Most recent publications

• Abdallah, Mariam Mohamed Reda H H; Koldsland, Odd Carsten; Bhatta, Laxmi & Sen, Abhijit (2026). Body mass index, physical activity, and severe periodontitis– a cross-sectional HUNT4 Oral Health Study. BMC Oral Health. 26(1). doi: 10.1186/s12903-026-07882-x. Full text in Research Archive
• Shanbhag, Siddharth; Mayol, Magdalena; Domic, Danijel; Bobbili, Madhusudhan Reddy; Grillari, Johannes & Alonso, Mariano Sanz [Show all 7 contributors for this article] (2025). Harnessing the Therapeutic Potential of Cell Secretomes and Extracellular Vesicles for Craniofacial Regenerative Applications. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.70007. Full text in Research Archive Show summary

  Although tissue engineering and cell therapy have been widely investigated as promising regenerative modalities, their clinical translation has partly been limited by a lack of standardization, high costs, and regulatory barriers. Recently, cell-free therapies (CFT) in the form of cell secretomes [conditioned media (CM)] and extracellular vesicles (EVs) have emerged as viable alternatives to cell therapies. However, much of the evidence is based on preclinical studies. This scoping review aimed to summarize the current evidence for using human-derived CFT, with a focus on EVs, for craniofacial regeneration. Based on predefined inclusion criteria and a systematic search covering three electronic databases (MEDLINE, EMBASE, Web of Science), 122 animal studies (n = 27 CM, n = 95 EVs), and 4 clinical studies (n = 2 CM, n = 2 EVs), mostly reporting on bone and periodontal regeneration, were included. The use of oral-derived CFT, particularly from the periodontal ligament, dental pulp, and gingiva, was frequently reported. A wide range of pre-conditioning strategies, dosages, and delivery methods were tested. The preclinical data revealed a clear adjunctive benefit of CFT with biomaterial scaffolds versus scaffolds alone for bone and periodontal regeneration. Limited clinical data based on small patient groups confirmed the safety and feasibility of CFT, although robust evidence for efficacy is lacking. Finally, several issues related to the clinical translation of CFT have been highlighted for future consideration.

• Miron, Richard J.; Shirakata, Yoshinori; Ahmad, Paras; Mario, Romandini; Estrin, Nathan E. & Farshidfar, Nima [Show all 8 contributors for this article] (2025). 30 years of enamel matrix derivative: Mimicking tooth development as a clinical concept. Periodontology 2000. ISSN 0906-6713. doi: 10.1111/prd.12635. Full text in Research Archive
• Solberg, Mai Soon; Bolstad, Anne Isine; Lie, Stein Atle; Shanbhag, Siddharth & Bunæs, Dagmar Fosså (2025). Scandinavian and North American Moist Snuff and Periodontitis: A Systematic Review and Meta‐Analysis. Journal of Clinical Periodontology. ISSN 0303-6979. 52(9), p. 1338–1361. doi: 10.1111/jcpe.14197. Full text in Research Archive Show summary

  ABSTRACT Aim To answer the focused PECOS question: in humans (P), what is the effect of Scandinavian or North American moist snuff (MS) (E), in comparison to non‐use (C), in terms of periodontitis (O) as demonstrated in clinical studies (S)? Methods Electronic databases (MEDLINE, EMBASE and Cochrane) and grey literature were searched for relevant studies reporting clinical and/or patient‐reported periodontal outcomes. Qualitative and quantitative syntheses (random‐effects meta‐analysis with pooled odds ratios [ORs] or effect sizes [ESs] and 95% confidence intervals [CIs]) were performed to determine the associations between MS use and primary (periodontitis) or secondary outcomes (gingival recession, gingivitis). Risk of bias (Newcastle–Ottawa scale) and certainty of evidence (GRADE) were assessed. Results Twenty‐two mostly cross‐sectional studies from Sweden ( n  = 11), the United States ( n  = 10) and Norway ( n  = 1) were included. MS use was most frequently associated with buccal recession. Qualitatively, an association between MS use and periodontitis ( n  = 16) was judged to be unlikely. Based on studies with high clinical heterogeneity, no significant associations were found between MS use and periodontitis ( n  = 2 [12,775 participants], OR = 1.49 [CI: 0.71–3.16]), recessions ( n  = 9 [3719 participants], ES = –0.04 [CI: –0.98 to 0.90]) or gingivitis ( n  = 3 [1429 participants], ES = 0.09 [CI: –0.36 to 0.55]). The certainty of evidence was judged to be very low. Conclusion The current evidence, mostly based on cross‐sectional studies and very low certainty, suggests that Scandinavian or North American MS use is not associated with periodontitis. Prospero CRD42023417652

• Mauland, Erik Klepsland & Neupane, Sudan Prasad (2025). The Influence of Psychological Stress and Stress‐Related Disorders in the Treatment Outcome of Periodontitis: A Systematic Review and Meta‐Analysis. Journal of Clinical Periodontology. ISSN 0303-6979. 52(12), p. 1760–1778. doi: 10.1111/jcpe.70022. Full text in Research Archive Show summary

  Background and Objective In humans 16 years and above with periodontitis (Population), how do psychological stress and stress‐related disorders (PSRD; Exposure) compared to those without PSRD (Comparison) affect clinical attachment level (CAL) upon periodontitis treatment (Outcome), as observed in experimental studies or descriptive pre–post studies (Study design)? Methods Five major databases were searched for pre–post studies, descriptive cohort and quasi‐experimental or randomised controlled trials (RCTs). For meta‐analysis, mean differences in CAL and bleeding on probing (BOP) were pooled with random‐effects models. Risk of bias, study quality and certainty of evidence were assessed. Results Thirteen studies (eight prospective, two retrospective, two quasi‐experimental and one pilot RCT) with 1610 participants were identified. PSRD (measured as stress in nine studies, depression in three studies and anxiety in one study) showed a negative influence on periodontitis treatment (steps 1 + 2: eight studies, steps 1 + 2 + 3 or 4: four studies, step 4: one study) outcomes. Meta‐analysis of steps 1 + 2 treatment results revealed that patients with PSRD (exposure: stress)—compared to those without—had smaller reductions in CAL (three studies; n  = 170; weighted mean difference (WMD) = 0.78 mm; p  = 0.01) and probing pocket depth (PPD; three studies; n  = 170; WMD = 1.02 mm; p  = 0.04) following periodontitis treatment in studies. Conclusion PSRD adversely affected periodontitis treatment outcomes, particularly concerning CAL and PPD, even though our confidence in the effect estimate is limited in the case of CAL and very low in the case of PPD. This conclusion, based on small treatment cohorts and quasi‐experimental studies following steps 1 + 2 of periodontitis treatment over a 3–6‐month period, warrants validation through rigorously designed studies.

• Shanbhag, Siddharth; Stødle, Ida Haukåen; Lie, Stein Atle; Alonso, Mariano Sanz & Verket, Anders (2025). Histological Outcomes of Root Coverage Procedures: A Systematic Review With Meta‐Analysis. Journal of Periodontal Research. ISSN 0022-3484. 61(1), p. 9–29. doi: 10.1111/jre.70043. Full text in Research Archive Show summary

  Objective: To answer the focused PEOS question: In animals or humans with gingival recession defects (P) what are the histological outcomes (O) of different root coverage procedures (RCPs) (E) in preclinical or clinical studies (S)? Methods: Electronic databases (MEDLINE, EMBASE, CENTRAL) were searched for eligible studies reporting histological outcomes of RCPs in large‐animal models or humans. Histomorphometric data from animal studies were summarized as pooled means (PM) for each RCP and compared between different RCPs using effect sizes (ES) based on random‐effects meta‐analyses. Results: Overall, 41 preclinical (32 canine‐, 5 porcine‐, 4 primate‐models) and 43 clinical studies, mostly case reports/series, were included. The most frequently reported RCPs were coronally advanced flaps with or without connective tissue grafts or soft‐tissue substitutes. Biologicals, such as enamel matrix derivatives (EMD) or membranes, were sometimes used as adjuncts in RCPs. In human biopsies, healing following RCPs mostly occurred via the formation of long junctional epithelium (JE) and connective tissue (CT) adhesion. Some degree of periodontal regeneration was reported in half of the studies. In canine studies with experimentally created defects and limited observation times, PM of new bone, cementum, and CT attachment ranged from 0.17 to 0.50, 0.97 to 2.39, and 1.31 to 2.47, respectively. Meta‐analyses revealed significantly greater new cementum with inserting fibers when using biologicals, particularly EMD (ES 0.86–0.92), or membranes (ES 0.87) as adjuncts in RCPs. Conclusion: Healing following RCPs is generally characterized by “repair” (long JE and CT adhesion). Based on animal studies, the adjunctive use of biologicals or membranes in RCPs may enhance periodontal regeneration at least in the short term.

• Herrera, David; Tonetti, Maurizio S.; Chapple, Iain; Kebschull, Moritz; Papapanou, Panos N. & Sculean, Anton [Show all 68 contributors for this article] (2025). Consensus Report of the 20th European Workshop on Periodontology: Contemporary and Emerging Technologies in Periodontal Diagnosis. Journal of Clinical Periodontology. ISSN 0303-6979. 52(S29), p. 33–33. doi: 10.1111/jcpe.14152. Full text in Research Archive Show summary

  ABSTRACT Background This Consensus Workshop dealt with diagnostic methodologies in the context of surveillance, screening, assessment of stage and grade, prognosis, monitoring and prediction of periodontal status. Several elements provided the impetus for the workshop, including the limited quality of available research on diagnostic tests, the rapid development of new technologies, the implementation of the 2018 classification and the declarations of the World Health Organisation on diagnosis and oral health. Aim To update and evaluate the evidence on diagnostic methods, considering recent advances in knowledge and the implementation of the 2018 classification. Methods The European Workshop Committee of the European Federation of Periodontology guided the development of a consensus report after commissioning eight systematic reviews within three working groups. The reviews were discussed during the in‐person consensus meeting involving 70 participants from 21 different countries. Results Working Group 1 discussed innovations in traditional diagnostic approaches, justified manual probing as the reference standard and assessed the value of image‐based methods. Working Group 2 analysed diagnostic tests based on microbial and host biomarkers and genetic diagnostic tests. Working Group 3 covered emerging technologies to be used within dental and non‐dental clinical settings, focusing principally on the impact of questionnaire‐based assessments and artificial intelligence systems (AIS) in interpreting different data modalities. Conclusion Although manual periodontal probing is firmly established as the reference standard, additional approaches based on imaging, biomarkers, host genetics, questionnaires and the development of emerging applied data science methods (e.g., AIS) are increasingly integrated in periodontal diagnostics.

• Maal, Mehrnaz Beheshti; Bueno, Jaime; Koldsland, Odd Carsten; Alonso, Mariano Sanz & Verket, Anders (2025). Oral Hygiene Reinforcement With or Without Repeated Instrumentation in the Treatment of Peri‐Implant Mucositis—A Randomised Controlled Trial. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.70012. Full text in Research Archive Show summary

  ABSTRACT Aim To assess the efficacy of repeated submarginal mechanical instrumentation, as an adjunct to oral hygiene instruction, in the treatment of peri‐implant mucositis. Material and Methods Patients with peri‐implant mucositis were allocated to a control group receiving oral hygiene instructions only, or a test group with adjunctive repeated ultrasonic instrumentation with a polyetheretherketone tip. Bleeding on probing reduction was the primary outcome. A blinded examiner recorded clinical variables, and intraoral scans were obtained at baseline, 12 weeks and 24 weeks. Results In total, 58 patients were recruited, and 50 completed the study. Clinical parameters improved from baseline in both groups. There were no significant differences in the reduction of the extent nor the severity of bleeding on probing between the control and the test group at the 12‐ and 24‐week follow‐ups, but a significantly higher reduction in the peri‐implant mucosa volume was observed in the test group from 12 to 24 weeks. Conclusions Ultrasonic instrumentation with a polyetheretherketone tip adjunctive to oral hygiene instructions did not render a higher reduction in bleeding on probing or lead to improved clinical outcomes. Still, it resulted in a higher reduction of the peri‐implant mucosa volume as compared to oral hygiene instructions alone.

• Mauland, Erik Klepsland; Maal, Mehrnaz Beheshti; Melbye, Elisabeth Lind; Aarbu, Naomi Østergren; Sørensen, Karoline & Ellingsen, Stig Aanerød [Show all 9 contributors for this article] (2025). The impact of peri-implant diseases and complications on oral health-related quality of life following dental implant therapy in Norway: A cross-sectional study. Clinical Oral Implants Research. ISSN 0905-7161. 36(10), p. 1219–1233. doi: 10.1111/clr.14467. Full text in Research Archive Show summary

  Objectives: To report oral health-related quality of life (OHRQoL) in a sample rehabilitated with dental implants and assess the influence of self-reported implant complications and clinical peri-implant status. A secondary aim was to investigate associations between OHIP-14 scores and patient-related variables. Materials and Methods: The Norwegian National Insurance Scheme registry for implant rehabilitation in 2014 was searched, and patients (n = 3083) were mailed a survey including OHIP-14, questions about peri-implant status, and patient-related variables. A subsample was examined clinically (n = 242). Associations of self-reported implant complications and clinical peri-implant status with OHIP-14 scores were evaluated by the Kruskal–Wallis test and logistic regression models. Results: The OHIP-14 mean sum score reported by the 1299 survey respondents was 4.1 (± 6.4). Self-report of complications was associated with higher OHIP-14 scores in a dose-dependent manner. Lower education (OR 1.54, 95% CI 1.05–2.22), female sex (OR 1.75, 95% CI 1.23–2.56), technical complication(s) (OR 1.58, 95% CI: 1.07–2.34), biological complication(s) (OR 2.41, 95% CI 1.67–3.49) and poor cleansability (OR 2.94, 95% CI 1.64–5.37) were associated (p < 0.05) with higher OHIP-14 mean sum scores in the adjusted regression model. For the 242 patients examined clinically, the OHIP-14 mean sum score was 3.8 (± 6.5). Peri-implant soft tissue dehiscence (OR 2.53, 95% CI 1.17–5.49) was associated with higher OHIP-14 mean sum scores in the adjusted regression model. Conclusions: OHIP-14 scores were low in this study, indicating good OHRQoL following implant rehabilitation in Norway. Complications lowered OHRQoL in a dose–response manner, confirmed by self-reports of complications and by the presence of peri-implant soft tissue dehiscence.

