Periodontal Tooth Research Articles

Influence of residual pockets on periodontal tooth loss: A retrospective analysis.

Individuals enrolled in supportive periodontal therapy (SPT) can still present with tooth loss due to periodontitis (TLP). There is limited evidence on the influence of residual pockets (RPc) and a defined "threshold" at which a patient's profile is set to be at high risk for TLP in the literature. Therefore, this study aimed to assess the influence of RPc on TLP and determine the prognostic performance of RPc compared to the staging and grading of periodontitis on TLP risk. Clinical data from 168 patients (3869 teeth) treated for periodontitis and receiving SPT for at least 10 years were evaluated in this retrospective study. TLP and the percentage of sites with RPc≥5mm or ≥6mm per patient were collected. The prognostic performance of RPc was compared to the staging and grading of the disease on TLP using a multilevel Cox proportional hazard regression model. Over a median follow-up of 25 years, 13.7% of teeth were lost, 4.6% of which were due to periodontitis. Most patients with TLP had ≥1 site with RPc ≥5mm (90.8%) or ≥6mm (77.6%). Multivariate multilevel Cox regression revealed that patients with >15% of sites with RPc ≥5mm had a hazard ratio of 2.34, and grade C had a hazard ratio of 4.6 for TLP compared to RPc ≤4mm/grade A. Grading exhibited the best discrimination and model fit. Patients with RPc ≥5mm at >15% of the sites are at risk for tooth loss. Grading and RPc ≥5mm displayed very good predictive capability of TLP.

Clinical and Microbiologic Outcomes of Ceramic Laminate Veneers Bonded to Teeth Without a Finish Line: 1-year Results of a Prospective Study.

Purpose: To evaluate changes in the periodontium of teeth restored with ultrathin (0.2 to 0.39 mm) ceramic laminate veneers (CLVs) placed subgingivally without a finish line compared to the same teeth before restorative treatment and to nonrestored antagonist teeth in healthy periodontium patients. Materials and Methods: A total of 73 CLVs were bonded onto the enamel surface of teeth without a finish line and with the cervical margin placed about 0.5 mm subgingivally. The gingival crevicular fluid was collected before bonding (baseline) and at 7, 180, and 365 days after bonding to quantify S mitis, P intermedia, and P gingivalis by quantitative polymerase chain reaction analysis. Visible plaque index (VPI), bleeding on probing (BOP), probing depth (PD), clinical attachment loss (CAL), gingival recession (GR), and marginal adaptation were evaluated from baseline to 365 days in both groups. Results: No statistically significant differences were observed in VPI, PD, or BOP at any time point in the intragroup or intergroup comparisons (P > .05). All restorations obtained the alpha concept for marginal adaptation (ie, the restoration margin remained ideal at all time points). There was a statistically significant difference for S mitis between 180 and 365 days (P = .03). No statistically significant difference was observed for P gingivalis at any time point (P > .05). Conclusion: The periodontium in the restored group showed a clinical behavior similar to baseline. Overcontouring of the ultrathin (up to 0.39 mm) CLV, similar to the cementoenamel junction convexity, did not contribute to plaque accumulation or changes in the oral microbiota of patients with a healthy periodontium and proper oral hygiene instruction.

Mural cell composition and functional analysis in the healing process of human gingiva from periodontal intrabony defects

