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Keywords = periodontal attachment loss

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23 pages, 4371 KiB  
Article
Advances in Periodontal Diagnostics: Application of MultiModal Language Models in Visual Interpretation of Panoramic Radiographs
by Albert Camlet, Aida Kusiak, Agata Ossowska and Dariusz Świetlik
Diagnostics 2025, 15(15), 1851; https://doi.org/10.3390/diagnostics15151851 - 23 Jul 2025
Viewed by 307
Abstract
Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining [...] Read more.
Background: Periodontitis is a multifactorial disease leading to the loss of clinical attachment and alveolar bone. The diagnosis of periodontitis involves a clinical examination and radiographic evaluation, including panoramic images. Panoramic radiographs are cost-effective methods widely used in periodontitis classification. The remaining bone height (RBH) is a parameter used to assess the alveolar bone level. Large language models are widely utilized in the medical sciences. ChatGPT, the leading conversational model, has recently been extended to process visual data. The aim of this study was to assess the effectiveness of the ChatGPT models 4.5, o1, o3 and o4-mini-high in RBH measurement and tooth counts in relation to dental professionals’ evaluations. Methods: The analysis was based on 10 panoramic images, from which 252, 251, 246 and 271 approximal sites were qualified for the RBH measurement (using the models 4.5, o1, o3 and o4-mini-high, respectively). Three examiners were asked to independently evaluate the RBH in approximal sites, while the tooth count was achieved by consensus. Subsequently, the results were compared with the ChatGPT outputs. Results: ChatGPT 4.5, ChatGPT o3 and ChatGPT o4-mini-high achieved substantial agreement with clinicians in the assessment of tooth counts (κ = 0.65, κ = 0.66, κ = 0.69, respectively), while ChatGPT o1 achieved moderate agreement (κ = 0.52). In the context of RBH values, the ChatGPT models consistently exhibited a positive mean bias compared with the clinicians. ChatGPT 4.5 was reported to provide the lowest bias (+12 percentage points (pp) for the distal surfaces, width of the 95% CI for limits of agreement (LoAs) ~60 pp; +11 pp for the mesial surfaces, LoA width ~54 pp). Conclusions: ChatGPT 4.5 and ChatGPT o3 show potential in the assessment of tooth counts on a panoramic radiograph; however, their present level of accuracy is insufficient for clinical use. In the current stage of development, the ChatGPT models substantially overestimated the RBH values; therefore, they are not applicable for classifying periodontal disease. Full article
(This article belongs to the Special Issue Application of Artificial Intelligence to Oral Diseases)
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17 pages, 2234 KiB  
Article
Impact of Live Ligilactobacillus salivarius CCFM1332 and Its Postbiotics on Porphyromonas gingivalis Colonization, Alveolar Bone Resorption and Inflammation in a Rat Model of Periodontitis
by Qing Hong, Yu Ren, Xin Tang, Bingyong Mao, Qiuxiang Zhang, Jianxin Zhao, Shumao Cui and Zhenmin Liu
Microorganisms 2025, 13(7), 1701; https://doi.org/10.3390/microorganisms13071701 - 20 Jul 2025
Viewed by 442
Abstract
Periodontitis is a chronic inflammatory disease caused by periodontopathic bacteria such as Porphyromonas gingivalis (P. gingivalis), which leads to alveolar bone destruction and systemic inflammation. Emerging evidence suggests that probiotics may mitigate periodontal pathology. To systematically evaluate the alleviative effects and [...] Read more.
