Periodontology 2000[JOURNAL]
Sun
200 papers
Advantages of horizontal centrifugation of platelet-rich fibrin in regenerative medicine and dentistry.
Farshidfar N, Apaza Alccayhuaman KA, Estrin NE … +4 more , Ahmad P, Sculean A, Zhang Y, Miron RJ
Periodontol 2000 · 2025 Mar · PMID 40130760 · Publisher ↗
The aim of this comprehensive review was to evaluate comparative studies on horizontal and fixed-angle centrifugation methods for preparing platelet-rich fibrin (PRF). Furthermore, additional studies utilizing horizontal...
The aim of this comprehensive review was to evaluate comparative studies on horizontal and fixed-angle centrifugation methods for preparing platelet-rich fibrin (PRF). Furthermore, additional studies utilizing horizontal PRF (H-PRF) were systematically investigated. This overview review article offers deeper insights into the advantages of H-PRF when compared to fixed-angle methods across a wide range of regenerative medical and dental applications. A comprehensive search was conducted in PubMed and Web of Science up to December 5, 2024. Grey literature was also searched via Google Scholar for additional relevant studies, and reference lists of eligible studies were screened for further potential inclusion. All in vitro, in vivo, and clinical studies that utilized horizontal or swing-out centrifugation to prepare solid or liquid PRF, along with their subfractions such as the buffy coat, platelet-poor plasma (PPP), or heated variants like albumin gel or albumin gel with liquid PRF (Alb-PRF) as interventions, were included in this study. A total of 75 studies were included. Thirteen studies directly compared horizontal centrifugation to fixed-angle centrifugation for producing PRF, while the remaining 62 studies were non-comparative and focused on expanding the uses and clinical applications of H-PRF. These studies spanned categories such as cell concentrations, fibrin matrix structure, growth factor release, antibacterial and anti-inflammatory properties, and regenerative applications in bone, periodontal, cartilage, skin, hair, regenerative endodontics, corneal defect repair, wound healing, and soft tissue regeneration. Of the studies comparing horizontal to fixed-angle centrifugation, 84.6% favored horizontal centrifugation, while 15.4% found no difference. None of the studies favored fixed-angle centrifugation. Additionally, more optimized methods for concentrating liquid-PRF (C-PRF) using horizontal centrifugation and extending the resorption properties of PRF-ranging from 2 to 3 weeks to membranes lasting 4 months through an albumin denaturation process were-further discussed. Based on these findings, it remains logical to utilize H-PRF in clinical practice owing to the greater superiority in results from the majority of studies. Nevertheless, further comparative clinical studies are needed to support these findings. While the current evidence is limited and further clinical trials are warranted, several studies have now indicated that horizontal centrifugation, compared to fixed-angle, results in higher cell concentrations, more uniform cell distribution, and increased growth factor release. These advantages suggest that the use of H-PRF may lead to enhanced clinical outcomes when the application of PRF is indicated. Since horizontal centrifugation can also lead to better cell separation, it should also be the preferred method for producing C-PRF and Alb-PRF for clinical applications.
Platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF): A systematic review across all fields of medicine.
Farshidfar N, Amiri MA, Estrin NE … +4 more , Ahmad P, Sculean A, Zhang Y, Miron RJ
Periodontol 2000 · 2025 Mar · PMID 40125556 · Publisher ↗
This systematic review aimed to evaluate all available evidence across all fields of medicine regarding the comparative effectiveness of platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF). A compre...
