Periodontology 2000最新文献

{"title":"Influence of defect morphology on the therapeutic outcomes of peri-implantitis.","authors":"Fernando Suárez, Alberto Monje","doi":"10.1111/prd.70081","DOIUrl":"https://doi.org/10.1111/prd.70081","url":null,"abstract":"<p><strong>Background: </strong>Peri-implant bone defect morphology is widely regarded as clinically relevant in the management of peri-implantitis, but its actual influence on treatment outcomes remains unclear. The aim of this review was to assess how peri-implant defect morphology has been defined, assessed, and analyzed in relation to the clinical, radiographic, and disease resolution outcomes following peri-implantitis treatment.</p><p><strong>Methods: </strong>A systematic review was performed including human clinical studies on nonsurgical and/or surgical peri-implantitis treatment that reported peri-implant defect morphology, included at least 10 treated implants, evaluated outcomes at a minimum of two time points, and presented at least 12 months of follow-up. Extracted data focused on morphology definitions and assessment methods, treatment characteristics, and morphology-related analyses of treatment outcomes. The primary outcome was the influence of peri-implant defect morphology on clinical, radiographic, and disease-resolution outcomes following peri-implantitis treatment.</p><p><strong>Results: </strong>Thirty-five studies were included in the qualitative synthesis. Marked heterogeneity was observed across study design, peri-implantitis definitions, morphology descriptions, therapeutic protocols, and outcome measures. Morphology was assessed mainly by periapical radiographs and intra-surgical evaluation, whereas three-dimensional imaging was uncommon and rarely used for baseline defect characterization. Although all included studies reported morphology to a degree sufficient for eligibility, only a minority incorporated it into analytical models, subgroup comparisons, regression analyses, or morphology-stratified outcome interpretation. When morphology was analyzed and reported, the approaches were inconsistent in describing the features of the peri-implantitis-related bone defects and included formal classifications, wall configuration, intrabony component, defect depth, defect width, defect angle, and/or number and location of missing walls. Some studies suggested more favorable outcomes in contained or circumferential defects and in narrower-angle defects, particularly for radiographic fill or bone gain when non-resective measures were carried out, but these findings were not consistent across investigations and were less evident for disease resolution.</p><p><strong>Conclusion: </strong>Defect morphology represents a key driver in selecting the therapeutic modality to manage peri-implantitis and in anticipating the degree of therapeutic response. However, the available evidence is limited by substantial heterogeneity in peri-implantitis definitions, morphology assessment methods, treatment protocols, outcome measures, and disease-resolution criteria, and only a minority of studies incorporated morphology into analytical models or subgroup comparisons capable of clarifying whether it truly modifies prognosis or treatment respons","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819243","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":"Management of extraction sites: From biological principles to clinical practice.","authors":"Emilio Couso-Queiruga, Gustavo Avila-Ortiz","doi":"10.1111/prd.70074","DOIUrl":"https://doi.org/10.1111/prd.70074","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a concise overview of the biological events and dimensional changes following tooth extraction and to summarize current therapeutic strategies for extraction site management, including alveolar ridge preservation (ARP), alveolar ridge reconstruction (ARR), partial extraction therapies (PET), and tooth autotransplantation (TAT).</p><p><strong>Materials and methods: </strong>This narrative review summarizes the biological mechanisms underlying post-extraction healing and evaluates evidence-based approaches for extraction site management. Clinical decision-making is discussed according to hard and soft tissue integrity.</p><p><strong>Results: </strong>Tooth extraction initiates a physiological remodeling process that frequently results in alveolar ridge resorption, potentially compromising subsequent prosthetic rehabilitation. To minimize post-extraction changes and establish a favorable biological foundation for tooth replacement, treatment should be tailored to site-specific characteristics. ARP is generally effective in limiting dimensional changes in sockets with intact alveolar walls, whereas ARR aims to restore ridge architecture in sites with substantial hard tissue defects, such as buccal dehiscences. PET and TAT are also viable alternatives for preserving alveolar ridge dimensions in selected cases. When indicated, immediate implant placement combined with interceptive therapies, including ARP, ARR, or PET, represents a feasible approach to shorten total treatment time. Careful clinical and radiographic assessment is essential to make sound decisions in commonly encountered clinical scenarios: (1) intact hard and soft tissues; (2) damaged alveolar bone without soft tissue dehiscence; and (3) combined hard and soft tissue deficiencies.