Background: Peri-implantitis is a destructive disease affecting the tissues surrounding dental implants. Biomaterials may be applied during surgical treatment to reconstruct bony defects and support soft tissue healing. However, current evidence is unclear if these treatments increase the likelihood of peri-implantitis resolution. Methods: A systematic review and meta-analysis was performed on randomized controlled trials (RCTs) comparing surgical treatment with addition of reconstructive biomaterials (intervention) versus surgical treatment of peri-implantitis alone (comparison) with follow-up periods of at least 12 months. Resolution of peri-implantitis, defined as a reduction of probing pocket depth (PPD) to ≤5 mm, absence bleeding on probing (BOP), and stable or decreasing radiographic defect level (RDL), was selected as the primary outcome. Secondary outcomes included RDL reduction, buccal mucosal recession (REC), and patient-related outcome measures (PROMs). Risk of bias and quality of evidence were calculated using established guidelines. Results: Seven studies reporting on 402 patients with 405 implants met inclusion criteria. Wide variations in outcome reporting prevented the synthesis and quantitative comparison of peri-implantitis disease resolution between intervention and comparison groups. Individual meta-analyses showed a weighted mean difference (WMD) in PPD reduction of 0.28 mm [95% confidence interval (CI) -0.30, 0.86] and a relative risk (RR) for absence of BOP of 1.11 (95% CI 0.78, 1.59) for the inclusion of biomaterials (intervention) over access flap alone (comparison). For RDL reduction, a WMD of 1.08 mm (95% CI 0.41, 1.74) with significant heterogeneity (Q p-val: < 0.01, I2: 85%) and for REC, a WMD of -0.38 (95% CI −0.66, −0.11) was found, both in favor of the intervention. Analysis of the heterogeneity affecting RDL identified a positive effect on RDL when hydrogen peroxide but not rotary titanium brushes were used as an adjunct for implant surface debridement. Conclusion: Current evidence suggests that incorporating reconstructive biomaterials into surgical treatment may not definitively enhance the likelihood of peri-implantitis disease resolution. However, this lack of effect may be due to other factors such as implant surface treatments which may also affect clinical outcomes. Overall, this work highlights the critical need for standardizing the reporting of composite outcomes for the resolution of peri-implantitis disease and controlling for implant surface treatment effects when assessing reconstructive biomaterials. Plain language summary: Peri-implantitis is a destructive disease affecting tissues around dental implants. We studied whether adding reconstructive biomaterials (i.e., biomaterials used to improve the likelihood of new bone formation or bone defect fill) to surgical treatments improves the clinical condition, meaning no further bone loss, probing pocket depths (PPD) ≤5 mm, and no bleeding on probing (BOP). We reviewed randomized controlled trials (RCTs) comparing surgery with biomaterials to surgery alone with at least 12 months of follow-up. The main outcomes measured were PPD reduction, absence of BOP, and radiographic defect level (RDL). Secondary outcomes included RDL change, buccal mucosal recession (REC), and patient-related outcomes (PROMs). Seven studies with 402 patients and 405 implants were analyzed. Due to variations in outcome reporting, it was challenging to compare the effectiveness of treatments. However, some individual analyses showed a small improvement in PPD and BOP with biomaterials. For RDL reduction, biomaterials showed better results, but with significant variability. REC also improved slightly with biomaterials. The analysis also suggested that using hydrogen peroxide, but not rotary titanium brushes, for implant cleaning could positively affect bone levels. The study concluded that adding biomaterials to surgical treatment does not definitively improve peri-implantitis resolution, possibly due to other factors like implant surface treatments. This study emphasized the need for standardized reporting and considering these factors in future research.