This systematic review aimed to evaluate all available evidence across all fields of medicine regarding the comparative effectiveness of platelet-rich plasma (PRP) versus injectable platelet-rich fibrin (i-PRF). A comprehensive search was conducted in PubMed, Scopus, and Web of Science up to September 30, 2024. Following a thorough screening process, studies were divided into in vitro, in vivo, and clinical studies based on their tissue/clinical indications. The initial search generated 2192 articles, of which 23 met the inclusion criteria. The findings demonstrated that i-PRF yielded higher platelet concentrations and offered a more sustained, long-term release of growth factors over time when compared to PRP. Overall, it was determined from in vitro studies that i-PRF significantly improved the activity of many cell types, including for skin, cartilage, periodontal, bone, soft tissue around dental implants, and pulp cells. In vivo outcomes also generally indicated that i-PRF outperformed PRP in cartilage and testicular regeneration. However, in orthodontic tooth movement, PRP was found to lead to superior short-term effects, while i-PRF showed more beneficial long-term effects. Clinical studies also found superior outcomes of i-PRF in skin regeneration, cartilage, and pulp regeneration. Outcomes regarding orthodontic tooth movement utilizing i-PRF or PRP remain controversial. In 72% of studies, i-PRF was found to lead to better outcomes across the various fields of medicine when compared to PRP, whereas 24% found no differences between the groups. Reasons and inconsistencies across the studies may be attributed to protocol differences and tissue types. Overall, additional clinical studies are needed with well-designed research and centrifugation protocols to better understand the regenerative potential of platelet concentrates in medicine. i-PRF offers a more sustained and prolonged release of growth factors and was favored in the majority of studies over PRP and should, therefore, be favored for the majority of medical and dental applications.
Genetic risk variants implicate impaired maintenance and repair of periodontal tissues as causal for periodontitis-A synthesis of recent findings.
Schaefer AS, Nibali L, Zoheir N … +2 more , Moutsopoulos NM, Loos BG
Periodontol 2000 · 2025 Feb · PMID 39953674 · Full text
Periodontitis is a complex inflammatory disease in which the host genome, in conjunction with extrinsic factors, determines susceptibility and progression. Genetic predisposition is the strongest risk factor in the first...
Periodontitis is a complex inflammatory disease in which the host genome, in conjunction with extrinsic factors, determines susceptibility and progression. Genetic predisposition is the strongest risk factor in the first decades of life. As people age, chronic exposure to the periodontal microbiome puts a strain on the proper maintenance of barrier function. This review summarizes our current knowledge on genetic risk factors implicated in periodontitis, derived (i) from hypothesis-free systematic whole genome-profiling studies (genome-wide association studies [GWAS] and quantitative trait loci [QTL] mapping studies), and independently validated through further unbiased approaches; (ii) from monogenic and oligogenic forms of periodontitis; and (iii) from syndromic forms of periodontitis. The genes include, but are not limited to, SIGLEC5, PLG, ROBO2, ABCA1, PF4, and CTSC. Notably, CTSC and PLG gene mutations were also identified in non-syndromic and syndromic forms of prepubertal and early-onset periodontitis. The functions of the identified genes in this review suggest that the pathways affected by the periodontitis-associated gene variants converge in functions involved in the maintenance and repair of structural integrity of the periodontal tissues. Particularly, these genes play a role in the healing of inflamed and ulcerated periodontal tissues, including roles in fibrinolysis, extrusion of cellular debris, extracellular matrix remodeling and angiogenesis. Syndromes that include periodontitis in their phenotype indicate that neutrophils play an important role in the regulation of inflammation in the periodontium. The established genetic susceptibility genes therefore collectively provide new insights into the molecular mechanisms and plausible causal factors underlying periodontitis.
The impact of the European Federation of Periodontology on European and global periodontology.
Sanz M, Kamma J, Goldstein M … +1 more , Tonetti M
Periodontol 2000 · 2025 Feb · PMID 39891466 · Publisher ↗
The European Federation of Periodontology (EFP), founded in 1991, is a non-profit organization comprising 43 national periodontal societies worldwide, representing over 18 000 professionals. Its mission is to promote per...
The European Federation of Periodontology (EFP), founded in 1991, is a non-profit organization comprising 43 national periodontal societies worldwide, representing over 18 000 professionals. Its mission is to promote periodontology and oral health globally. The EFP's strategic objectives include advancing the practice and development of periodontology, promoting scientific research, ensuring the integrity of the profession, and raising awareness of the link between periodontal and general health. These goals are pursued through initiatives such as EuroPerio, the EFP's flagship scientific congress held every 3 years, which attracts thousands of global participants, and European Workshops in Periodontology (EWPs), which foster evidence-based discussions and produce consensus reports. These workshops have produced landmark publications, including the new classifications of periodontal diseases and S3-level clinical practice guidelines for the treatment of periodontitis and peri-implant diseases. Additionally, the organization plays a central role in setting standards for postgraduate education in periodontology, accrediting programs across Europe and internationally, with 24 universities offering EFP-accredited programs as of 2024. The EFP also publishes the Journal of Clinical Periodontology, a key platform for disseminating scientific and clinical research. Through outreach campaigns in collaboration with global partners, the EFP aims to raise awareness of the links between periodontal health and systemic diseases, engaging medical professionals, international organizations, policymakers, and patient groups. A notable initiative is Gum Health Day, held annually on May 12, to promote public awareness of periodontal health. The EFP's activities have significantly contributed to the development of modern periodontology, both academically and clinically, with a substantial global impact.
