Aim: To investigate the contribution of the Single Immunoglobulin Interleukin-1 Receptor-Related Molecule (SIGIRR), a recently described negative mediator of inflammation signaling, in experimental periodontitis pathogenesis.
Methods: A comprehensive approach was employed, including the analysis of human periodontal tissues, in vitro experiments with Periodontal ligament stem cells (PDLSCs), and validation in a rat experimental periodontitis model. The mechanistic link between LPS stimulation and SIGIRR downregulation was investigated, focusing on the p38 pathway and transcription factor Sp1. Functional effects of SIGIRR overexpression on inflammatory cytokine production were assessed.
Results: SIGIRR expression was markedly downregulated in periodontitis and LPS-stimulated PDLSCs. This downregulation was mechanistically linked to LPS activation of the p38 pathway, which impaired nuclear translocation of the transcription factor Sp1, a key positive regulator of SIGIRR transcription. SIGIRR overexpression in PDLSCs significantly attenuated LPS-induced production of pro-inflammatory cytokines (IL-6, IL-8, TNF-α). Local administration of a SIGIRR-overexpressing lentivirus in the rat experimental periodontitis model effectively reduced local pro-inflammatory cytokine levels, and promoted alveolar bone repair.
Conclusion: Together, our findings establish a unique role for p38-Sp1-SIGIRR axis in the pathogenesis of experimental periodontitis and provide evidence that SIGIRR gene therapy promises to offer an alternative option for inflammation blockade and bone repair, facilitating the development of a novel therapeutic strategy.
{"title":"SIGIRR Inhibits Periodontitis-Associated Inflammation and Promotes Regeneration by Blocking Sp1 Nuclear Translocation.","authors":"Xuanxuan Yang, Weixu Li, Lizi Jin, Zhixiang Li, Bolun Zhang, Kaijin Hu, Meng Cao","doi":"10.1111/jre.70074","DOIUrl":"10.1111/jre.70074","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the contribution of the Single Immunoglobulin Interleukin-1 Receptor-Related Molecule (SIGIRR), a recently described negative mediator of inflammation signaling, in experimental periodontitis pathogenesis.</p><p><strong>Methods: </strong>A comprehensive approach was employed, including the analysis of human periodontal tissues, in vitro experiments with Periodontal ligament stem cells (PDLSCs), and validation in a rat experimental periodontitis model. The mechanistic link between LPS stimulation and SIGIRR downregulation was investigated, focusing on the p38 pathway and transcription factor Sp1. Functional effects of SIGIRR overexpression on inflammatory cytokine production were assessed.</p><p><strong>Results: </strong>SIGIRR expression was markedly downregulated in periodontitis and LPS-stimulated PDLSCs. This downregulation was mechanistically linked to LPS activation of the p38 pathway, which impaired nuclear translocation of the transcription factor Sp1, a key positive regulator of SIGIRR transcription. SIGIRR overexpression in PDLSCs significantly attenuated LPS-induced production of pro-inflammatory cytokines (IL-6, IL-8, TNF-α). Local administration of a SIGIRR-overexpressing lentivirus in the rat experimental periodontitis model effectively reduced local pro-inflammatory cytokine levels, and promoted alveolar bone repair.</p><p><strong>Conclusion: </strong>Together, our findings establish a unique role for p38-Sp1-SIGIRR axis in the pathogenesis of experimental periodontitis and provide evidence that SIGIRR gene therapy promises to offer an alternative option for inflammation blockade and bone repair, facilitating the development of a novel therapeutic strategy.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Richard J Miron, Nima Farshidfar, Yu-Kang Tu, Chian-Heng Su, Paras Ahmad, Nathan E Estrin, Reinhard Gruber, Yoshinori Shirakata, Dieter D Bosshardt, Mario Romandini, Anton Sculean