Periodontitis is a chronic inflammatory disease caused by periodontopathic bacteria such as Porphyromonas gingivalis (P. gingivalis), which leads to alveolar bone destruction and systemic inflammation. Emerging evidence suggests that probiotics may mitigate periodontal pathology. To systematically evaluate the alleviative effects and mechanisms of different forms of probiotics, including live bacteria and postbiotics, on periodontitis, we first screened and identified Ligilactobacillus salivarius CCFM1332 (L. salivarius CCFM1332) through in vitro antibacterial and anti-biofilm activity assays. Subsequently, we investigated its therapeutic potential in a rat model of experimental periodontitis. The results demonstrated that both live L. salivarius CCFM1332 (PL) and its postbiotics (PP) significantly reduced the gingival index (GI) and probing depth (PD) in rats, while suppressing oral colonization of P. gingivalis. Serum pro-inflammatory cytokine levels were differentially modulated: the PL group exhibited reductions in interleukin-17A (IL-17A), interleukin-6 (IL-6), and interleukin-1β (IL-1β) by 39.31% (p < 0.01), 17.26% (p < 0.05), and 14.74% (p < 0.05), respectively, whereas the PP group showed decreases of 34.79% (p < 0.05), 29.85% (p < 0.01), and 19.74% (p < 0.05). Micro-computed tomography (Micro-CT) analysis demonstrated that compared to the periodontitis model group (PM), the PL group significantly reduced alveolar bone loss (ABL) by 30.1% (p < 0.05) and increased bone volume fraction (BV/TV) by 49.5% (p < 0.01). In contrast, while the PP group similarly decreased ABL by 32.7% (p < 0.05), it resulted in a 40.4% improvement in BV/TV (p > 0.05). Histological assessments via hematoxylin and eosin (H&E) and tartrate-resistant acid phosphatase (TRAP) staining confirmed that both the PL group and the PP group alleviated structural damage to alveolar bone-supporting tissues and reduced osteoclast-positive cell counts. This study suggests that live L. salivarius CCFM1332 and its postbiotics reduce alveolar bone resorption and attachment loss in rats through antibacterial and anti-inflammatory pathways, thereby alleviating periodontal inflammation in rats. Full article
(This article belongs to the Section Medical Microbiology)
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14 pages, 858 KiB  
Article
Twelve-Month Follow-Up After the Treatment of Periodontal Conditions Using Scaling and Root Planning Alone vs. Laser-Assisted New Attachment Procedure
by Edwin Sever Bechir, Farah Bechir, Mircea Suciu, Anamaria Bechir and Andrada Camelia Nicolau
Diagnostics 2025, 15(14), 1799; https://doi.org/10.3390/diagnostics15141799 - 16 Jul 2025
Viewed by 442
Abstract
Background/Objectives: Periodontitis is a chronic inflammation of the periodontium that induces damage in the periodontal ligaments and the surrounding alveolar bone. This study aimed to comparatively evaluate the clinical outcomes of two therapies used in the management of periodontal conditions, represented by [...] Read more.
Background/Objectives: Periodontitis is a chronic inflammation of the periodontium that induces damage in the periodontal ligaments and the surrounding alveolar bone. This study aimed to comparatively evaluate the clinical outcomes of two therapies used in the management of periodontal conditions, represented by scaling and root planing (SRP) alone and laser-assisted new attachment procedure (LANAP). Methods: Two quadrants of the oral cavity from each selected patient were randomly allocated to one of the treatment groups, SRP or LANAP. The periodontal status was documented in a periodontal chart at baseline, six weeks, and one year after treatment. SRP was performed in the first group of patients. The LANAP protocol was carried out on the patients belonging to the second group. Results: The outcomes of the study highlighted that LANAP leads to a reduction in periodontal disease signs (pocket depth, bleeding on probing, and gingival recession), contributing to the formation of new attachment tissues. LANAP shows more stability in maintaining the improvements achieved during six weeks, while SRP shows a slight deterioration in several parameters, particularly attachment loss, between six weeks and one year. The collected data at six-week and one-year follow-ups show improvements in periodontal health, thus improving oral health. Conclusions: Both minimally invasive periodontal procedures were effective, with LANAP demonstrating greater efficiency in patients with chronic periodontal disease, a greater reduction in pocket depth, and improved clinical outcomes compared to SRP alone. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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16 pages, 857 KiB  
Article
The Effect of Antimicrobial Photodynamic Therapy on the Healing of the Post-Extraction Socket of the Mandibular Third Molar: A Randomized Clinical Study
by Alessia Pardo, Maria Lonardi, Annarita Signoriello, Gianluca Colapinto, Funda Goker, Margherita Tumedei, Massimo Albanese and Massimo Del Fabbro
J. Clin. Med. 2025, 14(14), 5029; https://doi.org/10.3390/jcm14145029 - 16 Jul 2025
Viewed by 214
Abstract
Objectives: We aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) in promoting wound healing after the surgical removal of inferior third molars. Methods: Patients in need of unilateral mandibular third molar extraction were randomly assigned to either a test [...] Read more.