</p><p><strong>Conclusions: </strong>ARP, ARR, PET, and TAT are predictable, evidence-based treatment modalities for the management of extraction sites. Optimal treatment planning should be based on site-specific characteristics and patient-related factors to maximize clinical outcomes and minimize postoperative complications.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819283","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":"Peri-implantitis and systemic inflammation: Current evidence, biological plausibility, and research gaps.","authors":"Yumeng Yan, Jeanie Suvan, Francesco D'Aiuto","doi":"10.1111/prd.70080","DOIUrl":"https://doi.org/10.1111/prd.70080","url":null,"abstract":"<p><strong>Background: </strong>Peri-implantitis is a biofilm-associated inflammatory condition characterized by peri-implant mucosal inflammation and progressive bone loss. The prevalence of peri-implantitis continues to rise among patients with dental implants. Although peri-implantitis and periodontitis share similar inflammatory phenotypes, histopathological studies have shown that peri-implantitis lesions may exhibit larger inflammatory infiltrates compared with periodontal lesions. This pronounced local inflammatory response provides biological plausibility for potential systemic inflammatory effects.</p><p><strong>Objective: </strong>To critically appraise the current evidence regarding the potential relationships of peri-implantitis with systemic inflammation and systemic diseases, distinguish peri-implantitis-specific findings from extrapolations based on periodontitis research, and highlight the principal methodological limitations and priorities for future investigations.</p><p><strong>Methods: </strong>A comprehensive narrative review of clinical studies, animal studies, and mechanistic studies exploring the relationships between peri-implantitis, systemic inflammation, and systemic diseases was conducted. Evidence was synthesized according to local inflammatory characteristics, potential biological pathways linking peri-implantitis to systemic effects, circulating inflammatory and metabolic alterations, and the methodological limitations of the available studies.</p><p><strong>Results: </strong>Some observational studies have reported elevated circulating inflammatory biomarkers, including C-reactive protein and selected cytokines, in patients with peri-implantitis. Limited interventional evidence also suggests that peri-implantitis treatment may influence some systemic inflammatory markers. However, evidence regarding specific systemic diseases and underlying biological mechanisms remains sparse and is largely indirect or extrapolated from periodontitis research. Most available studies are cross-sectional, involve small sample sizes, use heterogeneous methodologies, and provide limited control of confounding factors.</p><p><strong>Conclusions and clinical relevance: </strong>Current evidence suggests that peri-implantitis may be associated with systemic inflammatory changes. However, the available evidence is insufficient to establish causality or a clinically relevant systemic impact. Further adequately powered longitudinal, interventional, and mechanistic studies are needed to determine whether peri-implantitis independently contributes to systemic inflammation or whether the observed associations reflect shared risk factors and inflammatory pathways.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819285","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":"Definition and recommendations for trial methods for evaluating dentin hypersensitivity: A hybrid AI-assisted scoping review and Delphi consensus process.","authors":"Alexander J Pollard, Tom J Pollard, Anne-Marie Glenny, Jan Clarkson, Tanya Walsh, Maria Davies, Thomas Sounack, Matthew Wright, Joon Seong, Joshua Twigg, Rupert Austin, Rossana Izzetti, Crystal Marruganti, Robert Newcombe, Rebecca Bullock, Nicola X West","doi":"10.1111/prd.70079","DOIUrl":"https://doi.org/10.1111/prd.70079","url":null,"abstract":"<p><strong>Background: </strong>Dentin hypersensitivity (DH) is a common yet inconsistently defined condition impacting oral health and quality of life. Variability in diagnostic criteria and trial methodologies has limited comparability of previous research.</p><p><strong>Objectives: </strong>To map current definitions, diagnostic frameworks, and clinical trial methodologies in DH research. Assess alignment with current best practice guidelines and CONSORT reporting standards. Establish a consensus-based DH definition and core outcome set to guide future trials.