Periodontology 2000最新文献

{"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}

{"title":"Understanding extracellular vesicle biology, isolation, and characterization: The theory of EV ‐erything","authors":"Paras Ahmad, Nima Farshidfar, Nathan E. Estrin, Yulan Wang, Yufeng Zhang, Anton Sculean, Richard J. Miron","doi":"10.1111/prd.70068","DOIUrl":"https://doi.org/10.1111/prd.70068","url":null,"abstract":"Background Extracellular vesicles (EVs), especially exosomes, are nanoparticles increasingly recognized as key regulators of intercellular communication in both physiological and pathological aspects. Despite rapid progress, inconsistencies in nomenclature, isolation, and characterization continue to restrict translational advancement. This review aims to offer a comprehensive synthesis of EV biology, with a focus on biogenesis, molecular composition, heterogeneity, and methodological considerations for isolation and characterization. Methods A narrative review of the literature was performed, assessing historical progress, molecular mechanisms regulating EV biogenesis and payload selection, and existing experimental methods for EV isolation and analysis. Moreover, a comparative analysis of classical and emerging isolation approaches was conducted. Results EVs are shown to carry diverse bioactive cargo, such as proteins, lipids, and nucleic acids, allowing modulation of cascades implicated in immunity, tissue regeneration, and disease progression. Considerable variability exists across EV subpopulations, complicating categorization and functional attribution. Isolation techniques demonstrate unique trade‐offs between scalability, yield, purity, and functional integrity, with no universally optimal strategy. Crucially, methodological selection is highly based on downstream applications, with therapeutic and diagnostic uses necessitating fundamentally varying performance criteria. Conclusion EVs serve as dynamic signaling systems with significant therapeutic and diagnostic potential. Advancing the discipline needs standardized techniques, enhanced classification platforms, and context‐specific optimization of isolation approaches. A deeper comprehension of EV biology and methodological rigor will be necessary to unravel their full application in precision medicine.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"48 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596204","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":"Understanding Exosomes in Hair Regeneration","authors":"Paras Ahmad, Catherine Davies, Anton Sculean, Richard J. Miron","doi":"10.1111/prd.70057","DOIUrl":"https://doi.org/10.1111/prd.70057","url":null,"abstract":"Background Alopecia is a prevalent condition correlated with significant psychosocial challenges, while contemporary treatments exhibit variable efficacy, require extended use, and may cause adverse effects. This review aimed to comprehensively assess exosome‐mediated interventions as a novel cell‐free regenerative approach for hair regeneration across multiple alopecia subtypes. Methods A narrative‐scoping review was performed utilizing PubMed, Scopus, and Web of Science databases, identifying 80 preclinical and clinical studies. Eligible studies evaluated exosome‐based mechanisms, delivery systems, and treatment outcomes in hair regeneration without restriction on publication year. Results Exosomes derived from diverse origins (mesenchymal stem cells, hair follicle cells, blood, and plant‐mediated platforms) consistently enhanced hair regeneration via stimulating the Wnt/β‐catenin pathway, promoting VEGF‐regulated angiogenesis, and suppressing TGF‐β/SMAD‐mediated fibrosis and immune‐regulated follicular injury. Preclinical studies showed expedited telogen‐to‐anagen shift, increased follicular proliferation, and enhanced hair shaft properties. Clinical evidence from 11 studies (&gt;330 patients) showed significant increases in hair density (25–35 hairs/cm <jats:sup>2</jats:sup> ), shaft thickness, and patient satisfaction, with impacts sustained up to 1 year. Novel delivery approaches, including microneedles and hydrogels, further improved treatment efficacy. Reported side effects were transient and mild. Conclusion Exosome‐mediated interventions represent a promising, biologically targeted strategy for alopecia treatment, providing immunoregulatory and regenerative advantages superior to traditional approaches. Nonetheless, standardization of manufacturing, regulatory approval, and large‐scale randomized controlled trials are needed before routine clinical application.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"353 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596212","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 immunological imprint of recurrent periodontitis: From local tissue memory to central trained immunity","authors":"Qin Zhao, Shuyuan Qu, Qiangyuan Zhu, Kun Tan, Yiyi Zhou, Keer Yu, Richard J. Miron, Anton Sculean, Yufeng Zhang","doi":"10.1111/prd.70069","DOIUrl":"https://doi.org/10.1111/prd.70069","url":null,"abstract":"Background Despite successful reduction of bacterial load and clinical inflammation following periodontal therapy, high recurrence rates indicate that prior infections induce lasting host alterations, maintaining latent disease susceptibility Aim This review elucidates the biological basis of periodontal recalcitrance through innate immune memory (trained immunity), examining durable functional reprogramming at both local and systemic levels. Materials and Methods We comprehensively searched PubMed/MEDLINE and Scopus databases for peer‐reviewed