Objectives: We aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) in promoting wound healing after the surgical removal of inferior third molars. Methods: Patients in need of unilateral mandibular third molar extraction were randomly assigned to either a test or control group before surgery. During the test, a photoactive substance activated with laser light (20 mW, 660 nm) was applied to the post-extraction site for 60 s before suturing to promote healing and disinfection. The control group did not receive any laser applications after tooth removal. The probing pocket depth (PPD), bleeding on probing (BOP), plaque index (PI), gingival recession (REC), and levels of clinical attachment loss (CAL) before surgery (T0), 14 days after surgery (T1), and after 3 months after surgery (T2) were evaluated for the adjacent second molar. Post-operative swelling, pain (VAS index), the number of painkillers taken, alveolar probing, and Landry’s healing index were recorded at T1. Results: Sixty-five patients, aged between 14 and 39 years, were assigned randomly to test (n = 32) or control (n = 33) groups. Five dropouts occurred. Post-operative swelling and the VAS index were significantly lower in the test group compared to the control (p = 0.002 and p = 0.04, respectively). All periodontal indexes except recession significantly worsened at T1 in both groups. After three months, a significant improvement for PPD, CAL, and PI was recorded in the test group compared to the control (p = 0.001). Conclusions: According to the results of this study, the use of aPDT seems to have a beneficial effect on post-operative swelling and pain, as well as the plaque index, in the short-term follow-up. Full article
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21 pages, 5181 KiB  
Systematic Review
Beneficial Effect of Platelet-Rich Fibrin as an Adjunct to Nonsurgical Therapy After Subgingival Professional Mechanical Plaque Removal for Periodontitis: A Systematic Review and Meta-Analysis
by Monica Tanady, Fatimah Maria Tadjoedin, Sri Lelyati C. Masulili, Nadhia Anindhita Harsas and Adityo Widaryono
Clin. Pract. 2025, 15(7), 127; https://doi.org/10.3390/clinpract15070127 - 2 Jul 2025
Viewed by 468
Abstract
Background and Objectives: Periodontitis is an inflammatory disease that compromises the supporting structures of the teeth, leading to irreversible tissue damage and tooth loss. While subgingival professional mechanical plaque removal (PMPR) remains the gold standard treatment, there is increasing interest in adjunctive therapies. [...] Read more.
Background and Objectives: Periodontitis is an inflammatory disease that compromises the supporting structures of the teeth, leading to irreversible tissue damage and tooth loss. While subgingival professional mechanical plaque removal (PMPR) remains the gold standard treatment, there is increasing interest in adjunctive therapies. Platelet-rich fibrin (PRF) has gained attention as a promising biomaterial to enhance periodontal healing and regeneration. This study aimed to evaluate the clinical and immunological effectiveness of PRF as an adjunct to PMPR. Materials and Methods: Clinical studies published between January 2019 and August 2024 were included from the ProQuest, PubMed, PMC, ScienceDirect, Scopus, and EBSCO databases. Seven studies met the inclusion criteria, focusing on adults with periodontitis treated with PRF + PMPR compared to PMPR alone. Primary outcomes included changes in clinical and immunological parameters. Risk of bias was assessed using the Cochrane ROB2 tool. Meta-analysis was conducted using both fixed-effect and random-effects models, depending on heterogeneity. Results: The meta-analysis demonstrated significant improvements in clinical outcomes in the PRF + PMPR group, with reductions in probing pocket depth (SMD: −1.43 mm; 95% CI: −2.05 to −0.81; p < 0.00001), clinical attachment level (SMD: −1.34 mm; 95% CI: −1.95 to −0.73; p < 0.0001), bleeding on probing (SMD: −0.75 mm; 95% CI: −1.11 to −0.39; p < 0.00001), gingival recession (SMD: −0.79 mm; 95% CI: −1.33 to −0.25; p = 0.004), and gingival index (SMD: −0.82 mm; 95% CI: −1.37 to −0.28; p = 0.003). Favorable trends were also observed in IL-10, TGF-β, VEGF, PDGF-BB, periostin, and type I collagen levels. Conclusions: PRF enhances clinical and immunological outcomes and supports periodontal tissue stability when used as an adjunct to non-surgical therapy. Full article
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12 pages, 362 KiB  
Article
Are Inflammatory Markers and Periodontitis Effective in Predicting Miscarriage?
by Isa Temur, Selcen Ozcan Bulut, Safak Necati Dönertas, Aycan Dal Dönertas, Katibe Tugce Temur and Guldane Magat
Healthcare 2025, 13(13), 1565; https://doi.org/10.3390/healthcare13131565 - 30 Jun 2025
Viewed by 351
Abstract
Background/Objectives: Miscarriage is a common pregnancy complication that significantly impacts individuals’ health due to its physical and psychological effects. This study aimed to investigate the association between periodontal health and hematological parameters in women who experienced miscarriage before the 20th week of gestation, [...] Read more.