ObjectiveTo evaluate the composition and function of mural cell populations in human gingival tissues DesignA cross-sectional study was conducted on seven periodontitis (stage Ⅲ) patients. Gingival tissues were collected two months after scaling and root planing and divided into 3 groups: 1, h_h group (horizontal bone resorption, residual pocket depth ≤3 mm); 2, v_h group (vertical bone resorption >4 mm, residual pocket depth ≤3 mm); 3, v_i group (vertical bone resorption >4 mm, residual pocket depth ≥6 mm). Single-cell RNA sequencing (10X genomics) and subsequent bioinformatics analysis were performed. Protein expression of selected genes was confirmed by histological staining. ResultsTwo mural cell clusters, RGS5+THY1+ and ACTA2+MYH11+ subpopulations, were identified and confirmed by histological staining and cross-validation with three different single-cell RNA sequencing datasets in the GEO database. RGS5+THY1+ cluster in perivascular areas possessed cellular protrusions and exhibited immunomodulatory and synthetic phenotypes. In contrast, the ACTA2+MYH11+ cluster strictly distributed around vessel walls was characterized by a contractile phenotype. Mural cells closely interacted with endothelial cells through PDGF and NOTCH3 signaling. Mural cell loss was detected in the v_i group and in hopeless periodontal teeth, which might be caused by tumor necrosis factor-alpha induced apoptosis. ConclusionsGingival mural cells can be classified into two distinct clusters according to their gene signatures and cell morphology. The loss of mural cells may indicate periodontitis progression.

A case of precise prosthesis under the direction of target restoration space analysis after multidisciplinary combination therapy.

Quantitative grinding of abutment teeth is needed in crown and bridge restoration. Accurate quantitative preparation of teeth is one of the goals of minimally invasive restoration. In this paper, a case of congenital loss of upper and lower incisors was reported. Guided by the target restoration space (TRS), a personalized digital guide plate for tooth preparation was built to assist precise tooth preparation after the multidisciplinary combination therapy of orthodontic and periodontal teeth. Finally, the fixed bridge was prepared to meet the integrity, beauty, and function of the maxillary for the patient. In this case, the results suggest that the digital guide plate built under the guidance of TRS can be used to improve the accuracy of dental preparation.

Женские погребения IV в. до н. э. со змеями из могильника у с. Лятошинка

Introduction. The article presents the results of the study of two burials of the 4th century BC with snakes from the Lyatoshinka burial ground in the Volgograd Transvolga region. Methods and materials. In the process of investigation, an interdisciplinary approach was used with the inclusion of a typological method, the method of analogies and cross-dating, methods of craniological research (craniometry and cranioscopy), as well as methods for analyzing skulls pathological states. Ethnographic data were used to draw conclusions about semantics. The sources of the study are the paired burials 8 and 10 of kurgan 5 of the Lyatoshinka burial ground and three female skulls. Analysis. As a result of studying the funeral rite and elements of material culture, both burials were linked to the 4th century BC. The analysis of the anthropological material makes it possible to attribute the craniological type of women to the type of ancient Eastern Caucasoids, which is widely represented in the synchronous materials of the Southern Urals and the Lower Volga region. The morphological feature of this skull group is the presence of traces of deliberate fronto-occipital cranial deformation. The pathological state study of the skulls revealed that all the three women had chronic periodontal disease and severe tooth wear. Results and their discussion. The comprehensive analysis of the features of the funeral rite and grave goods, as well as the presence of traces of artificial cranial deformation, which at that time is very rare, suggests the lifetime function of these three women as female clergy.

Oral status of a noble European couple from the 16th century: A morphologic analysis of the teeth of Alessandro Farnese and his wife Maria D'Aviz.

Objective. To report the results of dental morphological analysis performed on the remains of two European nobles (Duke Alessandro Farnese and his wife Maria D'Aviz) who lived in the 16th century, together with hypotheses on their nutrition and oral hygiene habits. Design and results. The remains of Alessandro Farnese (1545-1592) and Princess Maria D'Aviz (1538-1577) were exhumed in Parma, Italy, in the context of an historical investigation into their possible causes of death. The skulls were examined and analysed through direct inspection, high-detailed photographs and radiographs. Ante mortem tooth loss (AMTL), postmortem tooth loss (PMTL), Scott and Smith dental wear indexes and the Kerr periodontal index were used to assess the dental and periodontal status of the couple. Alessandro Farnese suffered from severe dental wear while it was presumed that Maria D'Aviz was affected by periodontal disease and tooth decay. Conclusions. Based on the findings of the present analysis, we hypothesise that Alessandro Farnese's diet was mainly based on hard and unrefined foods, also suggested by limited historical reports. It is likely that Maria D'Aviz's nutrition was based on sugar-enriched foods.

