Periodontology 2000最新文献

{"title":"From senescence and inflammaging to systemic comorbidities: Drivers of aging-associated periodontitis.","authors":"James Cheng, Chew Tin Zar Aung, Samuel F Suslavich, Sinem Esra Sahingur, Yvonne L Hernandez-Kapila","doi":"10.1111/prd.70049","DOIUrl":"https://doi.org/10.1111/prd.70049","url":null,"abstract":"<p><strong>Background: </strong>Aging is accompanied by a chronic low-grade inflammatory process, known as inflammaging, as well as immunosenescence, an age-related decline and dysregulation of immune function, and cellular senescence, a process in which cells enter a state of irreversible growth arrest while actively releasing pro-inflammatory factors. These processes alter the host immune regulation and tissue homeostasis. Aging-associated mechanisms are being explored for their role in periodontal and peri-implant diseases because of their promotion of dysregulated inflammation, impaired healing, and heightened susceptibility to tissue destruction. Rather than viewing periodontitis as a condition driven solely by microbial burden, it should be understood as a multifactorial disease shaped by complex host-microbe interactions, in which host-driven processes, particularly senescence and inflammaging, play a central role in amplifying bidirectional oral-systemic interactions.</p><p><strong>Aim: </strong>This scoping review aims to (i) highlight the current understanding of the role of aging and its alterations in host inflammatory responses on immune function, tissue homeostasis, and cellular stress responses; (ii) explore the potential impact of \"inflammaging\" on the periodontium and interactions with systemic health; and (iii) explore possible therapeutic targets for senotherapy.</p><p><strong>Materials and methods: </strong>A literature search of the PubMed database was conducted using Boolean search strategies to identify publications related to the potential connections between aging and inflammation in the context of the oral cavity.</p><p><strong>Results: </strong>Of the total 283 articles that were screened, 87 met the eligibility criteria and were included in this scoping review. An additional 51 articles were obtained via manual search. The evidence demonstrates a link between inflammaging, age-related cellular senescence, and periodontal vulnerability to periodontal pathogens and periodontal destruction. Both experimental and clinical studies have shown increased senescence markers, dysregulated immune responses, and enhanced osteoclastic activity that lead to greater tissue destruction and alveolar bone loss. Systemic conditions such as Alzheimer's disease, diabetes, and cardiovascular disease can also amplify the inflammatory burden through shared pathways. Overall, our findings support the idea that older adults undergo immune dysregulation when challenged with microbes that ultimately cause a chronic periodontal inflammatory state.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841431","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":"Educational methods for implementation of proper oral hygiene behavior prior, during, and after orthodontic therapy of patients with periodontal problems.","authors":"Hong Jin Tan,Tilemachos Makropoulos,Jeanie Suvan","doi":"10.1111/prd.70045","DOIUrl":"https://doi.org/10.1111/prd.70045","url":null,"abstract":"BACKGROUNDPeriodontitis complicates orthodontic treatment due to compromised periodontal support and heightened susceptibility to inflammation. Effective plaque control is essential before, during, and after orthodontic intervention to maintain periodontal stability and prevent disease recurrence.METHODSThis narrative review explores evidence surrounding the importance of oral hygiene instruction (OHI), patient motivation, and behavior change strategies in managing ortho-perio patients.RESULTSEvidence suggests that behavior change is complex and knowledge alone is insufficient to maintain long-term self-care without clinician support and patient engagement. Individually tailored OHI, combined with patient-centered communication, can foster sustainable self-care habits. Ortho-perio oral hygiene routines are unique considering periodontal status and evolve alongside changes in orthodontic appliances. Emphasis should consistently be on four critical areas: the gingival margins, interproximal spaces, orthodontic brackets and archwires, and fixed retainers.CONCLUSIONOrthodontic treatment in patients with periodontitis is a dynamic process with constant oral environment changes. Ongoing personalized education and behavior change strategies tailored to treatment stage and periodontal risk are essential to support patient self-care and ensure long-term oral health.CLINICAL RELEVANCEA multidisciplinary approach from periodontal and orthodontic clinicians, involving ongoing education, customized hygiene strategies, and behavior support, is critical to achieving optimal treatment outcomes in ortho-perio patients.