Background/Objectives: Miscarriage is a common pregnancy complication that significantly impacts individuals’ health due to its physical and psychological effects. This study aimed to investigate the association between periodontal health and hematological parameters in women who experienced miscarriage before the 20th week of gestation, and to assess the potential predictive value of these parameters for miscarriage risk by comparing them with those of women with an uncomplicated pregnancy course. Methods: This study was a prospective case–control and cross-sectional study. It included a total of 82 participants, comprising 41 women with miscarriage and 41 healthy pregnant controls. The periodontal examinations included measurements of the Gingival Index (GI), Plaque Index (PI), Probing Depth (PD), Clinical Attachment Loss (CAL), and Simplified Calculus Index (SCI). Additionally, complete blood counts (CBCs) were obtained from all participants. Appropriate statistical analyses, including non-parametric, correlation, logistic regression, and ROC analyses, were conducted, with the significance level set at p < 0.05. Results: The primary outcome measure was CAL as an indicator of periodontal disease severity and its association with miscarriage risk. Additional outcomes included Plateletcrit (PCT), the Platelet Count (PLT), and the Neutrophil-to-Lymphocyte Ratio (NLR) to evaluate systemic inflammatory responses and their correlations with periodontal parameters. CAL was significantly elevated in the miscarriage group (p < 0.001) and emerged as the strongest predictor of miscarriage risk (OR = 0.0537, p < 0.001, AUC = 0.8691). PCT was significantly higher in the miscarriage group (p = 0.017) and positively correlated with the GI (p = 0.041), suggesting a link between systemic inflammation and periodontal health. Conclusions: Considering this study’s limitations, CAL was the strongest predictor of miscarriage, while PLT and PCT had some discriminative power. Collaboration between obstetricians and dentists can facilitate early diagnosis and intervention by promoting routine oral health check-ups before and during pregnancy. Additionally, integrating oral health assessments into prenatal care and developing public health policies could enhance access to dental services during both preconception and pregnancy periods. Full article
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14 pages, 574 KiB  
Article
Impact of Sympathetic Nervous System Activation and Inflammatory Response on Periodontitis Severity
by Dimitar Dimitrov, Antoaneta Mlachkova, Marina Miteva, Dimitar Parvanov and Velitchka Dosseva-Panova
Immuno 2025, 5(2), 22; https://doi.org/10.3390/immuno5020022 - 5 Jun 2025
Viewed by 1103
Abstract
The sympathetic nervous system (SNS) is crucial for stress response regulation and immune modulation. Prolonged SNS activation, often induced by stress exposure, disrupts immune homeostasis and intensifies inflammatory processes, contributing to periodontal disease progression. This study investigates the relationship between SNS activity and [...] Read more.
The sympathetic nervous system (SNS) is crucial for stress response regulation and immune modulation. Prolonged SNS activation, often induced by stress exposure, disrupts immune homeostasis and intensifies inflammatory processes, contributing to periodontal disease progression. This study investigates the relationship between SNS activity and periodontitis severity, utilizing salivary biomarkers chromogranin A (CgA) and alpha-amylase (sAA) alongside pro-inflammatory cytokines interleukin-1β (IL-1β) and interleukin-6 (IL-6). Saliva samples from 67 patients, categorized by periodontitis severity (Stages I/II and III/IV), were analyzed using enzyme-linked immunosorbent assay (ELISA). The results revealed significantly higher median levels of CgA (9.45 vs. 3.93 pmol/mL) and IL-1β (257.81 vs. 220.11 pg/mL) in patients with Stage III/IV periodontitis compared with those with Stage I/II, indicating heightened SNS activity and inflammatory response. Correlations between these biomarkers and clinical periodontal parameters, such as probing depth and clinical attachment loss, further support these findings. Despite elevated sAA levels in severe cases, statistical significance was not achieved. IL-6 levels also showed no significant variation across disease stages, although trends aligned with increased severity. This study highlights the interplay between SNA activation and periodontal inflammation, as evidenced by elevated salivary levels of CgA and IL-1β in patients with advanced periodontitis. By integrating neuroendocrine and inflammatory biomarkers into the diagnostic process, clinicians may be able to better identify patients at increased risk for periodontal breakdown and to consider adjunctive interventions such as stress management, thereby supporting more personalized approaches to periodontitis treatment. Full article
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18 pages, 5393 KiB  
Systematic Review
Autogenous Periosteal Graft Along with Open Flap Debridement Versus Open Flap Debridement Alone for the Treatment of Grade II Furcation Defect in Chronic Periodontitis Patients: A Systematic Review and Meta-Analysis
by Swapna A. Mahale, Prasad Dhadse, Sumedha Thosar, Vedant Bhandari, Akhil Patil, Sadatullah Syed, Ranjeet Ajit Bapat, Tanay Chaubal, Sumaiya Zabin Eusufzai and Shahabe Saquib Abullais
Medicina 2025, 61(5), 905; https://doi.org/10.3390/medicina61050905 - 16 May 2025
Viewed by 625
Abstract
Background and Objectives: Periodontal regeneration involves techniques intended at restoring the lost supporting tissue around a periodontally weakened tooth. These regenerative methods frequently utilize periosteal grafts to stimulate the evolvement of vital adjacent tissues. This paper intended to evaluate the use of [...] Read more.