A bilayered tissue engineered in vitro model simulating the tooth periodontium.

Due to the complexity of the structure of the tooth periodontium, regeneration of the full tooth attachment is not a trivial task. There is also a gap in models that can represent human tooth attachment in vitro and in vivo. The aim of this study was to develop a bilayered in vitro construct that simulated the tooth periodontal ligament and attached alveolar bone, for the purpose of tissue regeneration and investigation of physiological and orthodontic loading. Two types of materials were used to develop this construct: sol-gel 60S10Mg derived scaffold, representing the hard tissue component of the periodontium, and commercially available Geistlich Bio-Gide® collagen membrane, representing the soft tissue component of the tooth attachment. Each scaffold was dynamically seeded with human periodontal ligament cells (HPDLCs). Scaffolds were either cultured separately, or combined in a bilayered construct, for 2 weeks. Characterisation of the individual scaffolds and the bilayered constructs included biological characterisation (cell viability, scanning electron microscopy to confirm cell attachment, gene expression of periodontium regeneration markers), and mechanical characterisation of scaffolds and constructs. HPDLCs enjoyed a biocompatible 3-dimensional environment within the bilayered construct components. There was no drop in cellular gene expression in the bilayered construct, compared to the separate scaffolds.

Two canine tooth supported overdenture with ready-made attachments (3 year prospective study)

Purpose: To study the effect of two ready-made intra-radicular cemented attachments on abutment teeth periodontium of two canine tooth supported mandibular overdenture (OD) in 3 years study period. Materials and Methods: Ten patients with edentulous maxilla & a mandibular arch with only two canines remaining were selected based on certain criteria. All patients received maxillary complete dentures and an attachment-retained mandibular OD ; 1) Group [A] received magnetic attachment-retained OD, and 2) Group [B] received O-ring attachment-retained OD. Modified Gingival index (MGI), clinical attachment loss (CAL) and marginal bone changes (MBC) were investigated along a 3 years follow up period. Results: MGI results showed no statistically significant difference both in inter- & intra-group results. CAL results showed significant differences between successive periods of the same group with no difference between the two groups in comparable periods. Comparison of ∆ CAL values between groups in comparable periods also showed no statistical difference, but the sum of ∆ CAL in all 3 years showed statistical difference. Comparison of ∆ MBC values between groups in comparable periods showed statistical difference in the 2nd & 3rd follow-ups as well as in all 3 years combined. ∆ MBC & ∆ CAL, showed a weak positive correlation coefficient 0.368 in group 1, and a strong positive correlation 0.942 in group 2. Conclusion: It can be concluded that the two canine-supported mandibular overdenture, retained either by ball and socket or magnetic attachments, is an acceptable treatment modality with predictable clinical results from a periodontal point of view.

Analysis of the Therapeutic Effect of Nano-Silver on Periodontitis and Its Influence on Disease Recurrence

Periodontitis is a chronic oral inflammatory disease that is difficult to treat and is therefore the subject of clinical research seeking new and effective treatment. Nano-silver has antibacterial and anti-inflammatory effects; however, its application in periodontitis is not well studied. In this study, we show decreases in periodontitis-associated inflammatory cytokines interleukin IL-4, IL-6, IL-8, IL-10, and tumor necrosis factor alpha (TNF-a) (P < 0.05) and in oxidative stress (P < 0.05) under intervention with nano-silver solution. The protein expression of CCL21, heat-shock protein 90 (HSP90), andE-selectin in periodontal tissues decreased (P < 0.05), while bone structure improved (P < 0.05). This work suggests that nano-silver solution can effectively inhibit the inflammatory response and oxidative stress response of periodontitis and improve the periodontal tissue and tooth structure to some extent; it may provide a new periodontitis treatment in the future.