Objectives: The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an innovative, evidence-based approach to developing patient-centered and practical recommendations for the rehabilitation of the edentulous maxilla. Within this framework, Group 2 aimed to formulate clinical recommendations on the use of short, standard-length, and zygomatic implants in atrophic maxillae. Materials and Methods: Group 2 followed the S2k-level guideline framework of the Association of the Scientific Medical Societies in Germany (AWMF), applying a structured nominal group technique. The evidence base included two systematic reviews synthesizing patient-reported outcomes (PROs), clinician-reported outcomes (ClinROs), and their respective measures, as well as single-round international surveys involving expert clinicians, patients, and cross-disciplinary experts. Draft recommendations were discussed during the in-person consensus meeting in Boston (June 16–18, 2025) and finalized through anonymous plenary voting. Consensus thresholds were predefined at ≥ 75% and ≤ 95% agreement for consensus and > 95% agreement for strong consensus. Results: The Group 2 participants formulated 6 clinical recommendations addressing the domains patient selection, surgical treatment options (short, standard-length, and zygomatic implants), and treatment planning. All 6 recommendations reached consensus. Conclusions: The Group 2 consensus provides practical guidance for the use of short, standard-length, and zygomatic implants in atrophic maxillae, balancing surgical complexity, prosthetic feasibility, and patient-centered care. Remaining evidence gaps—especially regarding standardized outcome sets, loading protocols, prosthetic strategies for zygomatic implants, the use of short implants for full-arch restorations and maintenance frameworks—should be prioritized in future research.

Objective: To provide an overview on the effect of hyaluronic acid (HyA) on hard tissue healing in alveolar bone augmentation procedures in humans (PROSPERO registration: CRD42023464863). Methods: Three databases were searched until April 2025. Studies using HyA in any form and in any alveolar bone augmentation procedure were included, if a control group allowing to assess the effect of HyA was available; studies addressing periodontal regeneration or using HyA coated implants were not included. Primary outcome parameters, summarized descriptively, were histologic/radiographic new bone formation (NBF), alveolar ridge width (ARW) and height (ARH). The Cochrane Collaborations RoB 2.0 and ROBINS-I tool were used to assess the risk of bias. Results: Fourteen studies with a follow-up of 3–12 months were included, which contributed with 229 patients and 317 sites allowing to assess the effect of HyA. HyA was assessed as adjunct to maxillary sinus floor augmentation (MSFA), guided bone regeneration (GBR), and alveolar ridge preservation (ARP). The addition of HyA significantly improved NBF in 50 and 66% of the MSFA and ARP studies, respectively; however, a significant clinical improvement was not consistently observed. Advantages for NBF as well as ARW or ARH gain have been reported in GBR procedures, but the available data are limited and mostly descriptive. No differences were observed regarding reported post-operative complication rates. Due to the heterogeneity in treatments and outcome measures, as well as the limited number of studies, a meta-analysis was not feasible for any of the outcomes. Conclusions: In the original studies, positive and occasionally significant results have been reported for the adjunct use of HyA in alveolar bone augmentation; however, the effect size and clinical relevance is unclear, and further clinical research is needed. Clinical relevance: HyA in alveolar bone augmentation is safe, but it remains unclear in which indication and in which application form it may enhance quality and/or quantity of NBF and at what extent.

AIM: To assess the effect of a hyaluronic acid (HyA) containing gel on patient-related outcomes (PRO) and wound healing after palatal punch-biopsy representing a free gingival graft.

MATERIAL AND METHODS: A punch-biopsy (6 mm diameter, 2 mm thickness) was harvested from one side of the palate at Day 0 and from the contralateral side at Day 21. Sites were randomly allocated to either 0.3% HyA containing gel (test) or sterile saline solution (control), professionally applied after harvesting and then self-applied three times/day for 7 days. Up to 21 days PRO-related questionnaires were answered and intraoral scans and photographs recorded to assess wound re-epithelialization, tissue refill, and color match.

RESULTS: Eighteen of 25 recruited participants were analyzed. Pain perception, difficulties with eating/drinking, and taste alterations significantly decreased over time and were hardly experienced after Day 7 in both groups (p > 0.05). Participants reported significantly more often a positive experience after applying HyA compared to placebo, that is, in 8 versus 1 out of 18 cases. The residual wound area was significantly smaller in the test compared to control group at Day 7, and cases with a thicker palatal tissue showed tendency for faster re-epithelialization.

CONCLUSION: Despite the potential limitations of the present study (i.e., possibility of a carryover effect, questionable blinding of the participants), repeated local application of a 0.3% HyA containing gel appears to only accelerate re-epithelialization in an open palatal wound and provide a positive experience after application, but it did not improve any PRO in such small-sized wounds compared to sterile saline application.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05099718.

OBJECTIVE: This cross-sectional survey aimed to assess oral health in patients with inflammatory bowel diseases (IBD) living in Austria.

