Periodontology 2000最新文献

{"title":"Emerging risk factors influencing the occurrence of peri‐implantitis","authors":"Alberto Monje, Ronald E. Jung, Cristina Valles, Nadja Naenni","doi":"10.1111/prd.70031","DOIUrl":"https://doi.org/10.1111/prd.70031","url":null,"abstract":"Background The objective of the present review is to explore the evidence and biological plausibility of factors that may expose dental implants to a greater likelihood of developing peri‐implantitis. Material and Methods An electronic screening on the PubMed library the was carried out to identify potential emerging factors that influence the onset/progression of peri‐implantitis. These factors were explored and are presented in a narrative review. Results Seven major emerging factors were pinpointed as emerging risk factors influencing the onset/progression of peri‐implantitis. Concerning (1) anatomy‐related risk factors, it seems that crestal soft tissue thickness and the dimension of the mucosal attachment are factors worth being assessed in order to understand the susceptibility of implants to peri‐implantitis. In turn, concerning (2) prosthesis‐related factors, certain implant‐abutment connections may be more prone to peri‐implantitis. Moreover, (3) surgery‐related factors, in particular as regards inadequate bucco‐lingual and mesio‐distal positioning, were seen to be contributors to peri‐implantitis, while apico‐coronal implant positioning might be dictated by the emergence profile and the crestal connective tissue height. Inconclusive findings were obtained concerning (4) the type and materials of implant‐supportive restorations. However, a lack of cleansability and the convexity of the emergence profile were suggested to be key elements in promoting inflammation. Implant‐supported fixed restorations, in contrast to implant‐retained overdentures, may increase the likelihood of developing peri‐implantitis in high‐risk individuals, since monitoring and plaque control are often jeopardized. Furthermore, (5) the regular intake of certain medication may increase the susceptibility to disease by interrupting regular homeostasis and tissue repair. In turn, (6) non‐controlled systemic disorders or a history of peri‐implantitis were seen to be strongly associated with peri‐implantitis. Lastly, (7) operator‐related factors, including the level of training in implant surgery and implant prosthodontics, were also regarded as risk factors for peri‐implantitis. Conclusions Emerging factors are yet to be validated by scientific data. However, aiming at preventing disease onset and progression, clinicians are encouraged to apply all measures known to affect hard and soft tissue breakdown and plaque accumulation in the pursuit of long‐term peri‐implant health. Moreover, patient‐related factors must be identified for proper patient selection in implant therapy. Education and training in implant surgery and implant prosthodontics are needed to prevent peri‐implantitis.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"23 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147507920","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 horizontal bone augmentation at implant sites.","authors":"Jia-Hui Fu, Hui Jia Sophia Choo, Ding-Sen Ong, Henry Kwek","doi":"10.1111/prd.70026","DOIUrl":"https://doi.org/10.1111/prd.70026","url":null,"abstract":"<p><p>Horizontal bone augmentation is a fundamental surgical procedure in regenerative implant dentistry. In recent decades, this procedure has evolved, enabling clinicians to achieve predictable and stable horizontal bone augmentation that supports dental implant restorations. This narrative review summarizes the current literature on the biological mechanisms underlying bone regeneration and the key concepts of horizontal bone augmentation using various surgical techniques. A search of the electronic databases PubMed and Medline was conducted to gather scientific evidence regarding the surgical principles, biomaterials, soft tissue considerations, different methods of horizontal bone augmentation, the stability of regenerated bone, and the associated survival rates of implant restorations. The findings indicated that horizontal bone augmentation techniques could reliably increase bone width (ranging from 3 to 5 mm), over follow-up periods of 10 years or more. The long-term stability of this regenerated bone can be predictably attained by considering these four key parameters: (1) Careful case selection: A contained alveolar ridge defect in a non-smoking patient with optimal glycemic control and good oral hygiene. (2) Adherence to biologically sound surgical principles: This includes ensuring primary wound closure, maintaining adequate blood supply, creating and preserving space for augmentation and achieving overall stability of the surgical site during the healing phase. (3) Selection of appropriate biomaterials to facilitate effective bone regeneration. (4) Management of soft tissue through surgical interventions to create a stable wound during bone augmentation, as well as to maintain peri-implant bone health. This review presents clinical cases with long-term follow-up to illustrate the importance of these various aspects of bone augmentation in ensuring predictable long-term stability of regenerated bone.