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Endo-perio lesions are lesions involving pulp tissue with periodontal tissue. The bacterial infection of the pulp can spread to the furcation area through the accessory canal, causing damage to the furcation area. Regeneration therapy has good success when performed with flap surgery and is performed in cases of Grades I and II furcation involvement. Demineralized freeze-dried bone allograft (DFDBA) is a regenerating material that has osteoinductive and osteoconductive abilities. It has the advantage of successful treatment of bone defects. Biodentine is an agent used for direct pulp capping, root perforation and furcation repair, and apexification. It can bind and enter the dentinal tubules and create interlocking crystals with dentin. This case report presents the treatment of furcation involvement Grade II originating from endo-perio lesions by using DFDBA and Biodentine as regeneration materials with 6 months of follow-up.

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Vestibuloplasty (VP) is a surgical technique that allows the deepening of the vestibule of the mouth. The gold standard, especially if an increase in keratinized tissue (KT) is required, is represented by the free gingival graft (FGG). The need for a donor site, however, is a source of discomfort and possible complications. To overcome these aspects, numerous techniques and materials have been used. Horizontal platelet-rich fibrin (H-PRF) has been very successful in recent years in various oral surgery procedures due to its ability to promote tissue healing and regeneration. The reported case presents a new technique of VP using H-PRF, which allows avoiding the second surgical site. A 25-year-old patient with post-surgical reduction of vestibule depth and poor KT was treated with VP. The patient refused an FGG procedure. Therefore, VP was performed using an H-PRF membrane as a graft material to lengthen the vestibule and promote KT regeneration. After nine weeks, an increase in vestibule depth and KT width was evident. The use of H-PRF in VP has allowed predictable surgery without significant complications. It therefore represents an alternative to the traditional FGG to be seriously taken into consideration.

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Counting growth layers in dentine and/or secondary cementum is widely used for age determination in wild mammals but the underlying seasonal changes in the structure and degree of mineralisation of dental tissue have not been well characterised. We embedded first (m1) and second (m2) mandibular permanent molar teeth from a 12-year-old female Svalbard reindeer (Rangifer tarandus platyrhynchus) in PolyMethylMethAcrylate (PMMA), prepared cut and polished surfaces coated with evaporated carbon and used 20 kV back-scattered electron imaging in a scanning electron microscope (BSE-SEM) to study aspects of dental tissue structure which depend on the degree of mineralisation at the micron and sub-micron scale. BSE-SEM revealed differences between the mineral content of growth layers (annulations) in the secondary cementum and the primary and secondary dentine, the latter, incidentally, still forming at death in m1. Wide bands of less well mineralised tissue formed in the cementum during active appositional phases. Thin, denser bands formed by maturation-mineralisation of existing tissue when growth slowed in winter. This maturation mimics the processes seen in lamellar bone and articular cartilage. Counter to previous suggestions, there was evidence of substantial resorption and repair of the secondary cementum and of formation of dentine throughout life. Secondary dentine is layered by mineral content like cementum. In the crown, this was mainly tubular dentine with well-marked interglobular dentine layers. In the lower pulp chamber and root, it was largely without tubules. Substantial non-mineralised spaces found at the cement-dentine junction in the root apical regions in m2 represent inclusions of the Hertwig's Epithelial Root Sheath (HERS) or the Epithelial Rests of Malassez (ERM) between the two tissues, a phenomenon which has previously only been identified in Muridae. The anatomical changes which result in the formation of the incremental lines (annulations) in dental tissues of reindeer, identified here for the first time at the micrometre level, are likely to be common across most if not all long-lived species of mammals living in seasonal environments.

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Introduction: The pathological teeth migrations require correct multidisciplinary treatment which consists of periodontal surgery associated with early or late orthodontic treatment. The aim of this study was to know which of the two orthodontic treatments would have a better periodontal response. Material and Method: Two parameters, radiological (the height of the alveolar bone) and clinical (the depth of the periodontal pocket), were used to meet the objective of this work. Eighteen patients received early orthodontic treatment (straight wire appliance) after periodontal flap debridement surgery and eighteen others late orthodontic treatment (straight wire appliance). Results: The results showed the absence of significant difference between the two early and late orthodontic treatments after periodontal flap debridement surgery. Conclusion: Orthodontic treatment can be started early seven to ten days after periodontal surgery.