literature published primarily within the last decade (up to 2026). The search strategy utilized combinations of terms including “periodontitis”, “trained immunity”, “epigenetic reprogramming”, “bone marrow axis”, and “clonal hematopoiesis”. Mechanistic, multi‐omics, and clinical data were evaluated and synthesized, focusing on local resident cell reprogramming, ectopic lymphoid organogenesis, the periodontium‐bone marrow axis, and clonal hematopoiesis. Results Current evidence supports the existence of a multi‐level immunological imprint. Locally, gingival fibroblasts and resident immune cells acquire stable epigenetic modifications and undergo glycolytic shifts. These changes lower their activation thresholds, generating a hyper‐responsive microenvironment sustained by Tertiary Lymphoid Structures. Systemically, periodontal inflammation transmits endocrine signals (IL‐1β, type I interferons) to hematopoietic stem and progenitor cells. This central adaptation biases myeloid differentiation and establishes heritable epigenetic priming, accelerating the output of hyper‐reactive neutrophils. Additionally, age‐related Clonal Hematopoiesis of Indeterminate Potential (CHIP) amplifies this inflammatory dysregulation. Conclusions Periodontitis recurrence is fundamentally driven by maladaptive immunological memory. This persistent state is encoded via epigenetic and metabolic reprogramming within local tissues and central hematopoietic niches, exacerbating destruction upon microbial restimulation. Clinical Relevance Achieving true biological resolution in periodontitis requires a paradigm shift from solely controlling the biofilm to incorporating targeted host‐modulatory therapies that resolve these maladaptive epigenetic and metabolic adaptations","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"43 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596211","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":"Shared molecular framework and bidirectional effects of osteoporosis on periodontal disease and dental implant therapy in the elderly","authors":"Samin Sirous, Jaclyn C. Chalmers, Pin‐Ying Li, Yumna Subhani, Yvonne L. Hernandez‐Kapila","doi":"10.1111/prd.70062","DOIUrl":"https://doi.org/10.1111/prd.70062","url":null,"abstract":"Objectives This review synthesizes evidence regarding the prevalence, epidemiological associations, and mechanistic pathways between osteoporosis, periodontal disease, and dental implant therapy. Materials and Methods A literature review was conducted to identify studies focused on: osteoporosis, periodontal disease, and dental implants. Studies were categorized into: epidemiological, clinical, in vivo, and in vitro studies. Results Osteoporosis and periodontal disease are inflammation‐associated conditions prevalent in the elderly that share common risk factors, molecular framework, and effects on periodontal breakdown and implant outcomes. Low bone mineral density is linked to increased periodontal destruction, notably in postmenopausal women. Osteoporotic individuals exhibit 1.13 to 2.63 increased odds of having periodontitis. Clinical studies show implant survival remains high in osteoporotic patients, though it is modestly reduced to 94%. Anti‐resorptive therapies protect against bone loss but are associated with the risk of osteonecrosis. In vivo models reveal worsened periodontitis progression under osteoporotic conditions. Biologic agents, such as sclerostin‐neutralizing antibodies, are beneficial for disease management and bone regeneration in osteoporotic models. In vitro research examining mechanisms of altered bone metabolism has identified potential therapeutic targets for bone diseases, such as human periodontal ligament–derived mesenchymal stem cells and microbe‐associated molecular patterns. Conclusions Osteoporosis may increase susceptibility for periodontitis and peri‐implant bone loss, though implant therapy and periodontal regeneration may still be possible through proper and interdisciplinary treatment planning. Clinical Relevance Studies on the relationship between osteoporosis, periodontitis, and dental implant therapy emphasize the importance of integrative care. Risk factor identification and careful treatment planning are imperative to optimize clinical outcomes.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"35 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596275","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":"Impact of systemic diseases on periodontal remodeling: Mechanisms, mediators, and clinical relevance","authors":"Michael Wolf, Ulrike Schulze‐Späte, Thomas Van Dyke, Stefan Wolfart, Thomas Dietrich, Alberto Ortiz, Zhuojun Wu, Joachim Jankowski","doi":"10.1111/prd.70048","DOIUrl":"https://doi.org/10.1111/prd.70048","url":null,"abstract":"Background Periodontal remodeling is a continuous, adaptive process essential for maintaining the structural and functional integrity of periodontal tissues. While external factors such as bacterial biofilm, excessive forces, and poor oral hygiene are recognized triggers of periodontal pathologies, they do not fully explain their persistent prevalence. Objective This opinion paper emphasizes the impact of systemic diseases on periodontal homeostasis and considers periodontal disease as a manifestation of systemic dysfunction rather than solely a bacterial local disease. Methods This paper is conceptually designed as a narrative review and synthesizes the molecular and cellular mechanisms through which systemic diseases converge to disrupt periodontal remodeling. Results Emerging evidence underscores the critical role of