<p><strong>Aim: </strong>Enamel matrix derivative (EMD) has been utilized in periodontology for over 30 years to promote periodontal tissue regeneration by mimicking key biological processes of root development. Preclinical studies confirmed that EMD induces the formation of new cementum, periodontal ligament, and alveolar bone, especially when applied to dry, conditioned root surfaces with minimal/no blood contamination. After reviewing the biological foundations for the functioning of EMD, this systematic review analyzed the efficacy of EMD across multiple clinical indications.</p><p><strong>Methods: </strong>Randomized clinical trials (RCTs) fulfilling specific inclusion criteria were searched and included up to April 15th, 2025. Two review authors independently screened the titles and abstracts, carried out full-text analysis, extracted the data from the published reports, and performed the risk of bias assessment through the RoB2 tool of the Cochrane Collaboration. Disagreements were solved by consensus. Studies were categorized for four clinical indications: (1) nonsurgical treatment of periodontitis; (2) regenerative surgery of intrabony defects; (3) regenerative surgery of furcation defects; and (4) root coverage procedures of gingival recessions. The study results were summarized using random effects meta-analyses.</p><p><strong>Results: </strong>A total of 67 RCTs (9 nonsurgical, 41 intrabony, 4 furcation, and 13 recession), involving 2552 participants and 3521 defects, were included. In meta-analyses, EMD demonstrated superior outcomes in intrabony defects, achieving an added gain of 1.00 mm in probing pocket depth (PPD) reduction and 1.14 mm in clinical attachment level (CAL) over open flap debridement alone. The addition of EMD with bone grafts did not yield any significant improvement in clinical outcomes, except for greater CAL gain (0.79) when combined with xenografts. Non-resorbable membranes showed a more substantial reduction in PPD (1.08 mm) than EMD. For root coverage procedures, EMD showed modest but non-statistically significant improvements, with substantial heterogeneity across studies. A modest additional advantage in PPD reduction (0.30 mm) was found with the adjunctive application of EMD compared to subgingival instrumentation alone, although no enhancements were noticed in CAL. Evidence supporting its use in furcation defects remains limited.</p><p><strong>Conclusion: </strong>EMD is one of the few biological agents with human histologic evidence supporting periodontal regeneration. This is reflected in improved clinical outcomes when used in regenerative surgery for intrabony defects. Despite its biological plausibility for broader therapeutic applications, further high-quality randomized clinical trials are needed to better define its role in nonsurgical treatment of periodontitis, root coverage procedures, and regenerative surgery of furcation involvement. Future research should also focus on optimizing application
{"title":"30 Years of Enamel Matrix Derivative (EMD): Biological Foundations and Systematic Review With Meta-Analyses Across Multiple Clinical Indications.","authors":"Richard J Miron, Nima Farshidfar, Yu-Kang Tu, Chian-Heng Su, Paras Ahmad, Nathan E Estrin, Reinhard Gruber, Yoshinori Shirakata, Dieter D Bosshardt, Mario Romandini, Anton Sculean","doi":"10.1111/jre.70069","DOIUrl":"https://doi.org/10.1111/jre.70069","url":null,"abstract":"<p><strong>Aim: </strong>Enamel matrix derivative (EMD) has been utilized in periodontology for over 30 years to promote periodontal tissue regeneration by mimicking key biological processes of root development. Preclinical studies confirmed that EMD induces the formation of new cementum, periodontal ligament, and alveolar bone, especially when applied to dry, conditioned root surfaces with minimal/no blood contamination. After reviewing the biological foundations for the functioning of EMD, this systematic review analyzed the efficacy of EMD across multiple clinical indications.</p><p><strong>Methods: </strong>Randomized clinical trials (RCTs) fulfilling specific inclusion criteria were searched and included up to April 15th, 2025. Two review authors independently screened the titles and abstracts, carried out full-text analysis, extracted the data from the published reports, and performed the risk of bias assessment through the RoB2 tool of the Cochrane Collaboration. Disagreements were solved by consensus. Studies were categorized for four clinical indications: (1) nonsurgical treatment of periodontitis; (2) regenerative surgery of intrabony defects; (3) regenerative surgery of furcation defects; and (4) root coverage procedures of gingival recessions. The study results were summarized using random effects meta-analyses.