• Mustafa, Kamal; Yamada, Shuntaro; Sanchez, Nerea; Mayol, Magdalena; Gjerde, Cecilie & Alonso, Mariano Sanz (2025). Cell Therapy for Periodontal, Soft-Tissue, and Craniofacial Regeneration. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.70011. Full text in Research Archive Show summary

  Periodontal and craniofacial regeneration presents significant challenges owing to the complex tissue architecture, inadequate vascularization, and diminished stem cell populations within damaged tissues. Traditionally, autologous bone grafts or alternative bone substitute materials have been employed to address these conditions; however, these approaches are constrained by donor site morbidity, limited availability, and suboptimal regenerative efficacy. The advancement of mesenchymal stem/stromal cell (MSC) biology has accelerated the development of cell-based therapies in modern dentistry, which now focuses on biologically driven approaches to regenerate tissues. MSC-based therapies currently under investigation, both preclinically and clinically, show promise for improving tissue integration and healing processes of both soft and hard tissues, attributable to their multipotent nature, immunomodulatory properties, and paracrine signaling capabilities. Nevertheless, obstacles persist, including inconsistent standardization, limited scalability, regulatory hurdles, a paucity of controlled studies, and restricted biomaterial options. This review evaluates MSC-based treatments for periodontal and craniofacial reconstruction by discussing recent research findings and existing obstacles. This review also examines future prospects, such as advanced biofabrication methods, including 3D printing and bioprinting, which have the potential to improve personalized cell therapy for periodontal and craniofacial regeneration.

• Stødle, Ida Haukåen; Imber, Jean-Claude; Shanbhag, Siddharth; Salvi, Giovanni E.; Verket, Anders & Stähli, Alexandra (2025). Methods for Clinical Assessment in Periodontal Diagnostics: A Systematic Review. Journal of Clinical Periodontology. ISSN 0303-6979. 52(29), p. 58–73. doi: 10.1111/jcpe.14145. Full text in Research Archive
• Smedås, Anne Kari; Paris, Lovise Gangeskar; Anam, Niyaz Abdulbaqi Abdulmajid; Kristoffersen, Einar Klæboe; Alonso, Mariano Sanz & Mustafa, Kamal Babikeir Elnour [Show all 8 contributors for this article] (2025). Secretomes of Gingival Fibroblasts From Periodontally Diseased Tissues: A Proteomic Analysis. Clinical and Experimental Dental Research. 11(1). doi: 10.1002/cre2.70103. Full text in Research Archive Show summary

  Objective: Cell secretomes represent a promising strategy for periodontal and bone regeneration. The objective of this study was to characterize the secretome of human gingival fibroblasts (GF) from periodontally diseased tissues (GF-perio) using proteomics. Materials and Methods: Conditioned media of GF-perio from periodontitis patients (n = 6, 48-h serum-free culture) were subjected to liquid chromatography with tandem mass spectrometry. Global profiles, differentially expressed proteins (DEPs), and functional/gene-set enrichment (FEA) were analyzed using bioinformatics. Selected bone regeneration-related proteins were additionally measured using a multiplex immunoassay. Conditioned media of GF from periodontally healthy subjects were used as a reference. Results: Overall, 1833 proteins were detected in GF-perio secretomes, including several growth factors, cytokines, chemokines, and extracellular matrix proteins important for wound healing and regeneration. Key bone-related cytokines (FGF2, MCP1, GPNMB, MMP2, IL6, IL8) were confirmed by an immunoassay. Compared to the reference group, 127 exclusive proteins and 73 DEPs (p < 0.05) were identified in the GF-perio group. FEA revealed significant enrichment of “exosome” and “cytoplasm” related cellular components in GF-perio secretomes. Conclusion: The secretome of GF from periodontally diseased tissues may hold therapeutic potential, with several proteins important for wound healing and regeneration, especially those related to exosome functions.

• Ravidà, Andrea; Serroni, Matteo; Borgnakke, Wenche S.; Mario, Romandini; Wang, I-Ching & Arena, Claudia [Show all 9 contributors for this article] (2024). Short (≤6 mm) compared with ≥10-mm dental implants in different clinical scenarios: A systematic review of randomized clinical trials with meta-analysis, trial sequential analysis and quality of evidence grading. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13981. Full text in Research Archive Show summary

  Aim To systematically identify, synthesize and critically summarize the available scientific evidence from randomized controlled trials (RCTs) regarding whether short (≤6 mm) perform as well as long (≥10 mm) implants regarding implant survival, marginal bone loss, and biologic and prosthetic complications in different clinical scenarios. Materials and Methods Cochrane Collaboration's risk of bias tool and the GRADE approach were applied. Results were synthesized using random-effects meta-analyses assessed by trial sequential analyses. Results Forty reports on 19 RCTs comprising 2214 (1097 short; 1117 long) implants were included. Moderate/high certainty/quality evidence demonstrated similar 5-year survival rates for ≤6-mm and ≥10-mm implants in non-augmented bone and full-mouth rehabilitation in either jaw, and for 6-mm implants in the maxilla instead of sinus lift. Nevertheless, the evidence for 5-year survival rates remains inconclusive or insufficient for the remaining combinations of implant lengths and clinical scenarios. They include 4-mm and 5-mm implants as alternatives to sinus lift as well as placing all implant lengths ≤6 mm instead of vertical ridge augmentation with long implants. Marginal bone level and short- and long-term biologic or prosthetic complications were similar. Conclusions Based on moderate/high certainty/quality evidence from 5-year RCTs, implants ≤6 mm may be viable alternatives to ≥10-mm implants in either jaw in native bone and full-arch rehabilitation, and 6-mm implants may be used as an alternative to sinus lift. Trial registration: PROSPERO ID: CRD42021254365.

• Isler, Sila Cagri; Mario, Romandini; Akca, Gulcin; Bakirarar, Batuhan; Unsal, Berrin & Romanos, Georgios [Show all 7 contributors for this article] (2024). Soft-Tissue Phenotype as a Risk Indicator of Peri-Implantitis and Peri-Implant Soft-Tissue Dehiscence—A Cross-Sectional Study. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.14059. Full text in Research Archive Show summary

  Aim To investigate the association, as well as to characterize the associated panel of pro- and anti-inflammatory markers, between the different components of the peri-implant phenotype and the presence of peri-implantitis/peri-implant soft-tissue dehiscence (PISTD). Materials and Methods A total of 324 implants in 112 patients were included. The following components of the peri-implant phenotype were clinically measured through the use of a manual periodontal probe or a digital calliper: keratinized mucosa width (PIKM-W), mucosal thickness (MT), attached mucosa (AM) and vestibulum depth (VD). The presence of peri-implantitis and PISTD was assessed through clinical and radiographic examination. Mixed-models logistic regression analyses were performed to analyse the association between peri-implant phenotype and the presence of peri-implantitis or PISTD, adjusting for relevant confounders. Multiplex immunoassays were employed to evaluate the peri-implant crevicular fluid levels of a panel of pro- and anti-inflammatory markers. Results Peri-implant health, peri-implant mucositis and peri-implantitis were diagnosed in 36.6%, 21.4% and 42% of the patients (classified according to their worst implant) and 35.2%, 34.3%, and 30.5% of the implants, respectively. In the multi-level multiple regression model, the absence of PIKM-W (odds ratio [OR] = 9.24; 95% CI: 2.73–31.28), the absence of attached mucosa (OR = 19.58; 95% CI: 6.12–62.56) and a reduced (<4 mm) vestibulum depth (OR = 2.61; 95% CI: 1.05–6.48) were associated with peri-implantitis. Similarly, the absence of PIKM-W (OR = 6.32; 95% CI: 1.67–23.83), a thin (<2 mm) mucosa (OR = 157.75; 95% CI: 14.06–1769.9) and a reduced vestibulum depth (OR = 3.32; 95% CI: 1.02–10.84) were associated with the presence of PISTD. Implants with PIKM-W = 0 mm showed statistically significantly higher levels of interferon-γ in both regular (≥2 maintenance/year) and irregular (<2 maintenance/year) compliers (p = 0.046 and p = 0.012). In irregular compliers, the absence of PIKM-W was also associated with statistically significantly higher levels of interleukin (IL)-1β and IL-21 (p = 0.016, p = 0.046). These associations were independent of the effect of relevant confounders (e.g., plaque, compliance with maintenance, etc.). Conclusions Within their limits, the present findings indicate that (a) peri-implant soft-tissue phenotype appears to be associated with the presence of peri-implantitis and PISTD, and (b) in the absence of PIKM-W, the inflammatory response seems to be dysregulated and the soft-tissue remodelling up-regulated.

• Kalhan, Ashish C.; Kalhan, Tosha A.; Mario, Romandini; Bitencourt, Fernando V.; Cooray, Upul M. P. & Leite, Fábio R. M. [Show all 7 contributors for this article] (2024). Insulin resistance and periodontitis: Mediation by blood pressure. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.13333. Full text in Research Archive Show summary

  Aim This study investigated the association between the triglyceride-glucose (TyG) index, a surrogate marker of insulin resistance, and moderate/severe periodontitis and the role of blood pressure as a mediator in this association. A second aim was to assess the role of cardiometabolic conditions such as obesity, hypertension, and dyslipidemia as potential effect modifiers. Methods Data from 5733 US adults aged 30–64 years and with complete periodontal examination were analyzed (NHANES 2011–2014). Participants were classified as having moderate/severe periodontitis or mild/no periodontitis according to the CDC/AAP criteria as the outcome. The exposure was the TyG index, while both systolic (SBP), and diastolic (DBP) blood pressure were tested as mediators using parametric g-formula. Analyses were adjusted for relevant confounders, namely, age, sex, ethnicity, poverty-income ratio, and smoking, using inverse probability treatment weighting. Obesity status (based on a body mass index ≥30 kg/m2), self-report of hypertension and dyslipidemia (calculated based on the thresholds provided by National Cholesterol Education Program-Adult Treatment Panel-III) were tested as effect modifiers. Results The findings showed the TyG index to be associated with increased odds of moderate/severe periodontitis [odds ratio (OR), 95% confidence interval (CI) = 1.17 (1.11–1.23)], with 50% of the total effect mediated by SBP. Stratified analysis showed a stronger association in individuals with obesity, hypertension, and dyslipidemia compared to those without these conditions. However, in those taking anti-hypertensive medications, the association was partially mitigated. Sensitivity analysis using imputed data showed consistent results. Conclusion The TyG index was associated with increased odds of moderate/severe periodontitis, especially in individuals with obesity, hypertension, and dyslipidemia. SBP levels partially mediated this association.

• Nascimento, Gustavo G.; Alves-Costa, Silas & Mario, Romandini (2024). Burden of severe periodontitis and edentulism in 2021, with projections up to 2050: The Global Burden of Disease 2021 study. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.13337. Full text in Research Archive Show summary

  Aim To (i) assess the prevalence, incidence, and burden of severe periodontitis and edentulism in 2021, and (ii) forecast their rates in 2050. Methods Prevalence, incidence, and Years Lived with Disability (YLDs) for severe periodontitis and edentulism in 2021 were gathered globally, covering 204 countries, seven super regions, and 21 regions from the Global Burden of Disease (GBD) 2021 study. Prevalence, incidence, and YLDs due to periodontitis and edentulism to 2050 were projected using mixed-effects models with the socio-demographic index as the main covariate. Results In 2021, over 1 billion people were affected by severe periodontitis (1066.95 million; 95% UI: 896.55–1234.84), with a global age-standardized prevalence of 12.50% (10.53–14.49). South Asia had the highest prevalence rate, at 17.57% (14.73; 20.14). Edentulism affected 353 million people globally (300.60–416.20), resulting in an age-standardized prevalence of 4.11% (3.50; 4.83). The highest edentulism prevalence was found in Latin America and the Caribbean, at 7.39% (6.44; 8.39). By 2050, more than 1.5 billion people (+44.32%) are projected to have severe periodontitis, and over 660 million (+84.40%) to be edentulous. In the same year, 19.67% (130.23 million) of the edentulous people worldwide will be located in China. Severe periodontitis is expected to move up one position, and edentulism nine positions, among the most impactful Level 4 diseases/conditions affecting YLDs worldwide by 2050. Conclusion Severe periodontitis and edentulism remain major public health challenges in 2021, with the number of affected individuals projected to rise significantly in the coming decades.

• Khan, Sadia Nazir; Koldsland, Odd Carsten; Tiainen, Hanna & Hjortsjö, Carl (2024). Anatomical three-dimensional model with peri-implant defect for in vitro assessment of dental implant decontamination. Clinical and Experimental Dental Research. 10(1). doi: 10.1002/cre2.841. Full text in Research Archive Show summary

  Abstract Objectives Access to the implant surface plays a significant role in effective mechanical biofilm removal in peri‐implantitis treatment. Mechanical decontamination may also alter the surface topography of the implant, potentially increasing susceptibility to bacterial recolonization. This in vitro study aimed to evaluate a newly developed, anatomically realistic, and adaptable three‐dimensional (3D)printed model with a peri‐implant bone defect to evaluate the accessibility and changes of dental implant surfaces after mechanical decontamination treatment. Material and Methods A split model of an advanced peri‐implant bone defect was prepared using 3D printing. The function of the model was tested by mechanical decontamination of the exposed surface of dental implants (Standard Implant Straumann AG) coated with a thin layer of colored occlusion spray. Two different instruments for mechanical decontamination were used. Following decontamination, the implants were removed from the split model and photographed. Image analysis and fluorescence spectroscopy were used to quantify the remaining occlusion spray both in terms of area and total amount, while scanning electron microscopy and optical profilometry were used to analyze alteration in the implant surface morphology. Results The 3D model allowed easy placement and removal of the dental implants without disturbing the implant surfaces. Qualitative and quantitative assessment of removal of the occlusion spray revealed differences in the mechanism of action and access to the implant surface between tested instruments. The model permitted surface topography analysis following the decontamination procedure. Conclusion The developed 3D model allowed a realistic simulation of decontamination of implant surfaces with colored occlusion spray in an advanced peri‐implant defect. 3D printing allows easy adaptation of the model in terms of the shape and location of the defect. The model presents a valuable tool for in vitro investigation of the accessibility and changes of the implant surface after mechanical and chemical decontamination.