Introduction: Les migrations dentaires pathologiques exigent un traitement pluridisciplinaire correct qui consiste en une chirurgie parodontale associée à un traitement orthodontique précoce ou tardif. Le but de cette étude était de connaître lequel des deux traitements orthodontiques aurait une meilleure réponse parodontale. Matériel et méthode: Deux paramètres, radiologique (la hauteur du défaut osseux) et clinique (la profondeur de la poche parodontale), ont été utilisés afin de répondre à l'objectif de ce travail. Dix-huit patients ont reçu, après la chirurgie parodontale par un lambeau d'assainissement, un traitement orthodontique précoce (technique d'arc droit) et dix-huit autres un traitement orthodontique tardif (technique d'arc droit). Résultats: Les résultats ont montré l'absence de différence significative entre les deux traitements orthodontiques, précoce et tardif, après la chirurgie parodontale par un lambeau d'assainissement. Conclusion: Le traitement orthodontique peut débuter précocement dès sept à dix jours après la chirurgie parodontale.

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Introduction Periodontitis is a complex condition influenced by various factors involving interactions between the host and bacterial plaque. Porphyromonas gingivalis, an anaerobic gram-negative bacterium, is commonly linked with periodontal disease. Aim This study aimed to examine the occurrence of P. gingivalis in individuals diagnosed with chronic periodontitis (CP) compared to those who show no clinical indications of periodontal disease. Methodology Patients diagnosed with CP (including both severe and moderate cases) and individuals without any signs of periodontal disease were recruited for this study. Samples were collected from the gingival pockets using curettes and were subsequently subjected to anaerobic culturing. Results A group of 30 patients, divided into moderate and severe CP, along with 30 healthy individuals serving as controls, were examined. In individuals with CP, P. gingivalis was found in 23 (78%) of cases, while in healthy individuals, the prevalence was 10 (34%). The presence of P. gingivalis was notably higher in those with periodontal diseases compared to healthy subjects, with rates of 23 (78%) vs. 10 (34%), respectively. Conclusion P. gingivalis is frequently found in individuals with periodontal diseases as well as in those without such conditions, albeit in smaller quantities. Consequently, the existence of P. gingivalis raises the probability of developing periodontal disease and may be regarded as a notable potential contributor to its initiation.

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BACKGROUND: Mineral metabolism is critical for proper development of hard tissues of the skeleton and dentition. The dentoalveolar complex includes the following 4 mineralized tissues: enamel, dentin, cementum, and alveolar bone. Developmental processes of these tissues are affected by inherited disorders that disrupt phosphate and pyrophosphate homeostasis, although manifestations are distinct from those in the skeleton. TYPES OF STUDIES REVIEWED: The authors discuss original data from experiments and comparative analyses and review articles describing effects of inherited phosphate and pyrophosphate disorders on dental tissues. A particular emphasis is placed on how new therapeutic approaches for these conditions may affect oral health and dental treatments of affected patients. RESULTS: Disorders of phosphate and pyrophosphate metabolism can lead to reduced mineralization (hypomineralization) or inappropriate (ectopic) calcification of soft tissues. Disruptions in phosphate levels in X-linked hypophosphatemia and hyperphosphatemic familial tumoral calcinosis and disruptions in pyrophosphate levels in hypophosphatasia and generalized arterial calcification of infancy contribute to dental mineralization defects. Traditionally, there have been few options to ameliorate dental health problems arising from these conditions. New antibody and enzyme replacement therapies bring possibilities to improve oral health in affected patients. PRACTICAL IMPLICATIONS: Research over the past 2 decades has exponentially expanded the understanding of mineral metabolism, and has led to novel treatments for mineralization disorders. Newly implemented and emerging therapeutic strategies affect the dentoalveolar complex and interact with aspects of oral health care that must be considered for dental treatment, clinical trial design, and coordination of multidisciplinary care teams.

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The masticatory organ is at the center of dental practice. Tooth loss, regarded as an organ failure, is a core dispute in our profession, as it more often than not does not happen spon-taneously but is influenced by the dentist's treatment plan. Despite the prosthetic possibili-ties of tooth replacement, efforts should be made to preserve as many teeth as possible. Decisions between tooth preservation and extraction are complex and have far-reaching consequences. This article discusses this problem using a clinical case study of a 43-year-old female patient with pronounced localized periodontitis. After a comprehensive diagnosis and treatment planning, a daring regenerative therapy was carried out to try to preserve the tooth. The case shows that even seemingly hopeless teeth can be successfully treated syn-chronously using modern therapeutic approaches. Initial literature data supports the possi-bility of preserving severely compromised teeth in the long term in compliant patients. An integrative treatment approach based on individual patient factors and modern regenerative techniques may well be a viable alternative to tooth extraction and prosthetic restoration, albeit not inexpensive and uncomplicated. This communication emphasizes the need for precise diagnostics, a comprehensive treatment plan, and honest communication with pa-tients about the prospects of success and possible risks, and highlights the strengths of con-sistent tooth preservation.