Background and Objectives: Periodontal regeneration involves techniques intended at restoring the lost supporting tissue around a periodontally weakened tooth. These regenerative methods frequently utilize periosteal grafts to stimulate the evolvement of vital adjacent tissues. This paper intended to evaluate the use of autogenous periosteal grafts in treating grade II furcation defects (Glickman Classification 1953) in patients with chronic periodontitis. Materials and Methods: The databases MEDLINE (via PubMed), Cochrane, EBSCO, and Google Scholar were searched for papers published in English from January 1991 till December 2022. Three individuals examined the reclaimed articles according to the inclusion norms. Randomized controlled trials (RCTs) assessing the efficacy of autogenous periosteal grafts for treating Grade II furcation defects in chronic periodontitis patients were involved. Only four related studies were identified for data extraction, involving 80 patients aged 18 to 52 years. Outcome variables measured included horizontal bone loss (HD), vertical bone loss (VD), pocket depth (PD), clinical attachment level (CAL), bone height (BH), gingival recession (GR), plaque index (PI), and gingival index (GI). Data were examined using RevMan 5.4.1 software. Mean differences and 95% confidence intervals were employed to estimate effect sizes. Results: Both groups showed similar results for reductions in PI, GI, and BOP. However, The periosteal graft also yielded better outcomes for CAL gain, BH, and GR. The meta-analysis showed a significant overall effect of Periosteal Barrier Membrane (PBM) on horizontal and vertical bony change levels, but subgroup differences between unilateral and bilateral applications were not statistically significant due to high heterogeneity. Although the bilateral subgroup demonstrated significant benefits of PBM treatment, the overall findings across the clinical attachment level group remain inconclusive. Conclusion: Current evidence suggests that while PBM may benefit bilateral mandibular sites, and autogenous periosteal grafts offer no added advantage over OFD alone in Grade II furcation defects, the overall findings remain inconclusive. Full article
(This article belongs to the Special Issue Current and Future Trends in Dentistry and Oral Health)
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14 pages, 491 KiB  
Article
Role of Salivary Biomarkers IL-1β and MMP-8 in Early Detection and Staging of Periodontal Disease
by Liliana Sachelarie, Corina Laura Stefanescu, Rodica Maria Murineanu, Mircea Grigorian, Agripina Zaharia, Ioana Scrobota and Loredana Liliana Hurjui
Medicina 2025, 61(4), 760; https://doi.org/10.3390/medicina61040760 - 20 Apr 2025
Viewed by 1049
Abstract
Background: Periodontal disease is a chronic inflammatory condition affecting the supporting tissues of the teeth. Early diagnosis is crucial for preventing severe complications. This study investigates and compares the utility of two salivary biomarkers, interleukin-1 beta (IL-1β) and matrix metalloproteinase-8 (MMP-8), in [...] Read more.
Background: Periodontal disease is a chronic inflammatory condition affecting the supporting tissues of the teeth. Early diagnosis is crucial for preventing severe complications. This study investigates and compares the utility of two salivary biomarkers, interleukin-1 beta (IL-1β) and matrix metalloproteinase-8 (MMP-8), in the early detection and staging of periodontal disease. Methods: This study included 189 patients, all of whom were evaluated both clinically and biologically. Each participant provided unstimulated saliva samples, which were analyzed using ELISA methods to quantify IL-1β and MMP-8 levels. Clinical periodontal data, including probing depth (3.9 ± 0.6 mm), clinical attachment loss (3.4 ± 0.6 mm), and Plaque Index (2.35 ± 0.55), were collected for all subjects. Biomarker concentrations were then correlated with these clinical parameters and with disease severity, classified according to the 2018 EFP/AAP criteria. Results: IL-1β levels (210 ± 95 pg/mL) were strongly associated with early gingival inflammation, while MMP-8 levels (185 ± 140 ng/mL) correlated with periodontal tissue destruction (p < 0.01). MMP-8 showed a higher sensitivity for diagnosing advanced stages (p = 0.002), whereas IL-1β was more effective in detecting early inflammatory changes (p = 0.01). Logistic regression identified MMP-8 as a significant predictor of advanced disease (coefficient 0.85, p < 0.001) and IL-1β as an indicator of early inflammation (coefficient 0.25, p = 0.02). Conclusions: Both biomarkers are valuable tools for the diagnosis and staging of periodontal disease. MMP-8 is relevant for identifying advanced cases, while IL-1β supports early detection. Their combined use may enhance diagnostic accuracy and guide personalized periodontal care. Full article
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23 pages, 1162 KiB  
Article
AI Efficiency in Dentistry: Comparing Artificial Intelligence Systems with Human Practitioners in Assessing Several Periodontal Parameters
by Oana-Maria Butnaru, Monica Tatarciuc, Ionut Luchian, Teona Tudorici, Carina Balcos, Dana Gabriela Budala, Ana Sirghe, Dragos Ioan Virvescu and Danisia Haba
Medicina 2025, 61(4), 572; https://doi.org/10.3390/medicina61040572 - 23 Mar 2025
Viewed by 1172
Abstract
Artificial intelligence (AI) is increasingly used in healthcare, including dental and periodontal diagnostics, due to its ability to analyze complex datasets with speed and precision. Backgrounds and Objectives: This study aimed to evaluate the reliability of AI-assisted dental–periodontal diagnoses compared to diagnoses made [...] Read more.