Periodontal response to nonsurgical accelerated orthodontic tooth movement.
Oner F, Kantarci A
Periodontol 2000 · 2025 Jan · PMID 39840535 · Publisher ↗
Tooth movement is a complex process involving the vascularization of the tissues, remodeling of the bone cells, and periodontal ligament fibroblasts under the hormonal and neuronal regulation mechanisms in response to me...
Tooth movement is a complex process involving the vascularization of the tissues, remodeling of the bone cells, and periodontal ligament fibroblasts under the hormonal and neuronal regulation mechanisms in response to mechanical force application. Therefore, it will inevitably impact periodontal tissues. Prolonged treatment can lead to adverse effects on teeth and periodontal tissues, prompting the development of various methods to reduce the length of orthodontic treatment. These methods are surgical or nonsurgical interventions applied simultaneously within the orthodontic treatment. The main target of nonsurgical approaches is modulating the response of the periodontal tissues to the orthodontic force. They stimulate osteoclasts and osteoclastic bone resorption in a controlled manner to facilitate tooth movement. Among various nonsurgical methods, the most promising clinical results have been achieved with photobiomodulation (PBM) therapy. Clinical data on electric/magnetic stimulation, pharmacologic administrations, and vibration forces indicate the need for further studies to improve their efficiency. This growing field will lead to a paradigm shift as we understand the biological response to these approaches and their adoption in clinical practice. This review will specifically focus on the impact of nonsurgical methods on periodontal tissues, providing a comprehensive understanding of this significant and understudied aspect of orthodontic care.
Relationship between periodontitis and systemic diseases: A bibliometric and visual study.
Isola G, Polizzi A, Serra S … +2 more , Boato M, Sculean A
Periodontol 2000 · 2025 Jun · PMID 39775963 · Full text
To provide a comprehensive and updated mapping of observational studies assessing the relationship between periodontitis and systemic diseases through a bibliometric and visual analysis. A search was conducted using the...
To provide a comprehensive and updated mapping of observational studies assessing the relationship between periodontitis and systemic diseases through a bibliometric and visual analysis. A search was conducted using the Web of Science database, covering the period 1989 to 2024. The Medical Subject Headings (MeSH) from the US National Library of Medicine was used to categorize systemic conditions, focusing on terms unrelated to stomatognathic diseases. The analysis included keyword co-occurrence mapping, co-authorship, bibliographic coupling, and co-citation analysis. Quality indicators such as silhouette score, modularity, and centrality were considered to assess the network's quality. The research strategy identified 6106 records, of which 1519 met the inclusion criteria. The analysis revealed that 46.73% of the literature on the topic was published in the last 5 years and that the annual publication trend peaked in 2023. Nutritional & Metabolic Diseases (n = 398), Cardiovascular Diseases (n = 335), Female Urogenital Diseases & Pregnancy Complications (n = 244), and Musculoskeletal Diseases (n = 182) were the most representative categories of systemic diseases associated with periodontitis. The most co-cited journals on the topic were the Journal of Periodontology (n = 1412), the Journal of Clinical Periodontology (n = 1343), the Journal of Dental Research (n = 940), and Periodontology 2000 (n = 849). The USA, China, Brazil, and Sweden were the countries that contributed the most to the number of publications. The analysis conducted in the present study revealed a growing trend of observational studies evaluating the association between periodontitis and systemic diseases, highlighting the negative impact of periodontitis on a plethora of systemic conditions and a rising translational interest in this relationship. With an aging population, periodontitis is expected to affect a growing number of people in the coming decades, presenting significant challenges to public health. Improved knowledge is, therefore, essential to enable more comprehensive care, preventive strategies, and optimal oral health for patients with periodontitis.
