Periodontology 2000最新文献

{"title":"How to explain the beneficial effects of leukocyte‐ and platelet‐rich fibrin","authors":"Juan Blanco, Angel García Alonso, Lidia Hermida‐Nogueira, Ana B. Castro","doi":"10.1111/prd.12570","DOIUrl":"https://doi.org/10.1111/prd.12570","url":null,"abstract":"The survival of an organism relies on its ability to repair the damage caused by trauma, toxic agents, and inflammation. This process involving cell proliferation and differentiation is driven by several growth factors and is critically dependent on the organization of the extracellular matrix. Since autologous platelet concentrates (APCs) are fibrin matrices in which cells, growth factors, and cytokines are trapped and delivered over time, they are able to influence that response at different levels. The present review thoroughly describes the molecular components present in one of these APCs, leukocyte‐ and platelet‐rich fibrin (L‐PRF), and summarizes the level of evidence regarding the influence of L‐PRF on anti‐inflammatory reactions, analgesia, hemostasis, antimicrobial capacity, and its biological mechanisms on bone/soft tissue regeneration.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"102 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452905","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":"Diagnostic methods/parameters to monitor peri‐implant conditions","authors":"Alberto Monje, Giovanni E. Salvi","doi":"10.1111/prd.12584","DOIUrl":"https://doi.org/10.1111/prd.12584","url":null,"abstract":"The diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri‐implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary diagnostic tools (chairside) seem to be highly specific, while their sensitivity is lower compared with their use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth and implant sites and the aerobic/anaerobic nature of the microbiome, it seems plausible for pocket probing depth to be indicative of disease progression or tissue stability. In addition, understanding the inflammatory nature of peri‐implant diseases, it seems reasonable to advocate that bleeding, erythema, ulceration, and suppuration might be reliable indicators of pathology. Nevertheless, single spots of bleeding on probing may not reflect peri‐implant disease, since implants are prone to exhibit bleeding related to probing force. On the other side, bleeding in smokers lacks sensitivity owing to the decreased angiogenic activity. Hence, the use of dichotomous scales on bleeding in the general population, in contrast to indices that feature profuseness and time after probing, might lead to false positive diagnoses. The definitive distinction between peri‐implant mucositis and peri‐implantitis, though, relies upon the radiographic evidence of progressive bone loss that can be assessed by means of two‐ and three‐dimensional methods. Accordingly, the objective of this review is to evaluate the existing clinical and radiographic parameters/methods to monitor peri‐implant conditions.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"21 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452961","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":"Periodontal considerations during orthodontic intrusion and extrusion in healthy and reduced periodontium.","authors":"Gregory S Antonarakis, Alkisti Zekeridou, Stavros Kiliaridis, Catherine Giannopoulou","doi":"10.1111/prd.12578","DOIUrl":"10.1111/prd.12578","url":null,"abstract":"<p><p>In patients with advanced periodontal disease, pathological tooth migration may occur, which may require subsequent orthodontic treatment for both aesthetic and functional purposes. When planning orthodontic treatment mechanics, intrusive or extrusive forces are frequently indicated. Understanding tissue reactions during these movements is essential for clinicians when devising a comprehensive orthodontic-periodontal treatment plan. This knowledge enables clinicians to be fully aware of and account for the potential effects on the surrounding tissues. The majority of our understanding regarding the behavior of periodontal tissues in both healthy and compromised periodontal conditions is derived from animal studies. These studies offer the advantage of conducting histological and other assessments that would not be feasible in human research. Human studies are nevertheless invaluable in being able to understand the clinically relevant response elicited by the periodontal tissues following orthodontic tooth movement. Animal and human data show that in dentitions with reduced periodontal support, orthodontic intrusion of the teeth does not induce periodontal damage, provided the periodontal tissues do not have inflammation and plaque control with excellent oral hygiene is maintained. On the contrary, when inflammation is not fully controlled, orthodontic intrusion may accelerate the progression of periodontal destruction, with bacterial plaque remnants being displaced subgingivally, leading to further loss of attachment. Orthodontic extrusion, on the other hand, does not seem to cause further periodontal breakdown in dentitions with reduced periodontal support, even in cases with deficient