07月29日每日资讯

Abstract (Original English)

BACKGROUND: Vitamins A and C (VitA+C) are pivotal biomolecules, with synergistic effects, especially in conjoint presence, on cellular pluripotency and regenerative capabilities. This randomized trial aimed to evaluate (VitA+C)-augmented injectable platelet-rich fibrin (i-PRF) versus i-PRF alone with a modified minimally invasive surgical technique (M-MIST) in periodontal intraosseous defects in patients with stage III periodontitis.

METHODS: This parallel group, two-arm, triple-blinded, randomized controlled trial included patients with stage III grade B periodontitis (n = 28) randomly allocated to the test (VitA+C/i-PRF+M-MIST; n = 14) or the control (i-PRF+M-MIST; n = 14) group. The changes in radiographic linear defect depth (RLDD) (primary outcome), radiographic bone fill (RBF), and radiographic bone density (RBD) were recorded at baseline, 6, and 9 months. Clinical attachment level (CAL), probing depth (PD), gingival margin level (GML), plaque index (PI), and gingival index (GI; secondary outcomes) were recorded at baseline, 3 6, and 9 months. The in vitro release kinetics of VitA and VitC from the i-PRF were characterized over 7 days using high-performance liquid chromatography (HLPC).

RESULTS: VitA+C/i-PRF+M-MIST demonstrated a significantly higher RLDD-reduction at 6 months and a higher RBF percentage at 6 and 9 months compared with i-PRF+M-MIST (p < 0.05), with no intergroup differences regarding RBD. Both groups independently demonstrated significant improvements in CAL, PD, GML, RLDD, and BDA over time (p < 0.05). Significantly higher CAL-gain and PD-reduction were evident in the VitA+C/i-PRF+M-MIST group at 9 months (p < 0.05).

CONCLUSIONS: I-PRF with M-MIST significantly enhance periodontal clinical and radiographic parameters over time. Conjoint vitamin A/C augmentation of i-PRF at the described concentration results in significantly greater improvement in radiographic and clinical parameters of intraosseous defects compared with i-PRF alone.

CLINICAL TRIAL REGISTRATION: This study was registered in the US National Institutes of Health Clinical Trials Registry (NCT05499598; https://www.

CLINICALTRIALS: gov/).

Platelet‐rich fibrins (PRF) could serve as sustained‐release carriers for biomolecules. The current trial assessed the clinical benefits of an injectable‐PRF (i‐PRF) as a sustained‐release vehicle for vitamins A/C, at specifically defined pluripotency‐inducing concentrations, in combination with a minimally invasive surgical technique for stage III periodontitis intraosseous defects. The current findings demonstrate that vitamins A/C provide additional significant benefits on periodontal clinical and radiographic outcomes when used with a minimally invasive surgical technique for the management of intraosseous defects compared with i‐PRF alone.

Abstract (Original English)

BACKGROUND: Periodontal remodeling is a continuous, adaptive process essential for maintaining the structural and functional integrity of periodontal tissues. While external factors such as bacterial biofilm, excessive forces, and poor oral hygiene are recognized triggers of periodontal pathologies, they do not fully explain their persistent prevalence.

OBJECTIVE: This opinion paper emphasizes the impact of systemic diseases on periodontal homeostasis and considers periodontal disease as a manifestation of systemic dysfunction rather than solely a bacterial local disease.

METHODS: This paper is conceptually designed as a narrative review and synthesizes the molecular and cellular mechanisms through which systemic diseases converge to disrupt periodontal remodeling.

RESULTS: Emerging evidence underscores the critical role of systemic diseases, including chronic kidney disease, cardiovascular disease, liver dysfunction, and hematologic malignancies, in addition to studied uncontrolled diabetes mellitus, in destabilizing periodontal homeostasis. These systemic conditions are all associated with excess systemic inflammation that impairs regenerative capacity, mineralization, vascularity, and immune responses, fostering a subclinical environment prone to periodontal tissue pathologies with clinical impact. This opinion paper is conceptually designed as a narrative review and synthesizes the molecular and cellular mechanisms through which systemic diseases converge to disrupt periodontal remodeling, including periodontal pathologies as a consequence of systemic dysfunction rather than a purely bacterially induced local disease.

CONCLUSION: Clinically, this understanding demands intensified dental surveillance to uncover modifiers of susceptibility and interdisciplinary care for systemically compromised patients. Future research should identify early biomarkers of systemic impact and inform strategies that integrate oral and systemic health to reduce the periodontal disease burden.