Inflammation and mechanical force-induced bone remodeling.
Jeon HH, Huang X, Rojas Cortez L … +4 more , Sripinun P, Lee JM, Hong JJ, Graves DT
Periodontol 2000 · 2024 Dec · PMID 39740162 · Full text
Periodontitis arises from imbalanced host-microbe interactions, leading to dysbiosis and destructive inflammation. The host's innate and adaptive immune responses produce pro-inflammatory mediators that stimulate destruc...
Periodontitis arises from imbalanced host-microbe interactions, leading to dysbiosis and destructive inflammation. The host's innate and adaptive immune responses produce pro-inflammatory mediators that stimulate destructive events, which cause loss of alveolar bone and connective tissue attachment. There is no consensus on the factors that lead to a conversion from gingivitis to periodontitis, but one possibility is the proximity of the inflammation to the bone, which promotes bone resorption and inhibits subsequent bone formation during coupled bone formation. Conversely, orthodontic tooth movement is triggered by the mechanical force applied to the tooth, resulting in bone resorption on the compression side and new bone formation on the tension side. However, the environment around orthodontic brackets readily retains dental plaque and may contribute to inflammation and bone remodeling. The immune, epithelial, stromal, endothelial and bone cells of the host play an important role in setting the stage for bone remodeling that occurs in both periodontitis and orthodontic tooth movement. Recent advancements in single-cell RNA sequencing have provided new insights into the roles and interactions of different cell types in response to challenges. In this review, we meticulously examine the functions of key cell types such as keratinocytes, leukocytes, stromal cells, osteocytes, osteoblasts, and osteoclasts involved in inflammation- and mechanical force-driven bone remodeling. Moreover, we explore the combined effects of these two conditions: mechanical force-induced bone remodeling combined with periodontal disease (chronic inflammation) and periodontally accelerated osteogenic orthodontics (acute transient inflammation). This comprehensive review enhances our understanding of inflammation- and mechanical force-induced bone remodeling.
Methods for 3D evaluation and quantification of gingival recessions and gingival margin changes: Advancements from conventional techniques.
Gkantidis N, Dritsas K, Ghamri M … +2 more , Halazonetis D, Sculean A
Periodontol 2000 · 2024 Nov · PMID 39552108 · Publisher ↗
In an era of increasing life expectancy and growing patient demands towards lifelong natural tooth retention, accurate assessment of gingival recessions is crucial for diagnosing periodontal diseases, planning preventive...
In an era of increasing life expectancy and growing patient demands towards lifelong natural tooth retention, accurate assessment of gingival recessions is crucial for diagnosing periodontal diseases, planning preventive or restorative interventions, and evaluating their outcomes. The traditional two-dimensional (2D) methods, while useful, often fall short in capturing the complex topography of gingival tissue margins and their changes over time. By examining relevant published studies, this review highlights the transition from 2D to 3D techniques, analyzing the limitations of widely used 2D approaches, while emphasizing the potential of novel 3D tools and techniques. It discusses their comparative effectiveness, accuracy, and application challenges in clinical and research settings. Advancements in three-dimensional (3D) imaging regarding methodologies for the precise evaluation and quantification of free gingival margin changes and gingival recessions are explored and critically evaluated. The review underscores the potential for these technologies to enhance patient outcomes through more precise diagnosis and data generation. It also identifies gaps in current research and suggests directions for future investigation. Overall, this review provides a comprehensive overview of the state of the art in 3D evaluation methods for gingival recessions and gingival margin changes, offering valuable insights for clinicians and researchers.
Periodontal and orthodontic management of impacted canines.
Qali M, Li C, Chung CH … +1 more , Tanna N
Periodontol 2000 · 2024 Nov · PMID 39548814 · Publisher ↗
The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contribu...
The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contributes toward functional as well as neuromuscular stability, harmony, esthetics, and dentofacial balance. When an aberration is noted with the normal eruptive and development process, early diagnosis with strategic intervention is critical and may often require a multidisciplinary approach. A proper diagnosis, risk assessment, and management of the soft tissues, hard tissues, and adjacent structures are vital for a successful outcome. This review highlights the diagnostic and treatment modalities that require consideration for the orthodontic as well as the periodontal management of impacted canines. The reader is guided through the etiology, diagnosis, prevention, and intervention of clinical cases that were managed with different approaches.