THE ASSOCIATION BETWEEN FLOSSING TEETH AND ORAL HEALTH IN ADULTS

Background: In older people, the impact of oral habits is largely unknown. The goal of this study was to see if there was a link between flossing at home and the prevalence of periodontal disease in older people.
 Methodology: The incidence of tooth loss over a five-year period was also examined. Pearson chi-square tests and covariate-adjusted Cochran-Mantel-Haenszel tests were used to evaluate dichotomous and categorical variables. Clinical factors were compared using multiple linear regression depending on flossing practice. Molars exhibited the greatest benefit (>40%) for flossing practice (P = 0.0005) among all teeth. In conclusion, flossers had much less oral illness than non flossers when it came to older people. Over a 5-year period, flossers had decreased periodontal disease, dental caries, and tooth loss. These findings add to the growing body of evidence that flossing is an important oral hygiene habit for older persons who want to avoid the progression of oral disease.
 Keywords: OHI, interdental cleaning, elderly, prevention, periodontal disease, caries.

THE ROLE OF PDL-CEMENTUM ENTHESIS IN PROTECTING PDL UNDER MASTICATORY LOADING: A FINITE ELEMENT INVESTIGATION

Background: The function of periodontal ligament (PDL)-cementum enthesis (PCE) in transferring the mechanical stimuli within the tooth–periodontium (PDT)–bone complex was not made clear yet. This study aimed to evaluate the effects of PCE on the mechanical stimuli distribution within the PDL and alveolar bone in the tooth–PDT–bone complex under occlusal forces using the finite element method. Methods: A computed tomography-based model of alveolar bone and second premolar of mandible was constructed, in which the PDT was considered at the interface of alveolar bone and tooth. Under a 3 MPa distributed occluso-apical masticatory load, applied over the uppermost surface of crown, the von Mises strain (vMST) and strain energy density (SED) within PDL, and von Mises stress (vMSR) and SED within alveolar bone were calculated in two situations: 1. When the PCE was absent; and 2. When the PCE was present between the PDL and cementum. Results: PCE levels-off SED and vMST within PDL up to 59% and 27%, respectively, compared to the model with no PCE. Moreover, in the alveolar bone, SEDs and vMSR increased up to 28% and 30%, respectively, compared to the model without PCE. Conclusion: By including PCE in the tooth–PDT–bone model, the mechanical stimuli shifted from PDL to its surrounding alveolar bone. Thus, it can be speculated that the tooth–PDT–bone complex has the capability of reducing the risk of PDL damage, through shifting excess mechanical stimuli from PDL toward the alveolar bone, during prolonged cyclic masticatory loading, as well as while one applies nonphysiologic and therapeutic loads, such as in orthodontic tooth movement.

Tooth Loss Is Associated with Disease-Related Parameters in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis-A Cross-Sectional Study.

Background: The aim of this cross-sectional study was to investigate potential associations between periodontal inflamed surface area (PISA) and tooth loss with disease-related parameters in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Patients who attended the Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany, were included. The oral examination comprised the detection of the number of remaining teeth and periodontal condition based on staging and grading matrix. Based on periodontal pockets with positive bleeding on probing, the periodontal inflamed surface area (PISA) was determined. Disease related parameters were extracted from the patients’ records. Results: In total, 101 (RA) and 32 participants (AS) were included. Patients with RA had 22.85 ± 4.26 and AS patients 24.34 ± 5.47 remaining teeth (p < 0.01). Periodontitis stage III and IV was present in 91% (RA) and 81.2% (AS) of patients (p = 0.04). Associations between PISA and disease-related parameters were not found in both groups (p > 0.05). In RA, a higher age (p < 0.01), C-reactive protein (p = 0.02), disease activity (p < 0.01) and prednisolone intake (p < 0.01) were associated with fewer remaining teeth. In AS, a higher age (p = 0.02) and increased Bath Ankylosing Spondylitis Metrology Index (p = 0.02) were associated with a lower number of remaining teeth. Conclusions: Tooth loss is associated with disease activity, especially in RA individuals. Dental care to prevent tooth loss might be recommendable to positively influence oral health condition and disease activity in RA and SA patients.