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Introduction: Oral hygiene instruction (OHI) is essential during periodontitis treatment. Various OHI approaches have been explored, including mobile apps. Objective: To evaluate the mobile app-based OHI's effect on periodontitis management by analyzing clinical parameters and subgingival microbiota. Methods: Forty-four periodontitis patients were randomly assigned into two groups. The test group (n = 22) received scaling and root planing (SRP), OHI, and mobile app-based OHI, whereas the control group (n = 22) received SRP and OHI. Full mouth plaque score (FMPS), bleeding on probing (BOP) and probing pocket depth at the sampling sites (site-PPD) were assessed at baseline, one- and three-month visits. The 16S rRNA next-generation sequencing (NGS) was used to analyze subgingival plaque samples. Results: Significant reduction in FMPS, BOP, and site-PPD at one- and three-month visits compared to baseline (p < 0.001) with no significant differences across groups (p > 0.05). In test groups, intra-group analysis showed better improvement in BOP and site-PPD (p < 0.05) than control. The diversity and composition of subgingival microbiota did not differ between groups or timepoints (p > 0.05). Conclusions: Mobile app-based OHI showed no superior effects on improving clinical parameters and subgingival microbiota compared to conventional OHI. Further investigation into its long-term impact on periodontitis treatment is needed.

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INTRODUCTION: The emerging rise in novel computer technologies and automated data analytics has the potential to change the course of dental education. In line with our long-term goal of harnessing the power of AI to augment didactic teaching, the objective of this study was to quantify and compare the accuracy of responses provided by ChatGPT (GPT-4 and GPT-3.5) and Google Gemini, the three primary large language models (LLMs), to human graduate students (control group) to the annual in-service examination questions posed by the American Academy of Periodontology (AAP). METHODS: Under a comparative cross-sectional study design, a corpus of 1312 questions from the annual in-service examination of AAP administered between 2020 and 2023 were presented to the LLMs. Their responses were analyzed using chi-square tests, and the performance was juxtaposed to the scores of periodontal residents from corresponding years, as the human control group. Additionally, two sub-analyses were performed: one on the performance of the LLMs on each section of the exam; and in answering the most difficult questions. RESULTS: ChatGPT-4 (total average: 79.57%) outperformed all human control groups as well as GPT-3.5 and Google Gemini in all exam years (p < .001). This chatbot showed an accuracy range between 78.80% and 80.98% across the various exam years. Gemini consistently recorded superior performance with scores of 70.65% (p = .01), 73.29% (p = .02), 75.73% (p < .01), and 72.18% (p = .0008) for the exams from 2020 to 2023 compared to ChatGPT-3.5, which achieved 62.5%, 68.24%, 69.83%, and 59.27% respectively. Google Gemini (72.86%) surpassed the average scores achieved by first- (63.48% ± 31.67) and second-year residents (66.25% ± 31.61) when all exam years combined. However, it could not surpass that of third-year residents (69.06% ± 30.45). CONCLUSIONS: Within the confines of this analysis, ChatGPT-4 exhibited a robust capability in answering AAP in-service exam questions in terms of accuracy and reliability while Gemini and ChatGPT-3.5 showed a weaker performance. These findings underscore the potential of deploying LLMs as an educational tool in periodontics and oral implantology domains. However, the current limitations of these models such as inability to effectively process image-based inquiries, the propensity for generating inconsistent responses to the same prompts, and achieving high (80% by GPT-4) but not absolute accuracy rates should be considered. An objective comparison of their capability versus their capacity is required to further develop this field of study.

