Periodontology 2000最新文献

{"title":"Improving periodontal regeneration outcomes with hyaluronic acid: A systematic review and meta-analysis.","authors":"Abdusalam E Alrmali,Qasim Omer Butt,Rami Kassar,Parham Hazrati,Yousef Amrou,Anton Sculean,Hom-Lay Wang","doi":"10.1111/prd.70063","DOIUrl":"https://doi.org/10.1111/prd.70063","url":null,"abstract":"OBJECTIVESTo evaluate the clinical and radiographic efficacy of the adjunctive use of hyaluronic acid (HA) in regenerative periodontal surgery for the treatment of intrabony defects.MATERIALS AND METHODSA systematic search identified randomized controlled trials (RCTs) involving adult patients with intrabony defects who underwent regenerative periodontal surgery with adjunctive HA. The primary outcome was probing pocket depth (PPD) reduction; secondary outcomes included clinical attachment level (CAL) gain, gingival recession (REC), and radiographic defect depth (RDD) reduction. Meta-analysis according to the regenerative protocol was performed using random-effects models, with subgroup analyses.RESULTSFourteen RCTs met the inclusion criteria. Compared to controls, adjunctive HA resulted in an additional PPD reduction of approximately 0.7-1.2 mm and CAL gain of 0.7-1.1 mm, with more consistent effects at 12 months. Subgroup analyses indicated significant benefits when HA was applied alone or with membranes, whereas no added benefit was observed with bone substitute materials. Radiographic outcomes showed a favorable trend for HA, with an additional RDD reduction of about 0.7-1.0 mm, though heterogeneity was noted. Comparisons between HA and enamel matrix derivative (EMD) revealed comparable or slightly superior results for EMD.CONCLUSIONAdjunctive HA may enhance clinical and radiographic outcomes in intrabony defects when used in regenerative periodontal surgery, although heterogeneity and study quality warrant cautious interpretation of the findings.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"34 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148298907","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":"Does adherence to supportive periodontal care lower the risk of caries and related tooth loss? A systematic review and meta-analysis.","authors":"David Donnermeyer,Hendrik Meyer-Lückel,Alexandra Stähli,Raluca Cosgarea,Richard Johannes Wierichs","doi":"10.1111/prd.70060","DOIUrl":"https://doi.org/10.1111/prd.70060","url":null,"abstract":"OBJECTIVESThe present systematic review critically summarizes the results of clinical studies investigating the risk of crown or root caries and tooth loss in adult patients suffering from periodontitis in relation to their adherence to supportive periodontal care (SPC).MATERIALS AND METHODSFive electronic databases were searched for studies from 1947 to 2025. Odds ratios (or) were calculated for continuous outcome data (e.g., the number of new caries lesions or lost teeth) in a fixed or random-effects model.RESULTSThirty-nine articles, reporting 34 studies with 9685 patients at baseline with at least 157 779 teeth, were included. One study investigated the development of root caries at tooth level, 25 examined tooth loss at patient level, and 13 tooth loss at tooth level. A meta-analysis was not feasible for the outcome root caries. At patient level, significantly more less-adherent patients experienced tooth loss compared with adherent patients (OR = 1.50, 95% CI: 1.11-2.01). At tooth level, adherent patients showed significantly fewer lost teeth than less-adherent patients (OR = 1.64, 95% CI: 1.17-2.29).CONCLUSIONSAdhering to SPC reduces the risk of tooth loss in periodontitis patients. In contrast, evidence on root caries prevention is limited, with only one study addressing this outcome.CLINICAL RELEVANCEPrevention of caries and subsequent tooth loss is highly relevant for patients undergoing SPC. However, it remains insufficiently addressed in the current literature, underscoring the need for further well-designed studies investigating caries progression in periodontally compromised patients.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"179 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term stability of periodontal plastic surgery featuring traditional autogenous graft and coronally advanced flap alone.","authors":"Giovanni Zucchelli, Ilham Mounssif, Claudio Mazzotti, Diego Bianchelli, Valentina Bentivogli, Matteo Marzadori, Matteo Sangiorgi, Alessandro Zucchelli, Monica Mele, Martina Stefanini","doi":"10.1111/prd.70059","DOIUrl":"https://doi.org/10.1111/prd.70059","url":null,"abstract":"<p><strong>Background: </strong>Coronally advanced flap (CAF), either alone or in combination with a connective tissue graft (CTG), represents one of the most extensively investigated surgical approaches for the treatment of gingival recessions, demonstrating high rates of mean root coverage (MRC) and complete root coverage (CRC). However, evidence regarding their long-term performance remains limited.</p><p><strong>Aim: </strong>This review critically analyzes the long-term clinical performance of CAF alone and in combination with CTG, examining root coverage outcomes, stability of the gingival margin, keratinized tissue (KT), and gingival thickness (GT) gain, and esthetic integration over extended follow-up periods. The influence of baseline phenotype, surgical modifications, and specific clinical scenarios on long-term success is explored.