• Breivik, Torbjørn; Gjermo, Per E; Gundersen, Yngvar; Opstad, Per Kristian; Murison, Robert & Hugoson, Anders [Show all 8 contributors for this article] (2024). Microbiota-immune-brain interactions: A new vision in the understanding of periodontal health and disease. Periodontology 2000. ISSN 0906-6713. doi: 10.1111/prd.12610. Full text in Research Archive Show summary

  This review highlights the significance of interactions between the microbiota, immune system, nervous and hormonal systems, and the brain on periodontal health and disease. Microorganisms in the microbiota, immune cells, and neurons communicate via homeostatic nervous and hormonal systems, regulating vital body functions. By modulating pro-inflammatory and anti-inflammatory adaptive immune responses, these systems control the composition and number of microorganisms in the microbiota. The strength of these brain-controlled responses is genetically determined but is sensitive to early childhood stressors, which can permanently alter their responsiveness via epigenetic mechanisms, and to adult stressors, causing temporary changes. Clinical evidence and research with humans and animal models indicate that factors linked to severe periodontitis enhance the responsiveness of these homeostatic systems, leading to persistent hyperactivation. This weakens the immune defense against invasive symbiotic microorganisms (pathobionts) while strengthening the defense against non-invasive symbionts at the gingival margin. The result is an increased gingival tissue load of pathobionts, including Gram-negative bacteria, followed by an excessive innate immune response, which prevents infection but simultaneously destroys gingival and periodontal tissues. Thus, the balance between pro-inflammatory and anti-inflammatory adaptive immunity is crucial in controlling the microbiota, and the responsiveness of brain-controlled homeostatic systems determines periodontal health.

• Shanbhag, Siddharth; Al-Sharabi, Niyaz Abdulbaqi Abdulmajid; Fritz-Wallace, Katarina; Kristoffersen, Einar Klæboe; Bunæs, Dagmar Fosså & Mario, Romandini [Show all 9 contributors for this article] (2024). Proteomic Analysis of Human Serum Proteins Adsorbed onto Collagen Barrier Membranes. Journal of Functional Biomaterials. 15(10). doi: 10.3390/jfb15100302. Full text in Research Archive Show summary

  Collagen barrier membranes are frequently used in guided tissue and bone regeneration. The aim of this study was to analyze the signature of human serum proteins adsorbed onto collagen membranes using a novel protein extraction method combined with mass spectrometry. Native porcine-derived collagen membranes (Geistlich Bio-Gide®, Wolhusen, Switzerland) were exposed to pooled human serum in vitro and, after thorough washing, subjected to protein extraction either in conjunction with protein enrichment or via a conventional surfactant-based method. The extracted proteins were analyzed via liquid chromatography with tandem mass spectrometry. Bioinformatic analysis of global profiling, gene ontology, and functional enrichment of the identified proteins was performed. Overall, a total of 326 adsorbed serum proteins were identified. The enrichment and conventional methods yielded similar numbers of total (315 vs. 309), exclusive (17 vs. 11), and major bone-related proteins (18 vs. 14). Most of the adsorbed proteins (n = 298) were common to both extraction groups and included several growth factors, extracellular matrix (ECM) proteins, cell adhesion molecules, and angiogenesis mediators involved in bone regeneration. Functional analyses revealed significant enrichment of ECM, exosomes, immune response, and cell growth components. Key proteins [transforming growth factor-beta 1 (TGFβ1), insulin-like growth factor binding proteins (IGFBP-5, -6, -7)] were exclusively detected with the enrichment-based method. In summary, native collagen membranes exhibited a high protein adsorption capacity in vitro. While both extraction methods were effective, the enrichment-based method showed distinct advantages in detecting specific bone-related proteins. Therefore, the use of multiple extraction methods is advisable in studies investigating protein adsorption on biomaterials.

• Balta, Maria; Schreurs, Olaf Joseph Franciscus; Blix, Inger Johanne Schytte & Schenck, Karl (2024). The effect of resolvin D1<inf>n-3 DPA</inf> on primary oral epithelial cell migration in vitro. European Journal of Oral Sciences. ISSN 0909-8836. doi: 10.1111/eos.12981. Full text in Research Archive Show summary

  Specialized pro-resolving lipid mediators (SPMs) are known for their anti-inflammatory and pro-resolving actions. The aim of the present study was to find new functions of the SPM resolvin D1n-3 DPA (RvD1n-3 DPA) on oral epithelial cells. As a starting point, we used a dataset obtained by RNA high-throughput sequencing of oral epithelial cells exposed to TNF-α and RvD1n-3 DPA versus TNF-α alone. GOrilla enrichment analysis showed that the actin cytoskeleton was significantly overrepresented after adjustment for multiple hypothesis testing. As actin, amongst others, is closely related to cell migration, we then explored whether RvD1n-3 DPA can modulate oral epithelial cell migration. To this end, we used an in vitro cell migration model, including TNF-α treatment, to mimic an inflammatory cell state. The analysis revealed that RvD1n-3 DPA increased oral epithelial cell migration in the presence but not in the absence of TNF-α. Addition of RvD1n-3 DPA also induced F actin accumulation around the cell nucleus, indicating that RvD1n-3 DPA potentially can mediate processes of intracellular transport. This indicates that this lipid mediator may be a promising therapeutic candidate in oral mucosal wound healing.

• Lauretis, Angela De; Øvrebø, Øystein; Romandini, Mario; Lyngstadaas, Ståle Petter; Rossi, Filippo & Haugen, Håvard Jostein (2024). From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials. Advanced Science. doi: 10.1002/advs.202308848. Full text in Research Archive Show summary

  Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioural and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations in the field and future research areas. Our search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analysed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. We discuss the key properties required for functional regeneration, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, we suggest improving the design and reporting of clinical studies by strictly adhering to the CONSORT 2010 statement.

• Marruganti, Crystal; Mario, Romandini; Gaeta, Carlo; Trovato, Emanuele; Cinotti, Elisa & Rubegni, Pietro [Show all 8 contributors for this article] (2024). Treatment of periodontitis ameliorates the severity and extent of psoriasis—A randomized clinical trial. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.13314. Full text in Research Archive
• Khan, Sadia Nazir; Ribeiro-Vidal, Honorato; Virto, Leire; Bravo, Enrique; Nuevo, Paula & Koldsland, Odd Carsten [Show all 8 contributors for this article] (2024). The Decontamination Effect of an Oscillating Chitosan Brush Compared With an Ultrasonic PEEK-Tip: An In Vitro Study Using a Dynamic Biofilm Model. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.14360. Full text in Research Archive
• Stødle, Ida Haukåen; Koldsland, Odd Carsten; Lukina, Polina; Andersen, Ina Lervåg; Mjønes, Patricia Gjertrud & Rønne, Elin [Show all 9 contributors for this article] (2024). Undiagnosed Celiac Disease and Periodontal Bone Loss: A Cross-Sectional Radiological Assessment from the HUNT Study. International Journal of Dentistry. ISSN 1687-8728. 2024(1). doi: 10.1155/2024/1952244. Full text in Research Archive Show summary

  Objective. The objective was to assess radiographic periodontal bone loss in a population with previously undiagnosed celiac disease, and to compare it to a reference group without celiac disease. Background. Periodontitis and celiac disease are chronic inflammatory diseases with possible similar features related to immune reactions and microbial dysbiosis. The relationship between these two diseases is not clear. Methods. Clinical variables, blood samples, and answers to questionnaires were collected from participants in the fourth Trøndelag Health Study (HUNT4). Celiac disease was determined based on transglutaminase 2 (TG2), immunoglobulin A (IgA), and G (IgG) in serum samples. Seropositive individuals were invited to endoscopic examination and tissue sampling. Radiographically assessed bone loss caused by periodontitis in two different levels of severity was applied as outcome, that is, ≥15% and >33% of root length. Bone loss was determined in panoramic images in participants that had attended radiographic examination in the HUNT4 Oral Health Study or in the HUNT4 Coeliac Disease Study. The association between previously undiagnosed celiac disease and radiographic bone loss was estimated by adjusted Poisson regression models. Results. Radiographic assessment was completed in 485 individuals with celiac disease determined by positive serology and in 4,727 individuals with negative serology (without celiac disease). Compared to nonceliacs, seropositive participants were less likely to present with ≥15% radiographic bone loss (prevalence ratio (PR) 0.89 (95% CI 0.84–0.96). A similar association was also observed after histopathological confirmation of celiac disease (PR 0.89 (95% CI 0.82–0.98). No association between undiagnosed celiac disease and periodontal bone loss was observed when analyses were limited to individuals with severe bone loss (>33%). Conclusion. In this study of previously undiagnosed celiac disease and periodontal bone loss, newly diagnosed celiac disease was associated with less likelihood of presenting with ≥15% radiographic bone loss compared to a nonceliac reference group.

• Lindhe, Jan & Mario, Romandini (2024). Periodontology: The Past, the Present, the Future. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.13370. Full text in Research Archive Show summary

  In 2025, the Journal of Periodontal Research proudly celebrates its 60th anniversary. On this occasion, after more than 50 years, we are transitioning to 12 issues per year [1]. Together with this milestone, we introduce one of the exciting initiatives marking the journal's new era: a series of Perspective Articles under the theme “The Past, The Present, The Future”. This series will feature contributions from the “giants” of our field and will serve as a unique opening to each issue of the Journal of Periodontal Research. The series commences with an insightful contribution from one of the most influential figures ever in periodontology: Professor Jan Lindhe. This manuscript stems from a memorable conversation we shared over tea and biscuits at his home in May 2024. During this magnetic interview, I was transported back in time to relive the pivotal moments that have shaped periodontology, vividly recounted from his extraordinary memory. At the same time, I was struck by his revolutionary mindset, as he continues to challenge established dogmas and share his visionary ideas for the future of our discipline. I am delighted to share the essence of this unforgettable encounter, which holds a special place in my heart. I hope that this manuscript not only transports readers to that tea-and-biscuits moment, but also ignites a burst of inspiration from the past, present, and future of periodontology.

• Mauland, Erik Klepsland; Sørensen, Karoline; Aarbu, Naomi Østergren; Verket, Anders; Ellingsen, Stig Aanerød & Bull, Vibeke Hervik [Show all 9 contributors for this article] (2024). A Cross-Sectional Study of Peri-Implant Diseases in a Random Norwegian Population: Prevalence, Risk Indicators, and Clinical Validation of Patient-Reported Outcomes. Clinical Oral Implants Research. ISSN 0905-7161. 36(2), p. 153–165. doi: 10.1111/clr.14371. Full text in Research Archive Show summary

  Objectives The primary aim of this study was to investigate the prevalence of peri-implant diseases in a randomly selected Norwegian population. The secondary aims were to explore risk indicators for peri-implant diseases and to validate self-reported outcome measures from a survey with clinical parameters. Material and Methods Patients (n = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire and invited to a clinical examination. A randomly selected subset of responders underwent a clinical examination (n = 242). Full mouth clinical and radiographic examinations were conducted. Multiple logistic regression was used to assess patient-related risk indicators for peri-implantitis. Self-reported data were compared with data from the clinical examination using Spearman correlation and binary logistic regression. Results The prevalence of peri-implantitis was 17.0% at patient level and 8.6% at implant level, according to the 2018 classification. Risk indicators for peri-implantitis included smoking and periodontitis in the adjusted model. The correlation was strong (r = 0.91, p < 0.001) between number of self-reported implants and clinical counts, whereas self-reported peri-implant inflammation was associated with peri-implantitis (OR 6.4 [95% CI 3.0, 13.7]). Conclusions Smoking and periodontitis were identified as key risk indicators for peri-implantitis. Questionnaire data rendered clinically valid estimates of implant number, and self-reported peri-implant inflammation was associated with clinical peri-implantitis.

• Sødal, Anne Thea Tveit; Diep, My Tien; Skudutyte-Rysstad, Rasa; Singh, Preet Bano; Young, Alix & Jensen, Janicke Liaaen [Show all 9 contributors for this article] (2024). Oral helse blant 65-åringer i Oslo. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 12(134). doi: 10.56373/2024-12-5. Full text in Research Archive
• Bencze, Bulcsú; Cavalcante, Bianca Golzio Navarro; Mario, Romandini; Róna, Virág; Váncsa, Szilárd & Varga, Gábor [Show all 13 contributors for this article] (2024). Prediabetes and poorly controlled type-2 diabetes as risk indicators for peri-implant diseases:A systematic review and meta-analysis. Journal of Dentistry. ISSN 0300-5712. 146. doi: 10.1016/j.jdent.2024.105094. Full text in Research Archive Show summary

  Objective The study answers the PECO question: “In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?”. Prediabetes (5.7–6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association. Data Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c. Sources An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles. Study Selection Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm. Conclusions Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases. Clinical Significance Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health.

• Marruganti, Crystal; Gaeta, Carlo; Romandini, Mario; Cagidiaco, Edoardo Ferrari; Parrini, Stefano & Discepoli, Nicola [Show all 7 contributors for this article] (2023). Multiplicative effect of stress and poor sleep quality on periodontitis: A university-based cross-sectional study. Journal of Periodontology. ISSN 0022-3492. doi: 10.1002/JPER.23-0209. Full text in Research Archive Show summary

  Abstract Background The aim of this study was to evaluate the association of perceived stress and poor sleep quality with periodontitis in a university‐based cohort of individuals. Methods A total of 235 individuals were included in this cross‐sectional study. Perceived stress and sleep quality were evaluated through validated questionnaires, while periodontitis was identified with a full‐mouth periodontal examination protocol using both European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) and Centers for Disease Control and Prevention (CDC)/AAP case definitions. Simple and multiple linear and ordinal logistic regression analyses were performed to evaluate the association between perceived stress and sleep quality with periodontitis prevalence and severity. Results Stage III/IV periodontitis resulted associated with both moderate/high perceived stress (odds ratio [OR] = 5.4; 95% confidence interval [CI]: 2.2–13.5; p  &lt; 0.001) and poor sleep quality (OR = 3.0; 95% CI: 1.2–7.4; p  &lt; 0.05). The interaction between moderate/high perceived stress and poor sleep quality presented a multiplicative association with stage III/IV periodontitis (EFP/AAP; OR = 5.8; 95% CI: 1.6–21.3; p  &lt; 0.001). Multiple linear regression analyses indicated a similar trend of association also with linear periodontal parameters, that is, mean clinical attachment level (CAL) and mean probing pocket depth (PPD). Conclusions The findings from the present study suggest that stress and poor sleep quality may exert a multiplicative effect on periodontitis prevalence and severity.