Artificial intelligence (AI) is increasingly used in healthcare, including dental and periodontal diagnostics, due to its ability to analyze complex datasets with speed and precision. Backgrounds and Objectives: This study aimed to evaluate the reliability of AI-assisted dental–periodontal diagnoses compared to diagnoses made by senior specialists, specialists, and general dentists. Material and Methods: A comparative study was conducted involving 60 practitioners divided into three groups—general dentists, specialists, and senior specialists—along with an AI diagnostic system (Planmeca Romexis 6.4.7.software). Participants evaluated six high-quality panoramic radiographic images representing various dental and periodontal conditions. Diagnoses were compared against a reference “gold standard” validated by a dental imaging expert and senior clinician. A statistical analysis was performed using SPSS 26.0, applying chi-square tests, ANOVA, and Bonferroni correction to ensure robust results. Results: AI’s consistency in identifying subtle conditions was comparable to that of senior specialists, while general dentists showed greater variability in their evaluations. The key findings revealed that AI and senior specialists consistently demonstrated the highest performance in detecting attachment loss and alveolar bone loss, with AI achieving a mean score of 6.12 in identifying teeth with attachment loss, compared to 5.43 for senior specialists, 4.58 for specialists, and 3.65 for general dentists. The ANOVA highlighted statistically significant differences between groups, particularly in the detection of attachment loss on the maxillary arch (F = 3.820, p = 0.014). Additionally, AI showed high consistency in detecting alveolar bone loss, with comparable performance to senior specialists. Conclusions: AI systems exhibit significant potential as reliable tools for dental and periodontal assessment, complementing the expertise of human practitioners. However, further validation in clinical settings is necessary to address limitations such as algorithmic bias and atypical cases. AI integration in dentistry can enhance diagnostic precision and patient outcomes while reducing variability in clinical assessments. Full article
(This article belongs to the Section Dentistry and Oral Health)
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20 pages, 3843 KiB  
Review
Revolutionizing Periodontal Care: The Role of Artificial Intelligence in Diagnosis, Treatment, and Prognosis
by Giacomo Spartivento, Viviana Benfante, Muhammad Ali, Anthony Yezzi, Domenico Di Raimondo, Antonino Tuttolomondo, Antonio Lo Casto and Albert Comelli
Appl. Sci. 2025, 15(6), 3295; https://doi.org/10.3390/app15063295 - 18 Mar 2025
Viewed by 2077
Abstract
This review evaluates the application of artificial intelligence (AI), particularly neural networks, in diagnosing and staging periodontal diseases through radiographic analysis. Using a systematic review of 22 studies published between 2017 and 2024, it examines various AI models, including convolutional neural networks (CNNs), [...] Read more.
This review evaluates the application of artificial intelligence (AI), particularly neural networks, in diagnosing and staging periodontal diseases through radiographic analysis. Using a systematic review of 22 studies published between 2017 and 2024, it examines various AI models, including convolutional neural networks (CNNs), hybrid networks, generative adversarial networks (GANs), and transformer networks. The studies analyzed diverse datasets from panoramic, periapical, and hybrid imaging techniques, assessing diagnostic accuracy, sensitivity, specificity, and interpretability. CNN models like Deetal-Perio and YOLOv5 achieved high accuracy in detecting alveolar bone loss (ABL), with F1 scores up to 0.894. Hybrid networks demonstrate strength in handling complex cases, such as molars and vertical bone loss. Despite these advancements, challenges persist, including reduced performance in severe cases, limited datasets for vertical bone loss, and the need for 3D imaging integration. AI-driven tools offer transformative potential in periodontology by rivaling clinician performance, improving diagnostic consistency, and streamlining workflows. Addressing current limitations with large, diverse datasets and advanced imaging techniques will further optimize their clinical utility. AI stands poised to revolutionize periodontal care, enabling early diagnosis, personalized treatment planning, and better patient outcomes. Full article
(This article belongs to the Special Issue Deep Learning in Medical Image Processing and Analysis)
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17 pages, 1156 KiB  
Article
Guided Tissue Regeneration of Periodontal Infrabony Defects with Frozen Radiation-Sterilized Allogenic Bone Graft Versus Deproteinized Bovine Bone Mineral: 5-Year Outcomes of RCT
by Bartłomiej Górski, Aniela Brodzikowska, Kacper Nijakowski and Mariano Sanz
J. Funct. Biomater. 2025, 16(3), 95; https://doi.org/10.3390/jfb16030095 - 10 Mar 2025
Cited by 1 | Viewed by 1591
Abstract
The aim of this study was to compare the efficacy of the guided tissue regeneration (GTR) of periodontal infrabony defects using the frozen radiation-sterilized allogenic bone graft (FRSABG) versus deproteinized bovine bone mineral (DBBM) 5 years after treatment. The association between patients’ compliance [...] Read more.