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with the PRISMA-ScR framework examining DH definitions published post-1997 and design of randomized controlled trials (RCTs) over the last 5 years. A hybrid AI-assisted and manual data extraction approach was employed maximizing efficiency and rigor. Data were retrieved on definitions, diagnostic criteria, stimuli, outcomes, and design features. Quantitative summaries and thematic syntheses were generated for two domains: (i) definitions and diagnostic criteria (ii) trial design, stimuli, and outcomes.</p><p><strong>Results: </strong>Definitions of DH varied widely in the 72 included papers. Few studies incorporated all elements of the currently accepted definition, particularly with respect to exclusion of alternative pathologies. Recent literature introduced patient-centered and mechanistic extensions to the definition. Among 58 RCTs, CONSORT adherence was inconsistent, especially reporting of randomization, blinding, and effects estimates. The Delphi study achieved consensus on a refined case definition, minimum diagnostic criteria, validated assessment tools, and core outcome set (COS) encompassing clinician assessed, patient reported, and QoL measures.</p><p><strong>Conclusions: </strong>Substantial conceptual and methodological variation persists in DH research. The consensus-derived definition and COS offer foundations for standardized, high quality DH trials aligned with current evidence and patient priorities.</p><p><strong>Protocol registration: </strong>This protocol was registered a priori with Open Science Framework (OSF) - (https://doi.org/10.17605/OSF.IO/J6D7N). The scoping review was reported according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR).</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819277","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":"Dental implant survival, success, and failure in older populations: Beyond chronological age to systemic and local risk profiles.","authors":"Liza Harutyunyan, Yvonne L Hernandez-Kapila","doi":"10.1111/prd.70077","DOIUrl":"https://doi.org/10.1111/prd.70077","url":null,"abstract":"<p><strong>Aim: </strong>Assess the effect of chronological aging on dental implant outcomes by reviewing clinical evidence on implant survival, success, failure, and marginal bone loss in elderly populations.</p><p><strong>Methods: </strong>An electronic literature search of PubMed/MEDLINE and the Cochrane Library identified human studies published from January 1990 to July 2025 evaluating implant outcomes in elderly patients or age-stratified cohorts. Randomized controlled trials, systematic reviews, meta-analyses, cohort, case-control, and cross-sectional studies with ≥6-month follow-up were included. Outcomes assessed were implant survival, success, failure, and marginal bone loss.</p><p><strong>Results: </strong>Across longitudinal and retrospective studies, dental implant survival and success in elderly patients were consistently high and comparable to younger cohorts. Increasing age alone did not affect bone loss or failure, and several studies demonstrated lower early failure rates in older adults. Marginal bone loss was influenced primarily by implant site and gender rather than age. Systemic conditions including diabetes, cardiovascular disease, and osteoporosis were not independent predictors of poor outcomes. Smoking emerged as the most consistent modifiable risk factor. High dose antiresorptive therapy and radiotherapy adversely affected survival, whereas low dose antiresorptives did not. Elderly individuals in long-term care facilities represented a higher-risk subgroup due to reduced hygiene capacity and limited caregiver implant awareness. Orthopedic implant literature demonstrated similar age-related trends, with higher revision risks in younger patients.</p><p><strong>Conclusion: </strong>Current evidence suggests that chronological age alone does not independently compromise implant survival, success, failure, or marginal bone loss. Outcomes are driven primarily by local, behavioral, prosthetic, and systemic factors. Elderly patients remain appropriate candidates for implant therapy.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819264","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":"Decoding host-microbial dynamics in peri-implantitis: Ecosystem-specific experimental models.","authors":"Georgios A Kotsakis, Davi Araújo, Asaf Wilensky, Juliana Girón Bastidas, Stella Alimperti, Flavia Pirih","doi":"10.1111/prd.70076","DOIUrl":"https://doi.org/10.1111/prd.70076","url":null,"abstract":"<p><strong>Background: </strong>Peri-implantitis is an inflammatory disease arising within a unique host-microbial-biomaterial ecosystem. Unlike periodontitis, peri-implant tissues lack a periodontal ligament and epithelial junction integrity and interface with metal oxides on titanium surfaces. The inflammatory changes in peri-implant disease not only affect the host but also extend to the implant surfaces, which undergo corrosion and particle release. These specific ecological features must be accurately captured in preclinical experimental models to provide mechanistic insight and enable translational success.