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":15.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150115","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":"Zirconia, titanium, and polyetheretherketone implant abutments show equal long‐term clinical success—A systematic review and network meta‐analysis","authors":"Yasir Nabeel Al‐Mohammad, Caroline Kelly, Petrana Martinekova, Alexander Schulze Wenning, Szilvia Kiss‐Dala, Noémi Gede, Beáta Kerémi, Zsolt Németh, Péter Hermann, László Márk Czumbel, Krisztina Mikulás, Péter Hegyi, Anton Sculean, Gábor Varga","doi":"10.1111/prd.70018","DOIUrl":"https://doi.org/10.1111/prd.70018","url":null,"abstract":"Hundreds of millions of people have one or more missing teeth. Consequently, a substantial number of patients undergo implant therapy each year. However, technical complications and soft tissue inflammation associated with the implant abutment or the type of restoration can lead to bone loss and, ultimately, implant failure. Using the methodology of network meta‐analysis to rigorously compare and contrast the clinical performance of the three commonly used abutment materials: titanium (Ti), zirconium (Zr), and polyetheretherketone (PEEK) polymer. Until May 2025, a systematic search was performed in MEDLINE (PubMed), EMBASE, Scopus, and CENTRAL to find clinical studies comparing Ti, Zr, and PEEK implant abutments. Case reports, case series, in vitro, and in vivo studies were excluded. The Risk of Bias Tool 2, ROBINS‐I, and GRADE approaches were used for quality and certainty assessment. Thirty‐four articles (950 patients) were included, with various follow‐ups. All abutments had high survival rates and no significant differences in marginal bone loss (BL), probing depth (PD), bleeding on probing (BOP), and plaque index (PI). There was no significant difference between Zr and Ti for papillary index (PAP), with a general trend toward better results in Zr, which may be of clinical significance. There was a statistically significant difference in soft tissue discoloration (ΔE) values and technical complications of Zr versus Ti [MD: −2.03, CI: −3.89 to −0.18] and [OR: 0.26, CI: 0.09 to 0.72], respectively, indicating better esthetics and fewer technical complications in Zr. Both Ti and Zr are clinically successful and biologically acceptable. PEEK abutments demonstrated comparable characteristics with both Ti and Zr. However, more studies about PEEK and cost‐effectiveness analyses should also be performed to find the best options for clinical applications. PEEK can be a good alternative to Ti and Zr abutments for single‐tooth replacement in the anterior and premolar regions.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"25 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651141","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":"Alveolar bone regeneration after transplantation of immature teeth in orthodontic patients.","authors":"E Czochrowska,P Plakwicz","doi":"10.1111/prd.70023","DOIUrl":"https://doi.org/10.1111/prd.70023","url":null,"abstract":"The aim of the paper was to present the potential for alveolar bone regeneration following the autotransplantation of immature teeth, based on a literature review and case presentations. Surgical treatment planning for successful healing is discussed with regard to donor selection, the stage of root development, the morphology and position of the donor tooth and the size of the apical foramen. The follow-up observations include pulp healing, the regeneration of Herwig's epithelial root sheath and periodontal healing. Differences between unerupted and erupted teeth, as well as the role of a dental follicle during the surgical removal of the donor tooth were discussed. Additionally, the changes associated with tooth eruption and the role of the periodontal ligament (PDL) in promoting bone formation after the autotransplantation of immature teeth were described. By utilizing the natural healing capacity of the PDL, autotransplantation represents a valuable treatment option for restoring dentition and promoting alveolar bone regeneration in patients with missing teeth or dental anomalies. Clinical and radiological documentation, along with the treatment descriptions of three young orthodontic patients illustrate the concepts discussed provide clinical guidelines for the autotransplantation of immature teeth.