tooth removal compared with normal mice. Surprisingly, unlike previous studies, we found that the amount of cementum was not different in mice without sclerostin compared with normal mice. Additionally, we challenged the cementum by taking out the opposing tooth to cause the first mandibular molar to move up by building more cementum. Even with this challenge, we found no difference in the amount of cementum in mice lacking sclerost","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"In vitro comparison of zinc-based, chlorhexidine, and essential oil mouth rinses.","authors":"Thomas E Lallier, Brian S Goldfarb, Pooja Maney","doi":"10.1002/JPER.23-0619","DOIUrl":"https://doi.org/10.1002/JPER.23-0619","url":null,"abstract":"<p><strong>Background: </strong>Chlorhexidine (CHX)-based mouth rinses are frequently prescribed following periodontal surgeries. A more recently available brand of zinc-based mouth rinses advertises one of its mouth rinses as a substitute for chlorhexidine. The purpose of this study was to evaluate, in vitro, the effects of this brand of zinc-based mouth rinses on cell survival, cell motility, and gene expression of human gingival fibroblasts (HGFs).</p><p><strong>Methods: </strong>HGFs were exposed to essential oil (EO), CHX, and three types of one brand of zinc-based mouth rinses designed to treat breath malodor (ZnA), dry mouth (ZnB), and gingivitis (ZnC). Each mouth rinse was tested over a range of concentrations for its effects on HGF survival and motility. Gene expression of cytokines, interleukins, and growth factors were evaluated via reverse transcriptase-polymerase chain reaction (RT-PCR), as a means to assess potential influences on inflammation and wound healing.</p><p><strong>Results: </strong>Cell survival was significantly decreased for CHX and ZnC at 10% dilutions (p < 0.05). For all time points, cells exposed to ZnC displayed the greatest reduction in cell motility (p < 0.05). The various mouth rinses examined differentially altered the expression of growth factor transcripts. ZnC particularly enhanced the expression of BMP-2 and FGF-2.</p><p><strong>Conclusion: </strong>ZnC was more cytotoxic and inhibited cell motility to a greater extent than any of the other mouth rinses. Therefore, using ZnC as an alternative to CHX could potentially have negative effects on wound healing after periodontal surgery. However, further investigation is required to confirm the clinical relevance of these in vitro findings.</p><p><strong>Plain language summary: </strong>One type of zinc-based mouth rinse designed to replace chlorhexidine (often prescribed after oral surgeries) demonstrated the greatest oral cell death and reduction in cell movement when compared to other zinc-based mouth rinses. These zinc-based mouth rinses also reduced the amounts of proteins involved in regulating inflammation, potentially reducing the destruction of bone holding the teeth in place. They also changed the amounts of several molecules involved in tissue healing. It is unknown if this will speed or slow the healing of the soft tissues of the mouth.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficiency of oral keratinized gingiva detection and measurement based on convolutional neural network.","authors":"Gokce Aykol-Sahin, Ozgun Yucel, Nihal Eraydin, Gonca Cayir Keles, Umran Unlu, Ulku Baser","doi":"10.1002/JPER.24-0151","DOIUrl":"https://doi.org/10.1002/JPER.24-0151","url":null,"abstract":"<p><strong>Background: </strong>With recent advances in artificial intelligence, the use of this technology has begun to facilitate comprehensive tissue evaluation and planning of interventions. This study aimed to assess different convolutional neural networks (CNN) in deep learning algorithms to detect keratinized gingiva based on intraoral photos and evaluate the ability of networks to measure keratinized gingiva width.</p><p><strong>Methods: </strong>Six hundred of 1200 photographs taken before and after applying a disclosing agent were used to compare the neural networks in segmenting the keratinized gingiva. Segmentation performances of networks were evaluated using accuracy, intersection over union, and F1 score. Keratinized gingiva width from a reference point was measured from ground truth images and compared with the measurements of clinicians and the DeepLab image that was generated from the ResNet50 model. The effect of measurement operators, phenotype, and jaw on differences in measurements was evaluated by three-factor mixed-design analysis of variance (ANOVA).</p><p><strong>Results: </strong>Among the compared networks, ResNet50 distinguished keratinized gingiva at the highest accuracy rate of 91.4%. The measurements between deep learning and clinicians were in excellent agreement according to jaw and phenotype. When analyzing the influence of the measurement operators, phenotype, and jaw on the measurements performed according to the ground truth, there were statistically significant differences in measurement operators and jaw (p < 0.05).</p><p><strong>Conclusions: </strong>Automated keratinized gingiva segmentation with the ResNet50 model might be a feasible method for assisting professionals. The measurement results promise a potentially high performance of the model as it requires less time and experience.</p><p><strong>Plain language summary: </strong>With recent advances in artificial intelligence (AI), it is now possible to use this technology to evaluate tissues and plan medical procedures thoroughly. This study focused on testing different AI models, specifically CNN, to identify and measure a specific type of gum tissue called keratinized gingiva using photos taken inside the mouth. Out of 1200 photos, 600 were used in the study to compare the performance of different CNN in identifying gingival tissue. The accuracy and effectiveness of these models were measured and compared to human clinician ratings. The study found that the ResNet50 model was the most accurate, correctly identifying gingival tissue 91.4% of the time. When the AI model and clinicians' measurements of gum tissue width were compared, the results were very similar, especially when accounting for different jaws and gum structures. The study also analyzed the effect of various factors on the measurements and found significant differences based on who took the measurements and jaw type. In conclusion, using the ResNet50 model to identify and measure gum tis","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}