plaque control. This is attributed to the nature of the tooth movement, which directs any plaque remnants coronally (supragingivally), reducing the risk of adverse effects on the periodontal tissues. This specific type of tooth movement can be leveraged to benefit periodontal conditions by facilitating the regeneration of lost hard and soft periodontal tissues in a coronal direction. As a result, orthodontic extrusion can be employed in implant site development, offering an advantageous alternative to more invasive surgical procedures like bone grafting. Regardless of the tooth movement prescribed, when periodontal involvement is present, it is essential to prioritize periodontal therapy before commencing orthodontic treatment. Adequate plaque control is also imperative for successful outcomes. Additionally, utilizing light orthodontic forces is advisable to achieve efficient tooth movement while minimizing the risk of adverse effects, notably root resorption. By adhering to these principles, a more favorable and effective combined orthodontic-periodontal approach can be ensured. The present article describes indications, mechanisms, side effects, and histological and clinical evidence supporting orthodontic extrusion and intrusion in intact and reduced peri","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":17.5,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237237","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 diagnostics in periodontal diseases.","authors":"Daniel Manoil, Ana Parga, Nagihan Bostanci, Georgios N Belibasakis","doi":"10.1111/prd.12571","DOIUrl":"10.1111/prd.12571","url":null,"abstract":"<p><p>Microbial analytical methods have been instrumental in elucidating the complex microbial etiology of periodontal diseases, by shaping our understanding of subgingival community dynamics. Certain pathobionts can orchestrate the establishment of dysbiotic communities that can subvert the host immune system, triggering inflammation and tissue destruction. Yet, diagnosis and management of periodontal conditions still rely on clinical and radiographic examinations, overlooking the well-established microbial etiology. This review summarizes the chronological emergence of periodontal etiological models and the co-evolution with technological advances in microbial detection. We additionally review the microbial analytical approaches currently accessible to clinicians, highlighting their value in broadening the periodontal assessment. The epidemiological importance of obtaining culture-based antimicrobial susceptibility profiles of periodontal taxa for antibiotic resistance surveillance is also underscored, together with clinically relevant analytical approaches to guide antibiotherapy choices, when necessary. Furthermore, the importance of 16S-based community and shotgun metagenomic profiling is discussed in outlining dysbiotic microbial signatures. Because dysbiosis precedes periodontal damage, biomarker identification offers early diagnostic possibilities to forestall disease relapses during maintenance. Altogether, this review highlights the underutilized potential of clinical microbiology in periodontology, spotlighting the clinical areas most conductive to its diagnostic implementation for enhancing prevention, treatment predictability, and addressing global antibiotic resistance.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"176-193"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155506","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":"Artificial intelligence and personalized diagnostics in periodontology: A narrative review.","authors":"Vinay Pitchika, Martha Büttner, Falk Schwendicke","doi":"10.1111/prd.12586","DOIUrl":"10.1111/prd.12586","url":null,"abstract":"<p><p>Periodontal diseases pose a significant global health burden, requiring early detection and personalized treatment approaches. Traditional diagnostic approaches in periodontology often rely on a \"one size fits all\" approach, which may overlook the unique variations in disease progression and response to treatment among individuals. This narrative review explores the role of artificial intelligence (AI) and personalized diagnostics in periodontology, emphasizing the potential for tailored diagnostic strategies to enhance precision medicine in periodontal care. The review begins by elucidating the limitations of conventional diagnostic techniques. Subsequently, it delves into the application of AI models in analyzing diverse data sets, such as clinical records, imaging, and molecular information, and its role in periodontal training. Furthermore, the review also discusses the role of research community and policymakers in integrating personalized diagnostics in periodontal care. Challenges and ethical considerations associated with adopting AI-based personalized diagnostic tools are also explored, emphasizing the need for transparent algorithms, data safety and privacy, ongoing multidisciplinary collaboration, and patient involvement. In conclusion, this narrative review underscores the transformative potential of AI in advancing periodontal diagnostics toward a personalized paradigm, and their integration into clinical practice holds the promise of ushering in a new era of precision medicine for periodontal care.