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"424 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738969","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":"Oral health-related quality of life (OHRQoL) in people with dentin hypersensitivity: A systematic review of interventional studies.","authors":"G Kitsaras,K Bekes,S Kumbargere,C L Randall,K Asimakopoulou","doi":"10.1111/prd.70042","DOIUrl":"https://doi.org/10.1111/prd.70042","url":null,"abstract":"OBJECTIVEThis systematic review, the first in this field, aimed to evaluate if interventions for dentin hypersensitivity (DH) affect patient-reported oral health-related quality of life (OHRQoL).METHODSA systematic search was conducted across seven electronic databases and gray literature sources, focusing on interventional studies published from 2010 onward. Eligible studies included adult participants with DH and assessed OHRQoL using validated measures. Data extraction followed the PRISMA guidelines. Risk of bias was appraised using the JBI tool.RESULTSThirteen randomized controlled trials involving 616 participants were included. Interventions ranged from desensitizing agents, fluoride varnishes, and laser therapy to nonpharmacological approaches like behavioral techniques. QoL was measured primarily using OHIP-14 and DHEQ-15 tools. The certainty of evidence was rated as very low due to risks of bias, inconsistency, and imprecision.CONCLUSIONSKey findings from this review can help shape the way we understand, quantify, and explore QoL in patients diagnosed with DH. Although several interventions showed promise in reducing DH symptoms and improving QoL, the current evidence base is methodologically limited and inconsistent. High-quality studies using standardized, validated patient-reported outcome measures are needed. Clinical management of DH should incorporate assessment of OHRQoL to guide holistic, patient-centred care.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"136 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738975","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":"Long-term stability of vertical bone augmentation in implant dentistry: A domain-based review.","authors":"Istvan Urban,Pablo Antonio López-Galindo,Mahboube Hasheminasab,Sahar Baniameri,Alessandro Cucchi,Muhammad Saleh,Pietro Felice,Andrea Ravidà","doi":"10.1111/prd.70030","DOIUrl":"https://doi.org/10.1111/prd.70030","url":null,"abstract":"OBJECTIVESVertical ridge deficiency remains one of the most challenging conditions in preimplant surgery. Several techniques aim to restore lost vertical alveolar height, each with specific indications and limitations. Although these procedures often yield favorable short-term outcomes with stable bone levels, their long-term performance is crucial for determining true clinical value.MATERIALS AND METHODSA systematic search of three databases identified 614 records, of which 35 studies met the eligibility criteria of a minimum of 5 years of follow-up that performed vertical ridge augmentation. This review applied a domain-based evaluation framework derived from the Implant Dentistry Core Outcome Set and Measurement (ID-COSM) and the Bone Augmentation Core Outcome Set (BA-COSM). Implant survival and marginal bone loss were synthesized using random-effects models with inverse-variance weighting, with analyses stratified by follow-up duration and vertical ridge augmentation approach.RESULTSImplants placed in vertically augmented bone showed high long-term success, with survival rates of 96% at 5 years, 94% at 10 years, 98% at 15 years, and 95% at 20 years. Marginal bone levels remained stable, with a mean bone loss of 0.67 mm at 5 years and 0.72 mm at 10 years, 1.52 mm at 15 years and 1.53 mm at 20 years.CONCLUSIONSVertical ridge augmentation techniques support predictable implant survival and bone stability. However, heterogeneous reporting of outcomes limits comparability. A standardized, domain-based framework enhances evidence synthesis and clinical relevance in implant dentistry.