Periodontology 2000

Monje, Alberto; Amerio, Ettore; Mallor, Irene; Aparicio, Conrado

doi: 10.1111/prd.12638pmid: 40553005

Peri‐implant diseases are dysbiosis‐mediated inflammatory disorders that occur in susceptible hosts. Antimicrobials and immunomodulatory agents therefore might be pertinent as adjunctive measures in the treatment of such disorders. The aim of this narrative review was to examine the existing evidence and assess the effectiveness of emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri‐implant diseases. An electronic search in the PubMed library was carried out to identify traditional and emerging locally delivered antimicrobial and immunomodulatory approaches for the prevention/treatment of peri‐implant diseases. A narrative review was conducted to shed light on the role of these approaches to prevent and treat peri‐implant diseases. The use of traditional locally delivered antimicrobials as an adjunct to the nonsurgical or surgical treatment of peri‐implant diseases has been shown to be safe and effective to a certain extent. Nevertheless, the body of evidence is limited, which precludes the drawing of firm conclusions/recommendations on their daily use for the treatment of these disorders. Likewise, the existing evidence on traditional immunomodulatory approaches is scarce, and so firm conclusions/recommendations on their daily use for the treatment of these disorders cannot be made. Among the emerging antimicrobials and immunomodulatory strategies, argon plasma and lasers seem to offer benefits for the prevention and treatment of peri‐implant diseases, respectively. Significant advances have been made in the understanding and potential of novel locally delivered and immunomodulatory approaches for the prevention/treatment of peri‐implant diseases. Nevertheless, their clinical application is still limited by a lack of control over the bioactivity afforded by the known delivery systems and the scarcity of consistent nonclinical and clinical data. Awareness must be raised on the part of the industry to develop feasible agents/tools to enhance the efficacy of preventive and therapeutic strategies.

Miron, Richard J.; Shirakata, Yoshinori; Ahmad, Paras; Romandini, Mario; Estrin, Nathan E.; Farshidfar, Nima; Bosshardt, Dieter D.; Sculean, Anton

doi: 10.1111/prd.12635pmid: 40457946

The use of growth factors (GFs) has become a cornerstone of modern regenerative periodontology. While the extent to which GFs enhance tissue regeneration compared to other biomaterials was initially uncertain, it is now well established that GFs play a critical role in the regeneration of various tissue types. In the context of periodontal regeneration, enamel matrix derivative (EMD/Emdogain) has been a key biomaterial for over 30 years. Pioneering work by Lars Hammarström in the mid‐1990s led to a wealth of publications on the clinical concept of mimicking tooth development to promote periodontal regeneration. This approach has been shown to induce the formation of new cementum, with functionally oriented periodontal ligament fibers and new alveolar bone. This review begins with an overview of the biological basis of EMD, highlighting its role as a protein (primarily amelogenins) and growth factor complex that initiates and mimics tooth development. Subsequently, histological evidence from animal and human studies using EMD is presented, alongside a discussion of ongoing research avenues. Clinical outcomes are then narratively reviewed, focusing on EMD safety, early wound healing properties, and applications in various scenarios, including non‐surgical periodontal therapy, intra‐bony and furcation defects, periodontal regeneration, and as an adjunct to soft‐tissue grafting. The use of EMD has gained tremendous evidence over the past 30 years as a GF capable of enhancing both hard and soft tissue regeneration in periodontal therapy.

Chackartchi, Tali; Polak, David; Stabholz, Ayala; Chaushu, Stela

doi: 10.1111/prd.12634pmid: 40569018

This paper examines the complex interplay between orthodontic intervention and periodontal conditions in individuals with periodontitis. It outlines diagnostic and treatment approaches for adolescents and adults, considering their distinct periodontal, dental, and behavioral needs. Furthermore, the paper highlights the detrimental effects of orthodontic tooth movement in the presence of periodontal disease, emphasizing the critical importance of maintaining periodontal health throughout treatment. A comprehensive treatment strategy is presented, including the treatment sequence and periodontal maintenance during orthodontic tooth movement.