systemic diseases, including chronic kidney disease, cardiovascular disease, liver dysfunction, and hematologic malignancies, in addition to studied uncontrolled diabetes mellitus, in destabilizing periodontal homeostasis. These systemic conditions are all associated with excess systemic inflammation that impairs regenerative capacity, mineralization, vascularity, and immune responses, fostering a subclinical environment prone to periodontal tissue pathologies with clinical impact. This opinion paper is conceptually designed as a narrative review and synthesizes the molecular and cellular mechanisms through which systemic diseases converge to disrupt periodontal remodeling, including periodontal pathologies as a consequence of systemic dysfunction rather than a purely bacterially induced local disease. Conclusion Clinically, this understanding demands intensified dental surveillance to uncover modifiers of susceptibility and interdisciplinary care for systemically compromised patients. Future research should identify early biomarkers of systemic impact and inform strategies that integrate oral and systemic health to reduce the periodontal disease burden.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"5 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148596193","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":"Surgical considerations based on oral and periodontal vascularization.","authors":"Arvin Shahbazi,Edward P Allen,Sebastian Gschwindt,Kevin G Murphy,Gábor Baksa,Anton Sculean","doi":"10.1111/prd.70065","DOIUrl":"https://doi.org/10.1111/prd.70065","url":null,"abstract":"OBJECTIVESTo synthesize current evidence on vascular and anastomotic patterns, emphasizing their operative implications for optimizing flap perfusion, neovascularization, and wound healing in periodontal and implant surgery, while accounting for anatomical variability and collateral circulation.MATERIALS AND METHODSA comprehensive review of microvascular, macrovascular, and experimental studies was conducted, complemented by observations from 14 corrosion-cast human specimens, to evaluate vascular distribution, regional blood supply, and surgical implications related to incision and flap design.RESULTSThe mucosa and periodontium are supplied by multilayered vertical vascular networks composed of submucosal, supraperiosteal, alveolar, and periodontal ligament vessels, which are interconnected through diverse anastomoses, forming a functional horizontal circulation. The oral mucoperiosteum demonstrates region-specific vascularization: in the maxilla, hard palate, and maxillary tuberosity, interconnected extra- and intraosseous, zone-specific anastomotic networks predominate, and the mandibular mucoperiosteum exhibits a stratified extraosseous multivascular organization supported by collateral intraosseous connections via the retromolar and lingual foramina. Beyond inherent morphological variations, prolonged edentulism and inflammatory conditions, particularly in thin phenotypes, can alter vascular dimension and orientation through changes in physiological loading and connective tissue resorption, thereby disrupting anastomotic integrity and increasing flap susceptibility.CONCLUSIONSOptimal surgical outcomes are dependent upon a thorough understanding of the vascular architecture of the periodontium, mucoperiosteum, and anastomotic patterns with respect to morphology to preserve microcirculation.CLINICAL RELEVANCEFlap perfusion is critically dependent upon flap geometry and thickness, with tension-free designs necessary for preserving vascular supply. Narrow and overly thinned flaps predispose to hypoperfusion, hypoxia, and wound dehiscence. Surgical success relies upon meticulous consideration of region-specific anatomical heterogeneity and maintenance of blood flow.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"8 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148408370","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":"Of mice and men—The emerging oral–gut–brain axis of health and disease","authors":"Yvonne L. Hernandez‐Kapila, Daniel J. Weisenberger","doi":"10.1111/prd.70064","DOIUrl":"https://doi.org/10.1111/prd.70064","url":null,"abstract":"Objectives Oral health's inextricable links to systemic health are highlighted by the emerging oral–gut–brain axis and other well‐known axes. There is growing evidence of a complex oral–gut–brain axis linking mouth and gut microbiomes with the central nervous system. Axis disruptions, characterized as oral and gut dysbiosis or microbial imbalances, can trigger oral and systemic inflammation and neuroinflammation, contributing to diseases such as Alzheimer's disease and Parkinson's disease. Materials and Methods We summarize the oral–gut–brain axis mechanistic pathways, key evidence from human clinical and animal studies, and how the oral microbiome modulates human health and disease. Results Periodontal disease (PD) is associated with increased oral pathogen presence in diseased tissues throughout the human body. Preclinical models recapitulate these findings. Experimental periodontal infection induces dysbiosis that is linked to activation of inflammatory pathways that promote diseased phenotypes. Novel therapeutic approaches, including the probiotic fbacteriocin nisin, are increasingly recognized for targeted microbiome therapy at multiple inflection points across the axis. Nisin restores microbial balance, reduces inflammation, inhibits end‐organ pathology, prevents periodontal bone loss, and reduces brain amyloid/tau accumulation and cytokine expression. Conclusions These findings highlight the complexity of the oral–gut–brain axis and the ability to modulate the axis using bacteriocin‐based approaches. Clinical Relevance Future probiotic or antimicrobial strategies aimed at ameliorating neuroinflammatory and metabolic diseases via microbiome‐targeted therapy hold clinical promise.