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Background and Aims: In the case of mucous membrane pemphigoid with gingival expression (gMMP), the complete healing of the gingiva is generally not achieved despite medical treatment. Therefore, patients' oral comfort is impaired. The dysbiotic periodontal microbiota, generated by a lack of oral hygiene associated with persistent gingival pain, could the immunopathological mechanism to persist. The main objective of this study was to characterize the subgingival microbiota of the gMMP patients, and to highlight a potential link between this microbiological data and the clinical data. Methods: Subgingival biofilm was collected from 15 gMMP patients, medically treated or not, but not receiving periodontal treatment. The usual clinical periodontal parameters were recorded. The biofilm was analyzed by polymerase chain reaction quantitative. The risk factors of severe erosive gingivitis and severe periodontitis were assessed using Chi-square or Fischer's exact test were used. Results: Whatever the medical and periodontal conditions of the patients, the results showed the existence of three main communities of periodontopathic, dysbiotic bacteria. The first including Tannnerella forsythia, Peptostreptococcus micros, Fusobacterium nucleatum, and Campylobacter rectus, was found in 100% of the patients, the second enriched with Treponema denticola in 60% and the third enriched with Porphyromonas gingivalis and Prevotella intermedia in 26%. Furthermore, there was a significant positive link between the duration of gMMP and the severity of erosive gingivitis (p = 0.009), and the loss of deep periodontal tissue (p = 0.04). Conclusion: This pilot study suggests a high periodontal risk in gMMP patients. The pathological processes, autoimmune on the one hand and plaque-induced on the other, may amplify each other. The application of periodontal therapy is therefore necessary in parallel with medical treatment. Nevertheless, further controlled studies are required to validate and complement these preliminary results.

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INTRODUCTION: Periodontal disease is an infectious syndrome presenting inflammatory aspects. Radiographic evaluation is an essential complement to clinical assessment but has limitations such as the impossibility of assessing tissue inflammation. It seems essential to consider new exploration methods in clinical practice. Ultrasound of periodontal tissues could make it possible to visualize periodontal structures and detect periodontal diseases (periodontal pocket measurement and the presence of intra-tissue inflammation). Clinical Innovation Report: An ultrasound probe has been specially developed to explore periodontal tissues. The objective of this clinical innovation report is to present this device and expose its potential. DISCUSSION: Various immediate advantages favor using ultrasound: no pain, no bleeding, faster execution time, and an image recording that can be replayed without having to probe the patient again. Ultrasound measurements of pocket depth appear to be as reliable and reproducible as those obtained by manual probing, as do tissue thickness measurements and the detection of intra-tissue inflammation. CONCLUSIONS: Ultrasound seems to have a broad spectrum of indications. Given the major advances offered by ultrasound imaging as a complementary aid to diagnosis, additional studies are necessary to validate these elements and clarify the potential field of application of ultrasound imaging in dentistry.

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In recent years, significant advancements in dental and periodontal diagnostics have paved the way for improved care. Among the available approaches, laser fluorescence (LF) is a promising method. This case report explores the utilization of a 405 nm diode laser as a diagnostic tool in the non-surgical treatment of biofilm-induced gingivitis, as well as its application in routine daily practice for diagnosing restorations and dental caries. A 24-year-old male patient and a 21-year-old female patient were included. A 405 nm diode laser (Smart M, Lasotronix, Poland) was used as a diagnostic tool with a tip diameter of 8 mm. In case one, the utilization of the 405 nm diode laser enhanced the patient's ability to perceive the presence and extent of plaque and calculus, aiding in motivation and education regarding supra-gingival dental biofilm control and it assisted the operator in precisely localizing plaque and calculus, thereby enabling more effective mechanical debridement and ultimately improving treatment outcomes. In the second case, the utilization of the laser facilitated the detection of defective composite fillings aiding in both accurate diagnosis for the operator and effective communication with the patient regarding the need for re-treatment. This study illustrates the potential of the relatively new 405 nm diode laser as a promising diagnostic tool in the daily management of periodontal patients and the detection of defective dental fillings in daily practice.

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AIM: To update the competences and learning outcomes and their evaluation, educational methods and education quality assurance for the training of contemporary specialists in periodontology, including the impact of the 2018 Classification of Periodontal and Peri-implant Diseases and Conditions (2018 Classification hereafter) and the European Federation of Periodontology (EFP) Clinical Practice Guidelines (CPGs). METHODS: Evidence was gathered through scientific databases and by searching for European policies on higher education. In addition, two surveys were designed and sent to program directors and graduates. RESULTS: Program directors reported that curricula were periodically adapted to incorporate advances in diagnosis, classification, treatment guidelines and clinical techniques, including the 2018 Classification and the EFP CPGs. Graduates evaluated their overall training positively, although satisfaction was limited for training in mucogingival and surgical procedures related to dental implants. Traditional educational methods, such as didactic lectures, are still commonly employed, but they are now often associated with more interactive methods such as case-based seminars and problem-based and simulation-based learning. The evaluation of competences/learning outcomes should employ multiple methods of assessment. CONCLUSION: An update of competences and learning outcomes of specialist training in periodontology is proposed, including knowledge and practical application of the 2018 Classification and CPGs. Harmonizing specialist training in periodontology is a critical issue at the European level.