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"13 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738973","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":"Marginal bone loss around implants - What does it mean?","authors":"Carlotta Dionigi,Kostas Bougas,Tord Berglundh,Jan Derks","doi":"10.1111/prd.70036","DOIUrl":"https://doi.org/10.1111/prd.70036","url":null,"abstract":"BACKGROUNDChanges in peri-implant marginal bone levels (MBL) constitute a central outcome in studies on implant therapy and reflect the integrity of the supporting tissues over time.AIMTo summarize current evidence on MBL changes around dental implants, with emphasis on temporal patterns, methods of assessment and their clinical interpretation.MATERIALS AND METHODSThis narrative review is based on a targeted screening of the literature, including pre-clinical investigations, observational studies and clinical trials reporting radiographically assessed MBL changes. Population-based datasets and randomized controlled trials were prioritized.RESULTSThe available evidence indicates that most MBL change occurs during the early phases following implant installation and abutment connection and typically does not exceed 1 mm, reflecting physiological remodeling. After prosthetic loading, further MBL alterations are generally also limited, commonly within a range of 0.1-0.3 mm during the first year of function and minimal changes thereafter. Radiographic methods are most frequently used for MBL assessment, with reported measurement errors in the order of ≤0.5 mm. While mean MBL changes are small in most studies, analyses of distributions show that approximately 15-25% of implants present with bone loss exceeding 1 mm, whereas only a smaller proportion exhibits pronounced bone loss.CONCLUSIONSMBL changes over time are limited at the majority of dental implants. These alterations represent the cumulative effects of biological, mechanical and host-related factors. The interpretation of MBL changes should consider methodological aspects of assessment and reporting, as well as their relationship to peri-implant diseases. Progressive bone loss constitutes a defining feature of peri-implantitis.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"115 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738974","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":"Effectiveness of nonsurgical therapy of peri-implant mucositis: A systematic review.","authors":"Giulia Brunello,Alessandro Antonelli,Ulrike Schulze-Späte,Francisco Correia,Kathrin Becker","doi":"10.1111/prd.70047","DOIUrl":"https://doi.org/10.1111/prd.70047","url":null,"abstract":"OBJECTIVESThis systematic review intends to respond to the question: \"How do clinical parameters change in implants affected by peri-implant mucositis following different non-surgical treatment approaches or no treatment in patients monitored for a minimum of six months?\"MATERIALS AND METHODSA search for randomized clinical trials (RCTs) or prospective controlled clinical studies (NRCT) in MEDLINE-PubMed, Cochrane Central Register of Controlled Trials, and Web of Science was performed between May 2015 and April 2025. After a two-step screening, data extraction and risk of bias (RoB) assessment were performed. A network meta-analysis (NMA), incorporating multi-arm RCTs, was planned.RESULTSTwenty-one studies (19 RCTs; 2 NRCTs; 1068 patients) were included. The treatments comprised curettes, (ultra)sonic scalers, air-polishing, laser, antimicrobials, probiotics, and antibiotics, alone or in combination. Patient-related systemic and local factors and operator-related factors were sporadically reported and analyzed. To various extents all treatments resulted in a reduction in BOP. When reported, peri-implant mucositis resolution was achieved in a subset of patients, ranging from 9% to 100% (only in one study group). Microbiological and immunological data and patient-reported outcomes (PROs) were sparsely and heterogeneously reported. Only one-third of the studies presented low RoB. Due to limited data available and heterogeneity in treatment protocols and outcomes among the included studies, a NMA could not be performed.CONCLUSIONSWithin the limitations of this review, different nonsurgical treatment protocols, including mechanical debridement alone, all improved clinical parameters, whereas adjuncts yielded only minor improvements after 6 months. Standardized outcome sets and routine PROs are needed to improve comparability and decision-making in future studies.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"140 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738972","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":"Population level data on aging in periodontal and peri-implant health-Aging is not a contraindication for periodontal or peri-implant therapy.","authors":"Dong Yang,Jia Chang,Siyu Huang,Yvonne L Kapila","doi":"10.1111/prd.70041","DOIUrl":"https://doi.org/10.1111/prd.70041","url":null,"abstract":"OBJECTIVESGlobal population aging is leading to a greater retention of natural teeth into later life and an increasing prevalence of dental implant therapy. Although advanced age has traditionally been regarded as a risk factor for compromised outcomes, population level evidence remains lacking. This review synthesizes large-scale clinical and population-level studies to evaluate whether chronological age constitutes a genuine limiting factor for periodontal and implant treatment.MATERIALS AND METHODSThis review compared tooth loss