</p><p><strong>Aim: </strong>This review evaluates preclinical and microengineered models of peri-implantitis, focusing on how well they recapitulate the peri-implant mucosal barrier, the biomaterial interface, and systemic modifiers. We propose minimum criteria for \"true\" peri-implantitis models and outline ecosystem-specific platforms for translational research.</p><p><strong>Materials and methods: </strong>A literature search for this narrative review was conducted in PubMed, prioritizing in vivo peri-implantitis models and their use in assessing systemic comorbidities (e.g., diabetes) and local risk factors on peri-implant disease. Furthermore, emerging implant-specific organ-on-a-chip systems for 3D peri-implant mucosa are reviewed.</p><p><strong>Results: </strong>Ligature- and infection-based rodent and large-animal models have elucidated key bacterial-driven inflammatory pathways around dental implants, but careful consideration is needed to ensure long-term chronicity and to account for titanium degradation as a costimulatory pathogenic factor. Comorbidity-integrated models demonstrate that diabetes, vascular disease, and antiresorptive therapy amplify peri-implant bone loss and can precipitate MRONJ-like lesions. Organ-on-a-chip peri-implant mucosa platforms now enable controlled bacterial and titanium exposure, biomechanical strain, and human-relevant barrier readouts, aligned with reduction principles and prioritizing Human-Centered models.</p><p><strong>Clinical relevance: </strong>Ecosystem-specific models that incorporate microrough titanium, inflammatory biomaterial corrosion, barrier biology, and systemic risk factors are essential to advance the study of peri-implantitis. Such models provide a strong foundation for implant-specific investigations that move peri-implantitis management beyond biofilm-centric debridement into the management of host-microbial-biomaterial equilibrium.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontitis and metabolic dysfunction-associated steatotic liver disease.","authors":"Rafael Scaf de Molon, Erica Dorigatti de Avila, Davi da Silva Barbirato, Mariana Fampa Fogacci, Jamil Awad Shibli, Anton Sculean, Alpdogan Kantarci","doi":"10.1111/prd.70072","DOIUrl":"https://doi.org/10.1111/prd.70072","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Periodontitis is a chronic inflammatory disease with systemic effects that extend beyond the oral cavity and contribute to systemic immune and metabolic dysregulation. Chronic liver diseases, particularly metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive phenotypes, have emerged as major global health challenges. Increasing evidence suggests that these two conditions could be biologically and clinically interconnected, yet their relationship has not been comprehensively analyzed. This review critically appraises and integrates clinical, translational, and experimental evidence linking periodontitis and liver disease, with a particular focus on MASLD and related outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A comprehensive narrative review of the literature was conducted to synthesize evidence from epidemiological, clinical, translational, genetic, microbiological, and experimental studies investigating the relationship between periodontitis and chronic liver disease. Particular attention was given to studies examining the oral-gut-liver axis, shared immunometabolic mechanisms, and the effects of periodontal therapy on liver-related outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Epidemiological studies consistently demonstrate a higher prevalence and severity of periodontitis among individuals with chronic liver disease. Population-based and longitudinal studies further support bidirectional associations between periodontal inflammation and hepatic steatosis, fibrosis, cirrhosis, and liver-related mortality. Interventional studies provide preliminary evidence that periodontal therapy may improve hepatic biochemical, imaging, and inflammatory parameters. Genetic and Mendelian randomization studies indicate partially shared genetic susceptibility and overlapping immunometabolic pathways. Clinical microbiological and experimental studies demonstrate that periodontal dysbiosis, microbial translocation, systemic inflammation, and alterations in gut barrier integrity contribute to hepatic immune activation, oxidative stress, and fibrogenesis, supporting the biological plausibility of an oral-gut-liver axis. Conversely, liver disease-associated metabolic and immune dysfunction may further aggravate periodontal tissue destruction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Current evidence supports a biologically plausible bidirectional relationship between periodontitis and chronic liver disease, particularly