Periodontology 2000最新文献

{"title":"Engineered surface strategies to manage dental implant-related infections.","authors":"João Gabriel S Souza,Bruna E Nagay,Rodrigo Martins,Martinna Bertolini,Jamil A Shibli,Conrado Aparicio,Magda Feres,Valentim A R Barão","doi":"10.1111/prd.12637","DOIUrl":"https://doi.org/10.1111/prd.12637","url":null,"abstract":"When exposed to the oral environment, dental implants, like natural surfaces, become substrates for microbial adhesion and accumulation, often leading to implant-related infections-one of the main causes of implant failure. These failures impose significant costs on patients, clinicians, and healthcare systems. Despite extensive research, there is no consensus on the most effective protocol for managing peri-implantitis. Biomedical engineering has aimed to address this challenge by developing biocompatible implants with surface properties designed to enhance biological responses and reduce polymicrobial accumulation. Due to the complexity of interactions between implants and biological systems, no single material property can drive these processes. Instead, a combination of physical, chemical, and mechanical properties is required to ensure a safe and effective response. Antimicrobial coatings are developed either by incorporating antimicrobial agents onto surfaces or modifying the material's physicochemical properties. These coatings utilize a range of compounds for contact-killing or as drug-delivery systems. While biomaterials science has advanced rapidly in enhancing implant surfaces, these bioengineering techniques have progressed more rapidly than our understanding of the pathogenesis of implant infections. To bridge this gap, biomedical engineering must address emerging knowledge about implant infections, focusing on controlling microbial accumulation while simultaneously managing inflammatory responses to support tissue healing. This review critically evaluates current evidence on implant infection pathogenesis, antimicrobial coating technologies, and systematically assesses their in vivo (animal and human evidence) efficacy to guide future advancements in implant infection mitigation.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"9 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578582","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 outcomes of post-extraction alveolar ridge preservation and alveolar ridge reconstruction followed by delayed implant placement: A systematic review.","authors":"G Avila-Ortiz,E Couso-Queiruga,S Stuhr,L Chambrone","doi":"10.1111/prd.12642","DOIUrl":"https://doi.org/10.1111/prd.12642","url":null,"abstract":"This systematic review analyzed the long-term outcomes of alveolar ridge preservation (ARP) and alveolar ridge reconstruction (ARR) before delayed implant placement. Eight studies were included (one non-randomized clinical trial, one prospective case series, four retrospective comparative studies, and two retrospective case series). Risk of bias assessment, using a modified Newcastle-Ottawa Scale, revealed one high-quality study, four medium-quality studies, and three with low methodological quality. In total, 333 patients underwent ARP or ARR, with the most common approach involving xenogeneic bone grafting and socket sealing with a collagen membrane, matrix, or dressing. Follow-up ranged from 5 to 10 years. Due to methodological heterogeneity and limited data, quantitative analysis was not feasible. The implant survival rate was the most frequently reported outcome, followed by peri-implant marginal bone level changes and peri-implant disease incidence. Despite limited evidence, ARP and ARR appear to support favorable long-term outcomes, particularly in implant survival and bone stability. Further well-designed, large-scale studies comparing different ARP and ARR modalities with other therapies are needed to guide clinical decision-making.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"20 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144547856","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":"Orthodontic treatment in periodontitis patients.","authors":"Tali Chackartchi, David Polak, Ayala Stabholz, Stela Chaushu","doi":"10.1111/prd.12634","DOIUrl":"https://doi.org/10.1111/prd.12634","url":null,"abstract":"<p><p>This paper examines the complex interplay between orthodontic intervention and periodontal conditions in individuals with periodontitis. It outlines diagnostic and treatment approaches for adolescents and adults, considering their distinct periodontal, dental, and behavioral needs. Furthermore, the paper highlights the detrimental effects of orthodontic tooth movement in the presence of periodontal disease, emphasizing the critical importance of maintaining periodontal health throughout treatment. A comprehensive treatment strategy is presented, including the treatment sequence and periodontal maintenance during orthodontic tooth movement.