• Carvalho, Érika B. S.; Romandini, Mario; Sadilina, Sofya; Sant'Ana, Adriana C. P. & Alonso, Mariano Sanz (2023). Microbiota associated with peri-implantitis—A systematic review with meta-analyses. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.14153. Full text in Research Archive Show summary

  Abstract Aim To answer the following PECO question: “In systemically healthy human subjects (P), which are the differences between peri‐implantitis (E) and peri‐implant health/mucositis (C) in terms of bacterial presence/count (O)?” Materials and Methods Cross‐sectional studies fulfilling specific inclusion criteria established to answer the PECO question were included. Two review authors independently searched for studies, screened the titles and abstracts, did full‐text analysis, extracted the data from the included reports, and performed the risk of bias assessment through an adaptation of the Newcastle/Ottawa tool for cross‐sectional studies and of the JBI critical appraisal checklist. In case of disagreement, a third reviewer author took the final decision. Study results were summarized using random effects meta‐analyses. Results A total of 12 studies were included, involving 1233 participants and 1513 implants. Peri‐implantitis was associated with the presence of S . epidermidis (Odds ratio, OR = 10.28 [95% Confidence interval, CI: 1.26–83.98]), F .  nucleatum (OR = 7.83 [95% CI: 2.24–27.36]), T .  denticola (OR = 6.11 [95% CI: 2.72–13.76]), T .  forsythia (OR = 4.25 [95% CI: 1.71–10.57]), P .  intermedia (OR = 3.79 [95% CI: 1.07–13.35]), and P .  gingivalis (OR = 2.46 [95% CI: 1.21–5.00]). Conversely, the presence of A .  actinomycetemcomitans (OR = 3.82 [95% CI: 0.59–24.68]), S .  aureus (OR = 1.05 [95% CI: 0.06–17.08]), and C .  rectus (OR = 1.48 [95% CI: 0.69–3.17]) was not associated with peri‐implantitis. Conclusions Peri‐implantitis is associated with the presence of S .  epidermidis and specific periodontopathogens ( P .  gingivalis , T .  forsythia , T .  denticola , F .  nucleatum , and P .  intermedia ). (CRD42021254589)

• Baima, Giacomo; Minoli, Margherita; Michaud, Dominique S.; Aimetti, Mario; Alonso, Mariano Sanz & Loos, Bruno G. [Show all 7 contributors for this article] (2023). Periodontitis and risk of cancer: Mechanistic evidence. Periodontology 2000. ISSN 0906-6713. doi: 10.1111/prd.12540. Full text in Research Archive Show summary

  Abstract This review aims to critically analyze the pathways of interaction and the pathogenic mechanisms linking periodontitis and oral bacteria with the initiation/progression of cancer at different body compartments. A higher risk of head and neck cancer has been consistently associated with periodontitis. This relationship has been explained by the local promotion of dysbiosis, chronic inflammation, immune evasion, and direct (epi)genetic damage to epithelial cells by periodontal pathobionts and their toxins. Epidemiological reports have also studied a possible link between periodontitis and the incidence of other malignancies at distant sites, such as lung, breast, prostate, and digestive tract cancers. Mechanistically, different pathways have been involved, including the induction of a chronic systemic inflammatory state and the spreading of oral pathobionts with carcinogenic potential. Indeed, periodontitis may promote low‐grade systemic inflammation and phenotypic changes in the mononuclear cells, leading to the release of free radicals and cytokines, as well as extracellular matrix degradation, which are all mechanisms involved in carcinogenic and metastatic processes. Moreover, the transient hematogenous spill out or micro‐aspiration/swallowing of periodontal bacteria and their virulence factors (i.e., lipopolysaccharides, fimbriae), may lead to non‐indigenous bacterial colonization of multiple microenvironments. These events may in turn replenish the tumor‐associated microbiome and thus influence the molecular hallmarks of cancer. Particularly, specific strains of oral pathobionts (e.g., Porphyromonas gingivalis and Fusobacterium nucleatum ) may translocate through the hematogenous and enteral routes, being implicated in esophageal, gastric, pancreatic, and colorectal tumorigenesis through the modulation of the gastrointestinal antitumor immune system (i.e., tumor‐infiltrating T cells) and the increased expression of pro‐inflammatory/oncogenic genes. Ultimately, the potential influence of common risk factors, relevant comorbidities, and upstream drivers, such as gerovulnerability to multiple diseases, in explaining the relationship cannot be disregarded. The evidence analyzed here emphasizes the possible relevance of periodontitis in cancer initiation/progression and stimulates future research endeavors.

• Kubberød, Jon Olav; Torgersen, Gerald R.; Gjermo, Per E; Baelum, Vibeke & Preus, Hans Ragnar (2023). Five-year radiological findings from a randomized controlled trial of four periodontitis treatment strategies. European Journal of Oral Sciences. ISSN 0909-8836. doi: 10.1111/eos.12949. Full text in Research Archive Show summary

  Radiographic findings from long-term studies of periodontitis treatment have rarely been reported. Although bone destruction is a prominent feature of periodontitis, the long-term effect on alveolar bone levels of different treatment strategies, with or without adjunctive metronidazole (MTZ), has not been reported. We investigated the 5-year radiographic outcome of therapy in patient groups treated with conventional scaling and root planing (SRP) or same-day full-mouth disinfection (FDIS), with or without adjunctive MTZ. Following a 3-month oral hygiene phase, 184 periodontitis patients were randomly allocated to one of four treatment regimens: (i) FDIS+MTZ; (ii) FDIS+placebo; (iii) SRP+MTZ; or (iv) SRP+placebo. Following active treatment, patients received biannual maintenance. In total, 161 patients (87.5%) completed the 5-year follow-up examination, at which the radiographic bone level (RBL), clinical attachment level, probing pocket depth, presence of plaque, and bleeding were recorded again. At the 5-year follow up examination, minor radiological bone loss was observed in the intervention groups FDIS+placebo, SRP+MTZ, and SRP+placebo; by contrast, the FDIS+MTZ group did not show any change in RBL. Full-mouth disinfection did not generally perform better than conventional SRP performed over a period of 2 to 4 weeks.

• Apaza-Bedoya, Karin; Magrin, Gabriel Leonardo; Romandini, Mario; Blanco-Carrión, Juan & Benfatti, Cesar Augusto Magalhães (2023). Efficacy of alveolar ridge preservation with xenografts and resorbable socket sealing materials in the esthetic region: A systematic review with meta-analyses. Clinical Implant Dentistry and Related Research. ISSN 1523-0899. doi: 10.1111/cid.13257. Full text in Research Archive
• Stødle, Ida Haukåen; Sen, Abhijit; Høvik, Hedda; Verket, Anders & Koldsland, Odd Carsten (2023). Association between periodontitis stages and self-reported diseases in a Norwegian population: the HUNT study. BMC Oral Health. 23(1), p. 1–10. doi: 10.1186/s12903-023-03743-z. Full text in Research Archive Show summary

  Background The relationships between periodontitis and non-communicable diseases (NCDs) have been investigated through several different case-definitions. The differences in methodology may have hindered the basis of comparison between these studies. The classification from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions offers a unison platform that may facilitate future comparison of such research. The present study aimed to reproduce associations between periodontitis and other NCDs using the 2017 Classification, in the Trøndelag Health Study (HUNT). Material and methods The fourth HUNT-survey was carried out between 2017 and 2019. Clinical variables, blood samples and answers to questionnaires were collected from 4933 participants. Periodontal status was assessed based on the latest staging system, and its associations with NCDs were estimated by logistic regression models adjusted for potential confounders. Results Compared to no or Stage I periodontitis, participants with Stage III/IV periodontitis (radiographic bone loss exceeding 33%) were associated with cardiovascular disease, hyperglycemia in participants with diabetes and chronic obstructive pulmonary disease (COPD)/emphysema. Associations with hyperglycemia in participants with diabetes and COPD/emphysema were also observed in participants with Stage II periodontitis. The only observed association when considering never-smokers alone, was with COPD/emphysema. Conclusion Periodontitis Stage II and III/IV were associated with major NCDs. Effect sizes increased with increasing periodontitis stages, which implies greater occurrence of coincident comorbidities in patients with severe periodontitis.

• Abrahamsen, Siren; Koldsland, Odd Carsten & Preus, Hans Ragnar (2023). The anti-plaque effect of high concentration sodium bicarbonate dentifrice on plaque formation and gingival inflammation, irrespective to individual polishing technique and plaque quality. BMC Oral Health. 23. doi: 10.1186/s12903-023-03005-y. Full text in Research Archive Show summary

  Aim To assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation, and gingivitis, as compared to a control toothpaste, irrespective of individual brushing technique and plaque quality. Methods The experimental gingivitis model, with a split-mouth design was used to assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation. By producing individual fitted trays, the toothpaste was applied in the test quadrant and a control dentifrice in the contralateral. The participants used the individual fitted trays for 1 min every morning and evening, for 21 days. In this period, the participants was only allowed to brush the teeth in the opposite jaw, as usual. Twenty healthy individuals successfully completed the study. Results At 21 days, there was no statistically significant difference between test quadrant and control quadrant with regard to plaque indices, gingival index and number of bleeding sites. Conclusion This study demonstrated that the high concentration sodium bicarbonate dentifrice used did not produce statistically significant anti-plaque effect compared to the control dentifrice, in terms of Plaque- and Gingival Indices, number of bleeding sites or by Quigely and Hein, the Turesky modification Plaque Index, irrespective of brushing technique and individual plaque quality. Trial registration Regional Committee for Medical Research and Ethics, South-East Norway in 2021 (REK.2021/370116). Clinical Trial Registration: NCT05441371 (First registered 09/06/2022, First posted 01/07/2022) (http://www.clinicaltrials.gov). (Retrospectively registered).

• Haugbo, Helena Oladottir; Klepp, Pasquale Catherine & Verket, Anders (2023). Ulcerative colitis and periodontitis–a cross-sectional pilot study from a Norwegian cohort. Acta Odontologica Scandinavica. ISSN 0001-6357. doi: 10.1080/00016357.2023.2210660. Full text in Research Archive Show summary

  Background Inflammatory bowel disease, which includes ulcerative colitis (UC), is an inflammatory disorder with potential impact on periodontal disease, but evidence to date for this association is limited. The primary aim of this study was to investigate the prevalence of periodontitis according to the 2017-classification in a cohort of subjects with UC. The secondary aim was to assess a potential correlation of periodontal status with previous UC disease parameters and to assess oral health-related quality-of-life. Method A cohort from a community hospital in Norway with confirmed extensive UC was comprehensively examined. Periodontal parameters, OHIP-14 and demographic variables were collected. Previous UC data including colon activity index (CAI), Mayo score and years of UC diagnosis was used to explore a potential correlation with periodontal status. Results A total of 50 out of 63 invited patients participated. According to the 2017-classification, 74% of the patients presented periodontitis. No correlation was found between periodontitis (stage, grade, bleeding on probing or probing pocket depth ≥6mm) and CAI, Mayo score, or years with UC diagnosis. Conclusions Within the limitations of this study, the prevalence of periodontitis among patients with mild UC for more than 12 years was in line with that reported from a Norwegian general population. No correlation between periodontitis and UC disease indices or years with UC diagnosis was observed. The study suggests that the susceptibility to periodontitis may be limited in patients with well treated or mild UD who regularly attend the dental office, despite a considerable UC disease duration.

• Romandini, Mario; Bougas, Kostas; Alibegovic, Lamija; Hosseini, Sara; Carcuac, Olivier & Berglundh, Tord [Show all 7 contributors for this article] (2023). Long-term outcomes and prognostic factors of surgical treatment of peri-implantitis – A retrospective study. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.14228. Full text in Research Archive Show summary

  Abstract Aim To evaluate long‐term outcomes and prognostic factors of non‐reconstructive surgical treatment of peri‐implantitis. Materials and Methods One hundred forty‐nine patients (267 implants) were surgically treated for peri‐implantitis and followed for an average of 7.0 (SD: 3.6) years. The primary outcome was implant loss. Additional bone loss and surgical retreatment were secondary outcomes. Patient/implant characteristics, as well as clinical and radiographic parameters collected prior to initial surgery, were evaluated as potential predictors of implant loss. Flexible parametric survival models using restricted cubic spline functions were used; 5‐ and 10‐year predicted rates of implant loss were calculated according to different scenarios. Results Fifty‐three implants (19.9%) in 35 patients (23.5%) were lost during the observation period. Implant loss occurred after a mean period of 4.4 (SD: 3.0) years and was predicted by implant surface characteristics (modified surface; HR 4.5), implant length (HR 0.8 by mm), suppuration at baseline (HR 2.7) and disease severity (baseline bone loss: HR 1.2 by mm). Estimates of 5‐ and 10‐year implant loss ranged from 1% (best prognostic scenario; initial bone loss &lt;40% of implant length, turned implant surface and absence of suppuration on probing (SoP)) to 63% (worst prognostic scenario; initial bone loss ≥60% of implant length, modified implant surface and SoP) and from 3% to 89%, respectively. Surgical retreatment was performed at 65 implants (24.3%) in 36 patients (24.2%) after a mean time period of 4.5 (3.1) years. In all, 59.5% of implants showed additional bone loss, were surgically retreated or lost. Conclusions Recurrence of disease is common following surgical treatment of peri‐implantitis. The strongest predictor for implant loss was implant surface characteristics. Implant length as well as suppuration and disease severity at baseline were also relevant factors.

• Khan, Sadia Nazir; Koldsland, Odd Carsten; Roos-Jansåker, Ann-Marie; Wohlfahrt, Johan Caspar; Verket, Anders & Mdala, Ibrahimu [Show all 9 contributors for this article] (2023). Non-surgical treatment of mild to moderate peri-implantitis with an oscillating chitosan brush or a titanium curette—12-month follow-up of a multicenter randomized clinical trial. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.14078. Full text in Research Archive
• Romandini, Pierluigi; Marruganti, Crystal; Romandini, William Giuseppe; Alonso, Mariano Sanz; Grandini, Simone & Romandini, Mario (2023). Are periodontitis and dental caries associated? A systematic review with meta-analyses. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13910. Full text in Research Archive Show summary

  Abstract Aim The epidemiological relationship between periodontitis and caries remains controversial, and evidence synthesis is currently lacking. Therefore, this systematic review was designed to answer the following PECO question: ‘In human adults (P), do subjects suffering from periodontitis (E) have higher presence/number of untreated carious lesions and caries experience (O) than subjects not suffering from periodontitis (C)?’. Materials and Methods Observational studies that met specific inclusion criteria established to answer to the PECO question were included. Two review authors independently searched for eligible studies, screened the titles and abstracts, carried out the full text analysis, extracted the data and performed the risk of bias assessment. In case of disagreement, a third review author took the final decision during ad hoc consensus meetings. Data synthesis was carried out through random‐effects meta‐analyses. Results A total of 18 studies on 21 cohorts, involving 135,018 participants, were included. Meta‐analyses showed a significant association between periodontitis and the presence of at least one tooth with either untreated carious lesions (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.32–2.01; p  &lt;.00; I 2  = 83.0%) or caries experience (decayed and filled teeth ≥ 1) (OR = 1.27; 95% CI: 1.01–1.59; p  = .038; I 2  = 90.0%). Moreover, subjects with periodontitis exhibited a higher number of surfaces (difference in means [MD] = 0.86; 95% CI: 0.46–1.27; p  &lt;.001; I 2  = 0.0%) and teeth (MD = 0.35; 95% CI: 0.28–0.42; p  &lt;.001; I 2  = 69.6%) with untreated carious lesions, as well as a higher number of teeth with caries experience (standardized difference in means  [SMD] = 1.46; 95% CI: 0.15–2.78; p  = .029; I 2  = 98.9%) compared with those without periodontitis. Sensitivity analyses focusing on severe periodontitis as exposure mostly showed consistent results. Estimates for caries experience were only slightly attenuated in adjusted models compared with crude models. Subgroup analyses by caries location also indicated that periodontitis was associated only with root caries, while it was not with caries affecting the anatomical crown. Conclusions Periodontitis was found to be associated with the presence and number of treated/untreated root carious lesions. Therefore, caries‐specific preventive measures (e.g., fluorides) should be considered for individuals with periodontitis.

