Stéphane Kerner

Aim: To systematically evaluate the available evidence regarding the association between peri‐implantitis and systemic inflammatory biomarkers and/or systemic diseases, and to assess whether peri‐implantitis treatment influences systemic inflammatory burden. Particular attention was given to the methodological limitations of the available evidence and the potential role of residual confounding. Methods: A systematic review and meta‐analysis were conducted in accordance with PRISMA guidelines. Electronic searches were performed in MEDLINE, Embase, Scopus, and Web of Science from inception to December 2025, and updated in April 2026. Observational studies comparing systemic inflammatory biomarkers and/or presence of systemic diseases between individuals with and without peri‐implantitis, as well as interventional studies evaluating the impact of any peri‐implantitis treatment on the systemic inflammatory burden, were included. Random‐effects meta‐analyses were performed using Hedges' g (standardized mean difference). Results: Of 2399 records screened, 21 studies were included in the qualitative synthesis. Fourteen observational studies evaluated systemic inflammatory biomarkers, three randomized clinical trials assessed the effect of peri‐implantitis treatment on systemic outcomes, and four observational studies investigated associations with systemic diseases. Comparative meta‐analysis demonstrated significantly higher conventional CRP concentrations in patients with peri‐implantitis than in healthy implant controls (Hedges' g = 3.73; 95% CI: 0.63–6.83; p = 0.02), although heterogeneity was considerable ( I ² = 99%). In contrast, no significant differences were observed for high‐sensitivity CRP (hsCRP) (Hedges' g = −0.29; 95% CI: −0.61 to 0.04; p = 0.09; I ² = 2%), IL‐6, TNF‐α, IL‐10, or IL‐1β. Evidence regarding systemic diseases was limited and heterogeneous, precluding quantitative synthesis. Interventional studies suggested modest and predominantly short‐term reductions in selected inflammatory biomarkers following peri‐implantitis treatment, whereas consistent improvements in systemic metabolic outcomes were not demonstrated. Conclusion: Current evidence suggests that patients with peri‐implantitis may exhibit higher circulating conventional CRP concentrations in some observational studies. However, this finding should be interpreted cautiously given the substantial heterogeneity of the pooled analysis, the absence of significant differences for high‐sensitivity CRP, and the limited control of major confounding factors, in particular previous or concomitant periodontitis and other shared inflammatory and metabolic risk factors. Consequently, it remains uncertain whether peri‐implantitis represents an independent source of systemic inflammation or rather reflects a susceptible host phenotype characterized by shared inflammatory and metabolic risk factors. Well‐designed longitudinal and interventional studies are required before clinically meaningful systemic implications can be established.

Objective: To compare the peri-implant mucosal stability between an “open healing” approach (test) during immediate dental implant placement with bone grafting and immediate transmucosal provisionalization (non-occlusal) versus primary flap closure (control). Methods: This systematic review followed the PRISMA guidelines. A literature search was conducted in multiple databases up to May 2025. The primary outcome was peri-implant mucosal stability (Midfacial Mucosal Level (MML). Secondary outcomes include peri-implant soft tissue parameters (e.g. Papilla evaluation, mucosal thickness) and bone related outcomes (e.g. Marginal Bone Loss (MBL), buccal bone thickness and implant survival rate). Results: Out of 362 records, 12 studies were included, representing 431 patients and 438 implants. Most studies demonstrated a low risk of bias, although heterogeneity in outcomes assessment was observed. Meta-analysis showed limited midfacial mucosal changes between control and test groups, showing good stability of peri-implant keratinized tissue. Other soft and hard tissue outcomes were comparable between groups. Conclusion: The open healing approach with bone particle grafting during immediate dental implant placement appears as a viable option for supporting midfacial mucosa and maintaining mucosa and bone stability. However, more high-quality randomized controlled trials are necessary to confirm these findings. Clinical Relevance: This minimally invasive protocol appears to provide satisfactory outcomes by preserving peri-implant tissues, thereby reducing the need for multiple surgical interventions.

Background: Oral mucosa heals with minimal scar formation compared with other tissues. The aim of this study was to explore the differential healing properties between keratinized gingiva and non‐keratinized alveolar mucosa, and to analyze the healing dynamic of these tissues through a clinical photograph‐based prospective study. Methods: Fourteen patients received 26 interdental piezocisions as part of orthodontic therapy. Piezocisions penetrated through the oral mucosa, the periosteum, and the cortical bone. They overlapped both keratinized gingiva and non‐keratinized alveolar mucosa. Wounds were evaluated at four time points (1, 3, 8, and 20 weeks) by measuring the Mucosal Scarring Index (MSI) on standardized photographs. Results: The analysis included 364 incisions evaluated at four time‐points. The scar length showed a significant reduction up to 3 weeks in the alveolar mucosa ( p < 0.001) and up to 8 weeks in the gingiva ( p = 0.048). At 1 week, the posterior regions had higher MSI scoring than the anterior regions, particularly in the mandibular alveolar mucosa. No significant changes in the scar length or MSI scores were observed after 8 weeks, indicating stabilization of the healing processes. By 20 weeks, 64.05% and 52.22% of the incisions were devoid of scars in the gingiva and alveolar mucosa, respectively. Conclusion: The study confirmed that both oral mucosa and gingiva heal with no scar or minimal scarring, following full‐thickness incisions. Neither keloid nor hypertrophic scars were observed. No significant differences were found between gingiva and alveolar mucosa in terms of final scar visibility. However, healing outcomes were notably less favorable in the posterior regions, highlighting the influence of anatomical location. Plain language summary: Oral mucosa exhibits minimal scar formation compared with other tissues. Studies evaluating the healing dynamics of the various intraoral tissue types remain limited. This prospective study investigates the healing characteristics of keratinized gingiva and non‐keratinized alveolar mucosa, by focusing on scar formation following piezocision. Complete wound closure was observed at all sites 1 week after surgery. More than half of the piezocisions produced no visible scarring. Notably, even though the incisions penetrated the full thickness of the tissue and involved perforation of the vestibular cortical bone, no significant scarring was observed. However, increased scar visibility was noted in patients with pigmented gingiva. The healing results appear to vary according to anatomical regions.