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Machine learning (ML) has led to significant advances in dentistry, easing the workload of professionals and improving the performance of various medical processes. The fields of periodontology and implantology can profit from these advances for tasks such as determining periodontally compromised teeth, assisting doctors in the implant planning process, determining types of implants, or predicting the occurrence of peri-implantitis. The current paper provides an overview of recent ML techniques applied in periodontology and implantology, aiming to identify popular models for different medical tasks, to assess the impact of the training data on the success of the automatic algorithms and to highlight advantages and disadvantages of various approaches. 48 original research papers, published between 2016 and 2023, were selected and divided into four classes: periodontology, implant planning, implant brands and types, and success of dental implants. These papers were analyzed in terms of aim, technical details, characteristics of training and testing data, results, and medical observations. The purpose of this paper is not to provide an exhaustive survey, but to show representative methods from recent literature that highlight the advantages and disadvantages of various approaches, as well as the potential of applying machine learning in dentistry.

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Background: Gingivectomy has been the preferred method since the findings in 1884. It evolved from "blind" subgingival scaling to "the excision of the soft tissue". The use of these techniques is no longer mandatory in clinical situations; therefore, researchers have searched for numerous publications that have been registered regarding gingivectomy. This research aims to fill the niche area by assessing more about gingivectomy and it's trend among the periodontology topic of discussion. Methods: Descriptive and analytical observation by evaluating the result of the VOS viewer mapping and calculation throughout the bibliographic data from publications obtained from SCOPUS in July 2022. Results: There are 660 publications from six types of publication. Related keywords are compiled and visualized by network mapping. There is a significant gap among the contributing countries in the number of documents and number of citations per journal. However, a minimal gap is seen in other objectives, such as authors, journals, and institutions on their contribution towards the publication of gingivectomy topics. Conclusion: A total of 660 of 1914 articles were included in the analysis after the filtering process, and these articles were cited 5910 times, with an average of 9 citations per article.

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Capnocytophaga species are commonly found in human oral microbiome. The aim of the present study was to understand the association of the prevalence of oral Capnocytophaga species with oral hygiene and periodontal inflammation. A total of 136 patients (median age 72 years) who visited the Hiroshima University Hospital (Hiroshima, Japan) between April 2021 and June 2023 were enrolled. Swab samples were obtained from the tongue surface. DNA from Capnocytophaga species (C. ochracea and C. sputigena) was detected by real-time PCR analysis. Dental plaque accumulation was observed to assess the oral hygiene condition of participants. Additionally, clinical periodontal inflammation was assessed with periodontal inflamed surface area (PISA) scores. Clinical confounding factors such as age, sex, lifestyle-related disease, remaining teeth and denture wearing between Capnocytophaga species-positive and -negative groups were adjusted with a propensity score matching method. Mann-Whitney U and χ2 or Fisher's exact test were employed for statistical analysis. The prevalence rate was 67.6% for oral C. ochracea and 83.1% for C. sputigena. C. ochracea-positive participants showed significantly higher plaque control record scores (an indicator of dental plaque accumulation) than C. ochracea-negative participants (P=0.03). Additionally, C. ochracea/C. sputigena dual-positive participants exhibited significantly higher plaque control record and PISA scores than non-dual-positive participants (P=0.01 and P=0.04, respectively). Propensity score matching was conducted in the C. ochracea/C. sputigena dual-positive group and the non-dual-positive group for adjustment of clinical factors, resulting in 51 matched patient pairs. C. ochracea/C. sputigena dual-positive participants had significantly higher plaque control record scores than non-dual-positive participants (P=0.02). The present results suggest that the prevalence of both oral C. ochracea and C. sputigena is associated with poor oral hygiene in middle-aged and older people.