• Strauss, Franz Josef; Marruganti, Crystal; Romandini, Mario; Cavalla, Franco; Neira, Patricio & Jiménez, Francisco J. [Show all 9 contributors for this article] (2023). Epidemiology of mid-buccal gingival recessions according to the 2018 Classification System in South America: Results from two population-based studies. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13847. Full text in Research Archive Show summary

  Abstract Aim The aim of this investigation was to estimate the prevalence, severity and extent of mid‐buccal gingival recessions (GRs; classified according to the 2018 Classification System) and to identify their risk indicators in the South American population. Materials and Methods Epidemiological data from two cross‐sectional studies—performed on 1070 South American adolescents and 1456 Chilean adults—were obtained. All participants received a full‐mouth periodontal examination by calibrated examiners. GR prevalence was defined as the presence of at least one mid‐buccal GR ≥ 1 mm. GRs were also categorized into different recession types (RTs) according to the 2018 World Workshop Classification System. Analyses for RT risk indicators were also performed. All analyses were carried out at the participant level. Results The prevalence of mid‐buccal GRs was 14.1% in South American adolescents and 90.9% in Chilean adults. In South American adolescents, the prevalence of RTs was 4.3% for RT1 GRs, 10.7% for RT2 GRs and 1.7% for RT3 GRs. In Chilean adults, the prevalence of RT1 GRs was 0.3%, while the prevalence of RT2 and RT3 GRs was 85.8% and 77.4%, respectively. Full‐Mouth Bleeding Score (FMBS; &lt;25%) was associated with the presence of RT1 GRs in adolescents. The risk indicators for RT2/RT3 GRs mainly overlapped with those for periodontitis. Conclusions Mid‐buccal GRs affected 14.1% of South American adolescents, whereas they affected most of the Chilean adult population (&gt;90%). While RT1 GRs are more commonly observed in a non‐representative cohort of South American adolescents (when compared to Chilean adults), the majority of Chilean adults exhibit RT2/RT3 GRs.

• Verket, Anders; Koldsland, Odd Carsten; Bunæs, Dagmar Fosså; Lie, Stein Atle & Romandini, Mario (2023). Non-surgical therapy of peri-implant mucositis—Mechanical/physical approaches: A systematic review. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13789. Full text in Research Archive Show summary

  Aim To study in humans with peri-implant mucositis the efficacy of (Q1) mechanical/physical instrumentation over oral hygiene instructions alone; (Q2) any single mode of mechanical/physical instrumentation over others; (Q3) combinations of mechanical/physical instrumentation over single modes; and (Q4) repetitions of mechanical/physical instrumentation over single administration. Materials and Methods Randomized clinical trials (RCTs) fulfilling specific inclusion criteria established to answer the four PICOS questions were included. A single search strategy encompassing the four questions was applied to four electronic databases. Two review authors independently screened the titles and abstracts, carried out full-text analysis, extracted the data from the published reports and performed the risk of bias assessment through the RoB2 tool of the Cochrane Collaboration. In case of disagreement, a third review author took the final decision. Treatment success (i.e., absence of bleeding on probing [BoP]), BoP extent and BoP severity were considered as the implant-level outcomes of critical importance for the present review. Results A total of five papers reporting on five RCTs, involving 364 participants and 383 implants, were included. Overall, treatment success rates after mechanical/physical instrumentation ranged from 30.9% to 34.5% at 3 months and from 8.3% to 16.7% at 6 months. Reduction in BoP extent was 19.4%–28.6% at 3 months, 27.2%–30.5% at 6 months and 31.8%–35.1% at 12 months. Reduction in BoP severity was 0.3–0.5 at 3 months and 0.6–0.8 at 6 months. Q2 was addressed in two RCTs, which reported no differences between glycine powder air-polishing and ultrasonic cleaning, as well as between chitosan rotating brush and titanium curettes. Q3 was addressed by three RCTs, which showed no added effect of glycine powder air-polishing over the use of ultrasonic and of diode laser over ultrasonic/curettes. No RCTs were identified that answered Q1 and Q4. Conclusions Several mechanical/physical instrumentation procedures including curettes, ultrasonics, lasers, rotating brushes and air-polishing are documented; however, a beneficial effect over oral hygiene instructions alone or superiority over other procedures could not be demonstrated. Moreover, it remains unclear whether combinations of different procedures or their repetition over time may provide additional benefits.

• Ferrarotti, Francesco; Baima, Giacomo; Rendinelli, Martina; Citterio, Filippo; Mariani, Giulia Maria & Mussano, Federico [Show all 9 contributors for this article] (2023). Pocket closure after repeated subgingival instrumentation: a stress test to the EFP guideline for stage III-IV periodontitis. Clinical Oral Investigations. ISSN 1432-6981. doi: 10.1007/s00784-023-05279-6. Full text in Research Archive Show summary

  Abstract Objectives To study the effects of one or two repeated subgingival instrumentations (RSI) in achieving the endpoints of therapy (EoT) in open pockets [residual probing pocket depth (PPD) ≥ 6 mm and PPD 4–5 mm with bleeding on probing (BoP)] after steps I-II of therapy. Materials and methods Twenty-five patients (3,552 total sites; 1,450 open pockets) with stage III-IV periodontitis received steps I-II of periodontal therapy and were re-evaluated after 4–6 weeks (T1). Residual pockets received RSI at T1 and at 3 months (T2). EoT (PPD &lt; 4 or PPD &lt; 6 BoP-) rate at T1, T2 and 6 months (T3) was computed. The number of needed surgeries and treatment costs were calculated. Results At T1, 67.6% of open pockets achieved EoT. At residual PPD ≥ 6 mm at T1 ( n  = 172), one and two RSI resulted in 33.1% and 45.9% of EoT at T2 and T3, respectively. At residual PPD 4–5 mm with BoP at T1 ( n  = 298), one and two RSI resulted in 66.8% and 72.1% of EoT at T2 and T3, respectively. PPD at T1 predicted EoT after RSI in both cases, while tooth type only in residual PPD 4–5 mm BoP + . At T1, mean number of surgeries per patient and associated costs were significantly higher than after one/two RSI. Conclusions RSI may achieve EoT in residual PPD 4–5 mm BoP + and PPD ≥ 6 mm in a considerable number of cases. Clinical relevance These findings may support the administration of one/two cycles of RSI prior to surgical approach. Protocol registration ClinicalTrials.gov identification number: NCT04826926.

• Baima, Giacomo; Ribaldone, Davide; Romano, Federica; Aimetti, Mario & Romandini, Mario (2023). The Gum–Gut Axis: Periodontitis and the Risk of Gastrointestinal Cancers. Cancers. 15(18). doi: 10.3390/cancers15184594. Full text in Research Archive Show summary

  Periodontitis has been linked to an increased risk of various chronic non-communicable diseases, including gastrointestinal cancers. Indeed, dysbiosis of the oral microbiome and immune-inflammatory pathways related to periodontitis may impact the pathophysiology of the gastrointestinal tract and its accessory organs through the so-called “gum–gut axis”. In addition to the hematogenous spread of periodontal pathogens and inflammatory cytokines, recent research suggests that oral pathobionts may translocate to the gastrointestinal tract through saliva, possibly impacting neoplastic processes in the gastrointestinal, liver, and pancreatic systems. The exact mechanisms by which oral pathogens contribute to the development of digestive tract cancers are not fully understood but may involve dysbiosis of the gut microbiome, chronic inflammation, and immune modulation/evasion, mainly through the interaction with T-helper and monocytic cells. Specifically, keystone periodontal pathogens, including Porphyromonas gingivalis and Fusobacterium nucleatum, are known to interact with the molecular hallmarks of gastrointestinal cancers, inducing genomic mutations, and promote a permissive immune microenvironment by impairing anti-tumor checkpoints. The evidence gathered here suggests a possible role of periodontitis and oral dysbiosis in the carcinogenesis of the enteral tract. The “gum–gut axis” may therefore represent a promising target for the development of strategies for the prevention and treatment of gastrointestinal cancers.

• Baima, Giacomo; Shin, Hye-Sun; Arrica, Maria Antonietta; Laforì, Andreina; Cordaro, Massimo & Romandini, Mario (2023). The co-occurrence of the two main oral diseases: periodontitis and dental caries. Clinical Oral Investigations. ISSN 1432-6981. doi: 10.1007/s00784-023-05253-2. Full text in Research Archive Show summary

  Abstract Objectives Limited studies are available testing through multiple regression models the association between the two main oral diseases: dental caries and periodontitis. The aim of this cross-sectional population-based study was to verify whether dental caries and periodontitis co-occur in a representative sample of the South Korea population. Materials and methods A total of 23,405 subjects representative of 36.2 million of adults (KNHANES) were examined. Univariate and multiple regression analyses using 7 different models were applied, controlling for age, gender, smoking status, frequency of toothbrushing, use of interproximal toothbrushes and flossing, educational level, income, gum diseases treatment and tooth filling in the previous year, BMI, Vitamin D serum levels, alcoholism, diabetes status, stress and carbohydrates dietary intake. Results In the fully adjusted model, participants with periodontitis had, respectively, a mean of 0.82 (95% CI: 0.41–1.23) and of 0.36 (95% CI: 0.22–0.50) more untreated decayed surfaces and teeth than participants without periodontitis, with an OR to have at least one untreated decayed surface of 1.96 (95% CI: 1.66–2.32). However, cumulative caries experience (DF scores) and periodontitis were not associated. Conclusions In this large nationally representative population, periodontitis and untreated dental caries co-occur. However, when considering cumulative caries experience (DF scores), the two diseases do not appear related. Clinical relevance In light of their possible co-occurrence, clinicians should implement integrative diagnostic, preventive and treatment strategies for both diseases.

• Mauland, Erik Klepsland; Bull, Vibeke Hervik; Melbye, Elisabeth Lind & Verket, Anders (2023). Patient-reported outcomes following dental implant rehabilitation according to reason for missing teeth: A survey from a Norwegian population 8 years following treatment. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13895. Full text in Research Archive Show summary

  Abstract Aim The aim of this study was to assess patient‐reported outcomes (PROs) 8 years after dental implant rehabilitation in a sample with tooth loss due to periodontitis (TLP) and a sample with missing teeth for other reasons (MTOR). Materials and Methods The Norwegian National Insurance Scheme registry of subsidized dental implant therapy was searched, and patients ( n  = 3083) rehabilitated with dental implants in 2014 were mailed a questionnaire. PROs were described by relative frequencies, and the TLP and MTOR subsamples were compared using chi‐square test. Multiple linear regression analyses were used to investigate variables potentially predicting PROs. Results Of the respondents ( n  = 1299), more than 90% were partly or fully satisfied with the treatment outcome. Complications were reported by 44.2%. Patients who lost teeth due to periodontitis ( n  = 784) reported greater oral function improvement and better pre‐treatment information, and were more likely to experience complications when compared with patients who lost teeth for other reasons ( n  = 515). Age, level of education, self‐funded cost, pre‐treatment information, history of complications and the reason for missing teeth were found to predict PROs. Conclusions In a Norwegian population rehabilitated with dental implants in 2014, satisfaction with the treatment outcome and the aesthetic outcome was high, irrespective of the reason for missing teeth. Self‐report of complications and lack of pre‐treatment information were the strongest predictors of inferior patient satisfaction and also predicted inferior oral function.

• Balta, Maria (2023). Vital Pulp Therapy of Young First Permanent Molars: A Retrospective Study on Radiographic Findings 24 Months Post-treatment. Oral Health & Preventive Dentistry. ISSN 1602-1622. Full text in Research Archive
• Thieu, Minh Khai Le; Mauland, Erik Klepsland & Verket, Anders (2022). Satisfaction and preferences among patients with both implant-supported single crown and tooth-supported fixed dental prosthesis: a pilot study. Acta Odontologica Scandinavica. ISSN 0001-6357. doi: 10.1080/00016357.2022.2155239. Full text in Research Archive Show summary

  Objective The objective of the study was to assess patient-reported preferences and outcomes in patients rehabilitated with both an implant-supported single crown (ISC) and a tooth-supported fixed dental prosthesis (FDP). Materials and methods The electronic journal system at the Faculty of Dentistry, University of Oslo, was searched to find patients presenting both an ISC and an FDP replacing no more than two teeth between abutments. Identified patients that agreed answered a questionnaire followed by a clinical examination. Descriptive statistics was calculated. Results Thirty patients were included. The mean function time was 11.8 years for FDPs and 6.6 years for ISCs. All but three patients were satisfied with both rehabilitation modalities. No patients were unsatisfied with aesthetics or function of either rehabilitation. All patients reported satisfactory function of their restorations and reported chewing without problems. The self-reported post-operative complications were few, but less than observed in the clinical examinations. Conclusions More patients reported food impaction with their FDP as compared to their ISC. Function and aesthetics of FDPs and ISCs were rated similarly, but more patients found the ISC treatment more uncomfortable. Despite this finding, most patients would prefer to undergo ISC treatment if they were to replace another missing tooth.