</p><p><strong>Material and methods: </strong>A comprehensive narrative review of randomized clinical trials (RCTs), controlled studies, case series, and retrospective cohorts with a minimum follow-up of 5 years was conducted. Outcomes were stratified by surgical technique (CAF vs. CAF + CTG), defect complexity, and follow-up duration (5 to >20 years).</p><p><strong>Results: </strong>CAF alone demonstrates satisfactory short-term coverage but exhibits gradual apical relapse over time, particularly in inadequate phenotype. Long-term studies indicate progressive reduction of CRC, with stability strongly linked to early gingival margin position and phenotype maturity. In contrast, CTG adjunctive therapy consistently enhances long-term stability by increasing KT and GT, improving resistance to mechanical and biological relapse. According to the authors' experience, CTG is especially beneficial in anatomically or etiologically complex conditions. Extended follow-up (>20 years) confirms the enduring role of CTG-driven phenotype modification in preventing marginal relapse.</p><p><strong>Conclusions: </strong>Long-term success in root coverage procedures is predominantly phenotype-dependent. While CAF alone may be appropriate in selected sites with favorable anatomical and phenotypic features, CAF + CTG remains the gold standard for securing stable outcomes over time, particularly in challenging clinical scenarios. The drawbacks of applying CTG must be considered alongside the treatment benefits.</p><p><strong>Clinical relevance: </strong>Future therapeutic algorithms should incorporate a phenotype- and defect-driven approach to optimize the lifetime stability of periodontal plastic surgery outcomes.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259109","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-Is it mainly a clinician-initiated complication of implant therapy?","authors":"Stephen T Chen, Alberto Monje, Franz J Strauss, Frank Schwarz, Andrea Roccuzzo, Irena Sailer, Dennis Tarnow, France Lambert, Sascha Jovanovic, Daniel Buser","doi":"10.1111/prd.70051","DOIUrl":"https://doi.org/10.1111/prd.70051","url":null,"abstract":"<p><strong>Aim: </strong>The high prevalence of peri-implantitis is concerning, with a growing consensus that the majority of cases are complications initiated by clinician-related errors rather than classic pathology. A primary predisposing factor for peri-implantitis is exposure of the micro-rough implant surfaces to the peri-implant sulcus after treatment.</p><p><strong>Objectives: </strong>To identify surgical/prosthetic factors causing micro-rough surface exposure and advocate for prevention and evidence-based protocols.</p><p><strong>Materials and methods: </strong>This paper reviews evidence linking surgical and prosthetic errors to micro-rough surface exposure to the sulcus and subsequent peri-implantitis development.</p><p><strong>Results: </strong>Surgical factors for surface exposure include malposition, avascular necrosis, and incomplete bone regeneration of peri-implant defects. Prosthetic factors include cement remnants and wide prosthetic emergence angles. Clinician-influenceable co-factors-including patient compliance, history of periodontitis, uncontrolled systemic factors/habits, lack of keratinized mucosa, prosthetic misfit, overcontoured/uncleansable prostheses, failure to detect early bone loss or mucosal changes, and inadequate maintenance-contribute to the initiation and progression of peri-implantitis once micro-rough surfaces are exposed.</p><p><strong>Conclusions: </strong>Most peri-implantitis cases are preventable complications. Professional education and research must prioritize identifying clinician-related errors and adherence to foundational treatment principles. This requires a paradigm shift toward a complication-based model of peri-implantitis.</p><p><strong>Clinical relevance: </strong>To reduce the risk of peri-implantitis, clinicians should avoid clinical errors that lead to exposure of the micro-rough implant surface. Hybrid surface designs and subcrestal micro-rough surface placement should be considered as safety buffers. Success depends on meticulous diagnostics and planning, proper surgical/prosthetic execution, cleansable prosthesis design, and proactive maintenance to detect early bone loss and soft tissue changes.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199701","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 regenerative dentistry.","authors":"Paras Ahmad, Anton Sculean, Richard J Miron","doi":"10.1111/prd.70054","DOIUrl":"https://doi.org/10.1111/prd.70054","url":null,"abstract":"<p><strong>Background: </strong>Regenerative dentistry is shifting from cell-based strategies to cell-free biologics capable of orchestrating intricate tissue repair. Exosomes, nanosized extracellular vesicles carrying bioactive molecular payloads, have emerged as central modulators of intercellular communication. This review aimed to offer a comprehensive synthesis of exosome-based regenerative processes across oral and craniomaxillofacial (CMF) tissues.