ИННОВАЦИОННЫЙ ПОДХОД К ЛЕЧЕНИЮ ПОПЕРЕЧНЫХ ПЕРЕЛОМОВ КОРНЕЙ МОЛЯРОВ

A tooth fracture is a traumatic injury to a tooth with the disturbance of its crown or root part integrity. A root fracture is a fracture that involves cementum, dentin, periodontium and, in some cases, dental pulp. Root fractures occur in 0.2-7% of all cases of permanent teeth injuries. The aim of the study was to investigate clinical effectiveness of using a material based on hydroxyapatite «Bioplast-Dent» paste and a material based on mineral trioxide aggregate - «Rutsil» in the treatment of a transverse fracture of the medial tooth root 4.6 (clinical case). The object of the study was a patient with a fracture of the medial tooth root 4.6 and destructive processes in the tissues of the apical periodontium of tooth 4.6, who applied to the Chair of Restorative Dentistry with the course of the Faculty for Advanced Training &amp; Retraining of «VSMU» in 2019. Temporary obturation of the root canals of the root of tooth 4.6 was performed using the material based on hydroxyapatite «Bioplast-Dent» in the form of a paste. Permanent obturation of the root canals of the root of tooth 4.6 was carried out using domestic material based on mineral trioxide aggregate (MTA) - «Rutsil». The final restoration of the tooth crown was carried out after X-ray control from the moment of permanent obturation of the root canals in 3 months. Additionally, dynamic R-control was performed in 12 months. The results of the treatment have shown that the use of hydroxyapatite-containing paste and domestic material based on mineral trioxide aggregate - «Rutsil» brings about activation of osteogenesis in periodontal tissues and stops the process of resorption in the fracture line, shortening the time of bone tissue recovery and contributing to a greater success of treatment.

Influence of Occlusal Bite Forces on Teeth with Altered Periodontal Support: A Three-Dimensional Finite Element Stress Analysis.

Background:Masticatory forces generate various degrees of stress and strain in the periodontium of teeth which determine the clinical functions and load-bearing capacity of the teeth. There are few in vitro studies that have analyzed stress generated due to combined forces acting on the teeth. Thus, the objective of the present study was to do a comparative analysis of the influence of various stresses on the periodontal ligament and alveolar bone of maxillary central incisor with normal bone height and reduced bone height under simulated standard masticatory using finite element stress analysis.Methodology:A 3D model of the tooth was obtained with the help of ANSYS software. These models were subjected to various oblique forces, i.e., 100N and 235.9N, applied at 45° angle on the lingual surface of the maxillary central incisor and stress values were recorded in three dimensions. The results from FE analysis were analyzed using 3D Von Mises Criteria.Results:It was observed that in healthy periodontium; it was observed that among the periodontal structure studied, the maximum stress levels were exerted on root followed by cortical bone, cancellous bone, and PDL, irrespective of the force, as compared to the diseased periodontium, in which the bone height was reduced, the maximum stresses were on root followed by cortical bone, PDL, and cancellous bone.Conclusion:The main factor governing the success of any periodontal procedure depends on the height of the remaining bone and the amount of force exerted on to the tooth and the stress generated within the tooth. The finite element method could be of substantial importance in this respect as it can assess the stresses of various occlusal forces on the periodontal ligament, root, cortical bone, and cancellous bone of teeth in a periodontally healthy and diseased state.