METHODS: Data collection was conducted with an online questionnaire, including when possible validated tools, covering general medical history, socioeconomic factors, IBD-related parameters, and various oral health parameters, that is, tooth loss rate, prevalence of severe periodontitis, oral health-related quality of life (OHRQoL), and presence of oral lesions. The questionnaire was disseminated to the members of the Austrian Crohn's Disease/Ulcerative Colitis Association.

RESULTS: The analysis included the responses of 327 patients (68% female; average age 46 years), 134 with ulcerative colitis (UC) or IBD unclassified, and 193 with Crohn's disease (CD). Based on self-reported data, about 85% of the patients reported intake of an IBD-related medication and about two thirds of the responders reported some IBD activity in the past 12 months. Approximately 24% of the patients had < 20 remaining teeth, 34% had severe periodontitis, and 7% reported poor OHRQoL. IBD diagnosis did not affect the odds for having < 20 teeth or self-reported severe periodontitis, but patients with CD presented more frequently with poor OHRQoL. In addition, patients with CD received more frequently information from their physician on the possibility of oral lesions due to IBD; however, > 50% of all patients indicated not having any problems with oral lesions.

CONCLUSIONS: Oral health remains inadequately addressed in patients with IBD despite the significant need for dental care. Hence, treating physicians should motivate patients with IBD to inform their dentist about their diagnosis and to maintain regular dental checkups.

Aim: To histologically evaluate the healing of intrabony periodontal defects treated with guided tissue regeneration (GTR), if it is combined with orthodontic tooth movement (OTM) or used as a sole treatment. Materials and Methods: Twenty subjects requiring regenerative periodontal therapy and OTM were treated with the use of extended, coronally advanced flaps according to the GTR techniques with the utilization of deproteinized bovine bone mineral (DBBM) particles. Patients either received early initiation of OTM (test) or had their teeth splinted (control) after the surgical intervention. Re-entry procedures were scheduled 9 months postoperatively to obtain a biopsy from the previous defect sites. The primary outcome variable comprised histological and histomorphometric analysis. Results: Control group cases (n = 9) revealed nice embedding of graft particles into newly formed bone, which were predominantly present in the central and apical third of the biopsy samples. The coronally located DBBM was more often encapsulated in the connective tissue. Test samples (n = 10), both at the tension and pressure sites, demonstrated incorporation of a reduced graft ratio into newly formed bone. Ongoing bone formation and the presumably orthodontic-induced remodeling also interfered with the bone substitute material. Histomorphometry showed a distribution of 17.4% versus 33.9% new bone (p = 0.011), 33.2% versus 16.3% graft ratio (p = 0.001) and 49.4% versus 49.7% soft tissue components (p = 0.74) in the control versus test groups, respectively. Conclusions: Early initiation of tooth movement does not appear to adversely affect periodontal bone healing. A pronounced graft reduction and new bone formation in test patients, compared to those in controls, occurred presumably due to the effects of orthodontic-induced bone remodeling.

Objectives: To evaluate the influence of operator access on surface roughness parameters and material loss following implantoplasty (IP).

Material and Methods: A total of 42 dental implants were utilized in this study, and three different implant designs. Two set-ups were used: a table-top, allowing unrestricted access, and a phantom-head, imposing limitations in access and better replicating the clinical situation. A combination of tungsten carbide burs and silicone polishers was used to perform IP on the implants. The total amount of time required for IP of each implant was measured for comparisons between modalities, and a 2D roughness profile analysis (Ra and Rz) was conducted using a contact stylus profilometer. The weight and the diameter of the implants were also measured before and after IP was performed.

Results: A statistically significant difference was found between the Ra (p = 0.004) and Rz (p = 0.019) values of implants prepared under table-top conditions, being smoother, when compared to the ones prepared in the phantom head. The time required to perform IP was significantly different between the two different settings (p < 0.001) and between some implant types. The set-up in which IP was performed did not have a significant impact on the change in implant mass (p = 0.926) or in implant diameter (p = 0.721).

Conclusions: Implants treated with IP in the phantom-head set-up exhibited significantly greater surface roughness and required longer procedural time compared to those treated in the table-top model, but did not influence material loss.

BACKGROUND: Rapidly evolving evidence, from preclinical and clinical studies, indicates a possible connection between inflammatory bowel disease and periodontitis. This study aimed to summarize the evidence from preclinical in vivo studies regarding the possible link between periodontitis and colitis.

METHODS: A systematic literature search was performed and resulting studies were screened against predefined eligibility criteria; data from included studies were extracted, and meta-analyses were performed whenever possible.