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497614","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":"Emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases.","authors":"Alberto Monje,Ettore Amerio,Irene Mallor,Conrado Aparicio","doi":"10.1111/prd.12638","DOIUrl":"https://doi.org/10.1111/prd.12638","url":null,"abstract":"Peri-implant diseases are dysbiosis-mediated inflammatory disorders that occur in susceptible hosts. Antimicrobials and immunomodulatory agents therefore might be pertinent as adjunctive measures in the treatment of such disorders. The aim of this narrative review was to examine the existing evidence and assess the effectiveness of emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. An electronic search in the PubMed library was carried out to identify traditional and emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. A narrative review was conducted to shed light on the role of these approaches to prevent and treat peri-implant diseases. The use of traditional locally delivered antimicrobials as an adjunct to the nonsurgical or surgical treatment of peri-implant diseases has been shown to be safe and effective to a certain extent. Nevertheless, the body of evidence is limited, which precludes the drawing of firm conclusions/recommendations on their daily use for the treatment of these disorders. Likewise, the existing evidence on traditional immunomodulatory approaches is scarce, and so firm conclusions/recommendations on their daily use for the treatment of these disorders cannot be made. Among the emerging antimicrobials and immunomodulatory strategies, argon plasma and lasers seem to offer benefits for the prevention and treatment of peri-implant diseases, respectively. Significant advances have been made in the understanding and potential of novel locally delivered and immunomodulatory approaches for the prevention/treatment of peri-implant diseases. Nevertheless, their clinical application is still limited by a lack of control over the bioactivity afforded by the known delivery systems and the scarcity of consistent nonclinical and clinical data. Awareness must be raised on the part of the industry to develop feasible agents/tools to enhance the efficacy of preventive and therapeutic strategies.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"242 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370368","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":"The relationship between maternal periodontitis and congenital cytomegalovirus: A hypothetical model and therapeutic implications","authors":"Jørgen Slots","doi":"10.1111/prd.12632","DOIUrl":"https://doi.org/10.1111/prd.12632","url":null,"abstract":"BackgroundThe primary goal of periodontology is to prevent tooth loss and reduce the risk of focal infections. Periodontitis lesions can harbor hundreds of thousands of active cytomegaloviruses (virions), which can easily enter the systemic circulation and potentially infect the fetus of a mother with compromised immunity. The healthy, non‐inflamed periodontium contains no PCR‐detectable cytomegalovirus. Maternal cytomegalovirus may be linked to cleft lip and cleft palate, prepubertal and juvenile periodontitis, and systemic diseases.AimThis article presents an anti‐cytomegalovirus periodontal therapy aimed at preventing congenital cytomegalovirus disorders.Materials and MethodsImmunodeficient and periodontitis‐affected women in the pre‐gestational period or the first trimester of pregnancy are prime candidates for periodontal treatment. The periodontal diagnosis and drug treatment ought to be performed by well‐informed dentists (periodontists). Treatment consists of a one‐time valacyclovir regimen (1 g BID on days 1 and 2, and 500 mg BID on days 3–7), subgingival and supragingival ultrasonic scaling using a 0.1%–0.2% sodium hypochlorite cooling solution, individually tailored oral hygiene instructions, and patient‐administered daily subgingival irrigation with a 0.1%–0.2% sodium hypochlorite solution.ResultsCytomegalovirus in maternal periodontitis likely serves as a critical nidus for fetal infection. The combined treatment of valacyclovir, ultrasonic scaling, and sodium hypochlorite rinses markedly reduces or eliminates the mother’s periodontal cytomegaloviruses.Clinical relevanceThe proposed noninvasive anti‐cytomegalovirus periodontal therapy is highly safe for the pregnant mother and the fetus. The anti‐cytomegalovirus periodontal treatment is expected to control the mother’s periodontal cytomegalovirus load and, consequently, part of the baby’s congenital disease risk. Research is encouraged on the relationship between periodontal cytomegalovirus and congenital diseases.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"51 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328498","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":"The role of the oral microbiome, host response, and periodontal disease treatment in Alzheimer's disease: A primer.","authors":"Jaclyn C Chalmers, Yvonne L Hernandez-Kapila","doi":"10.1111/prd.12631","DOIUrl":"https://doi.org/10.1111/prd.12631","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is the leading cause of cognitive impairment and dementia in elderly patients worldwide. There is increasing evidence that periodontal disease may have an important role in the complex, multifactorial pathogenesis of AD.</p><p><strong>Aim: </strong>This narrative review aims to (1) highlight the current understanding of the role of periodontal disease in AD, including molecular and immunological evidence, epidemiological studies, and biological mechanisms linking periodontal disease to AD; and (2) explore the potential impact of periodontal therapy as part of an individualized, multitherapeutic approach to AD.