Periodontal diseases in Africa.
Olujitan M, Ayanbadejo PO, Umeizudike K … +3 more , Oyapero A, Okunseri C, Butali A
Periodontol 2000 · 2025 Jun · PMID 39494604 · Full text
Periodontal diseases, a group of complex conditions marked by an excessive immune response and periodontal tissue destruction, are a global health concern. Since 1990, the incidence of these diseases has doubled, with We...
Periodontal diseases, a group of complex conditions marked by an excessive immune response and periodontal tissue destruction, are a global health concern. Since 1990, the incidence of these diseases has doubled, with Western sub-Saharan Africa experiencing the highest burden. Accurate diagnosis and case identification are crucial for understanding the etiology, features of disease, research, treatment and prevention. Modern perspectives on periodontal disease classification are based on commonality among those affected. However, current literature is often plagued by methodological inconsistencies and focused on disease mechanisms in European populations. Health inequalities in low- and middle-income countries (LMICs) are exacerbated by these challenges, with sub-Saharan Africa, and Nigeria specifically, facing unique difficulties such as clinical personnel shortages and limited research infrastructure. This review explored disparities in periodontal disease research, care and outcomes in African populations. We highlighted these disparities and identified the factors contributing to inequities in periodontal health outcomes. We further demonstrated the critical need for inclusive and equitable healthcare and research practices tailored to the unique challenges faced by diverse populations and regions with limited resources. Addressing these disparities is essential for ensuring that advancements in healthcare are accessible to all, thereby improving global oral health and general health.
Periodontal disease: A systemic condition.
Villoria GEM, Fischer RG, Tinoco EMB … +2 more , Meyle J, Loos BG
Periodontol 2000 · 2024 Oct · PMID 39494478 · Full text
For decades, periodontitis has been considered to be a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were...
For decades, periodontitis has been considered to be a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were each studied separately, and relationships were shown. The associations of periodontitis with morbidities, such as cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, respiratory diseases, have been demonstrated. As most such studies were cross-sectional in nature, questions about causality cannot be univocally answered. And periodontitis as an independent risk factor for one systemic disease, becomes even more difficult to assess since recently periodontitis has also been associated with multimorbidity. Periodontitis and many systemic diseases share environmental, lifestyle and genetic risk factors, and share immunopathology. Moreover, suffering from one common noncommunicable disease may increase the susceptibility for another such chronic disease; the systemic effects of one condition may be one of various risk factors for another such disease. The overarching effect of any systemic disease is it causing a pro-inflammatory state in the individual; this has also been shown for periodontitis. Moreover, in periodontitis a prothrombotic state and elevated immunological activity have been shown. As such, when we consider periodontal disease as another systemic disease, it can affect the susceptibility and progression of other systemic diseases, and importantly, vice versa. And with this, it is not surprising that periodontitis is associated with a variety of other noncommunicable diseases. The medical definition of a systemic disease includes diseases that affect different organs and systems. Thus, the aim of this opinion paper is to propose that periodontitis should be considered a systemic disease in its own right and that it affects the individual's systemic condition and wellbeing. The dental and medical profession and researchers alike, should adapt this paradigm shift, advancing periodontal disease out of its isolated anatomical location into the total of chronic noncommunicable diseases, being for some conditions a comorbid disease and, vice versa, comorbidities can affect initiation and progression of periodontal disease.
Autogenous platelet concentrates for treatment of intrabony defects-A systematic review with meta-analysis.
Miron RJ, Moraschini V, Estrin N … +7 more , Shibli JA, Cosgarea R, Jepsen K, Jervøe-Storm PM, Wang HL, Sculean A, Jepsen S
Periodontol 2000 · 2025 Feb · PMID 39425513 · Full text
To provide an overview of the use of autogenous platelet concentrates (APCs) in periodontal regeneration and to conduct a systematic review (SR) of the treatment outcomes of periodontal intrabony defects by using platele...