• Sødal, Anne Thea Tveit; Hove, Lene Hystad; Diep, My Tien; Skudutyte-Rysstad, Rasa & Koldsland, Odd Carsten (2022). Periodontal conditions in a 65-year-old population and prevalence of periodontitis according to three different bone level thresholds. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02276-1. Full text in Research Archive Show summary

  Aims The aims of this cross-sectional study were to describe the prevalence and severity of periodontal disease in a 65-year-old population in Oslo, Norway, and to investigate to what extent the radiographic bone level threshold for periodontitis case definition influences the prevalence. Materials and methods A random sample of 454 subjects underwent a clinical and radiographic examination and answered a questionnaire regarding general health, medications, and smoking habits. Clinical periodontal parameters (periodontal pocket depths, bleeding on probing, mobility, and furcation involvement) and radiographic bone loss were used to identify periodontitis cases and to assess periodontal stage and grade. Results Of the 454 participants, 52.6% were defined as “periodontitis cases”. Of the total study population “unstable cases of recurrent periodontitis” were present in 38.1%, 16.5% of the participants were assigned to stage II, 32.8% to stage III, and 3.3% to stage IV. When lowering the radiographic bone loss cutoff from > 3 mm to > 2 mm or > 1 mm the prevalence of periodontitis increased to 91.9% and 99.6%. Conclusions Periodontitis was common among 65 year-olds living in Oslo, and in the majority of those with periodontitis, the disease was recurrent and unstable. This study also shows that the choice of bone loss cutoff for defining a periodontitis case affects the prevalence estimates to a large extent. In addition, this study addresses weaknesses in the use of the consensus report of the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions for epidemiologic studies in its current form.

• Thieu, Minh Khai Le; Stoetzel, Sabine; Rahmati, Maryam; Khassawna, Thaqif El; Verket, Anders & Sanz-Esporrin, Javier [Show all 9 contributors for this article] (2022). Immunohistochemical comparison of lateral bone augmentation using a synthetic TiO<inf>2</inf> block or a xenogeneic graft in chronic alveolar defects. Clinical Implant Dentistry and Related Research. ISSN 1523-0899. doi: 10.1111/cid.13143. Full text in Research Archive Show summary

  Objectives To evaluate osteogenic markers and alveolar ridge profile changes in guided bone regeneration (GBR) of chronic non-contained bone defects using a non-resorbable TiO2 block. Material and methods Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for 8 weeks before GBR. Treatment was assigned by block randomisation: TiO2 block: TiO2-scaffold and a collagen membrane, DBBM particulates: Deproteinised bovine bone mineral (DBBM) and a collagen membrane, Empty control: Only collagen membrane. Bone regeneration was assessed on two different healing timepoints: early (4 weeks) and late healing (12 weeks) using several immunohistochemistry markers including alpha smooth muscle actin (α-SMA), osteopontin, osteocalcin, tartrate-resistant acid phosphatase and collagen type I. Histomorphometry was performed on Movat Pentachrome and Von Kossa/Van Gieson stained sections. Stereolithographic models were used to compare alveolar profile changes. Results The percentage of α-SMA and osteopontin increased in TiO2 group after 12 weeks of healing at the bone-scaffold interface, while collagen type I increased in the empty control group. In the defect area, α-SMA decreased in the empty control group, while collagen type I increased in the DBBM group. All groups maintained alveolar profile from 4 to 12 weeks, but TiO2 group demonstrated the widest soft tissue contour profile. Conclusions The present findings suggested contact osteogenesis when GBR is performed with a TiO2 block or DBBM particulates. The increase in osteopontin indicated a potential for bone formation beyond 12 weeks. The alveolar profile data indicated a sustained lateral increase in lateral bone augmentation using a TiO2 block and a collagen membrane, as compared to DBBM and a collagen membrane or a collagen membrane alone.

• Sødal, Anne Thea Tveit; Skudutyte-Rysstad, Rasa; Diep, My Tien; Koldsland, Odd Carsten & Hove, Lene Hystad (2022). Periodontitis in a 65-year-old population: risk indicators and impact on oral health-related quality of life. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02662-9. Full text in Research Archive Show summary

  Aims The aims of the present study were to investigate socioeconomic and behavioral risk indicators for severe periodontitis in a 65-year-old Norwegian population, and to investigate how periodontitis impacts oral health-related quality of life. Material and methods A sample of 65-year-old residents in Oslo, born in 1954, was randomly selected for this study. The participants answered a questionnaire regarding country of birth, education, diabetes, smoking habits, dental attendance pattern, and tooth-brushing habits. In addition, oral health-related quality of life (OHRQoL) was assessed by the Oral Health Impact Profile-14 questionnaire (OHIP-14). Negative impact on OHRQoL was defined as responding “fairly often” or “very often” to at least one of the OHIP-14 items. The diagnosis of periodontitis was based on clinical and radiographic periodontal measurements and classified based on the consensus report from the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Results Of 796 eligible participants, 460 individuals agreed to participate in the present study (response rate 58%). Seven participants were excluded from the analyses due to < 2 remaining teeth (n = 3) or missing questionnaire (n = 4), resulting in a study sample of 453 individuals (233 men and 220 women). An association was found between non-western country of birth, diabetes type 2, lower education, smoking, non-regular dental visits, and severe periodontitis (stage III or IV, n = 163) in bivariate analyses (Chi-square test). However, in the multiple logistic regression model, only non-western country of birth, diabetes type 2 and smoking (former and current), were associated with higher odds of severe periodontitis. The overall mean OHIP-14 total score was 3.6 (SD: 6.1). Participants with stage III or IV periodontitis reported a significantly higher OHIP-14 total score (mean: 4.7, SD: 7.4), indicating a lower OHRQoL, compared to non-periodontitis participants (mean: 2.9, SD: 4.9). Conclusions In the present study, non-western birth country, diabetes type 2, and smoking were found as significant risk indicators for severe periodontitis. Overall, results indicate a good OHRQoL among 65-year-olds in Oslo, however, a tendency of reduced OHRQoL with increasing severity of periodontitis was observed.

• Preus, Hans Ragnar; Al-Lami, Gunnar & Bælum, Vibeke (2022). Effekten av en forlenget munnhygienefase før periodontal behandling. En randomisert klinisk studie. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(3), p. 242–248. doi: 10.56373/2022-3-4. Full text in Research Archive
• Koldsland, Odd Carsten; Damsgaard, Christian & Stavropoulos, Andreas (2022). Behandling af periimplantitis. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(2), p. 112–120. doi: 10.56373/2022-2-3. Full text in Research Archive
• Khan, Sadia Nazir; Koldsland, Odd Carsten; Roos-Jansåker, Ann-Marie; Wohlfahrt, Johan Caspar; Verket, Anders & Mdala, Ibrahimu [Show all 9 contributors for this article] (2022). Non-surgical treatment of mild to moderate peri-implantitis using an oscillating chitosan brush or a titanium curette—A randomized multicentre controlled clinical trial. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.14007. Full text in Research Archive Show summary

  Objectives This prospective, parallel-group, examiner-blinded, multicentre, randomized, controlled clinical trial aimed to assess the efficacy of an oscillating chitosan brush (OCB) versus titanium curettes (TC) on clinical parameters in the non-surgical treatment of peri-implantitis. Material and Methods In five dental specialist clinics, 39 patients with one implant with mild to moderate peri-implantitis, defined as 2–4 mm radiographic reduced bone level, bleeding index (BI) ≥ 2, and probing pocket depth (PPD) ≥ 4 mm were randomly allocated to test and control groups, receiving OCB or TC debridement, respectively. Treatment was performed at baseline and three months. PPD, BI, and Plaque index (PI) were measured at six sites per implant and recorded by five blinded examiners at baseline, one, three, and six month(s). Pus was recorded as present/not present. Changes in PPD and BI were compared between groups and analysed using multilevel partial ordinal and linear regression. Results Thirty-eight patients completed the study. Both groups showed significant reductions in PPD and BI at six months compared with baseline (p < .05). There was no statistically significant difference in PPD and BI changes between the groups. Eradication of peri-implant disease as defined was observed in 9.5% of cases in the OCB group and 5.9% in the TC group. Conclusions Within the limitations of this six-month multicentre clinical trial, non-surgical treatment of peri-implantitis with OCB and TC showed no difference between the interventions. Eradication of disease was not predictable for any of the groups.

• Preus, Hans Ragnar; Aass, Anne Merete & Grytten, Jostein Ivar (2022). Munnhelse i sykehjem - en undersøkelse gjort i Akershus. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(4), p. 320–326. doi: 10.56373/2022-4-3. Full text in Research Archive
• Rustand, Kristin; Aass, Anne Merete; Sen, Abhijit & Koldsland, Odd Carsten (2022). Oral health-related quality of life following peri-implantitis surgery: A prospective study. Clinical Oral Implants Research. ISSN 0905-7161. 33(8), p. 858–867. doi: 10.1111/clr.13967. Full text in Research Archive Show summary

  Aim The aim of this prospective study was to describe long-term patient-reported outcomes following surgical treatment of peri-implantitis. Methods Oral health-related quality of life (OHRQoL) of 43 patients diagnosed with peri-implantitis was recorded using the short form of the Oral Health Impact Profile (OHIP-14), where low scores indicate low impact. A Norwegian version of the OHIP-14 form was filled out 1 week before and 6-, 18- and 36 months after the peri-implant surgery. The mean and median OHIP-14 scores were calculated for its seven domains (i.e., Functional limitation, Physical pain, Psychological discomfort, Physical disability, Psychological disability, Social disability, and Handicap) across four different time points. The dataset was analyzed to find correlations between independent variables and the OHIP-scores. Results The OHIP-14 scores were at a low level from baseline to 36 months post-surgery. The mean scores at specific time points were at baseline 7.2 (SD 7.3), 6 months post-surgery 6.0 (SD 6.9), 18 months post-surgery 6.8 (SD 9.7), and 3 years post-surgery 7.0 (SD 9.4). None of these changes were statistically significant. Specific domains of OHRQoL did not significantly differ across different time points (pre- and post-surgery) in males (except for domain “Handicap”) or females (except for domain “Functional limitation”). Conclusions The reported OHIP-14 measures were initially low and stayed low up to 3 years after peri-implant surgery. This may indicate that neither the disease nor the treatment deteriorated or improved the OHRQoL.

• Könönen, Eija; Klausen, Bjarne; Verket, Anders & Derks, Jan (2022). Non-surgical periodontal therapy: Recommendations by the European Federation of Periodontology and guidelines in Nordic countries. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(1), p. 22–31. doi: 10.56373/2022-1-5. Full text in Research Archive
• Berglundh, Tord; Koldsland, Odd Carsten & Grauballe, Morten (2022). Ny klassificering av periimplantära sjukdomar. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(1), p. 44–49. doi: 10.56373/2022-1-7. Full text in Research Archive
• Verket, Anders; Klausen, Bjarne; Könönen, Eija & Derks, Jan (2022). Kirurgisk parodontalbehandling: Anbefalinger fra European Federation of Periodontology og retningslinjer i de nordiske lande. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(1), p. 34–41. doi: 10.56373/2022-1-6. Full text in Research Archive
• Balta, Maria; Schreurs, Olaf Joseph Franciscus; Hansen, Trond Vidar; Tungen, Jørn Eivind; Vik, Anders & Glaab, Enrico [Show all 10 contributors for this article] (2022). Expression and function of resolvin RvD1n-3 DPA receptors in oral epithelial cells. European Journal of Oral Sciences. ISSN 0909-8836. 130:e12883(4), p. 1–10. doi: 10.1111/eos.12883. Full text in Research Archive Show summary

  Chronic inflammatory responses can inflict permanent damage to host tissues. Specialized pro-resolving mediators downregulate inflammation but also can have other functions. The aim of this study was to examine whether oral epithelial cells express the receptors FPR2/ALX and DRV1/GPR32, which bind RvD1n-3 DPA, a recently described pro-resolving mediator derived from omega-3 docosapentaenoic acid (DPA), and whether RvD1n-3 DPA exposure induced significant responses in these cells. Gingival biopsies were stained using antibodies to FPR2/ALX and DRV1/GPR32. Expression of FPR2/ALX and DRV1/GPR32 was examined in primary oral epithelial cells by qRT-PCR, flow cytometry, and immunofluorescence. The effect of RvD1n-3 DPA on intracellular calcium mobilization and transcription of beta-defensins 1 and 2, and cathelicidin was evaluated by qRT-PCR. FPR2/ALX and DRV1/GPR32 were expressed by gingival keratinocytes in situ. In cultured oral epithelial cells, FPR2/ALX was detected on the cell surface, whereas FPR2/ALX and DRV1/GPR32 were detected intracellularly. Exposure to RvD1n-3 DPA induced intracellular calcium mobilization, FPR2/ALX internalization, DRV1/GPR32 translocation to the nucleus, and significantly increased expression of genes coding for beta-defensin 1, beta-defensin 2, and cathelicidin. This shows that the signal constituted by RvD1n-3 DPA is recognized by oral keratinocytes and that this can strengthen the antimicrobial and regulatory potential of the oral epithelium.

• Rosing, Kasper; Björnsson, Magnús; Pöllänen, Marja; Klinge, Björn & Verket, Anders (2022). Organisering af parodontal diagnostik og behandling i de nordiske lande. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 132(2), p. 148–157. doi: 10.56373/2022-2-7. Full text in Research Archive
• Romandini, Mario; Laforì, Andreina; Pedrinaci, Ignacio; Baima, Giacomo; Ferrarotti, Francesco & Lima, Cristina [Show all 10 contributors for this article] (2022). Effect of sub-marginal instrumentation before surgical treatment of peri-implantitis: A multi-centre randomized clinical trial. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13713. Full text in Research Archive
• Sørdahl, Anne Judith & Verket, Anders (2022). Patient and professional use of the root coverage esthetic score (RES) and how it relates to patient satisfaction following periodontal plastic surgery. BMC Oral Health. 22(1). doi: 10.1186/s12903-022-02326-8. Full text in Research Archive Show summary

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• Amjad, Sabrena; Ahmed, Ifrah; Shaddiq, Sana; Sørum, Henning & Preus, Hans Ragnar (2021). Klorheksidinresistens: Et problem i emning. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 131, p. 1092–1096. Full text in Research Archive
• Solhaug, Maren Bråten; Schreurs, Olaf Joseph Franciscus; Schenck, Karl; Blix, Inger Johanne Schytte & Bækkevold, Espen Sønderaal (2021). Origin of langerin (CD207)-expressing antigen presenting cells in the normal oral mucosa and in oral lichen planus lesions. European Journal of Oral Sciences. ISSN 0909-8836. 130:e12835(1), p. 1–12. doi: 10.1111/eos.12835. Full text in Research Archive Show summary

  The number of langerin-expressing antigen-presenting cells is higher in oral lichen planus than in normal oral mucosa. However, langerin may be expressed by several functionally different lineages of antigen presenting cells (APCs), and this has important implications for our understanding of the pathogenesis of oral lichen planus. The aim of this study was to determine the origin of the langerin-expressing APCs. To this end, we examined oral mucosal biopsies from healthy persons and patients with oral lichen planus using multicolor immunofluorescence. In normal oral mucosa, a substantial fraction of Langerhans cells expressed Ki-67, indicating that steady-state oral mucosal Langerhans cells are at least partially maintained by self-renewal. In oral lichen planus, the numbers of Langerhans cells were higher but proliferation was not altered, indicating that the higher cell numbers appeared to depend on recruited dendritic cell (DC)-precursors. Moreover, we found a markedly higher number of langerin+ APCs within the lamina propria of oral lichen planus lesions. Such cells did not display monocyte- or macrophage markers, but rather showed a phenotype compatible with tissue-elicited IRF4+ cDC2. Detailed understanding of how the oral mucosal APC network is regulated and the functional capacities of the different ontogenies may identify novel treatment targets for oral lichen planus.