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"368 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645040","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":"Late facial growth and continuous dentoalveolar eruption: Implications for optimal dental implant placement.","authors":"Nicola Alberto Valente,Salvatore D'Amato,Mauro Farella","doi":"10.1111/prd.70024","DOIUrl":"https://doi.org/10.1111/prd.70024","url":null,"abstract":"After somatic growth ceases, craniofacial remodeling continues throughout adulthood, and teeth maintain a slow but persistent tendency to erupt. These ongoing skeletal and dental changes contribute to the progressive infraocclusion of dental implants. Our aim was to critically evaluate the evidence on late facial growth and continuous dentoalveolar eruption, and their implications for timing, risk assessment, and management of dental implants. A critical review of the current literature was conducted, focusing on longitudinal studies, clinical trials, and systematic reviews addressing residual facial bone remodeling, dentoalveolar eruption, and implant infraocclusion. Particular attention was given to patient-specific factors and patient-reported outcomes. Late craniofacial growth and continuous eruption of natural teeth contribute to spatial discrepancies between implants and adjacent dentition, even in skeletally mature adults. Younger age, increased anterior facial height, hyperdivergent facial patterns, and high smile lines were identified as key risk factors for implant infraocclusion. While delaying implant placement may reduce the risk of infraocclusion, there is no clear age threshold beyond which implants are entirely stable. Certain surgical techniques and prosthetic designs may mitigate long-term infraocclusion, and alternative treatments such as orthodontic space closure or adhesive bridges may provide a viable solution in selected cases. Progressive infraocclusion of implants is a multifactorial phenomenon influenced by residual craniofacial growth and alveolar changes. A thorough understanding of these biological processes and associated risk factors is essential to guide clinicians in selecting the optimal timing for implant placement and in considering alternative treatment strategies when appropriate. An evidence-based, patient-centered approach can help improve long-term functional and aesthetic outcomes, as well as patient satisfaction.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"245 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645014","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":"Chemical agents to control biofilm formation in step 1 of care—Toothpastes and mouthwashes/concepts and challenges","authors":"Maud Joosstens, Cees Valkenburg, Fridus Van der Weijden","doi":"10.1111/prd.70022","DOIUrl":"https://doi.org/10.1111/prd.70022","url":null,"abstract":"Maintaining optimal oral hygiene is important for overall oral care, ensuring the well‐being of teeth and their surrounding tissues. In addition, it promotes fresh breath and a pleasing smile. A key element of oral self‐care is the daily use of toothpaste during regular brushing. This plays an important role in preventing tooth decay and addressing broader oral health concerns like periodontal diseases. Toothpaste ingredients offer significant benefits to oral health, particularly stannous fluoride, which contributes to the efficacy of toothpaste formulations by demonstrating notable anticariogenic and antibacterial properties. However, toothpaste has potential side effects, such as those caused by flavoring, and sodium lauryl sulfate, a foaming agent known for its potential to irritate mucous membranes. Beyond toothpaste, the integration of mouthwash into daily oral care routines offers the potential to further improve overall oral hygiene. Chlorhexidine in mouthwash formulations stands out as an active ingredient that is highly effective. This paper investigates the effects of chemical plaque inhibitors where possible through comprehensive systematic evaluations of existing literature. It aimed to provide an understanding of how chemical agents used in oral self‐care contribute to promoting and maintaining optimal oral hygiene.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"5 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145583116","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":"Adjunctive antimicrobials and host modulators in nonsurgical periodontal therapy: Focus on patients with diabetes and smokers","authors":"Poliana Mendes Duarte, Rafael Lazarin, Nathalia Vilela, Magda Feres","doi":"10.1111/prd.70020","DOIUrl":"https://doi.org/10.1111/prd.70020","url":null,"abstract":"Smoking and diabetes mellitus (DM) are major risk factors for periodontitis, often leading to greater disease severity and reduced response to scaling and root planing (SRP). Consequently, adjunctive therapies have been explored to enhance treatment outcomes in these high‐risk populations. Given that periodontitis is an infectious‐inflammatory disease, both antimicrobial and host‐modulating agents have been proposed