The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune‐inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non‐invasive imaging and with patient‐reported outcome measures. We also envisage that the integration of multi‐omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
Systematic reviews are cumbersome yet essential to the epistemic process of medical science. Finding significant reports, however, is a daunting task because the sheer volume of published literature makes the manual screening of databases time-consuming. The use of Artificial Intelligence could make literature processing faster and more efficient. Sentence transformers are groundbreaking algorithms that can generate rich semantic representations of text documents and allow for semantic queries. In the present report, we compared four freely available sentence transformer pre-trained models (all-MiniLM-L6-v2, all-MiniLM-L12-v2, all-mpnet-base-v2, and All-distilroberta-v1) on a convenience sample of 6110 articles from a published systematic review. The authors of this review manually screened the dataset and identified 24 target articles that addressed the Focused Questions (FQ) of the review. We applied the four sentence transformers to the dataset and, using the FQ as a query, performed a semantic similarity search on the dataset. The models identified similarities between the FQ and the target articles to a varying degree, and, sorting the dataset by semantic similarities using the best-performing model (all-mpnet-base-v2), the target articles could be found in the top 700 papers out of the 6110 dataset. Our data indicate that the choice of an appropriate pre-trained model could remarkably reduce the number of articles to screen and the time to completion for systematic reviews.
15 February 2018 in Journal of Periodontal Research
To adapt the supranational European Federation for Periodontology (EFP) S3-Level Clinical Practice Guideline for treatment of periodontitis (stage I-III) to a UK healthcare environment, taking into account the views of a broad range of stakeholders, and patients. This UK version is based on the supranational EFP guideline (Sanz et al., 2020) published in the Journal of Clinical Periodontology. The source guideline was developed using the S3-level methodology, which combined the assessment of formal evidence from 15 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 62 clinical recommendations for the treatment of stage I-III periodontitis, based on a step-wise process mapped to the 2017 classification system. The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for the adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework and following the S3-process, the underlying systematic reviews were updated and a representative guideline group of 75 delegates from 17 stakeholder organisations was assembled into three working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the dental community in the UK. The aim of S3-level guidelines is to combine the evaluation of formal evidence, grading and synthesis with the clinical expertise of a broad range of stakeholders to form clinical recommendations. Herein, the first major international S3-level guideline in dentistry, the EFP guideline, was implemented for direct clinical applicability in the UK healthcare system.