</p><p><strong>Methods: </strong>A structured literature review was performed utilizing PubMed, Scopus, and Web of Science databases without time restriction. Eligible studies included in vitro, in vivo, and clinical investigations assessing exosome-based mechanisms, molecular signaling pathways, and bioengineering approaches in regenerative dentistry.</p><p><strong>Results: </strong>Exosomes derived from stem cells, immune cells, and dental tissues showed multifaceted regenerative impacts across periodontal, endodontic, orthodontic, and CMF applications. Mechanistically, exosomes mediated osteogenesis, angiogenesis, immune regulation, oxidative stress, and stem cell recruitment through central pathways, such as the PI3K/AKT, MAPK/ERK, Wnt/β-catenin, TGF-β/BMP, and NF-κB. They enhanced macrophage polarization toward anti-inflammatory phenotypes, restored osteoclast-osteoblast homeostasis, enhanced angiogenesis, and preserved mitochondrial homeostasis. In regenerative endodontics, exosomes enhanced cell viability, decreased apoptosis, and improved odontogenic differentiation and neurovascular coupling. In orthodontic and CMF regeneration, they coordinated mechanotransduction, osteogenesis, and angiogenesis. Bioengineering approaches, such as scaffold-mediated platforms, preconditioning, and genetic modification, further improved exosome stability, targeting, and treatment efficacy.</p><p><strong>Conclusion: </strong>Exosomes represent a versatile and robust cell-free treatment approach capable of orchestrating intricate oral tissue regeneration. Despite promising preclinical evidence, challenges associated with standardization, scalability, and clinical validation must be addressed to allow translation in routine dental practice.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138657","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":"Regenerative periodontal surgery and orthodontic therapy in the treatment of patients with stage IV periodontitis and pathologic tooth migration.","authors":"Karin Jepsen, Christina Tietmann, Peter Proff, Søren Jepsen","doi":"10.1111/prd.70046","DOIUrl":"https://doi.org/10.1111/prd.70046","url":null,"abstract":"<p><strong>Background: </strong>Patients suffering from stage IV periodontitis are often characterized by pathologic tooth migration, drifting, flaring, posterior bite collapse, and secondary occlusal trauma (case type 2). Many times, these patients seek treatment because of functional and esthetic demands. The majority of these patients could benefit from an integrated, interdisciplinary approach combining periodontal therapy and orthodontics.</p><p><strong>Materials and methods: </strong>This narrative review aimed to update the scientific evidence on current treatment approaches for patients with stage IV case type 2, presenting with intrabony defects and pathological tooth migration. The strategic sequencing and timing of periodontal-regenerative surgery and orthodontic tooth movement are emphasized.</p><p><strong>Results: </strong>Managing these patients is complex and requires careful coordination between periodontal and orthodontic specialists. Until recently, the timing of periodontal regeneration and orthodontic tooth movement has been unclear. However, new treatment guidelines and results from ongoing clinical research have provided new information. Based on the currently available evidence, it can be recommended that following a successful completion of steps 1 and 2 of periodontal therapy and regenerative periodontal surgery of intrabony defects using biomaterials according to current guideline recommendations at the migrated teeth, orthodontic tooth movement can be initiated as early as 4 weeks postoperatively. Provided patients maintain excellent oral hygiene and strictly adhere to an individualized supportive care program, favorable periodontal outcomes with significant improvements of their periodontal status can be expected with long-term stability up to 10 years. Moreover, this approach also leads to favorable orthodontic outcomes and does not increase the risk of external root resorption. These results were consistent regardless of the type of movement (translation, intrusion/extrusion, or buccal/lingual) or the type of biomaterial used.</p><p><strong>Conclusions and clinical relevance: </strong>Patients suffering from stage IV periodontitis with pathologic tooth migration requiring periodontal-regenerative therapy and orthodontic treatment can be successfully managed in the long term. The synergistic effects of a combined periodontal-regenerative and early orthodontic therapy have been demonstrated to result in a significantly improved oral health-related quality of life for patients, with restoration of function and esthetics.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016681","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 diabetic wound healing.","authors":"Paras Ahmad, Yulan Wang, Yufeng Zhang, Anton Sculean, Richard J Miron","doi":"10.1111/prd.70055","DOIUrl":"https://doi.org/10.1111/prd.70055","url":null,"abstract":"<p><strong>Background: </strong>Diabetic wounds signify a major complication of diabetes mellitus, characterized by chronic inflammation, compromised angiogenesis, and high risk of infection, amputation, and mortality. Contemporary therapies remain limited in efficacy and durability. This review aimed to comprehensively assess exosome-mediated interventions as a cell-free regenerative approach for diabetic wound healing.