Abstract Objectives Due to the inconsistent definitions, reporting methods and study characteristics, prevalences of peri-implant diseases significantly varied in studies. This study aimed to ...systematically analyze implant-based and subject-based prevalences of peri-implant diseases and assess clinical variables potentially affecting the prevalence. Sources Electronic search of studies was conducted using MEDLINE (PubMed), EMBASE and Web of Science. Publication screening, data extraction, and quality assessment were performed. Study selection Clinical studies having an at least average three-year follow-up period were selected. The numbers of subjects and implants in the studies had to be equal to or more than thirty. Data Forty seven studies were selected and prevalences of peri-implant diseases were analyzed. Since heterogeneity existed in each outcome (I2 = 94.7, 95.7, 95.3, and 99.3 for implant-based and subject-based peri-implantitis and peri-implant mucositis, respectively), the random-effects model based on the DerSimonian and Laird method, which incorporate an estimate of heterogeneity in the weighting, was applied to obtain the pooled prevalence. Weighted mean implant-based and subject-based peri-implantitis prevalences were 9.25% (95% Confidence Interval (CI): 7.57, 10.93) and 19.83% (CI 15.38, 24.27) respectively. Weighted mean implant-based and subject-based peri-implant mucositis prevalences were 29.48% (CI: 22.65, 36.32) and 46.83% (CI: 38.30, 55.36) respectively. Functional time and implant to subject ratio were associated with subject-based peri-implantitis prevalence, but not peri-implant mucositis prevalences. Conclusions Peri-implant diseases were prevalent and prevalence of peri-implantitis increased over time. Prevalences of peri-implantitis and peri-implant mucositis might not be highly associated since the prevalences were influenced by distinct variables. The results should be carefully interpreted because of data heterogeneity. Clinical significance Peri-implant diseases affect a significant number of dental implants and patients. It is important to understand the difficulties in diagnosis of these diseases and risk factors which may be modified to reduce the potential for disease occurrence or progression.
Aim
Smoking is a risk factor for periodontitis. This study aimed to evaluate the impact of smoking on clinical outcomes of non‐surgical periodontal therapy.
Materials and Methods
Electronic databases ...were searched to screen studies published before May 2020. The included studies had to have two groups: smokers (S) and non‐smokers (NS) with periodontitis. The outcomes evaluated were differences between groups in probing depth (PD) reduction and clinical attachment level (CAL) gain after non‐surgical periodontal therapy. Meta‐regressions were conducted to evaluate correlations between outcomes and other contributing factors.
Results
Seventeen studies were included. The post‐treatment PD reduction in the S group was smaller than in the NS group (weighted mean difference in PD reduction: −0.33 mm, 95% confidence interval (CI): −0.49, −0.17, p < .01). The CAL gain in the S group was also smaller than in the NS group (weighted mean difference in CAL gain: −0.20 mm, CI: −0.39, −0.02, p < .01). Additionally, baseline PD significantly affected the difference in PD reduction between two groups.
Conclusions
Smoking negatively impacts clinical responses to non‐surgical periodontal therapy. Smokers with periodontitis have significantly less PD reduction and CAL gain than non‐smokers.
Aim
The goal was to use a deep convolutional neural network to measure the radiographic alveolar bone level to aid periodontal diagnosis.
Materials and Methods
A deep learning (DL) model was ...developed by integrating three segmentation networks (bone area, tooth, cemento‐enamel junction) and image analysis to measure the radiographic bone level and assign radiographic bone loss (RBL) stages. The percentage of RBL was calculated to determine the stage of RBL for each tooth. A provisional periodontal diagnosis was assigned using the 2018 periodontitis classification. RBL percentage, staging, and presumptive diagnosis were compared with the measurements and diagnoses made by the independent examiners.
Results
The average Dice Similarity Coefficient (DSC) for segmentation was over 0.91. There was no significant difference in the RBL percentage measurements determined by DL and examiners (p=.65). The area under the receiver operating characteristics curve of RBL stage assignment for stages I, II, and III was 0.89, 0.90, and 0.90, respectively. The accuracy of the case diagnosis was 0.85.
Conclusions
The proposed DL model provides reliable RBL measurements and image‐based periodontal diagnosis using periapical radiographic images. However, this model has to be further optimized and validated by a larger number of images to facilitate its application.