Background: Oligodontia is a rare condition characterized by the absence of at least 6 teeth. Implant‐supported prosthetic rehabilitation offers a reliable solution for affected patients. However, the unique periodontal traits of oligodontia raise questions about the best prosthetic approach for papilla reconstruction. This retrospective study aims to assess papilla and gingival esthetics in implant‐supported rehabilitation of patients with oligodontia. The study compared 3 prosthetic rehabilitation options: adjacent implants, bridges, and cantilevers. Methods: Twenty‐seven patients with oligodontia who received implant‐supported treatment participated in the study. Esthetic evaluations were performed using the pink esthetic score (PES) for teeth, implants, and pontics, while the papilla index score (PIS) was used to assess papilla appearance. Interdental sites were divided into 3 groups: control (papilla between teeth), tooth–papilla (papilla between tooth and pontic or implant), and implant–papilla (papilla between implants or between implant and pontic). Results: The study included 292 teeth, 116 implants, 27 pontics. The mean follow‐up for implants was 36.0 ± 19.8 months and for prosthetic rehabilitation, 26.7 ± 20.8 months. PES was highest for teeth (13.5 ± 1.04), followed by implants (12 ± 1.97) and pontics (11.9 ± 2.04) ( p < 0.001). PIS demonstrated a difference ( p < 0.001) between control (2.72 ± 0.64), tooth–papilla (2.17 ± 0.86), and implant–papilla (1.26 ± 0.84). No statistical difference was observed between the 2 implants and between an implant and pontic. Conclusion: Natural teeth consistently demonstrated superior esthetic outcomes in PES. However, papilla regeneration was more successful when a tooth was involved in the prosthetic restoration. Reversely, when required, 2 single‐crown implant‐supported and cantilever implant‐supported are similarly effective in papilla outcomes. Plain language summary: Oligodontia, a rare condition characterized by the absence of at least 6 teeth, presents challenges in achieving natural‐looking dental restorations. This study evaluated the esthetic outcomes of implant‐supported prosthetic treatments in 27 patients with oligodontia, focusing on interdental papilla reconstruction. Three rehabilitation methods were compared: adjacent implants, bridges, and cantilevers. Esthetic assessments used the pink esthetic score (PES) for teeth, implants, and pontics, and the papilla index to measure papilla quality. Results showed that natural teeth achieved the highest PESs, followed by implants and pontics. For papilla quality, sites involving natural teeth scored better than those between 2 implants or between an implant and a pontic. Our findings emphasize that natural teeth presence in prosthetic designs improves esthetic outcomes, particularly in papilla regeneration. However, when incorporating natural teeth is not an option, adjacent crown‐supported implants and cantilever‐supported implants offer equally effective solutions in esthetic outcomes.

Aims: Understanding and integrating patients' preferences into clinical practice can enhance personalized care, improve patient's adherence to treatment, and lead to better therapeutic outcomes. The aim of this scoping review was to map the existing literature investigating patients' preferences in periodontal and implant therapy while identifying key areas for future research and development. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses for Scoping Reviews (PRISMA‐ScR) guidelines, an electronic search was conducted in four databases (PubMed, Google Scholar, Cochrane Library, and ScienceDirect) in July 2024 to identify studies evaluating patients' preferences for periodontal and implant therapy. Results: The literature search yielded 384 studies, of which eight articles met the inclusion criteria. These studies were conducted between 2003 and 2019 in Brazil, China, Austria, Italy, Germany, Canada, USA, Chile, France, Spain, and Portugal. A total of 1642 patients were included. Preferences were assessed using various quantitative and mixed methodologies. Results indicate a strong preference for treatments aimed at preserving teeth, favoring conservative approaches. When teeth cannot be restored, most patients prefer an implant‐supported fixed partial denture to avoid damaging adjacent teeth with a conventional tooth‐supported fixed partial denture. In this context, treatment predictability is ranked as the most important factor. While no sociodemographic factors appeared to be associated with preferences in periodontal treatments, several predictors were identified for dental implant therapy. Younger patients, women, individuals with higher education levels, and those with high perceived dental health showed a higher willingness to pay for dental implants. Conclusion: The literature on patients' preferences in periodontal and implant therapies is scarce. Several trends are identified but further longitudinal studies are needed to explore patients' preferences over time and the role of sociodemographic and cultural segmentation criteria.