</p><p><strong>Methods: </strong>This narrative-scoping review was conducted using PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases, identifying 176 preclinical and clinical studies. Included studies evaluated exosome origins, mechanisms of action, delivery platforms, and treatment outcomes in diabetic wound healing.</p><p><strong>Results: </strong>Exosomes derived from mesenchymal stem cells, progenitor cells, blood products, immune cells, and natural sources consistently improved wound healing by enhancing angiogenesis, re-epithelialization, fibroblast proliferation, and extracellular matrix remodeling, while decreasing oxidative stress and chronic inflammation. Mechanistically, these effects were regulated via the stimulation of the PI3K/AKT, ERK/MAPK, STAT3, HIF-1α/VEGF, and Nrf2 signaling, together with the suppression of the AGE/RAGE-regulated ferroptosis and apoptosis. Biomaterial-based delivery systems, including scaffolds, microneedle patches, and hydrogels, significantly enhanced exosome retention, stability, and treatment efficacy. Across studies, exosome treatments showed expedited wound closure, enhanced collagen deposition, and improved vascularization in diabetic models.</p><p><strong>Conclusion: </strong>Exosome-mediated therapies represent a promising and multifaceted regenerative strategy for diabetic wound healing, addressing pivotal pathophysiological deficits. Nevertheless, challenges associated with standardization, scalability, and clinical validation must be resolved before widespread clinical application.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016700","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":"Implant therapy in older patients: Prosthetic considerations and biomechanical implications for frailty/aging.","authors":"Yu-Ting Yeh, Lan-Lin Chiou, Debora Yoon, Kayla Lieuw, Bryan Yang, Sabrina Maniewicz, Alkisti Zekeridou, Donald A Curtis, Frauke Müller, Yvonne L Hernandez-Kapila, Guo-Hao Lin","doi":"10.1111/prd.70058","DOIUrl":"https://doi.org/10.1111/prd.70058","url":null,"abstract":"<p><strong>Background: </strong>Population aging is reshaping prosthodontic care for both partially and completely edentulous individuals. In older adults, conditions such as frailty, comorbidities, polypharmacy, and cognitive decline can have a direct impact on the biological and biomechanical demands of implant therapy, thereby influencing the success of implant treatment.</p><p><strong>Materials and methods: </strong>This narrative review synthesizes evidence on implant therapy in older patients, integrating prosthetic and biomechanical considerations with patient-related factors. The literature search addressed implant survival, complications, prosthetic and material design, peri-implant soft tissue considerations, and treatment options such as shortened dental arch approaches, implant-assisted removable partial dentures (IARPDs), implant overdentures, and complete dentures, as well as maintenance strategies with patient and caregiver education.</p><p><strong>Results: </strong>Implant survival in older patients remains high, and age alone should not be considered as a limiting factor for implant treatment. Hygiene-oriented prosthetic designs, including non-mucosa-contact intaglio surfaces and emergence angles less than 30°, were associated with reduced plaque accumulation and peri-implant bone loss in older adults. While limited keratinized mucosa correlated with greater plaque and recession, phenotype modification should be evaluated on a case-by-case basis, carefully weighing the benefits against the surgical burden for the older patient. Ceramic materials accumulate less plaque as compared with processed acrylic resin, and veneered zirconia remained more prone to chipping than monolithic zirconia. Alternative treatment options-such as overdentures to enhance bite force, a shortened dental arch when posterior implants are contraindicated, or IARPDs to improve stability-may be especially appropriate for older patients with functional limitations. Caregiver participation and structured maintenance significantly reduce peri-implantitis risk.</p><p><strong>Conclusion: </strong>Implant therapy in older patients, including individuals aged 75 years and above, is highly feasible when age-related risks are addressed, prostheses are designed for cleansability and retrievability, and maintenance includes structured follow-up and caregiver support.</p><p><strong>Clinical relevance: </strong>Clinicians should emphasize functional goals, hygiene-accessible designs, pragmatic treatment alternatives, selective peri-implant soft tissue management when indicated, and personalized maintenance supported by patient and caregiver education.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006218","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 facial esthetics and skin aging.","authors":"Richard J Miron, Catherine Davies, Anton Sculean, Paras Ahmad","doi":"10.1111/prd.70053","DOIUrl":"https://doi.org/10.1111/prd.70053","url":null,"abstract":"<p><strong>Background: </strong>Skin aging is a multifactorial process mediated by intrinsic (genetic and metabolic) and extrinsic (environmental) factors leading to functional and structural deterioration, including wrinkles, loss of collagen and elastin, as well as various pigmentation disorders. Exosomes, the smallest subset of extracellular vesicles, have emerged as potent cell-free regulators of intercellular communication with significant regenerative potential. This scoping review synthesized available in vitro, in vivo, and clinical evidence investigating the role of exosomes in facial esthetics and skin rejuvenation.