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Objective: This study assessed the demographic characteristics of the periodontal workforce in Saudi Arabia. Methods: This was a retrospective study of periodontists practicing in Saudi Arabia from January 2000 through May 2023. The data were requested from the Saudi Commission for Health Specialties and included the number of periodontists and dentists, the number of Saudi and non-Saudi periodontists, the sex distribution of periodontists, their ranking, and the geographic distribution across the 13 regions. Results: This study identified 700 practicing periodontists, representing 2.2 periodontists per 100,000 people. Consultant periodontists composed 31% of the population, mostly Saudi nationals. Approximately 53% of practicing periodontists resided in Saudi Arabia, mostly in the Riyadh, Makkah, and Eastern Provinces. Al Bahah, Najran, and the Northern Borders had fewer periodontists. Conclusion: This study provides valuable insights into shaping the periodontal workforce in Saudi Arabia. Future studies on the factors related to the periodontology workforce can assist policymakers in implementing effective strategies to significantly improve the current workforce.

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This study aimed to investigate correlation between mitochondrial reactive oxygen species and Porphyromonas gingivalis in the process of cementoblast pyroptosis. Lactate dehydrogenase activity assay, enzyme-linked immunosorbent assay, western blotting and flow cytometry analysis were utilized to explore whether Porphyromonas gingivalis triggered pyroptosis in cementoblasts. Reactive oxygen species and mitochondrial reactive oxygen species were detected using flow cytometry and fluorescence staining. The effect of mitochondrial reactive oxygen species on the Porphyromonas gingivalis-induced pyroptosis of cementoblasts was assessed by Mito-Tempo, mitochondrion-targeted superoxide dismutase mimetic. Phosphorylation levels of p65 were measured by western blotting. SC75741, a nuclear factor-kappa B inhibitor, was added to block the nuclear factor-kappa B in the Porphyromonas gingivalis-infected cementoblasts. Porphyromonas gingivalis triggered pyroptosis of cementoblasts, and an elevation in reactive oxygen species generation in the mitochondria was observed. Inhibition of mitochondrial reactive oxygen species reduced pyroptosis and nuclear factor-kappa B signaling pathway mediated the pyroptotic cell death in Porphyromonas gingivalis-infected cementoblasts. Together, our findings demonstrate that mitochondrial reactive oxygen species increased by Porphyromonas gingivalis participated in the pyroptosis of cementoblasts. Targeting mitochondrial reactive oxygen species may offer therapeutic strategies for root surface remodeling or periodontal regeneration.

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OBJECTIVES: Esthetic crown lengthening (ECL) is commonly advocated to treat patients with altered passive eruption (APE). Since the introduction of the minimally invasive surgical concept, a limited number of studies have investigated this technique in a standardized manner, with further studies required to verify the validity and predictability of the minimally invasive FL-technique. The current randomized trial compares a minimally invasive (ECL), using piezosurgery with flapless-approach (FL), versus an open-flap (OF) approach in the management of patients with APE Type 1B. MATERIALS AND METHODS: Twenty-four patients diagnosed with APE Type 1B were randomly assigned into test (FL) with tunneling approach or control (OF) group with minimally invasive flap reflection (n = 12/group). Postoperative pain was assessed during the first 48 h. Gingival margin (GM) level relative to a custom-made stent (rGM) and patient satisfaction were assessed preoperative, immediately after surgery, at 3 and 6 months postsurgically. Postoperative swelling was reported for the first week postsurgically. Plaque index (PI), bleeding on probing (BoP), clinical attachment level (CAL), pocket depth (PD) and pink esthetic score (PES), were evaluated at baseline and 6 months. Linear regression analysis was conducted for pain. RESULTS: OF-group reported significantly higher pain and swelling scores than FL-group during the first 48 h (p < 0.05). FL-group showed no significant differences regarding rGM between 3 and 6 months, in contrast to OF-group, where a significant decrease in rGM was notable (p < 0.05). No significant differences in PI, BoP, CAL, PD, PES, and patient satisfaction scores were evident between groups (p > 0.05). Regression analysis demonstrated that treatment and gender were significant predictors for pain (p < 0.05). CONCLUSIONS: Within the current study's limitations, piezo-surgical ECL with FL-approach presented significantly lower postoperative pain, swelling, and early GM stability compared to OF-approach. CLINICAL SIGNIFICANCE: Piezosurgical ECL with a FL-approach can be considered a predictable technique with advantages over the OF-approach in the management of patients with APE Type1B.

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AIM: The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology (Education in Periodontology in Europe) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID-19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face-to-face (F2F) teaching and the move to student-centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels. MATERIALS AND METHODS: Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated. RESULTS: The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student-centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms. CONCLUSIONS: Live F2F teaching continues to be highly trusted; however, all types of student-centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.