Influence of fat-free, fat and sucrose diets on rat periodont condition

Aim. To investigate the effect of consumption of diets with different content of fat and sugar on the state of the periodontium of rats.Methods. The rats received a semi-synthetic fat-free diet (FFD), a fat diet (5 % sunflower oil), and a sucrose diet (50 % sucrose) for 30 days. Determined the degree of periodontal atrophy, tooth decay and in the gum homogenate - the activity of elastase, catalase, urease, lysozyme and the content of malondialdehyde (MDA).Results. Sugar diet increases the degree of periodontal atrophy and tooth decay, but decreases elastase activity in the gums and increases catalase activity. Fat diet does not affect periodontal atrophy and tooth decay, but it reduces catalase activity.Conclusion. The increase in the intensity of caries and periodontal atrophy under the influence of a sucrose diet is probably due to the stimulation of the formation of lactic acid. Fat nutrition does not affect the intensity of dental caries and the degree of periodontal atrophy.

Abstract P123: Prospective Association Between Periodontal Disease And Brain Imaging Markers Of Cerebrovascular And Neurodegenerative Disease: The Atherosclerosis Risk In Communities Study

Background: Periodontal disease (PD) is associated positively with neurocognitive outcomes. Few studies have investigated the relationship between PD and indicators of brain aging and vascular changes. Hypothesis: PD is associated with greater cerebral small vessel disease, lower total and regional brain volumes and elevated β-amyloid (Aβ) deposition. Methods: We included 6,793 participants who received full-mouth periodontal examinations and tooth counts at Visit 4 (1996-1998) of the Atherosclerosis Risk in Communities Study. We used a modified 3-level version of the Periodontal Profile Class to categorize PD based on severity and extent of gingival inflammation and tissue loss. Among participants who attended Visit 5 (2011-2013), n=1,306 received a brain MRI and n=248 received a PET scan. Total brain volume, Alzheimer’s disease signature volume, and presence of microhemorrhages and cerebral infarctions were ascertained via 3T MRI; Aβ deposition was assessed from PET. We regressed brain volumes on baseline PD status using weighted multivariable linear regression. Presence of cerebrovascular microhemorrhages, infarctions, or elevated Aβ (standardized uptake value ratio&gt;1.2) were regressed on PD category using logistic models. We examined the interaction between Apolipoprotein E ε4 ( APOE ) allele possession and PD categories on the Aβ outcome. Results: Prevalence of baseline periodontal disease was 73% (959/1306) and 87% (206/248) among the MRI and PET subgroups, respectively. PD was not associated with volumetric brain measures nor microhemorrhages. PD was inversely associated with the odds of subcortical and lacunar infarctions. PD and Aβ were not associated in main effect or interaction analyses, although there was a notably stronger association among carriers of APOE . Conclusion: PD was not associated with altered brain structure, cerebral microhemorrhages or elevated Aβ deposition. Counter to the hypothesis, PD and complete tooth loss were inversely associated with cerebral infarctions.

Periodontitis Is Associated With Risk of Conventional Stent Restenosis: Pilot Case-Control Study

Objectives: Percutaneous coronary angioplasty with stent implantation has been established as the main form of treatment of atherosclerosis. However, 16 to 44% of patients may evolve with stent restenosis. Periodontitis is an inflammatory condition associated with bacterial infection, that may lead to periodontal tissue destruction and tooth loss. This study aimed to evaluate the association between stent restenosis and periodontitis.Materials and Methods: Coronary angiography exams presenting stent imaging with and without restenosis were analyzed. Patients meeting the inclusion and exclusion criteria were selected and allocated in 2 groups: case (restenosis) and control (without restenosis). We evaluated if systemic and periodontal variables were predictors of restenosis (primary outcome) using a multivariable stepwise logistic regression. Additionally, we compared clinical and periodontal conditions between the control and case groups (secondary outcomes) using Chi-square test and ANOVA test.Results: Data from 49 patients (case n = 15; control n = 34) were analyzed. The results showed that stages III and IV periodontitis and lack of physical activity were significant predictors of stent restenosis (OR 5.82 and 5.98, respectively). Comparisons regarding the diagnosis of periodontal conditions between control and case groups did not present significant differences in the incidence of periodontitis and alveolar bone loss.Conclusion: Stages III and IV periodontitis increased the incidence of stent restenosis. These findings suggest that advanced stages of periodontal disease might lead to the occurrence of negative outcomes after coronary angioplasty with stent placement.