RESULTS: Thirty-four publications using mice or rats were included; 26 experiments evaluated the effect of inoculation with oral bacteria on experimental colitis, 3 the effect of experimental periodontitis on experimental colitis, and 7 the effect of experimental colitis on periodontal status; 45% (9), 78% (14), 57% (12), and 89% (16) of the studies found a significantly higher body weight loss, shorter colon length, higher disease activity index (DAI), and higher intestinal histopathological assessment scores (IHA), respectively, in animals exposed to inoculation with oral bacteria and experimental colitis compared with animals with only colitis. Meta-analyses confirmed that inoculation with oral bacteria significantly aggravated colitis, that is, significant negative overall effect on body weight, colon length, DAI, and IHA. Among the tested bacteria, Fusobacterium nucleatum had the strongest effect followed by Porphyromonas gingivalis. The results of the remaining interactions and comparisons are inconclusive due to a limited number of studies and differences in study design.

CONCLUSIONS: Inoculation with the periodontitis-associated bacteria F. nucleatum and probably also P. gingivalis exacerbates experimental colitis in mice. It is yet unclear whether colitis can affect periodontal health and/or disease.

Background: This Consensus Workshop dealt with diagnostic methodologies in the context of surveillance, screening, assessment of stage and grade, prognosis, monitoring and prediction of periodontal status. Several elements provided the impetus for the workshop, including the limited quality of available research on diagnostic tests, the rapid development of new technologies, the implementation of the 2018 classification and the declarations of the World Health Organisation on diagnosis and oral health.

Aim: To update and evaluate the evidence on diagnostic methods, considering recent advances in knowledge and the implementation of the 2018 classification.

Methods: The European Workshop Committee of the European Federation of Periodontology guided the development of a consensus report after commissioning eight systematic reviews within three working groups. The reviews were discussed during the in‐person consensus meeting involving 70 participants from 21 different countries.

Results: Working Group 1 discussed innovations in traditional diagnostic approaches, justified manual probing as the reference standard and assessed the value of image‐based methods. Working Group 2 analysed diagnostic tests based on microbial and host biomarkers and genetic diagnostic tests. Working Group 3 covered emerging technologies to be used within dental and non‐dental clinical settings, focusing principally on the impact of questionnaire‐based assessments and artificial intelligence systems (AIS) in interpreting different data modalities.

Conclusion: Although manual periodontal probing is firmly established as the reference standard, additional approaches based on imaging, biomarkers, host genetics, questionnaires and the development of emerging applied data science methods (e.g., AIS) are increasingly integrated in periodontal diagnostics.

AIM: To assess the potential benefit of using adjunct systemic antibiotics in surgical peri-implantitis treatment.

MATERIALS AND METHODS: Six databases were searched (December 2024) for randomised/non-randomised clinical studies. After duplicate study selection, data extraction and risk-of-bias assessment, random-effects meta-analyses of odds ratios (ORs) or mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by the analysis of certainty of evidence.

RESULTS: Seven studies (three randomised and four non-randomised, comprising 595 patients and 1388 implants) were included. Systemic antibiotics were associated with greater short-term treatment success (n = 5; OR = 2.33; 95% CI: 1.29-4.21), bone gain (n = 4; MD = 0.37 mm; 95% CI: -0.68 to -0.07), increased bone level stability (n = 3; OR = 2.73; 95% CI: 1.50-4.99), reduced bleeding on probing (n = 6; OR = 0.49; 95% CI: 0.31-0.78), reduced suppuration on probing (n = 3; OR = 0.33; 95% CI: 0.18-0.61) and increased gingival recession (n = 3; MD = 0.18 mm; 95% CI: 0-0.36 mm) (p < 0.05). Systemic antibiotics seem to benefit only implants with modified surfaces (ORs: modified 4.10 vs. turned 0.79), and event that, without long-term benefits (≥ 3 years). Finally, one trial found that antibiotics probably increased diarrhoea risk.

CONCLUSIONS: Evidence from randomised/non-randomised studies seems to indicate that systemic antibiotics benefit surgical peri-implantitis treatment, in the short term (1-2 years), especially for implants with a modified surface, while data on adverse effects is scarce. No substantial long-term benefits are seen (≥ 3 years). Uncertainty still exists regarding the potential benefit of systemic antibiotics as adjunct to surgical management of peri-implantitis.