• Stødle, Ida Haukåen; Verket, Anders; Høvik, Hedda; Sen, Abhijit & Koldsland, Odd Carsten (2021). Prevalence of periodontitis based on the 2017 classification in a Norwegian population. The HUNT Study. Journal of Clinical Periodontology. ISSN 0303-6979. doi: 10.1111/jcpe.13507. Full text in Research Archive Show summary

  Aim This cross-sectional study assesses the prevalence of periodontitis in a large Norwegian population, based on the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. The prevalence of periodontitis was determined by bone loss recorded on radiographs (orthopantomogram [OPG] and bitewing [BW]) and by clinical examination. Materials and methods As part of a large population health study (The HUNT Study), 7347 participants aged 19 years and older were invited to the HUNT4 Oral Health Study. Radiographic bone loss (RBL) and periodontal stage and grade were assessed in 4863 participants. Results Periodontal examination was performed in 4863 participants. RBL and clinical registrations corresponding to periodontitis as defined were observed in 72.4%. The prevalence of periodontitis increased after 40 years of age, with severe forms occurring primarily after 60 years of age. Stage I was observed in 13.8%, Stage II in 41.1%, Stage III in 15.3%, and Stage IV in 2.3% of the population. Grade A, B, and C was observed in 5.7%, 60.2%, and 6.2%, respectively. Conclusion Periodontitis was frequently observed in the investigated population. The prevalence of periodontitis Stage III and Stage IV combined was observed in 17.6% of the study population.

• Thieu, Minh Khai Le; Haugen, Håvard Jostein; Esporrin, Javier Sanz; Sanz, Mariano; Lyngstadaas, Ståle Petter & Verket, Anders (2021). Guided bone regeneration of chronic non-contained bone defects using a volume stable porous block TiO2 scaffold: An experimental in vivo study. Clinical Oral Implants Research. ISSN 0905-7161. doi: 10.1111/clr.13708. Full text in Research Archive Show summary

  Objectives To evaluate new lateral bone formation and lateral volume augmentation by guided bone regeneration (GBR) in chronic non‐contained bone defects with the use of a non‐resorbable TiO2‐block. Materials and methods Three buccal bone defects were created in each hemimandible of eight beagle dogs and allowed to heal for eight weeks before treatment by GBR. Each hemimandible was randomly allocated to 4 or 12‐week healing time after GBR and three intervention groups were assigned by block randomization: TiO2 block: TiO2‐scaffold and a collagen membrane, DBBM particles: Deproteinized bovine bone mineral (DBBM) and a collagen membrane, Empty control: Collagen membrane only. Microcomputed tomography (microCT) was used to measure the lateral bone formation and width augmentation. Histological outcomes included descriptive analysis and histomorphometric measurements. Results MicroCT analysis demonstrated increasing new bone formation from four to twelve weeks of healing. The greatest width of mineralized bone was seen in the empty controls, and the largest lateral volume augmentation was observed in the TiO2 block sites. The DBBM particles demonstrated more mineralized bone in the grafted area than the TiO2 blocks, but small amounts and less than the empty control sites. Conclusion The TiO2 blocks rendered the largest lateral volume augmentation but also less new bone formation compared to the DBBM particles. The most new lateral bone formation outward from the bone defect margins was observed in the empty controls, indicating that the presence of either graft material leads to slow appositional bone growth.

• Hussain, Badra; Haugen, Håvard Jostein; Aass, Anne Merete; Alonso, Mariano Sanz; Antonoglou, Georgios & Bouchard, Philippe [Show all 23 contributors for this article] (2021). Peri-Implant Health and the Knowing-Doing Gap—A Digital Survey on Procedures and Therapies. Frontiers in Dental Medicine. 2(726607). doi: 10.3389/fdmed.2021.726607. Full text in Research Archive Show summary

  Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the tools and procedures most commonly used today to treat peri-implant diseases and successfully manage peri-implant health. The primary aim was to assess whether there is consensus in the choice of treatment to manage peri-implant diseases and to prevent their recurrence once treated. The secondary aim was to obtain insight into future protocols and /or devices, and the research and development needed. Materials and Methods: Participants in this digital survey were professionals specialising in periodontology, oral surgery, and implant dentistry. The questionnaire included both a series of closed- and open-ended questions. A total of 16 countries participated. The survey was sent by e-mail to 70 individuals, 66 received the survey and 37 of receivers responded, two of the participants were excluded due to insufficient filling of the survey. In the end 35 respondents completed the survey. Results: Respondents agree that the efficacy of mechanical and chemical decontamination of implant surfaces needs to be improved and better documented. It is a common opinion that the current remedies, mostly adapted from periodontal practises, do not provide effective and reliable clinical outcomes when treating peri-implant ailments. There is a general agreement amongst experts that regularly scheduled (3–6-month intervals) maintenance treatments are essential for maintaining peri-implant health in patients experiencing implant complications. Respondents are also concerned about unnecessary use of systemic antibiotics for managing peri-implant health. Conclusion: Regardless of agreements in parts, there was no observed consensus on the most effective treatment options for treating peri-implantitis. The experts all agree it is an urgent need for well-designed, long-term follow-up randomised and controlled clinical trials comparing interventions to provide an evidence-based strategy for peri-implant health management.

• Thieu, Minh Khai Le; Homayouni, Amin; Hæren, Lena Ringsby; Tiainen, Hanna; Verket, Anders & Ellingsen, Jan Eirik [Show all 13 contributors for this article] (2021). Impact of simultaneous placement of implant and block bone graft substitute: an in vivo peri-implant defect model. Biomaterials Research. ISSN 1226-4601. 25(43). doi: 10.1186/s40824-021-00245-3. Full text in Research Archive Show summary

  Background Insufficient bone volume around an implant is a common obstacle when dental implant treatment is considered. Limited vertical or horizontal bone dimensions may lead to exposed implant threads following placement or a gap between the bone and implant. This is often addressed by bone augmentation procedures prior to or at the time of implant placement. This study evaluated bone healing when a synthetic TiO2 block scaffold was placed in circumferential peri-implant defects with buccal fenestrations. Methods The mandibular premolars were extracted and the alveolar bone left to heal for 4 weeks prior to implant placement in six minipigs. Two cylindrical defects were created in each hemi-mandible and were subsequent to implant placement allocated to treatment with either TiO2 scaffold or sham in a split mouth design. After 12 weeks of healing time, the samples were harvested. Microcomputed tomography (MicroCT) was used to investigate defect fill and integrity of the block scaffold. Distances from implant to bone in vertical and horizontal directions, percentage of bone to implant contact and defect fill were analysed by histology. Results MicroCT analysis demonstrated no differences between the groups for defect fill. Three of twelve scaffolds were partly fractured. At the buccal sites, histomorphometric analysis demonstrated higher bone fraction, higher percentage bone to implant contact and shorter distance from implant top to bone 0.5 mm lateral to implant surface in sham group as compared to the TiO2 group. Conclusions This study demonstrated less bone formation with the use of TiO2 scaffold block in combination with implant placement in cylindrical defects with buccal bone fenestrations, as compared to sham sites.

• Maal, Mehrnaz Beheshti & Verket, Anders (2021). Implantoplasty- provoking or reducing inflammation? – a systematic scoping review. Acta Odontologica Scandinavica. ISSN 0001-6357. doi: 10.1080/00016357.2021.1945142. Full text in Research Archive Show summary

  Objectives To evaluate clinical parameters associated with inflammation after adjunctive implantoplasty in conjunction with surgical treatment of peri-implantitis. Materials and methods A systematic literature search was performed in 2 databases until 29. December 2020 to find publications that report on clinical parameters after surgical peri-implantitis treatment which included adjunctive implantoplasty. Clinical studies on implantoplasty reporting on BoP as outcome were included, but other clinical or radiographic outcomes were also considered. Results The search resulted in 18 articles that fulfilled the inclusion criteria. The results indicated improvements of BoP and clinical parameters following surgical peri-implantitis treatment with adjunctive implantoplasty. Conclusions Within its limits, the findings of the present scoping review indicated that BoP is reduced following surgical peri-implantitis treatment with adjunctive implantoplasty, and that this improvement is in line with surgical peri-implantitis treatment without adjunctive implantoplasty.

• Balta, Maria; Papathanasiou, Evangelos; Blix, Inger Johanne S. & Dyke, T E Van (2021). Host Modulation and Treatment of Periodontal Disease. Journal of Dental Research. ISSN 0022-0345. 100, p. 798–809. doi: 10.1177/0022034521995157. Full text in Research Archive
• Salvesen, Barbro Fostad; Grytten, Jostein; Rongen, Gunnar; Koldsland, Odd Carsten & Vandevska-Radunovic, Vaska (2021). Periodontal status in long-term orthodontic retention patients up to 10 years after treatment – a cross-sectional study. Acta Odontologica Scandinavica. ISSN 0001-6357. 79(8), p. 623–629. doi: 10.1080/00016357.2021.1921842. Full text in Research Archive Show summary

  Objective To assess periodontal status in long-term orthodontic retention patients and investigate possible risk indicators. Materials and Methods Plaque index (PI), gingival index (GI), probing pocket depth (PPD), gingival recessions (GR) and calculus were recorded in 211 patients with or without fixed retainers. Results Periodontal parameters were within the limits of clinically healthy periodontium. The use of fixed retainers was associated with higher PI in the maxilla (ß = 1.10 [0.37]; p <.05). Older age was associated with higher PI in the mandible (ß = 0.27 [0.11]; p <.05). Smoking was associated with gingival bleeding on both palatal (ß = 0.63 [0.16]; p < .01) and labial sides in the maxilla (ß = 0.46 [0.20]; p <.05). Smoking was also associated with increased prevalence of GR in the mandible (ß = 0.24 [0.07]; p <.01), while use of snuff had similar effect on the labial side in the maxilla (ß = 0.35 [0.08]; p <.01). Higher age (ß = 0.05 [0.02]; p <.05) and the presence of a retainer (ß = 0.23 [0.07]; p < .05) were associated with calculus accumulation on the lingual side in the mandible. Conclusion The present observational study suggest that long-term fixed retainers alone have no detrimental effect on the periodontium. Additional factors may increase the risk of plaque deposits and increased probing pocket depths. Further prosepective studies are needed to confirm the present outcome.

• Balta, Maria (2021). Specialized Pro-Resolving Mediators as Potential Regulators of Inflammatory Macrophage Responses in COVID-19. Frontiers in Immunology. Full text in Research Archive
• Balta, Maria & Kalogirou, Eleni-Marina (2021). Tumors of the labial mucosa: a retrospective study of 1045 biopsies. Medicina Oral. ISSN 1698-4447. Full text in Research Archive
• Hussain, Badra; Karaca, Ebru Ozkan; Kuru, Bahar Eren; Gursoy, Hare; Haugen, Håvard Jostein & Wohlfahrt, Johan Caspar (2021). Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone—a randomized, feasibility parallel-arm clinical trial. Journal of Periodontology. ISSN 0022-3492. doi: 10.1002/JPER.21-0496. Full text in Research Archive Show summary

  Background A brush made of chitosan has shown to be an effective and harmless device for non-surgical treatment of mild to moderate peri-implantitis. To date, no study has evaluated the use of a chitosan brush in the non-surgical treatment of residual pockets in periodontal treatment. Methods Seventy-eight patients with periodontitis were included in this multicenter, randomized, examiner-blind clinical trial of 6 months duration. Patients with residual probing pocket depth (PPD) of ≥5 mm and ≤7 mm following previous active periodontal treatment were included. Patients were assigned either subgingival treatment with curettes (control) or an oscillating chitosan brush (test). Changes in bleeding on probing (BoP) and PPD between baseline and terminal evaluation at 6 months were evaluated. Results A significant reduction in both PPD and BoP was seen within both groups. There was no significant difference in BoP between test and control groups after 6 months, but the reduction in PPD was significantly improved in the test group (P ≤ 0.01). The combined outcome of no BOP and PPD ≤4 mm was significantly better in the test group (P ≤ 0.01). No adverse reactions were seen. Conclusion Treatment of residual periodontal pockets (PPD = 5 to 7 mm) with a chitosan brush disclosed equal or better clinical results as compared to regular curettes. This study supports that a chitosan brush can be used for subgingival biofilm removal and soft tissue curretage in the treatment of periodontitis.