To provide an overview of the use of autogenous platelet concentrates (APCs) in periodontal regeneration and to conduct a systematic review (SR) of the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) compared with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 21 categories and into five different groups as follows: Group I (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD versus Titanium-PRF (T-PRF) Group II, (3) Comparative PRF protocols (PRF vs. T-PRF), Group III (Comparative Studies to PRF): (4) OFD/PRP versus OFD/PRF, (5) OFD/bone graft(BG)/PRGF versus OFD/BG/PRF, (6) OFD/EMD versus OFD/PRF, (7) OFD/BG/EMD versus OFD/BG/PRF, (8) OFD/collagen membrane (CM) versus OFD/PRF, (9) OFD/BG/BM versus OFD/BG/PRF, (10) OFD/BG versus OFD/PRF, Group IV (Addition of PRF to treatment groups) (11) OFD/BG versus OFD/BG/PRF, (12) OFD/GTR versus OFD/GTR + PRF (13) OFD/EMD versus OFD/EMD/PRF (14) OFD/BG/BM versus OFD/BG/BM/PRF, Group V (Addition of Biomaterial/Biomolecule to PRF): OFD/PRF versus … (15) OFD/PRF/BG, (16) OFD/PRF/antibiotic, (17) OFD/PRF/Metformin, (18) OFD/PRF/Bisphosphonates, (19) OFD/PRF/Statins, (20) OFD/BG/PRF versus OFD/BG/PRF/Statins, and (21) OFD/PRF/low-level laser therapy (LLLT). Weighted means and forest plots were calculated for probing pocket depth (PPD), clinical attachment level (CAL), and radiographic bone fill (RBF). From 596 records identified, 55 RCTs were included. Group I: The use of OFD/PRF statistically significantly reduced PPD and improved CAL and RBF when compared to OFD. Group II: A significant difference between various PRF protocols was only observed for PPD. Group III: No significant advantage was found when comparing OFD/PRF to the following groups: OFD/PRP, OFD/EMD, OFD/BM, or OFD/BG. Group IV: The addition of PRF to OFD/BG led to significant improvements in PPD, CAL and RBF compared with OFD/BG alone. Group V: The addition of either a BG as well as three of the following biomolecules (metformin, bisphosphonates, and statins) to OFD/PRF led to statistically significant improvements in PPD, CAL, and/or RBF when compared to OFD/PRF alone. The use of PRF significantly improved clinical outcomes in intrabony defects when compared to OFD alone. Similar results were observed when OFD/PRF was compared with OFD/BG, OFD/EMD, OFD/PRP, and OFD/BM. The addition of PRF to a bone grafting material as well as the addition of various small biomolecules to PRF may offer additional clinical advantages, thus warranting further investigations. Future research investigating various protocols of PRF, longer-term outcomes, as well as PRF at the human histological level remains needed.
Orthodontic management of uneven gingival margins in patients with healthy or reduced periodontium to improve smile aesthetics.
Martin C, Papageorgiou SN, Gonzalez-Martin O … +1 more , Sanz M
Periodontol 2000 · 2024 Oct · PMID 39415330 · Publisher ↗
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Autologous platelet concentrates in root coverage procedures.
Barootchi S, Tavelli L, Vinueza MEG … +5 more , Sabri H, Andrade C, Pinto N, Sanz A, Wang HL
Periodontol 2000 · 2025 Feb · PMID 39403998 · Full text
Gingival recessions are vastly prevalent among the general population. With regards to their treatment, recent advancements in periodontal and microsurgical procedures, focusing on minimal invasiveness and patient-center...
Gingival recessions are vastly prevalent among the general population. With regards to their treatment, recent advancements in periodontal and microsurgical procedures, focusing on minimal invasiveness and patient-centered therapies, have propelled a shift in their contemporary treatment, highlighting the field of biologics and bioactive mediators. Among different classes and types of biologics, autologous platelet concentrates (APCs), also referred to as autologous blood-derived products, are commonly used and preferred among many clinicians. These are essentially obtained via venipuncture (intravenous access) followed by centrifugation, for which numerous protocols and preparation methods have been used, leading to varieties of blood-derived products. In this review, via a systematic search, we explored the efficacy of the different utilized preparation methods and centrifugation protocols of APCs (e.g., platelet-rich plasma (PRP), platelet-rich fibrin (PRF), leucocyte-PRF, advanced-PRF, concentrated growth factor (CGF), etc.) for the treatment of type 1 gingival recessions (RT1, without interproximal attachment loss or noticeable tooth displacement), as well as their effectiveness relative to a common control (treatment with flap advancement alone without any additional material). Based on the available literature from randomized trials found in our systematic search, we observed that utilization of PRF can significantly enhance treatment outcomes when performing a coronally advanced flap, in terms of the amount of root coverage. The improvement in root coverage was further enhanced in the presence of baseline keratinized tissue width, and with an increasing relative magnitude (the more the baseline keratinized tissue width, the better the root coverage outcomes when using PRF). The efficacy of these products needs to be further explored with different graft substitutes and matrices, as well as relative to other commonly applied biologics, through well-conducted and adequately-powered randomized clinical trials.