DENTAL ORTHOPEDIC REHABILITATION IN PATIENTS WITH PROBLEMS RELATED TO TYPE 2 DIABETES. Literature Review

The paper discusses modern approaches to restoration of dentition defects in patients with type 2 diabetes mellitus (DM). Endocrinopathy severely affects the status of the teeth periodontium, the oral mucosa and the jaw bone tissue and poses a challenge to the denture design. This accounts for the techniques employed to prepare supporting teeth for prosthetics and the choice of construction materials which should ensure optimal functional capacity, biocompatibility and aesthetics. Besides, our article reveals systematized specifics of prosthetic treatment using dental implants in patients suffering from diabetes.

Development of a nomogram for the prediction of periodontal tooth loss using the staging and grading system: A long-term cohort study.

To develop and internally validate a nomogram built on a multivariate prediction model including parameters from the new classification of periodontal diseases, able to predict, at baseline, the occurrence of tooth loss due to periodontal reason (TLP). A total of 315 individuals diagnosed with periodontal disease and receiving a minimum of one annual supportive periodontal therapy visit were included in the study. Patients were staged and graded based upon baseline data. The population was divided into a development (254 patients) and a validation (61 patients) cohort to allow subsequent temporal validation of the model. According to the TLP at the 10-year follow-up, patients were categorized as "low tooth loss" (≤ 1 TLP) or "high tooth loss" (≥ 2 TLP). Bootstrap internal validation was performed on the whole data set to calculate an optimism-corrected estimate of performance. The generated nomogram showed a strong predictive capability (AUC=0.81) and good calibration with an intercept=0 and slope=1. These findings were confirmed by internal validation using bootstrapping (average bootstrap AUC=0.83). The clinical implementation of the present nomogram guides the prediction of patients with high risk of disease progression and subsequent tooth loss for personalized care.

LPCGF and EDTA conditioning of the root surface promotes the adhesion, growth, migration and differentiation of periodontal ligament cells.

Liquid-phase concentrated growth factor (LPCGF), a new-generation platelet concentrate, may potently stimulate human periodontal ligament (PDL) cells. This study assessed the effectiveness of ethylenediaminetetraacetic acid (EDTA) and/or LPCGF on periodontally diseased root surfaces through their effects on PDL cells. Dentin blocks prepared from periodontal teeth were divided into four groups and treated as follows: group I, scaling and root planning (SRP); group II, SRP + EDTA; group III, SRP + LPCGF; and group IV, SRP+EDTA + LPCGF. PDL cells were cultured on dentin blocks, and LPCGF-induced biological effects were evaluated by migration and cell adhesion/proliferation assays. Furthermore, PDL cell differentiation was assessed by real-time polymerase chain reaction (PCR). Significantly more adherent cells were observed in the EDTA, LPCGF and combination treatment groups than in the control group. Root conditioning with EDTA and/or LPCGF enhanced cell proliferation and migration more than SRP did. Compared with the control group, the combined treatment group exhibited significant upregulation of cell differentiation-related genes. Electron microscopy of the tooth surface revealed removal of the smear layer and exposed dentin holes in the EDTA-treated group but not in the control group. EDTA and LPCGF application to periodontitis-affected root surfaces forms a surface suitable for cell attachment, growth, migration and differentiation. Thus, LPCGF is promising in clinical periodontics applications. Further studies to support these results are necessary.