Aim
This randomized controlled trial aimed to investigate the efficacy of soft‐tissue augmentation (STA) with a subepithelial connective tissue graft (SCTG) or an acellular dermal matrix (ADM) on ...reducing tissue alterations at an immediate implant site.
Materials and Methods
This trial had three groups: (i) immediate implant with SCTG (ICT group); (ii) immediate implant with ADM (IAD group); (iii) immediate implant without STA (control group). Forty‐six patients were randomly assigned to each group. Implants were placed at the maxillary anterior or premolar areas and restored after the 6‐month visit. Clinical outcomes, including buccal soft‐tissue contour, peri‐implant mucosal level, soft‐tissue thickness and keratinized tissue width, were measured at baseline and at 3‐, 6‐ and 12‐month follow‐up visits. Radiographic bone levels were measured at baseline and at 6‐ and 12‐month follow‐up visits. Patient‐reported outcomes were also collected.
Results
STA procedures increased peri‐implant mucosal thickness and maintained buccal soft‐tissue contours. Compared to the control group, STA groups did not prevent peri‐implant mucosal recession or interproximal bone resorption. Generally, no significant differences in clinical outcomes were detected between the ICT and IAD groups. Most patients were highly satisfied with the immediate implant procedure and outcomes without significant differences between groups.
Conclusions
STA at immediate implant sites enhanced soft‐tissue thickness and maintained soft‐tissue contours but did not prevent peri‐implant mucosal recession or interproximal bone resorption. Long‐term follow‐up should be performed since these results were reported for only up to 1 year.
This study aimed to investigate the levels of serum, gingival crevicular fluid (GCF), and salivary adipokines and their possible relationship with periodontitis and obesity. An electronic search was ...conducted in the following databases: PubMed/ Medline, Scopus, and EBSCOhost through February 2023. Two independent reviewers screened the titles, s, and full text of all the studies. Studies comparing the levels of adipokines in GCF, serum, and/or saliva in subjects with obesity and periodontitis (group 1), subjects with normal weight and periodontitis (group 2), and subjects with obesity and gingival health (group 3) were included. Meta‐analyses and meta‐regression were performed on the data from included studies. Seventeen studies with study participants ranging from 30 to 120 were included with subjects in each group ranging from 10 to 40. There was a significant increase in levels of serum TNF‐α, leptin, IL‐6, and CRP between groups 1 and 2 (p < .05). In GCF, TNF‐α and resistin levels were significantly higher (p < .05) in Group 1 vs. 2. Serum level of leptin was higher for group 1 vs. 3 (p < .05). Meta‐regression analysis revealed that the obesity definition (body mass index (BMI) cut‐off value >25 or >30) was significant for serum resistin (p < .05) and GCF resistin (p < .05) between group 1 and 2. The current analysis indicates that both periodontitis and obesity can modulate the pro‐inflammatory cytokines at systemic and local levels. This bidirectional interaction of periodontitis and obesity via the inflammation pathway seems likely plausible. Further studies are required to elucidate this mechanism in more detail.
Objective
To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal ...bone resorption for different placement and restoration protocols.
Material and methods
An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021. Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow‐up visits within a year of implantation. A meta‐analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta‐regression were performed.
Results
From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: 0.56, 0.86) and 0.58 mm (95% confidence interval: 0.43, 0.72), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD.
Conclusions
This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further well‐conducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.
Recently, several studies demonstrated the potential of using specialized pro‐resolving lipid mediators (SPMs), as a novel approach, in treating periodontitis in pre‐clinical models. This review ...aimed to systematically evaluate the biological actions of SPMs on periodontal tissues in animals with experimentally induced periodontitis. This systematic review was performed by following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Studies were searched in three databases. Meta‐analysis was not performed because of the data heterogeneity. Study quality was assessed using Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) Risk of Bias tool. Six studies using an experimental periodontitis model to test the efficacy of SPMs were selected. Resolvin E1 and lipoxins were topically applied to treat experimental periodontitis. Alveolar bone loss could be significantly prevented and regenerated by applying SPMs, when compared to the control group. The dosages of SPMs and the periods of disease induction varied based on the pre‐clinical model employed. Two studies further demonstrated the positive shift in microbial composition, in line with positive shift in inflammatory status, that are regulated by SPMs. Clinical studies are needed to optimize the application of SPMs in treating periodontal diseases in humans.