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted up to January 2nd, 2026, using PubMed, Scopus, Web of Science, and Google Scholar. Search terms included ((extracellular vesicle) OR (exosome)) AND ((esthetic) OR (aesthetic) OR (rejuvenation)). All in vitro, in vivo, and human clinical studies were included without restriction.</p><p><strong>Results: </strong>A total of 54 studies (from 472 records) were included: 27 in vitro, 16 in vivo, and 29 clinical studies (several overlap). In vitro outcomes demonstrated that exosomes improved cell viability, proliferation, and migration, while enhancing extracellular matrix formation (collagen, elastin, fibronectin) and upregulating antiaging-associated gene expression. These impacts were accompanied by alleviated inflammation, oxidative stress, and regulation of senescence and autophagic signaling. Animal research supported these outcomes, showing enhanced fat graft retention, improved angiogenesis, facilitated dermal remodeling, and epidermal thickening, together with expedited wound repair and reduced expression of matrix metalloproteinases and inflammatory regulators. Clinical studies consistently report decreases in wrinkles, pore size, erythema, scarring, and hyperpigmentation, along with improved skin elasticity, texture, hydration, and thickness. Both patient-reported and clinician-assessed outcomes, including the Global Aesthetic Improvement Scale, demonstrate positive outcomes. Additional advantages included decreased acne severity, shorter recovery times, and fewer adverse effects.</p><p><strong>Conclusions: </strong>Exosomes showed substantial regenerative potential in facial esthetics and skin antiaging. Nevertheless, heterogeneity in study methodologies and the limited number of high-quality RCTs require further well-designed studies to establish optimized protocols and ensure long-term efficacy and safety.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932453","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":"From senescence and inflammaging to systemic comorbidities: Drivers of aging-associated periodontitis.","authors":"James Cheng, Chew Tin Zar Aung, Samuel F Suslavich, Sinem Esra Sahingur, Yvonne L Hernandez-Kapila","doi":"10.1111/prd.70049","DOIUrl":"https://doi.org/10.1111/prd.70049","url":null,"abstract":"<p><strong>Background: </strong>Aging is accompanied by a chronic low-grade inflammatory process, known as inflammaging, as well as immunosenescence, an age-related decline and dysregulation of immune function, and cellular senescence, a process in which cells enter a state of irreversible growth arrest while actively releasing pro-inflammatory factors. These processes alter the host immune regulation and tissue homeostasis. Aging-associated mechanisms are being explored for their role in periodontal and peri-implant diseases because of their promotion of dysregulated inflammation, impaired healing, and heightened susceptibility to tissue destruction. Rather than viewing periodontitis as a condition driven solely by microbial burden, it should be understood as a multifactorial disease shaped by complex host-microbe interactions, in which host-driven processes, particularly senescence and inflammaging, play a central role in amplifying bidirectional oral-systemic interactions.</p><p><strong>Aim: </strong>This scoping review aims to (i) highlight the current understanding of the role of aging and its alterations in host inflammatory responses on immune function, tissue homeostasis, and cellular stress responses; (ii) explore the potential impact of \"inflammaging\" on the periodontium and interactions with systemic health; and (iii) explore possible therapeutic targets for senotherapy.</p><p><strong>Materials and methods: </strong>A literature search of the PubMed database was conducted using Boolean search strategies to identify publications related to the potential connections between aging and inflammation in the context of the oral cavity.</p><p><strong>Results: </strong>Of the total 283 articles that were screened, 87 met the eligibility criteria and were included in this scoping review. An additional 51 articles were obtained via manual search. The evidence demonstrates a link between inflammaging, age-related cellular senescence, and periodontal vulnerability to periodontal pathogens and periodontal destruction. Both experimental and clinical studies have shown increased senescence markers, dysregulated immune responses, and enhanced osteoclastic activity that lead to greater tissue destruction and alveolar bone loss. Systemic conditions such as Alzheimer's disease, diabetes, and cardiovascular disease can also amplify the inflammatory burden through shared pathways. Overall, our findings support the idea that older adults undergo immune dysregulation when challenged with microbes that ultimately cause a chronic periodontal inflammatory state.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}