as adjuncts to support mechanical debridement. This narrative review critically evaluates clinical evidence from randomized clinical trials and systematic reviews assessing the efficacy of these adjuncts in the nonsurgical management of periodontitis in smokers and patients with DM. Local antimicrobials have shown site‐specific clinical benefits like probing depth reduction and clinical attachment gain, particularly in deep pockets, although microbiological evidence is limited. Systemic antimicrobials, particularly the amoxicillin‐metronidazole combination, demonstrated sustained clinical and microbiological improvements, especially in diabetic patients. Among host‐modulating strategies, sub‐antimicrobial dose doxycycline and locally delivered statins have shown promising effects, though high‐quality, long‐term evidence is still lacking. Adjunctive therapies may improve periodontal treatment outcomes in high‐risk populations, particularly in cases of severe disease. Nonetheless, significant heterogeneity in study design, outcome assessment, and risk factor control limits the generalizability of current findings. Future research should prioritize rigorous methodology, stratified analyses, and the use of clinically meaningful endpoints to better inform evidence‐based decisions on adjunctive therapies in patients with risk factors.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"117 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515888","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 sinus complication management","authors":"Pablo Galindo‐Moreno, Tiziano Testori, Miguel Padial‐Molina, Allinson Olaechea, Francisco O'Valle, Pablo Galindo‐Fernandez","doi":"10.1111/prd.70021","DOIUrl":"https://doi.org/10.1111/prd.70021","url":null,"abstract":"Maxillary sinus augmentation shows a low incidence of complications and high clinical success due to favorable biological conditions and typically transient issues. Most complications are intraoperative, such as Schneiderian membrane perforation or hemorrhage, and are often resolved immediately. Postoperative complications, like sinusitis, graft loss, and voice alterations, are less frequent but clinically relevant. This study evaluates the long‐term effects of intraoperative and postoperative complications in maxillary sinus augmentation. A specific classification was used to differentiate these complications, focusing on their impact on bone graft maintenance and dental implant survival. Special attention was given to the progression of sinus inflammatory pathology, from preoperative conditions to acute and chronic sinusitis. While intraoperative complications are generally manageable, they can predispose patients to postoperative issues that affect long‐term outcomes. Sinus membrane perforation emerged as a key intraoperative factor linked to later sinusitis, compromising graft integrity and implant stability. The evolution of sinus inflammation significantly influences the long‐term success of both graft material and implants. Complications in maxillary sinus augmentation, if not properly managed, can have lasting effects. Careful surgical technique and thorough postoperative monitoring are essential to mitigate risks and ensure long‐term success. Recognizing the long‐term impact of these complications is crucial for optimizing outcomes in maxillary sinus augmentation.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"56 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498366","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":"Functional requirements for guided bone regeneration/guided tissue regeneration membrane design: Progress and challenges.","authors":"Huilu Zhan,Ruijianghan Shi,Haohao Ni,Haiyan Li,Changyong Yuan,Kaili Lin,Anton Sculean,Richard J Miron","doi":"10.1111/prd.70019","DOIUrl":"https://doi.org/10.1111/prd.70019","url":null,"abstract":"Guided tissue regeneration (GTR) and guided bone regeneration (GBR) membranes are critical for reconstructing periodontal/bone defects, but existing membranes face limitations in osteogenic potential, antibacterial efficacy, degradation kinetics, mechanical stability, and immunomodulation within the complex oral microenvironment. This review aims to explore cellular interactions between alveolar bone regenerative cells and GBR/GTR membranes, membrane design strategies based on biological functions, and advancements in material engineering to overcome current clinical challenges. A comprehensive search strategy was implemented across PubMed, Scopus, Web of Science databases, as well as clinical trials registers. Data pertinent to membrane synthetic methodology, biological behavior, tissue regeneration outcomes were retrieved from the original studies. A qualitative assessment was performed. Overall, ideal GBR/GTR membranes must meet several functional requirements: (i) Clinical necessities include biocompatibility, selective permeability for