• Skallevold, Hans Erling & Verket, Anders (2020). Myasthenia gravis og orale utfordringer. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 130(8), p. 614–617. Full text in Research Archive
• Preus, Hans Ragnar; Al-Lami, amar Saad Abdulraheem & Baelum, Vibeke (2020). Oral hygiene revisited. The clinical effect of a prolonged oral hygiene phase prior to periodontal therapy in periodontitis patients. A randomized clinical study. Journal of Clinical Periodontology. ISSN 0303-6979. 47(1), p. 36–42. doi: 10.1111/jcpe.13207. Full text in Research Archive
• Bunæs, Dagmar Fosså; Verket, Anders; Aass, Anne Merete & Bolstad, Anne Isine (2020). Kopplingen mellan diabetes typ2 och parodontal sjukdom. Tandläkartidningen. ISSN 0039-6982. 112(1), p. 48–53. Full text in Research Archive
• Hugo, Jørgen; Koldsland, Odd Carsten; Aass, Anne Merete & Tiainen, Hanna (2020). Development and initial testing of an in vitro model simulating class II furcation defects. Clinical and Experimental Dental Research. doi: 10.1002/cre2.346. Full text in Research Archive Show summary

  Objective To compare surface topography of porcine and human root dentin and to develop a new in vitro model for class II furcation defects. The hypothesis for this study was that porcine mandible blocks can function as a model for class II furcation defects. Background Treatment of mandibular class II furcation defects is unpredictable. There is a need for in vitro models to investigate new treatment methods. Methods A model to investigate the surface topography of porcine and human root dentin was developed and the two tissues compared by SEM imaging and profilometer. A novel method for studying class II furcation defects was then tested. Blocks of porcine mandibles with molar 3 were prepared. Buccal class II furcation defects were created. The furcation area was isolated and bioluminescent Staphylococcus epidermidis Xen43 was used to form a biofilm in the furcation area to test the functionality of the novel furcation model. Results Micromechanical damage caused by debridement on porcine and human root dentin showed similar pattern. No significant difference in the surface morphological parameters was observed between the corresponding porcine and human samples. The model allowed for assessment of the root surface inside the furcation area. While the number of viable bacteria in the furcation following debridement could be quantified, no significant difference between the treatment groups was detected, likely due to bacterial colonization within the periodontal ligament space. Conclusion Porcine and human root dentin show similar surface topography following surface debridement. Porcine mandible blocks can function as a model for class II furcation defects. However, further development and refinement of the novel in vitro model is warranted.

• Maal, Mehrnaz Beheshti; Ellingsen, Stig Aanerød; Reseland, Janne Elin & Verket, Anders (2020). Experimental implantoplasty outcomes correlate with fibroblast growth in vitro. BMC Oral Health. 20, p. 25–25. doi: 10.1186/s12903-020-1012-1. Full text in Research Archive Show summary

  Background Implantoplasty is an option in peri-implantitis treatment, but little is known about the effect on the soft tissue. The aim of the study was to characterize surface roughness following experimental implantoplasty and to examine its effect on human fibroblast growth and secretion of selected proteins. Methods Titanium grade IV coins were mechanically treated with six different rotating bur sequences; diamond burs or carbide burs alone, or followed by either Arkansas stone bur or silicone burs. Machined and rough-surface sandblasted, acid-etched (SLA) coins were used as control. The surface topography was characterized by scanning electron microscope and profilometer. Human gingival fibroblasts from two donors were cultured on the coins to quantify the effect on cell morphology, growth, and protein secretion by confocal microscopy and multiplex immunoassay. Results All surface roughness parameters were lower for the surfaces treated with experimental implantoplasty than for the SLA surface, and the sequence of carbide burs followed by silicone burs rendered the least rough surface of the test groups. The implantoplasty procedures changed the elemental composition of the titanium surface. High surface roughness showed a weak to moderate negative correlation to fibroblast growth, but induced a higher secretion of VEGF, IL-6 and MCP-3 to the cell medium compared to the least rough surfaces of the test groups. At day 30 fibronectin levels were higher in the SLA group. Conclusions The surface roughness following implantoplasty demonstrated a weak to moderate negative correlation with the growth of fibroblasts. The addition of Arkansas stone and silicon burs to the experimental implantoplasty bur protocol rendered an initial increase in fibroblast growth. Implantoplasty altered the elemental composition of the titanium surface, and had an effect on the fibroblast cytokine secretion and fibronectin levels.

• Bunæs, Dagmar; Verket, Anders; Aass, Anne Merete & Bolstad, Anne Isine (2020). Tyypin 2 diabeteksen ja parodontaalisairauksien välinen yhteys. Suomen hammaslaakarilehti. ISSN 0355-4090. 3, p. 24–29. Full text in Research Archive
• Mauland, Erik Klepsland; Preus, Hans Ragnar & Aass, Anne Merete (2020). Comparison of commercially available 0.2% chlorhexidine mouthwash with and without anti-discoloration system: A blinded, crossover clinical trial. Journal of Clinical Periodontology. ISSN 0303-6979. 47(12), p. 1522–1527. doi: 10.1111/jcpe.13382. Full text in Research Archive Show summary

  Aim To evaluate clinical performance and side effects of two commercially available 0.2% chlorhexidine mouthwashes after periodontal surgery, one with (test) and one without (control) an anti‐discoloration system. Materials and methods This single‐centre, crossover clinical trial included 38 patients undergoing two sessions of periodontal flap surgery. The participants used two different 0.2% chlorhexidine products, one with and one without an anti‐discoloration system, in the 14‐day post‐operative periods. Plaque, gingival inflammation, tooth staining, side effects and patient preference were evaluated. Results The control mouthwash (without an anti‐discolouring system) produced significantly lower plaque (p = 0.02) and gingival index (p = 0.01) compared to the test mouthwash. The test mouthwash produced significantly less staining in the gingival (p = 0.002) and approximal areas (p = 0.0004), but no difference was detected in the buccal area of the teeth. The patients did not show preference for any of the mouthwashes. Conclusion Chlorhexidine mouthwash without an anti‐discoloration system resulted in significantly lowered plaque and gingival index compared to chlorhexidine mouthwash with an anti‐discoloration following periodontal surgery. No difference in patient preference was found despite less side effects produced by the chlorhexidine mouthwash with the anti‐discoloration system.

• Bunæs, Dagmar Fosså; Verket, Anders; Aass, Anne Merete & Bolstad, Anne Isine (2020). A cross-link between diabetes mellitus type 2 and periodontal disease. Tandlægebladet. ISSN 0039-9353. 124, p. 24–29. Full text in Research Archive
• Bunæs, Dagmar Fosså; Verket, Anders; Aass, Anne Merete & Bolstad, Anne Isine (2020). Sammenheng mellom diabetes mellitus Type 2 og periodontal sykdom. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 130(1), p. 10–16. Full text in Research Archive Show summary

  Tidsskriftet mangler DOI, la til nettsidelenke i kommentarfelt i stedet. /CVN 01.02.21 https://www.tannlegetidende.no/i/2020/1/m-122

• Balta, Maria (2020). Periodontal therapy increases neutrophil extracellular trap degradation. Innate Immunity. ISSN 1753-4259. Full text in Research Archive
• Koldsland, Odd Carsten & Aass, Anne Merete (2020). Supportive treatment following peri-implantitis surgery: An RCT using titanium curettes or chitosan brushes. Journal of Clinical Periodontology. ISSN 0303-6979. 47(10), p. 1259–1267. doi: 10.1111/jcpe.13357. Full text in Research Archive Show summary

  Aims The aim of this randomized controlled trial was to assess the effect of two maintenance programmes when treatments were performed every third month from six to 18 months following surgical treatment of peri‐implantitis. Materials and methods At the 6‐month post‐surgical evaluation, 44 subjects were randomized into groups receiving supportive peri‐implant treatment either by the use of titanium curettes or chitosan brushes at implants registered with BoP and PPD >3 mm. Follow‐up examinations and supportive therapy were performed 6, 9, 12, 15 and 18 months post‐surgically. Clinical and radiographic assessments were made. Results The percentage of implants registered with inflammation was high at the 6‐month baseline examination (>80% bleeding on probing in both test and control group) and remained high throughout the observation period. Similar observations were made for all clinical parameters, and no significant difference was found between test and control groups. Conclusions In the present study, no statistical significant difference was found when supportive peri‐implant treatment was performed with either titanium curettes or chitosan brushes. Within the limits of the study, the results might indicate the need of more effective submucosal cleaning procedures following peri‐implant surgery.

• Wohlfahrt, Johan Caspar; Aass, Anne Merete & Koldsland, Odd Carsten (2019). Treatment of peri-implant mucositis with a chitosan brush? A pilot randomized clinical trial. International Journal of Dental Hygiene. ISSN 1601-5029. p. 1–7. doi: 10.1111/idh.12381. Full text in Research Archive
• Norum, Thomas Åge; Aass, Anne Merete & Koldsland, Odd Carsten (2019). Pain and morbidity after non-surgical and surgical treatment of peri-implantitis. Acta Odontologica Scandinavica. ISSN 0001-6357. doi: 10.1080/00016357.2019.1632474. Full text in Research Archive
• Preus, Hans Ragnar; Maharajasingam, Nisha; Rosic, Jovana & Baelum, Vibeke (2019). Oral hygiene phase revisited: How different study designs have affected results in intervention studies. Journal of Clinical Periodontology. ISSN 0303-6979. 46(5), p. 548–551. doi: 10.1111/jcpe.13109. Full text in Research Archive
• Ketharanthan, Vimalan; Torgersen, Gerald R.; Petrovski, Beata & Preus, Hans Ragnar (2019). Radiographic alveolar bone level and levels of serum 25-OH-Vitamin D3 in ethnic Norwegian and Tamil periodontitis patients and their periodontally healthy controls. BMC Oral Health. 19(1). doi: 10.1186/s12903-019-0769-6. Full text in Research Archive Show summary

  Background Studies suggest association between low serum 25-OH-Vitamin D3 (VitD) and chronic destructive periodontal diseases. The main sources of VitD is sun exposure and fat fish. Subjects with dark skin will therefore generate less VitD as response to sun exposure. The aim of the study was to assess the radiographic bone level and levels of serum VitD in ethnic Norwegian and Tamil periodontitis patients and their respective healthy controls. Methods Twenty-seven Tamil periodontitis patients living in Norway were compared to 21 Tamil controls as well as to 21 Norwegian periodontitis patients and 23 Norwegian controls. Marginal bone level was diagnosed on radiographs. VitD levels were diagnosed in blood samples by high-performance liquid chromatography-mass spectrometry. Results VitD levels were lower in Norwegian periodontitis patients than in controls, while no significant differences were observed between Tamil periodontitis patients and controls despite the significant difference between RBL between the periodontitis patients and controls in both groups. When calculating the odds ratio for having periodontal disease in both populations together, it appeared that one unit increased serum VitD (i.e. 1 nmol/L) decreased the odds of having radiographic bone loss by 4%. Conclusion According to logistic regression, and after correcting for confounding factors, VitD levels showed significant association with the presence of periodontitis, as expressed by radiographic bone loss, in all patients combined.

• Fardal, Øystein; Grytten, Jostein Ivar; Martin, John; Ellingsen, Stig; Fardal, Patrick & Heasman, Peter [Show all 7 contributors for this article] (2018). Adding smoking to the Fardal model of cost‐effectiveness for the lifetime treatment of periodontal diseases. Journal of Periodontology. ISSN 0022-3492. 89(11), p. 1283–1289. doi: 10.1002/JPER.17-0467. Full text in Research Archive Show summary

  Background Little is known about the financial costs that smoking adds to the lifetime treatment of periodontal disease. Methods The total lifetime cost of periodontal treatment was modeled using data from private periodontal practice. The costs of initial and supportive therapy, re‐treatment and tooth replacements (with bridgework or implants) were identified using average dental charges from the American Dental Association survey. Smoking costs at $6 and $10 for 20 cigarettes were compared to the costs of lifetime periodontal treatment for stable and unstable compliant patients. Results Smoking added 8.8% to the financial cost of the lifetime cost of periodontal therapy in stable maintenance patients, 40.1% in patients who needed one extra maintenance visit, and 71.4% in patients who needed two extra maintenance visits per year in addition to added retreatment. The cost of smoking far exceeded the cost of periodontal treatment; For patients who smoked 10 to 40 cigarettes per day at the cost of $6 or $10 a pack, the cost of smoking exceeded the cost of lifetime periodontal treatment by between 2.7 and 17.9 times. Smoking 40 cigarettes at $10 a packet for 3.4 years would pay for the entire lifetime cost of periodontal treatment. Conclusion Smoking adds considerable extra financial costs to the lifetime treatment of periodontal diseases. The cost of smoking itself exceeds the cost of periodontal therapy.

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• Stødle, Ida Haukåen; Koldsland, Odd Carsten; Lukina, Polina; Andersen, Ina Lervåg; Mjønes, Patricia Gjertrud & Rønne, Elin [Show all 9 contributors for this article] (2024). Undiagnosed coeliac disease and periodontal bone loss: A cross-sectional radiological assessment from the HUNT Study. Full text in Research Archive
• Romandini, Mario (2024). Welcome to the new protagonists of the Journal of Periodontal Research: Our Associate Editors and Editorial Board members! Journal of Periodontal Research. ISSN 0022-3484. 59(2), p. 235–236. doi: 10.1111/jre.13253. Full text in Research Archive
• Vigouroux, François; Mario, Romandini; Tavelli, Lorenzo & Baima, Giacomo (2024). New Cover of the Journal of Periodontal Research—The Story Behind. Journal of Periodontal Research. ISSN 0022-3484. doi: 10.1111/jre.13364. Full text in Research Archive
• Romandini, Mario (2024). Journal of Periodontal Research—the past, the present, the future: The legacy of periodontology is here! Journal of Periodontal Research. ISSN 0022-3484. 59(1), p. 1–2. doi: 10.1111/jre.13238. Full text in Research Archive
• Stødle, Ida Haukåen; Koldsland, Odd Carsten; Lukina, Polina; Andersen, Ina Lervåg; Mjønes, Patricia Gjertrud & Rønne, Elin [Show all 9 contributors for this article] (2024). Periodontitt hos personer med tidligere ukjent cøliaki. Full text in Research Archive
• Khan, Sadia Nazir; Koldsland, Odd Carsten & Hjortsjö, Carl (2019). Bacteriostatic effect of filling materials used in implant-abutment-screw-channel: A pilot study. Full text in Research Archive
• Liskiewicz, Krystyna Anna; Sunde, Pia Titterud; Verket, Anders; Økstad, Ole Andreas & Simm, Roger (2019). C-di-GMP signaling in Treponema denticola and its role in pathogenesis of periodontal diseases. Full text in Research Archive
• Liskiewicz, Krystyna Anna; Sunde, Pia Titterud; Verket, Anders; Økstad, Ole Andreas & Simm, Roger (2019). C-di-GMP signaling in Treponema denticola and its role in pathogenesis of periodontal diseases. Full text in Research Archive
• Maal, Mehrnaz Beheshti; Stig, Aanerød Ellingsen; Reseland, Janne Elin & Verket, Anders (2018). Impact of implantoplasty on surface roughness and human fibroblast growth in vitro. Full text in Research Archive
• Norton, Inghild; Valør, Liv Oddrun; Koldsland, Odd Carsten; Aass, Anne Merete; Grjibovski, Andrei M. & Preus, Hans Ragnar (2018). Klinisk effekt av et kommersielt munnskyllemiddel på plakk og gingivitt. Den norske tannlegeforenings Tidende. ISSN 0029-2303. 128(3), p. 188–194. Full text in Research Archive

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