Autologous platelet concentrates as adjuvant in the surgical management of medication-related osteonecrosis of the jaw.
Bennardo F, Barone S, Antonelli A … +1 more , Giudice A
Periodontol 2000 · 2025 Feb · PMID 39345044 · Full text
Medication-related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therap...
Medication-related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet-rich plasma (PRP), plasma-rich in growth factors (PRGF), and leukocyte- and platelet-rich fibrin (L-PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L-PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.
Autologous platelet concentrates in alveolar ridge preservation: A systematic review with meta-analyses.
Siawasch SAM, Yu J, Castro AB … +4 more , Dhondt R, Teughels W, Temmerman A, Quirynen M
Periodontol 2000 · 2025 Feb · PMID 39345008 · Full text
In order to evaluate the therapeutic advantages of various autologous platelet concentrates (APC) as a single biomaterial during alveolar ridge preservation (ARP), a systematic review with meta-analyses was conducted. Pu...
In order to evaluate the therapeutic advantages of various autologous platelet concentrates (APC) as a single biomaterial during alveolar ridge preservation (ARP), a systematic review with meta-analyses was conducted. PubMed, EMBASE, Web of Science, and Scopus were screened for randomized controlled trials (RCTs) that were released prior to 2024. The selected papers compared an APC with either unassisted healing (blood clot) or another biomaterial during ARP (third molars were not included). The outcome parameters included alveolar bone dimension alterations, soft tissue healing, and post-op pain intensity. The search yielded 35 papers (33 studies), one applying platelet-rich plasma (PRP), six using plasma rich in growth factors (PRGF), and 28 using leukocyte- and platelet-rich fibrin (L-PRF). These studies showed a large heterogeneity (e.g., outcome parameters, timing, surgical approach, and inclusion criteria), which hindered drawing strong conclusions. In most studies, however, ARP with PRP, PRGF, and L-PRF alone produced faster soft tissue healing, less post-extraction pain, less alveolar ridge resorption, more socket bone fill, and a higher bone density when compared to unassisted (spontaneous) healing. The ultimate benefit appears to be significantly influenced by the surgical approach. Limited literature exists comparing APC with other biomaterials for ARP, resulting in inconclusive data. APC application for ARP is a promising strategy to improve soft and hard tissue healing and reduce post-extraction pain.
Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis.
Miron RJ, Moraschini V, Estrin NE … +6 more , Shibli JA, Cosgarea R, Jepsen K, Jervøe-Storm PM, Sculean A, Jepsen S
Periodontol 2000 · 2025 Feb · PMID 39324633 · Full text
The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized...