rates, periodontal soft and hard tissue status, and treatment outcomes between younger and older cohorts. Regarding implant therapy, the assessment primarily evaluated success and survival rates across various time periods, peri-implant bone loss, relevant clinical parameters, as well as implant allergies, peri-implantitis, and peri-implant mucositis. Furthermore, data on orthopedic implants were analyzed to provide a comparative perspective on age-related biomaterial integration.RESULTSPeriodontal treatments remain significantly effective, although outcomes of non-surgical periodontal therapy vary among different age groups. Surgical periodontal therapy outcomes show no significant age-related differences. Advanced age is not consistently associated with higher implant failure rates. Several studies report comparable or even higher survival rates in older patients. Marginal bone loss and probing depths are similar across age groups. Orthopedic implant literature similarly shows that age alone does not preclude successful outcomes.CONCLUSIONSAging is not a contraindication for periodontal or implant therapy and is not a default risk factor for failure. Thorough evaluation of systemic health and individualized treatment planning are more critical for overall treatment success than a patient's chronological age.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"1 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147738971","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":"Systemic and local antibiotics in the management of peri-implantitis: A systematic review and network meta-analysis.","authors":"Jamil A Shibli,Vittorio Moraschini,Khalila C Cotrim,Valentim A R Barão,Wim Teughels,Thabet Asbi,Daniela F Bueno,Anton Sculean,João Gabriel S Souza","doi":"10.1111/prd.70029","DOIUrl":"https://doi.org/10.1111/prd.70029","url":null,"abstract":"BACKGROUNDPeri-implantitis is a biofilm-induced inflammatory condition with challenging management due to the complexity of implant surface topographies and the polymicrobial and well-structured profile of the biofilm colonizing these surfaces. Adjunctive use of antibiotics has been explored to enhance the outcomes of both surgical and non-surgical therapies, but its impact remains questionable.OBJECTIVETo critically evaluate the clinical effects of systemic and local antibiotic therapies, combined with mechanical debridement (MD), in the surgical and non-surgical treatments for peri-implantitis.MATERIAL AND METHODSFive databases and gray literature were systematically searched through March 2026. Twenty-one studies involving 1,718 implants were included. Pairwise and network meta-analyses were conducted using random-effects models to compare the efficacy of antibiotic regimens on clinical parameters, including probing pocket depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), plaque index (PLI), and marginal bone loss (MBL).RESULTSSystemic metronidazole combined with amoxicillin was most effective in reducing PPD and MBL, especially when used in the surgical treatment of peri-implantitis. For non-surgical intervention, metronidazole demonstrated the most effective results, particularly for CAL and MBL. Minocycline microspheres and the combination of amoxicillin and metronidazole showed the best results among local therapies. Overall, antibiotics improved clinical parameters when compared to mechanical debridement alone, but with substantial microbiological variability depending on the delivery method and intervention type.CONCLUSIONThe most effective treatments were metronidazole as adjunct to non-surgical treatment and combined with amoxicillin adjuncts to open flap debridement. While local antibiotic applications also enhance clinical parameters, they appear less effective than systemic regimens. Future well-designed clinical trials focusing on microbiological outcomes and standardized protocols are warranted to optimize periimplantitis management strategies.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"319 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695207","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 adjunctive use of hyaluronic acid in surgical and nonsurgical periodontal treatment. A systematic review and meta-analysis.","authors":"Roberto Rotundo,Luca Coccoluto,Michele Nieri,Lorenzo Marini,Andrea Pilloni,Anton Sculean,Giuseppe Mainas","doi":"10.1111/prd.70044","DOIUrl":"https://doi.org/10.1111/prd.70044","url":null,"abstract":"BACKGROUNDHigh interest has been recently shown toward the use of hyaluronic acid (HA) gel as adjuvant to nonsurgical but also to surgical periodontal therapy.AIMTo update the knowledge on the potential clinical effects of HA when used in conjunction with nonsurgical and surgical (both regenerative and mucogingival) periodontal therapy by applying the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.MATERIALS