MASLD. Integration of epidemiological observations with mechanistic findings suggests that periodontal inflammation may contribute to liver disease progression through interconnected microbial, inflammatory, immunological, and metabolic pathways. Although causality remains to be established, these findings support greater integration of periodontal care into the multidisciplinary management of chronic liver disease and highlight the need for well-designed prospective studies and interve","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819251","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":"Microbial and host-derived biomarkers for the diagnosis and management of peri-implant diseases.","authors":"Su Sheng Quach, Ausra Ramanauskaite, Sašo Ivanovski, Pingping Han, Frank Schwarz, Emilio A Cafferata","doi":"10.1111/prd.70083","DOIUrl":"https://doi.org/10.1111/prd.70083","url":null,"abstract":"<p><strong>Objectives: </strong>To critically evaluate the current evidence on microbial and host-derived biomarkers for the diagnosis and management of peri-implant diseases, with emphasis on their biological relevance, potential clinical utility, and current translational limitations.</p><p><strong>Materials and methods: </strong>A narrative review of the literature was performed, integrating evidence from clinical, translational, and experimental studies investigating molecular biomarkers in peri-implant health, peri-implant mucositis, and peri-implantitis. Evidence on detection methodologies, biological relevance, and associations with disease presence and treatment response was synthesized.</p><p><strong>Results: </strong>Molecular approaches have identified distinct microbial profiles, host immune-inflammatory signatures, and metabolic patterns associated with peri-implant disease states. Microbiological biomarkers, including specific bacterial taxa and dysbiotic community shifts, provide insights into disease etiology, while host-derived biomarkers-such as cytokines, enzymes, and bone turnover markers-reflect underlying inflammatory and tissue remodeling processes. Emerging fields, including extracellular vesicles and metabolomics, further expand the repertoire of candidate biomarkers. Despite these advances, substantial heterogeneity in sampling protocols, analytical platforms, and case definitions limits comparability across studies. Consequently, no molecular biomarker or panel has yet achieved sufficient validation for routine clinical implementation.</p><p><strong>Conclusions: </strong>Molecular biomarkers hold significant promise for improving early diagnosis, risk stratification, and treatment monitoring of peri-implant diseases; however, their clinical translation remains constrained by methodological and validation challenges. To date, no single biomarker demonstrates sufficient accuracy or consistency to support standalone clinical use. Future progress will likely depend on integrative approaches combining multiple biomarker domains alongside clinical parameters to enable reliable and clinically applicable diagnostic strategies.</p><p><strong>Clinical relevance: </strong>Integration of microbial and host-derived molecular data, supported by standardized methodologies and robust clinical validation, may enable more precise, personalized approaches to peri-implant disease diagnosis and management.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819287","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":"Beyond biologic sex: Exploratory insights into the heterogeneity of hormonal and contextual drivers of periodontal and peri‐implant outcomes","authors":"Caitlin Neapole, Mark Gettas, Roberto Farina, Yvonne Hernandez‐Kapila","doi":"10.1111/prd.70071","DOIUrl":"https://doi.org/10.1111/prd.70071","url":null,"abstract":"Background Periodontal and peri‐implant diseases are multifactorial inflammatory conditions influenced by microbial, host, hormonal, genetic, and behavioral factors. Although sex‐based differences in immune and inflammatory responses are well recognized in medicine, the extent to which biologic sex and hormonal status influence the prevalence, severity, and biologic markers of periodontal and peri‐implant diseases remains unclear. Objective This narrative review synthesizes available human and animal evidence to evaluate whether sexual dimorphism exists in periodontal disease and peri‐implant disease expression and to synthesize available evidence regarding hormonal status and biologic markers as potential modifying factors. Methods A comprehensive literature search was conducted to identify human and animal studies evaluating sex‐associated differences in periodontal disease, peri‐implant mucositis, and peri‐implantitis. Sixty‐eight human studies and 29 animal studies were included. Human studies encompassed epidemiologic, clinical, and biomarker‐based investigations, while animal studies included direct male–female comparisons and female‐only hormonal deficiency models. Results Most population‐based