</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 periodontal disease and AD.</p><p><strong>Results: </strong>Most of the evidence for a link between periodontal disease and AD is limited to preclinical research and epidemiological investigations. A direct causal link has not yet been demonstrated in human clinical studies, but periodontal pathogenic bacteria have been detected in brain tissue and cerebrospinal fluid of patients with AD. Further, colocalization of gingipain proteases secreted by Porphyromonas gingivalis has been found in AD pathological lesions. Epidemiological studies support associations between periodontal disease and increased risk/prevalence of cognitive decline, AD, and AD mortality. Two mechanistic theories have been proposed to explain the connection between periodontitis and AD: the \"microbial involvement\" theory focuses on periodontal disease-associated pathogenic bacteria, whereas the \"inflammatory cascade\" theory focuses on proinflammatory mediators as drivers of neuroinflammation that may exacerbate pathologic lesions associated with AD. Preclinical studies of periodontal therapies targeting oral microbiota or their byproducts have investigated small-molecule gingipain inhibitors and novel therapeutics that restore oral microbial homeostasis (e.g., probiotic bacteriocin nisin). In animal models, gingipain inhibitors and nisin showed inhibitory effects on formation of pathological lesions of AD or neuroinflammation and microbiome changes, respectively; however, no impact on cognition was found with use of gingipain inhibitors in patients with mild-to-moderate AD.</p><p><strong>Conclusions: </strong>Additional studies are needed to better understand the potential causal relationship between periodontal disease and AD, including further exploration of therapies targeting the oral-brain axis.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266853","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":"Scoring algorithm for predicting periodontitis in dentate adults using self-report measures - National Health and Nutrition Examination Survey 2009-2012.","authors":"Paul I Eke, Liang Wei, Gina Thornton-Evans, Wenche S Borgnakke","doi":"10.1111/prd.12624","DOIUrl":"https://doi.org/10.1111/prd.12624","url":null,"abstract":"<p><strong>Aim: </strong>Our goal was to develop and externally validate oral health self-report measures for predicting periodontitis in a representative U.S. adult population (30-79 years old) and to evaluate a predictive scoring tool for periodontitis constructed from the best performing model parameter estimates.</p><p><strong>Methods: </strong>The predictive models for periodontitis using demographic characteristics and self-reported oral health measures were developed and tested with the National Health and Nutrition Examination Survey (NHANES) 2009-2012 data (development 2009-2010, validation 2011-2012). The best performing model was externally validated against clinical periodontitis cases defined by measurements from a full-mouth periodontal examination at six sites around all teeth excluding third molars. A predictive scoring tool derived from the transformed sum of the model coefficient estimates was also externally validated. Model performances were evaluated by their sensitivity, specificity, predictive accuracy, and area under the receiver-operating characteristic curve (AUROC).</p><p><strong>Results: </strong>Our best model used self-reported oral health, smoking, and demographics. Predictive Risk Scores (PRS) of ≥65 captured about 98% of the true periodontitis cases. Three forms of the model (1-individual risk factor variables, 2-continuous PRS, and 3-PRS categories) were applied to the development and validation data sets. Overall, all three forms had high sensitivity (>84%) in both the development and validation data sets and had similar AUROC (around 80%). Specificity was low to moderate. When externally validated, the model incorporating PRS as a continuous measure had high sensitivity (84.0%) and low specificity (57.5%), with AUROC of 79.5% and predictive accuracy of 71.6%. Similarly, when PRS as a categorical variable was externally validated, the model had a high sensitivity (82.8%) and low specificity (59.9%), with an AUROC of 79.3% and predictive accuracy of 72.0%.</p><p><strong>Conclusion: </strong>Overall, modeling of four self-report oral health measures, combined with smoking and demographic characteristics, performs well in predicting clinical periodontitis in a nationally representative sample of the adult dentate US adult population. Compared with clinical periodontal examination, this approach is promising as a viable, non-clinical, and much less resource-intensive alternative method for estimating the burden of periodontitis.