AND METHODSThree different PICOS frameworks were used to guide the inclusion of eligible studies dealing with the adjunctive application of HA in nonsurgical, surgical periodontal therapy, and in root coverage procedures. The following variables were considered: clinical attachment level gain (CALgain), pocket depth reduction (PPDred), recession reduction, pocket closure (for nonsurgical), bleeding score (for nonsurgical), bone gain (for surgical and nonsurgical), percentage of root coverage (%RC, for root coverage procedures). A detailed systematic search was conducted in the following targeted electronic databases: Medline via Pubmed, EMBASE, Cochrane Database of Systematic Reviews and Scielo. Studies were grouped into three predefined analytical strata corresponding to nonsurgical therapy, surgical periodontal therapy, and mucogingival procedures, allowing separate meta-analyses tailored to each clinical scenario. Risk of Bias assessment was performed by using the RoB 2.0 Tool and the overall strength of the available evidence was determined by using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.RESULTSFrom 1554 records, 31 studies were included in the systematic review, but only 20 were eligible for meta-analysis. In nonsurgical periodontal therapy, the adjunctive application of HA showed an overall statistically significant improvement in terms of CALgain (difference of 0.72 mm, 15 studies), PPDred (difference of 0.57 mm, 16 studies), and bone gain (difference of 0.56 mm, 2 studies). However, when only studies at low risk of bias were considered, the statistically significant difference was not confirmed. No statistically significant differences were observed for recession reduction, pocket closure and bleeding score. In surgical periodontal therapy, two studies suggested greater CALgain (difference of 1.36 mm, 2 studies) and PPDred (difference of 1.03 mm, 2 studies) with adjunctive HA, though both trials were at unclear risk of bias. For mucogingival procedures, two studies showed a modest increase in %RC RC (difference of 15.29%, 2 studies), while no benefit was found for other clinical parameters.CONCLUSIONSWithin its limitations, the present analysis shows that the adjunctive use of HA produces variable clinical effects across periodontal therapies. Small improvements are observed in nonsurgical treatment, and limited data suggest a potentially favorable effect in periodontal healing. Overall, the current evidence does not allow definitive clinica","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"23 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695208","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":"Factors affecting the efficacy of nonsurgical therapy of peri-implantitis.","authors":"Elena Calciolari,Federico Rivara,Nikolaos Donos,Jérôme F Lasserre,Selena Toma","doi":"10.1111/prd.70034","DOIUrl":"https://doi.org/10.1111/prd.70034","url":null,"abstract":"OBJECTIVES AND MATERIALS AND METHODSThis article critically reviews the current knowledge on the factors influencing the efficacy of non-surgical therapy (NST) of peri-implantitis, taking also advantage of the know-how from periodontitis management.RESULTSDespite the limited available literature, it is clear that factors influencing the possibility to access and effectively decontaminate the implant (by the clinician and by the patient) and factors influencing patients' response and their wound healing potential are likely to play a crucial role. In this respect, assessing the appropriateness of implant-supported prostheses and verify their cleanability (and, whenever needed, modify/replace them) becomes of crucial importance. Likewise, promoting smoking cessation, controlling underlying relevant medical conditions (e.g. type 2 diabetes) and improving patient's compliance to meticulous oral hygiene can enhance NST outcomes.CONCLUSIONSFuture studies are needed to better clarify the plethora of factors impacting on NST efficacy and how clinicians can further promote disease resolution by selecting/adapting decontamination protocols, use of adjunctives and motivation strategies.CLINICAL RELEVANCEAlthough NST is always the first treatment approach in peri-implantitis management, its efficacy in promoting disease resolution is currently limited, especially in cases presenting advanced pathology and complex peri-implant defect configurations. It is becoming increasingly clear that successful NST does not only entail an effective biofilm removal, but it requires a multi-level approach where the peri-implant tissues are considered in close interrelation with the implant-abutment-prosthesis complex.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"18 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147695244","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}