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"23 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371984","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":"Patient‐centered perspectives and feelings on peri‐implantitis and its therapy","authors":"Jungwon Lee, Young‐Chang Ko, Seung‐Ju Lee, Frank Schwarz, Ki‐Tae Koo","doi":"10.1111/prd.70067","DOIUrl":"https://doi.org/10.1111/prd.70067","url":null,"abstract":"Objectives Peri‐implantitis is a common biological complication of dental implant therapy that affects peri‐implant tissues as well as patients' psychological well‐being and oral health‐related quality of life. This review summarizes patient‐centered perspectives on peri‐implantitis, focusing on patient perception at diagnosis, treatment experiences, and treatment‐related discomfort. Materials and Methods A narrative review of the literature was conducted to identify studies addressing patient perceptions, emotional responses, and patient‐reported outcomes related to peri‐implantitis management. Evidence from qualitative studies, cross‐sectional investigations, and clinical trials reporting patient‐centered outcomes was evaluated. Results The literature shows that peri‐implantitis often progresses with minimal or no subjective symptoms, resulting in a discrepancy between clinical findings and patient awareness at diagnosis. Disclosure of the diagnosis is frequently associated with anxiety, stress, and concerns regarding implant prognosis and treatment burden. During treatment, patients commonly anticipate considerable pain and invasiveness; however, actual treatment‐related discomfort is generally mild to moderate and transient, with postoperative pain peaking early and resolving within a short period. Patient experiences are strongly influenced by the clarity of diagnostic explanations, expectation management, and the quality of clinician–patient communication. Conclusions Peri‐implantitis has a measurable psychosocial impact beyond clinical parameters. Patient perceptions at diagnosis and during treatment play a key role in treatment acceptance and adherence. Clinical Relevance Many patients are diagnosed with peri‐implantitis without prior awareness of the disease. Clear communication regarding diagnosis, expected treatment‐related discomfort, and prognosis may reduce anxiety, improve treatment acceptance, and support long‐term maintenance care.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"36 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148372002","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":"Effects of non‐surgical periodontal therapy on intrabony periodontal defects at different re‐evaluation time points: A systematic review of randomized controlled trials and clinical recommendations","authors":"Luca Ramaglia, Vincenzo Iorio‐Siciliano, Leopoldo Mauriello, Andrea Blasi, Anton Sculean","doi":"10.1111/prd.70061","DOIUrl":"https://doi.org/10.1111/prd.70061","url":null,"abstract":"Objective The aim of this systematic review and meta‐analysis was to evaluate the longitudinal temporal pattern of periodontal probing depth (PPD) reduction in intrabony periodontal defects following non‐surgical periodontal therapy (NSPT), both as a monotherapy and with adjunctive locally delivered pharmacological agents. Materials and Methods A comprehensive electronic search was performed in PubMed/MEDLINE and Embase databases to identify randomized controlled trials (RCTs). Eligible studies included adult patients with vertical defects treated with NSPT and reporting defect‐level PPD values at predefined follow‐up intervals (3, 6, 9, or 12 months). Pairwise temporal comparisons were conducted within treatment arms (6 vs. 3, 9 vs. 6, and 12 vs. 6 months) using standardized mean differences (SMD) in a random‐effects model. Risk of bias was assessed with the Cochrane RoB 2 tool and certainty of evidence with GRADE. Results Eight RCTs met the inclusion criteria. Significant PPD reduction occurred between 3 and 6 months (SMD = −1.07; 95% CI −1.70 to −0.45, <jats:italic>p</jats:italic> &lt; 0.001). Further significant improvements were detected between 6 and 9 months (SMD = −1.35; 95% CI −2.08 to −0.63) and sustained at 12 months compared to 6 months (SMD = −1.70; 95% CI −2.73 to −0.66). High heterogeneity was observed (I <jats:sup>2</jats:sup> = 83–89%). Temporal PPD reduction across consecutive follow‐up intervals was considered the primary outcome. Subgroup analyses suggested similar trends for both NSPT alone and adjunctive therapies. Conclusions Clinical healing of intrabony defects after NSPT is a dynamic process extending up to 12 months, far beyond the traditional 3‐months mark. Initial re‐evaluation at 3 months primarily assesses inflammation control, whereas a 6–12 months window more accurately reflects definitive outcomes. Clinical Relevance Clinicians should exercise caution when scheduling surgical intervention for vertical defects. Delaying definitive decisions beyond 3 months for sites showing progressive improvement may avoid unnecessary surgical procedures and promote patient‐centered outcomes through continued non‐surgical maturation.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"41 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148322701","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}