human studies reported a higher prevalence or severity of periodontitis in males, characterized by greater clinical attachment loss and probing depths. However, several studies – particularly those involving adolescents – reported no sex differences, and a minority demonstrated female‐predominant gingival inflammation, often in hormonally active life stages. In peri‐implant disease, findings were largely inconsistent, with most studies reporting no significant association between biologic sex and peri‐implantitis, while smaller subsets identified either male or female sex as a potential risk factor. Animal studies demonstrated heterogeneous sex‐associated outcomes in direct male–female comparisons. In contrast, female‐only estrogen‐deficiency models consistently showed increased periodontal destruction and impaired peri‐implant bone remodeling. Conclusion Current evidence does not support uniform or universal sexual dimorphism in periodontal or peri‐implant disease. Rather, the available literature remains heterogenous and largely exploratory, with observed differences varying according to hormonal status, age, inflammatory profile, and behavioral and environmental exposures. Across both human and animal studies, estrogen deficiency emerged as a consistent modifier of periodontal and peri‐implant outcomes across species. Future studies incorporating prospective hormonal stratification, biologic‐marker analysis, and large‐scale epidemiologic datasets may help clarify multifaceted risk patterns.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"23 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754574","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":"Beyond biologic sex: Exploratory insights into the heterogeneity of hormonal and contextual drivers of periodontal and peri-implant outcomes.","authors":"Caitlin Neapole, Mark Gettas, Roberto Farina, Yvonne Hernandez-Kapila","doi":"10.1111/prd.70071","DOIUrl":"https://doi.org/10.1111/prd.70071","url":null,"abstract":"<p><strong>Background: </strong>Periodontal and peri-implant diseases are multifactorial inflammatory conditions influenced by microbial, host, hormonal, genetic, and behavioral factors. Although sex-based differences in immune and inflammatory responses are well recognized in medicine, the extent to which biologic sex and hormonal status influence the prevalence, severity, and biologic markers of periodontal and peri-implant diseases remains unclear.</p><p><strong>Objective: </strong>This narrative review synthesizes available human and animal evidence to evaluate whether sexual dimorphism exists in periodontal disease and peri-implant disease expression and to synthesize available evidence regarding hormonal status and biologic markers as potential modifying factors.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted to identify human and animal studies evaluating sex-associated differences in periodontal disease, peri-implant mucositis, and peri-implantitis. Sixty-eight human studies and 29 animal studies were included. Human studies encompassed epidemiologic, clinical, and biomarker-based investigations, while animal studies included direct male-female comparisons and female-only hormonal deficiency models.</p><p><strong>Results: </strong>Most population-based human studies reported a higher prevalence or severity of periodontitis in males, characterized by greater clinical attachment loss and probing depths. However, several studies - particularly those involving adolescents - reported no sex differences, and a minority demonstrated female-predominant gingival inflammation, often in hormonally active life stages. In peri-implant disease, findings were largely inconsistent, with most studies reporting no significant association between biologic sex and peri-implantitis, while smaller subsets identified either male or female sex as a potential risk factor. Animal studies demonstrated heterogeneous sex-associated outcomes in direct male-female comparisons. In contrast, female-only estrogen-deficiency models consistently showed increased periodontal destruction and impaired peri-implant bone remodeling.</p><p><strong>Conclusion: </strong>Current evidence does not support uniform or universal sexual dimorphism in periodontal or peri-implant disease. Rather, the available literature remains heterogenous and largely exploratory, with observed differences varying according to hormonal status, age, inflammatory profile, and behavioral and environmental exposures. Across both human and animal studies, estrogen deficiency emerged as a consistent modifier of periodontal and peri-implant outcomes across species. Future studies incorporating prospective hormonal stratification, biologic-marker analysis, and large-scale epidemiologic datasets may help clarify multifaceted risk patterns.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.8,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762018","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}