nutrient exchange, and clinical operability. GTR aims to create and maintain a stable isolated space to protect blood clots, thereby enabling blood clots and the newly formed tissue to effectively block the migration of epithelial cells. GBR demands rigid space maintenance to resist mucosal compression in edentulous ridges, with greater emphasis on mechanical stability for large bone defects. Degradation kinetics must align with slower bone formation (3-6 months). (ii) Appropriate surface properties (roughness, morphology, stiffness, wettability, charge) and porosity/pore size are critical for cell behavior. (iii) Membrane-based biological regulation can promote cell adhesion and migration, and balance osteoclastogenesis and osteogenesis. Optimization strategies include incorporating bioactive substances for bone regeneration, immunomodulatory agents for anti-inflammatory responses, and antibacterial additives for clinical performance. GBR/GTR membranes require multifunctional integration of barrier functionality, tailored biodegradation, mechanical robustness, and proactive bioactivity (osteogenic, angiogenic, immunomodulatory, and antibacterial). Future designs must prioritize understanding cell-material interactions to develop membranes that dynamically synchronize with the regenerative microenvironment. This review provides a foundation for developing next-generation membranes that effectively address complex oral microenvironment challenges and significantly improve clinical outcomes in bone defect reconstruction. Optimized membranes will enhance space maintenance, reduce infection rates, mitigate premature degradation, and improve predictability in reconstructing periodontal and alveolar bone defects, ultimately advancing regenerative outcomes in implant dentistry and periodontal surgery.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"29 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491577","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":"Antibiotics in the treatment of young patients with molar-incisor pattern periodontitis (C-MIP).","authors":"Manuela Maria Viana Miguel,Mauro Pedrine Santamaria,Renato Corrêa Viana Casarin,Camila Schmidt Stolf,Luciana Salles Branco-de-Almeida,Luciana Macchion Shaddox","doi":"10.1111/prd.70004","DOIUrl":"https://doi.org/10.1111/prd.70004","url":null,"abstract":"Grade C molar-incisor pattern periodontitis (C-MIP) is characterized by an aggressive and rapid loss of tooth-supporting structures, affecting 1st molars incisors. This response seems to be due to an exaggerated host inflammatory response triggered by a dysbiotic and specific microbial environment. With higher prevalence in young individuals of lower socioeconomic status and African descendants, or from mixed-race populations, this disease also shows a strong familial aggregation that points to a genetic contribution, not yet fully elucidated. Despite the high focus on 1st molar and incisor permanent dentition with usual onset around puberty, this aggressive attachment bone loss has also been reported in the primary dentition, with some retrospective studies suggesting a possible disease initiation in the prepubertal stages. A. actinomycetemcomitans has been strongly implicated in C-MIP severity and progression, although newer technologies have pointed out some other associated species implicated in this disease. Although several clinical therapies have been proposed to treat C-MIP over time, nonsurgical mechanical treatment with systemic antibiotics (ABX) has shown a positive impact on clinical, immunological, and microbiological outcomes in the short and long term, both in primary and permanent affected dentitions. Despite the limited comparative clinical trials approaching C-MIP, the combination of adjunctive amoxicillin (AMX) and metronidazole (MTZ) with nonsurgical debridement is the most recommended ABX regimen to date. Several bacterial species associated with C-MIP are also reduced following this regimen, along with an increased number of health-associated species and modulation of the inflammatory response, both locally and systemically, associated with clinical parameters of success. Despite the systemic ABX benefits, the authors emphasize the importance of early diagnosis and patients' compliance with frequent maintenance care to sustain successful outcomes. Surgical intervention may also be recommended based on remaining residual pockets, along with residual intrabony defects and furcation involvement. In this review, the authors also highlight a comparison of treatment approaches with generalized forms of the disease in young individuals (C-G) and discuss potential future strategies to understand better, prevent, and successfully treat this aggressive disease.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"13 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433998","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}