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"220-231"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141458594","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":"Nonionizing diagnostic imaging modalities for visualizing health and pathology of periodontal and peri-implant tissues.","authors":"Andy Wai Kan Yeung, Abeer AlHadidi, Rutvi Vyas, Michael M Bornstein, Hiroshi Watanabe, Ray Tanaka","doi":"10.1111/prd.12591","DOIUrl":"10.1111/prd.12591","url":null,"abstract":"<p><p>Radiographic examination has been an essential part of the diagnostic workflow in periodontology and implant dentistry. However, radiographic examination unavoidably involves ionizing radiation and its associated risks. Clinicians and researchers have invested considerable efforts in assessing the feasibility and capability of utilizing nonionizing imaging modalities to replace traditional radiographic imaging. Two such modalities have been extensively evaluated in clinical settings, namely, ultrasonography (USG) and magnetic resonance imaging (MRI). Another modality, optical coherence tomography (OCT), has been under investigation more recently. This review aims to provide an overview of the literature and summarize the usage of USG, MRI, and OCT in evaluating health and pathology of periodontal and peri-implant tissues. Clinical studies have shown that USG could accurately measure gingival height and crestal bone level, and classify furcation involvement. Due to physical constraints, USG may be more applicable to the buccal surfaces of the dentition even with an intra-oral probe. Clinical studies have also shown that MRI could visualize the degree of soft-tissue inflammation and osseous edema, the extent of bone loss at furcation involvement sites, and periodontal bone level. However, there was a lack of clinical studies on the evaluation of peri-implant tissues by MRI. Moreover, an MRI machine is very expensive, occupies much space, and requires more time than cone-beam computed tomography (CBCT) or intraoral radiographs to complete a scan. The feasibility of OCT to evaluate periodontal and peri-implant tissues remains to be elucidated, as there are only preclinical studies at the moment. A major shortcoming of OCT is that it may not reach the bottom of the periodontal pocket, particularly for inflammatory conditions, due to the absorption of near-infrared light by hemoglobin. Until future technological breakthroughs finally overcome the limitations of USG, MRI and OCT, the practical imaging modalities for routine diagnostics of periodontal and peri-implant tissues remain to be plain radiographs and CBCTs.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"87-101"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477165","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":"Radiographic assessment of the peri-implant site.","authors":"Philipp Sahrmann, Sebastian Kühl, Dorothea Dagassan-Berndt, Michael M Bornstein, Nicola U Zitzmann","doi":"10.1111/prd.12577","DOIUrl":"10.1111/prd.12577","url":null,"abstract":"<p><p>While peri-implant mucositis relies solely on clinical parameters, radiological assessment becomes indispensable for diagnosing peri-implantitis. Intraoral radiography, with its simplicity of application, low radiation exposure, and adequate representation of peri-implant structures, stands out as the standard of care for both immediate and follow-up assessments. Standardization by custom-made radiologic splints allows for excellent comparability with previous images and allows for the determination of even small changes in contour and density of the peri-implant bone. Furthermore, other radiographic modalities like panoramic radiography and cone beam computed tomography (CBCT) may provide useful features for specific patients and clinical cases while also showing innate limitations. Beyond the assessment of the marginal peri-implant bone level as the crucial parameter of clinical relevance, radiologic assessment may reveal various other findings related to the prosthetic restoration itself, the precision of its fit to the implant, and the peri-implant soft and hard tissues. Since such findings can be crucial for the assessment of peri-implant health and the implants' prognosis, a systematic diagnostic evaluation pathway for a thorough assessment is recommended to extract all relevant information from radiologic imaging. This article also provides an overview of the clinical and chronological indications for different imaging modalities in peri-implant issues.