Objectives: Root resorption in permanent teeth is a common pathological process that often follows dental trauma or orthodontic treatment. More rarely, root resorption is a feature of genetic disorders and can help with diagnosis. Thus, the present review aims to determine which genetic disorders could induce pathological root resorptions and thus which mutated genes could be associated with them. Methods: We conducted a systematic review following the PRISMA guidelines. Articles describing root resorptions in patients with genetic disorders were included from PubMed, Embase, Web of Science, and Google Scholar. We synthesized the genetic disorder, the type, severity, and extent of the resorptions, as well as the other systemic and oral symptoms and histological features. Results: The synthetic analysis included 25 studies among 937 identified records. We analyzed 21 case reports, three case series, and one cohort study. Overall, we highlighted 14 different pathologies with described root resorptions. Depending on the pathology, the sites of resorption, their extent, and their severity showed differences. Conclusion: With 14 genetic pathologies suspected to induce root resorptions, our findings are significant and enrich a previous classification. Among them, three metabolic disorders, three calcium–phosphorus metabolism disorders, and osteolysis disorders were identified.

Aim: Oligodontia (OD) is a rare developmental condition characterized by the absence of six or more teeth. Dental implant placement may be challenging due to anatomical factors. This study aims to evaluate the alveolar bone dimensions in OD patients compared with controls.Materials and Methods: On maxillary and mandibular cone‐beam computed tomography (CBCT), bone height and width were measured at every tooth and edentulous site. The distance to the inferior alveolar nerve was also measured. Fifty‐three OD patients (40 maxillary and 32 mandibular CBCT) and 82 controls (51 maxillary and 31 mandibular CBCT) were compared using mixed models.Results: Compared with those in OD patients, maxillary permanent teeth and edentulous sites showed significantly higher mean height in control patients (incisive‐canine site height: +2.12 mm; edentulous incisive‐canine site height: +4.46 mm [p > .001]). For the mandibular permanent teeth, mean height was higher in controls than in OD patients at the incisive‐canine (+3.82 mm [p > .001]) and premolar areas (+2.06 mm [p > .001]). Only edentulous incisive‐canine sites were significantly different between controls and OD patients (mean: +0.52 mm [p > .001]). Changes in alveolar nerve position were observed in case of molar agenesis.Conclusion: Maxillary and mandibular bone dimensions are reduced in OD patients compared with controls both in sites with permanent teeth and in edentulous areas.

Aim: Clinical photographs have been advocated in studies dealing with the quantity of root coverage. Changes in different angles of the camera when taking a photograph may lead to parallax errors resulting in inaccurate measurements. The aim of this study was to explore the distortion of the photographs according to the shooting angle.Methods: A dental simulation model with a recession defect on tooth 21 was used. Photographs were taken with a digital camera at 5° intervals between 0° to 35°, by shifting the position of the model. Recession depth and root surface area were calculated with ImageJ and implemented in a mathematical model. The relationship between the experimental measurements and the outcomes of the mathematical model was statistically evaluated. The model was confirmed by clinical data.Results: When the central axis of the lens of the camera focused on the experimental tooth is within a cone angle ≤36°, the maximum distortion of the recession area ranges from 0% to 14%, the maximum percentage occurring when the angle is coronal to the central axis.Conclusions: Photographs without an external device connected to the camera provide a valuable support for root coverage assessment when using ImageJ as a measuring tool.

Gingival conditions and tooth sensitivity of young patients with amelogenesis imperfecta lack in depth studies. This case-control study aimed to compare (1) the gingival inflammation, the presence of enamel defects, and tooth sensitivity in young patients with and without amelogenesis imperfecta and (2) to investigate if any difference exists between subtypes of amelogenesis imperfecta. Methodology We compared forty-two participants with amelogenesis imperfecta with forty-two controls matched for age, gender, and the number of examined sites. Based on interview, clinical examination, and intraoral photography, we collected data on periodontal conditions, enamel defects and the presence of tooth sensitivity. Comparison tests were performed to investigate if any difference existed between cases and controls; and among cases, between the different subtypes of amelogenesis imperfecta. We performed a post-hoc analysis for any significant difference observed. Results We observed more gingival inflammation, enamel defects and tooth sensitivity among cases (all p<0.05). Participants with hypocalcified amelogenesis imperfecta had more gingival inflammation, enamel defects, and tooth sensitivity than patients with the hypoplastic and hypomature subtypes (all p<0.05). After adjustment for dental plaque, gingival inflammation was associated with the presence of amelogenesis imperfecta (OR (95%CI) = 1.14 (1.05; 1.24). p<0.01). Conclusion Gingival inflammation, enamel defect and tooth sensitivity are more frequently observed among young patients with amelogenesis imperfecta, and more specifically among children with the hypocalcified subtype.