The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins. Weighted means and forest plots were calculated for the reduction of probing pocket depth (PPD), gain of vertical and horizontal clinical attachment levels (VCAL and HCAL), gain in vertical and horizontal bone levels (VBL, HBL), and radiographic bone fill (RBF). From 45 articles identified, 21 RCTs reporting on class II furcations were included. The use of OFD/PRF and OFD/BG/PRF statistically significantly reduced PPD and improved VCAL and HCAL when compared to OFD or OFD/BG, respectively. The comparison between OFD/PRF alone versus OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2 led to similar outcomes for all investigated parameters, including a reduction in PPD, VCAL/HCAL gain, and RBF. The additional incorporation of a BG to OFD/PRF only mildly improved outcomes, whereas the addition of AM improved clinical outcomes. The addition of small biomolecules such as metformin, bisphosphonates, or statins all led to significant improvements in PPD, VCAL, and HCAL when compared to OFD/PRF alone. Noteworthy, a very high heterogeneity was found in the investigated studies. The use of PRF significantly improved clinical outcomes in class II furcation defects when compared to OFD alone, with similar levels being observed between OFD/PRF and/or OFD/BG, OFD/CM, OFD/PRP, or OFD/rhBMP2. Future research geared toward better understanding potential ways to enhance the regenerative properties of PRF with various small biomolecules may prove valuable for future clinical applications. Future histological research investigating PRF in human furcation defects is largely needed. The use of PRF in conjunction with OFD statistically significantly improved PPD, VCAL, and HCAL values, yielding comparable outcomes to commonly used biomaterials. The combination of PRF to bone grafts or the addition of small biomolecules may offer additional clinical benefits, thus warranting future investigation.
Impact of public health and patient-centered prevention strategies on periodontitis and caries as causes of tooth loss in high-income countries.
Kocher T, Meisel P, Baumeister S … +1 more , Holtfreter B
Periodontol 2000 · 2025 Jun · PMID 39323071 · Full text
In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled info...
In high-income countries, the oral health of the population is influenced by public health interventions, widespread use of oral care products, dental practice measures, and the cost of dental treatment. We compiled information on changes of the prevalence of proximal and upstream determinants of periodontitis, caries, and tooth loss over the last three decades to outline their potential effects on changes of oral health during this period. Information was retrieved from repeated cross-sectional studies and from published literature. While both the prevalence of edentulism and the number of missing teeth (from the DMF-T index) decreased, the number of sound teeth as well as the total number of teeth increased. The prevalence of severe periodontitis was unchanged, whereas the prevalence of periodontal health and moderate periodontitis may have increased to a minor extent. Concerning oral health risk factors, the proportion of individuals with tertiary education increased, while smoking prevalence declined. More and more people used oral care products. Whether one reimbursement system worked better than another one in terms of tooth retention could not be elucidated. In tooth retention, population-wide use of fluoridated toothpastes had the greatest impact. To some extent, the higher number of teeth present may be related to the more frequent use of interdental cleaning aids and powered toothbrushes. Since there was no decrease in severe periodontitis in most cohorts, periodontal interventions probably contributed little to improved tooth retention.
Autologous platelet concentrates after third molar extraction: A systematic review.
Siawasch SAM, Yu J, Castro AB … +3 more , Temmerman A, Teughels W, Quirynen M
Periodontol 2000 · 2025 Feb · PMID 39318055 · Publisher ↗
Surgical removal of impacted mandibular third molars is often followed by postoperative sequelae like pain, swelling, trismus, etc. This systematic review explored the benefits of applying different autologous platelet c...
Surgical removal of impacted mandibular third molars is often followed by postoperative sequelae like pain, swelling, trismus, etc. This systematic review explored the benefits of applying different autologous platelet concentrates (APCs) in the extraction socket of third molars. For this systematic review, PubMed, EMBASE, Web of Science, and Scopus have been utilized, initially yielding 544 papers. The search was narrowed to randomized controlled trials (RCTs, n = 59) published before 2024, all comparing the outcome of applying APCs in the extraction socket of surgically removed impacted mandibular third molars with unassisted healing (blood clot). Most RCTs primarily assessed the impact of APCs on postoperative sequelae. Some RCTs looked at soft- and hard-tissue healing. Eleven studies used PRP, three PRGF, and 45 L-PRF. A detailed analysis revealed a large heterogeneity between studies rendering a meta-analysis impossible. Moreover, the risk of bias was considered high. In the majority of RCTs, the application of an APC resulted in statistically significant reductions of postoperative sequelae (lower pain intensity, lower consumption of analgesics, less postoperative edema, and a lower incidence of trismus and alveolar osteitis), as well as a faster soft tissue healing, and qualitatively and quantitatively better bone healing. A minority of studies reported significant differences in periodontal parameters distally from the second molar.
Inflammation indices in association with periodontitis and cancer.
Walther KA, Gröger S, Vogler JAH … +2 more , Wöstmann B, Meyle J
Periodontol 2000 · 2024 Oct · PMID 39317462 · Full text
Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. In...
Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described.
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