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"70-86"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477166","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":"Conventional diagnostic criteria for periodontal diseases (plaque-induced gingivitis and periodontitis).","authors":"Lisa J A Heitz-Mayfield","doi":"10.1111/prd.12579","DOIUrl":"10.1111/prd.12579","url":null,"abstract":"<p><p>This narrative review addresses conventional diagnostic criteria used in clinical practice to discriminate between periodontal health, gingivitis, and periodontitis. Visual examination of the color and texture of the periodontal tissues, assessment of plaque deposits, periodontal probing assessments, and diagnostic imaging enable the collation of information to make a periodontal diagnosis, followed by an appropriate treatment plan. The periodontal probe is an essential diagnostic tool to assess probing pocket depth, clinical attachment level, bleeding on probing, and the degree of furcation involvement at multirooted teeth. When clinical signs and symptoms of periodontitis are identified, diagnostic imaging enables evaluation of the level and extent of bone destruction and bone defect morphology. The diagnostic process requires clinicians who are trained to evaluate, record, and interpret these measures. This narrative review focuses on conventional clinical diagnostic parameters which, despite their limitations, are considered the current standard of care.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"10-19"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237201","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":"Tooth- and implant-related prognostic factors in treatment planning.","authors":"Anastasiya Orishko, Jean-Claude Imber, Andrea Roccuzzo, Alexandra Stähli, Giovanni E Salvi","doi":"10.1111/prd.12597","DOIUrl":"https://doi.org/10.1111/prd.12597","url":null,"abstract":"<p><p>Following a comprehensive patient examination, including the assessment of periodontal and peri-implant diseases as well as considering the patient's needs, a pretherapeutic prognosis for each tooth and implant is given. Teeth and implants with a secure pretherapeutic prognosis require simple procedures and may be regarded as secure abutments for function and with a doubtful pretherapeutic prognosis usually need a comprehensive therapy. Such teeth and implants must be brought into the category with a secure prognosis by means of additional therapy such as endodontic, restorative, and surgical procedures. Teeth and implants with a hopeless pretherapeutic prognosis should be extracted/explanted during the initial phase of cause-related therapy (i.e., infection control). For example, teeth with vertical root fracture or unrestorable caries and implants with mobility or unrestorable malposition fall into the category of hopeless units. The primary goal of periodontal and peri-implant therapy should be to arrest disease progression. The latest consensus statement highlights that periodontitis can be successfully controlled and treated teeth can be retained for life. Nevertheless, for patients with uncontrolled contributing factors, the endpoints might not always be achievable, and low disease activity may be an acceptable therapeutic goal. Similarly, the management of peri-implantitis frequently requires surgical intervention following nonsurgical therapy due to incomplete treatment outcomes. Different surgical modalities can be effective and lead to significant improvement; however, achieving complete resolution of peri-implantitis is challenging, not always predictable, and can depend on multiple baseline factors. Therefore, this review aims at summarising available evidence on the rationale for incorporating systemic, lifestyle-related, clinical, and radiographic prognostic factors into treatment planning of patients diagnosed with periodontal and peri-implant diseases.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"95 1","pages":"102-128"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133413","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 promise and challenges of genomics-informed periodontal disease diagnoses.","authors":"Luigi Nibali, Kimon Divaris, Emily Ming-Chieh Lu","doi":"10.1111/prd.12587","DOIUrl":"10.1111/prd.12587","url":null,"abstract":"<p><p>Recent advances in human genomics and the advent of molecular medicine have catapulted our ability to characterize human and health and disease. Scientists and healthcare practitioners can now leverage information on genetic variation and gene expression at the tissue or even individual cell level, and an enormous potential exists to refine diagnostic categories, assess risk in unaffected individuals, and optimize disease management among those affected. This review investigates the progress made in the domains of molecular medicine and genomics as they relate to periodontology. The review summarizes the current evidence of association between genomics and periodontal diseases, including the current state of knowledge that approximately a third of the population variance of periodontitis may be attributable to genetic variation and the management of several monogenic forms of the disease can be augmented by knowledge of the underlying genetic cause. Finally, the paper discusses the potential utility of polygenic risk scores and genetic testing for periodontitis diagnosis now and in the future, in light of applications that currently exist in other areas of medicine and healthcare.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"194-202"},"PeriodicalIF":17.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788807","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}