The aim of this study was to compare the efficacy of the guided tissue regeneration (GTR) of periodontal infrabony defects using the frozen radiation-sterilized allogenic bone graft (FRSABG) versus deproteinized bovine bone mineral (DBBM) 5 years after treatment. The association between patients’ compliance and periodontitis recurrence with 5-year outcomes was also evaluated. Thirty infrabony defects in 15 stage III/IV periodontitis patients were randomly allocated to the FRSBAG group (tests) or the DBBM group (controls). Between 1 and 5 years, one patient was lost to follow-up and one tooth was extracted due to root fracture. No tooth was extracted for periodontal reasons. Consequently, 13 teeth in test sites and 14 teeth in control sites were available for the 5-year analysis. The clinical attachment level gain (CAL-G, primary outcome), probing pocket depth (PPD), radiographic defect depth (DD), and linear defect fill (LDF) were examined at baseline and 5 years post-surgically. Both groups showed statistically significant improvements in all evaluated clinical and radiographic parameters at 5 years, with insignificant intergroup differences. CAL-Gs were 4.46 ± 2.07 mm in the FRSBAG group, and 3.86 ± 1.88 mm in the DBBM group (p = 0.5442). In six (43%) patients, we observed periodontitis recurrence, among whom two (33.33%) participated regularly in supportive periodontal care (SPC) and the other four (66.7%) did not take part in SPC. A regression analysis revealed that periodontitis recurrence was a significant predictor of CAL loss and DD increase. FRSBAG and DBBM were both equally effective 5 years after the GTR of infrabony defects. Within the limitations of the present study, its outcomes advocate that both grafts may be considered as a viable option based on patient preferences and clinical considerations. Full article
(This article belongs to the Special Issue Advanced Biomaterials for Periodontal Regeneration)
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16 pages, 238 KiB  
Review
The Decision Between Tooth Retention or Replacement with Implants: A Continuing Dilemma
by Eleni Bentour, Eirini Papamanoli and Ioannis K. Karoussis
Dent. J. 2025, 13(3), 99; https://doi.org/10.3390/dj13030099 - 26 Feb 2025
Viewed by 1303
Abstract
The global adoption of dental implants has significantly reshaped modern dental practices, with the market projected to reach USD 16 billion by 2029. However, despite high success rates, dental implants can still be prone to complications, particularly when underlying causes of tooth loss, [...] Read more.
The global adoption of dental implants has significantly reshaped modern dental practices, with the market projected to reach USD 16 billion by 2029. However, despite high success rates, dental implants can still be prone to complications, particularly when underlying causes of tooth loss, such as periodontal disease and bone loss, are not addressed. This paper explores the biological and mechanical considerations in the decision-making process between preserving a tooth through periodontal therapy or opting for extraction and implant placement. It also highlights the importance of a holistic approach that includes assessing the patient’s oral health, periodontal status, and the biomechanical factors influencing tooth retention. Periodontal therapy has been proven to be highly effective, with both non-surgical and surgical therapies showing long-term efficacy in preserving natural teeth, especially in the presence of furcation involvement. Studies show that proper periodontal management, including regular maintenance therapy after the active therapy, significantly enhances tooth survival, even in cases of severe periodontitis. In contrast, dental implants, while effective, are not free of complications, mainly inflammatory peri-implant diseases, but also mechanical complications, which can compromise long-term outcomes. The paper reviews clinical studies on implant survival, demonstrating that periodontal therapy can sometimes offer a more cost-effective and biologically sound alternative to implant therapy, especially for teeth with severe attachment loss or furcation involvement. In conclusion, treatment decisions should be based on a comprehensive evaluation of clinical, biological, and patient-specific factors. By integrating regenerative therapies even in more compromised teeth and addressing the root causes of tooth loss, implant rehabilitation can be postponed for many years and offer a cost-effective and successful long-term treatment plan. This approach underscores the importance of individualized care in the evolving landscape of restorative dentistry and implantology. Full article
(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)
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17 pages, 3643 KiB  
Systematic Review
Bony Defect Regeneration in Periodontitis: A Systematic Review of the Literature Regarding the Use of Enamel Matrix Derivative Proteins
by Eugen Bud, Silvia-Izabella Pop, Anamaria Bud, Benjamin Robert Steele and Alexandru Vlasa
Dent. J. 2025, 13(3), 92; https://doi.org/10.3390/dj13030092 - 20 Feb 2025
Cited by 2 | Viewed by 2340
Abstract
Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was [...] Read more.
Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was to observe and analyze recent information from the literature on the effect of enamel matrix derivative proteins on the bony defects caused by periodontitis. Methods: Through using two major online databases and search engines, the literature was manually searched for papers published until May 2024. To find relevant studies, this research utilized a combination of target keywords, and the reference lists of manuscripts that were chosen for inclusion in this study were checked and analyzed in tabular form, enabling the collection and comparison of data. Results: According to the results, the average value of the probing depth gained was 4 mm for the EMD™ alone and 4.25 mm for the EMD combined with surgical techniques such as open-flap techniques, platelet derivatives, and growth factors. In regard to clinical attachment level (CAL) gaining, average values of 3.6 mm in EMD™ alone and 3.86 mm with EMD™ combined with other techniques were observed. Conclusions: It can be concluded that the healing propensity depends on the morphological structure of the bone defect represented by the wall stage, and there is a certain coherence and correlation between the values of probing depth (PD) and clinical attachment level (CAL), whether for the use of EMD alone or its use in combination with other materials. Full article
(This article belongs to the Special Issue New Perspectives in Periodontology and Implant Dentistry)
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18 pages, 300 KiB  
Article
Oral Health Status and Factors Associated with Oral Health in Patients with Alzheimer’s Disease: A Matched Case-Control Observational Study
by Reza Aghasizadeh Sherbaf, George Michael Kaposvári, Katalin Nagy, Magdolna Pakáski, Márió Gajdács, Danica Matusovits and Zoltán Baráth
J. Clin. Med. 2025, 14(5), 1412; https://doi.org/10.3390/jcm14051412 - 20 Feb 2025
Cited by 1 | Viewed by 1480
Abstract
Background: Alzheimer’s disease (AD) is a chronic neurodegenerative disease, ranking as the seventh leading cause of death in both sexes. There is increasing awareness of the role of chronic periodontal disease and severe tooth loss as a modifiable risk factor for developing AD. [...] Read more.
Background: Alzheimer’s disease (AD) is a chronic neurodegenerative disease, ranking as the seventh leading cause of death in both sexes. There is increasing awareness of the role of chronic periodontal disease and severe tooth loss as a modifiable risk factor for developing AD. The aim of the present observational study was to assess AD patients with non-affected healthy controls in the context of their dental and periodontal health outcomes; additionally, the potential impact of anamnestic factors and lifestyle habits on oral health outcomes was also studied. Methods: A total of n = 41 AD patients receiving treatment at the Department of Psychiatry, University of Szeged, were compared with n = 41 age- and gender-matched controls from individuals seeking dental treatment and from retirement homes (mean age was 83.32 ± 7.82 years). Dental and periodontal status indices were assessed according to World Health Organization (WHO) criteria. Results: Overall, 51.2%, 68.3%, and 87.8% of AD patients received mood stabilizers, drugs for their non-cognitive symptoms and cognitive symptoms, respectively. Severe tooth loss was observed in 43.9% of AD patients and 56.1% of controls, respectively. There were no significant differences among AD patients and controls regarding the dental status indices studied (p > 0.05 for all indicators). AD patients had significantly higher plaque indices (%) (59.06 ± 15.45 vs. 41.35 ± 7.97; p < 0.001), bleeding on probing (BOP%) (62.65 ± 12.00 vs. 40.12 ± 10.86; p < 0.001), pocket depth [PD] (2.63 ± 0.56 vs. 2.29 ± 0.13; p = 0.002) and attachment loss [AL] (2.85 ± 0.79 vs. 2.39 ± 0.41; p = 0.026) values, compared to controls. Smoking (vs. non-smokers; 56.28 ± 12.36 vs. 51.40 ± 13.23, p = 0.038) and consumption of alcohol (vs. non-drinkers; 58.68 ± 9.86 vs. 54.78 ± 14.86, p = 0.040) were associated with higher plaque indices [%], while no similar effects were shown for dental status parameters (p > 0.05). In contrast, coffee intake and vitamin supplement use had no significant effect on dental or periodontal status parameters (p > 0.05 in all cases). Conclusions: The results of our study underscore the substantial treatment needs of AD patients, calling for heightened awareness among dental healthcare professionals. Full article
(This article belongs to the Special Issue Oral Hygiene: Updates and Clinical Progress)
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