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258668","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":"30 years of enamel matrix derivative: Mimicking tooth development as a clinical concept","authors":"Richard J. Miron, Yoshinori Shirakata, Paras Ahmad, Mario Romandini, Nathan E. Estrin, Nima Farshidfar, Dieter D. Bosshardt, Anton Sculean","doi":"10.1111/prd.12635","DOIUrl":"https://doi.org/10.1111/prd.12635","url":null,"abstract":"The use of growth factors (GFs) has become a cornerstone of modern regenerative periodontology. While the extent to which GFs enhance tissue regeneration compared to other biomaterials was initially uncertain, it is now well established that GFs play a critical role in the regeneration of various tissue types. In the context of periodontal regeneration, enamel matrix derivative (EMD/Emdogain) has been a key biomaterial for over 30 years. Pioneering work by Lars Hammarström in the mid‐1990s led to a wealth of publications on the clinical concept of mimicking tooth development to promote periodontal regeneration. This approach has been shown to induce the formation of new cementum, with functionally oriented periodontal ligament fibers and new alveolar bone. This review begins with an overview of the biological basis of EMD, highlighting its role as a protein (primarily amelogenins) and growth factor complex that initiates and mimics tooth development. Subsequently, histological evidence from animal and human studies using EMD is presented, alongside a discussion of ongoing research avenues. Clinical outcomes are then narratively reviewed, focusing on EMD safety, early wound healing properties, and applications in various scenarios, including non‐surgical periodontal therapy, intra‐bony and furcation defects, periodontal regeneration, and as an adjunct to soft‐tissue grafting. The use of EMD has gained tremendous evidence over the past 30 years as a GF capable of enhancing both hard and soft tissue regeneration in periodontal therapy.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"7 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201441","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":"Mystery and misery of locally-delivered drug therapy in periodontics. Historical concepts and current state.","authors":"Andrea Mombelli, Alkisti Zekeridou","doi":"10.1111/prd.12630","DOIUrl":"https://doi.org/10.1111/prd.12630","url":null,"abstract":"<p><p>The primary objective is to critically analyze approaches to local therapy for periodontal disease, particularly in light of its well-established systemic implications. We specifically address common misconceptions and overestimations regarding the potential of local treatments in contrast to their actual clinical effectiveness. Historically, the therapeutic approach to periodontitis has concentrated on local intervention within periodontal pockets. Local drug delivery systems show potential for targeting periodontal infections with high drug concentrations while minimizing systemic side effects. This could potentially help overcome the challenges posed by microbial biofilms. However, evidence suggests that periodontitis is not a disease affecting only confined areas of a dentition. Currently, in the presence of multiple deep pockets, local therapy is less cost-effective than systemic antibiotics due to the costs of products and the extensive professional chair time required for their application. Isolated deep pockets in otherwise stable dentitions are often caused by problems that cannot be resolved with antimicrobial agents. Finally, recurrent biofilm formation in residual pockets during the maintenance phase can be addressed through suitable physical rather than chemical procedures.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174416","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":"Supportive periodontal care during active orthodontic therapy in patients with history of stage IV periodontitis: A narrative review.","authors":"Alexandra Stähli,Anastasiya Orishko,Jean-Claude Imber,Andrea Roccuzzo,Anton Sculean,Dimitrios Kloukos,Giovanni E Salvi","doi":"10.1111/prd.12627","DOIUrl":"https://doi.org/10.1111/prd.12627","url":null,"abstract":"The present narrative review aims to summarize the existing literature on recommendations for supportive periodontal care (SPC) in patients undergoing combined periodontal-orthodontic treatment. It outlines a comprehensive step-4 treatment sequence in patients diagnosed with stage IV periodontitis and concurrent orthodontic problems. The delivery of SPC characterizes step 4 of the comprehensive treatment sequence, focusing on the prevention of bacterial re-infection and the recurrence of the disease. Step 4 includes repeated assessments of residual probing pocket depths (PPD) greater than 5 mm, bleeding on probing (BoP) and/or suppuration around teeth and implants, as well as evaluation of furcation involvement. Extensive evidence indicates the efficacy of rigorous self-performed plaque control and adherence to regular SPC following active periodontal therapy as vital for managing caries and periodontitis, thereby reducing possible tooth loss. Current evidence indicates that patients with stage IV periodontal disease can safely proceed with orthodontic treatment following active periodontal therapy. Nonetheless, it is the authors' recommendation for patients undergoing periodontal-orthodontic treatment to participate in an SPC program scheduled every 3-4 months.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"11 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143857197","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}