Abstract
Background
The aim of this study was to develop artificial intelligence (AI) guided framework to recognize tooth numbers in panoramic and intraoral radiographs (periapical and bitewing) ...without prior domain knowledge and arrange the intraoral radiographs into a full mouth series (FMS) arrangement template. This model can be integrated with different diseases diagnosis models, such as periodontitis or caries, to facilitate clinical examinations and diagnoses.
Methods
The framework utilized image segmentation models to generate the masks of bone area, tooth, and cementoenamel junction (CEJ) lines from intraoral radiographs. These masks were used to detect and extract teeth bounding boxes utilizing several image analysis methods. Then, individual teeth were matched with a patient’s panoramic images (if available) or tooth repositories for assigning tooth numbers using the multi-scale matching strategy. This framework was tested on 1240 intraoral radiographs different from the training and internal validation cohort to avoid data snooping. Besides, a web interface was designed to generate a report for different dental abnormalities with tooth numbers to evaluate this framework’s practicality in clinical settings.
Results
The proposed method achieved the following precision and recall via panoramic view: 0.96 and 0.96 (via panoramic view) and 0.87 and 0.87 (via repository match) by handling tooth shape variation and outperforming other state-of-the-art methods. Additionally, the proposed framework could accurately arrange a set of intraoral radiographs into an FMS arrangement template based on positions and tooth numbers with an accuracy of 95% for periapical images and 90% for bitewing images. The accuracy of this framework was also 94% in the images with missing teeth and 89% with restorations.
Conclusions
The proposed tooth numbering model is robust and self-contained and can also be integrated with other dental diagnosis modules, such as alveolar bone assessment and caries detection. This artificial intelligence-based tooth detection and tooth number assignment in dental radiographs will help dentists with enhanced communication, documentation, and treatment planning accurately. In addition, the proposed framework can correctly specify detailed diagnostic information associated with a single tooth without human intervention.
Periodontitis is a biofilm-induced inflammatory disease characterized by dysbiosis of the commensal periodontal microbiota. It is unclear how natural regulation of inflammation affects the ...periodontal biofilm. Promoters of active resolution of inflammation, including resolvin E1 (RvE1), effectively treat inflammatory periodontitis in animal models. The goals of this study were 1) to compare periodontal tissue gene expression in different clinical conditions, 2) to determine the impact of local inflammation on the composition of subgingival bacteria, and 3) to understand how inflammation impacts these changes. Two clinically relevant experiments were performed in rats: prevention and treatment of ligature-induced periodontitis with RvE1 topical treatment. The gingival transcriptome was evaluated by RNA sequencing of mRNA. The composition of the subgingival microbiota was characterized by 16S rDNA sequencing. Periodontitis was assessed by bone morphometric measurements and histomorphometry of block sections. H&E and tartrate-resistant acid phosphatase staining were used to characterize and quantify inflammatory changes. RvE1 treatment prevented bone loss in ligature-induced periodontitis. Osteoclast density and inflammatory cell infiltration in the RvE1 groups were lower than those in the placebo group. RvE1 treatment reduced expression of inflammation-related genes, returning the expression profile to one more similar to health. Treatment of established periodontitis with RvE1 reversed bone loss, reversed inflammatory gene expression, and reduced osteoclast density. Assessment of the rat subgingival microbiota after RvE1 treatment revealed marked changes in both prevention and treatment experiments. The data suggest that modulation of local inflammation has a major role in shaping the composition of the subgingival microbiota.
Aim
This systematic review aimed to investigates the types and incidences of complications following sinus floor elevations (SFE) along with their prevention and management strategies.
Materials and ...methods
Electronic database and hand search were conducted to screen the literature published from January 1960 to June 2021. The selected studies had to report well‐described SFE techniques, complications during, and post‐SFE. Data extraction included types of SFE techniques, complications, and their treatment strategies.
Results
A total of 74 studies with 4411 SFE procedures met the inclusion criteria. Different SFE techniques demonstrated varying patterns for both complications and complication rates. Postoperative pain, swelling, and edema were widely reported. The most common complications that required intervention following Lateral SFE (LSFE) were sinus membrane perforation (SMP), wound dehiscence, graft exposure and failure, and sinusitis. LSFE had more SMPs and sinusitis cases compared with a transcrestal SFE (TSFE). The presence of benign paroxysmal positional vertigo following TSFE was significant in certain selected studies.
Conclusion
Given the inherent limitations, this systematic review showed distinct features of complications in SFE using varying techniques. Treatment planning for these procedures should incorporate strategies to avoid complication occurrence.
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