</p><p><strong>Results: </strong>A total of 67 RCTs (9 nonsurgical, 41 intrabony, 4 furcation, and 13 recession), involving 2552 participants and 3521 defects, were included. In meta-analyses, EMD demonstrated superior outcomes in intrabony defects, achieving an added gain of 1.00 mm in probing pocket depth (PPD) reduction and 1.14 mm in clinical attachment level (CAL) over open flap debridement alone. The addition of EMD with bone grafts did not yield any significant improvement in clinical outcomes, except for greater CAL gain (0.79) when combined with xenografts. Non-resorbable membranes showed a more substantial reduction in PPD (1.08 mm) than EMD. For root coverage procedures, EMD showed modest but non-statistically significant improvements, with substantial heterogeneity across studies. A modest additional advantage in PPD reduction (0.30 mm) was found with the adjunctive application of EMD compared to subgingival instrumentation alone, although no enhancements were noticed in CAL. Evidence supporting its use in furcation defects remains limited.</p><p><strong>Conclusion: </strong>EMD is one of the few biological agents with human histologic evidence supporting periodontal regeneration. This is reflected in improved clinical outcomes when used in regenerative surgery for intrabony defects. Despite its biological plausibility for broader therapeutic applications, further high-quality randomized clinical trials are needed to better define its role in nonsurgical treatment of periodontitis, root coverage procedures, and regenerative surgery of furcation involvement. Future research should also focus on optimizing application","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yixuan Jiang, Zhengyu Guan, Xiu Yao, Xiaomeng Liu, Dan Qiu, Boyuan Sun, Hongjiao Li
Aim: To identify and validate druggable gene targets for periodontitis using integrative human genomic analyses and to explore their therapeutic potential through pharmacological evaluation.
Methods: To identify therapeutic targets for periodontitis, we performed Mendelian randomization (MR) and colocalization analyses using the cis-expression quantitative trait loci (cis-eQTL) data of druggable genes and genome-wide association studies (GWAS) data. This approach allowed us to pinpoint druggable gene targets significantly associated with periodontitis, which were then validated by immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Next, we applied drug prediction and molecular docking to identify candidate drugs for the key druggable target. Finally, pharmacological analyses were conducted to evaluate the efficacy of these drugs in vitro and in vivo.
Results: A total of six genes (CACNB4, PSMA4, GAA, FGF2, AURKAIP1, and ADAM12) were found to be causally associated with periodontitis in the MR analysis, of which two (CACNB4 and PSMA4) were further supported by colocalization analyses. CACNB4 was significant in both cohorts in MR analysis and supported by localization and experimental evidence. Moreover, the reliability of this target was confirmed in patient samples. We then identified drugs with repurposing potential that target CACNB4, namely verapamil and safinamide. Pharmacological analyses showed that both agents attenuated osteoclast differentiation, indicating therapeutic potential. Importantly, validation at the cellular level confirmed the activity of these candidate drug targets.
Conclusion: Through MR analysis, we identified CACNB4 as a potential druggable gene for periodontitis. Among the drugs targeting CACNB4, verapamil and safinamide emerged as the most promising candidates for periodontitis treatment. Pharmacological studies further demonstrated that these agents may inhibit osteoclast differentiation by targeting CACNB4, thereby offering potential therapeutic options for periodontitis.
{"title":"Integrative Human Genomic and Pharmacological Analyses Identify CACNB4 as a Druggable Target for Periodontitis.","authors":"Yixuan Jiang, Zhengyu Guan, Xiu Yao, Xiaomeng Liu, Dan Qiu, Boyuan Sun, Hongjiao Li","doi":"10.1111/jre.70073","DOIUrl":"10.1111/jre.70073","url":null,"abstract":"<p><strong>Aim: </strong>To identify and validate druggable gene targets for periodontitis using integrative human genomic analyses and to explore their therapeutic potential through pharmacological evaluation.</p><p><strong>Methods: </strong>To identify therapeutic targets for periodontitis, we performed Mendelian randomization (MR) and colocalization analyses using the cis-expression quantitative trait loci (cis-eQTL) data of druggable genes and genome-wide association studies (GWAS) data. This approach allowed us to pinpoint druggable gene targets significantly associated with periodontitis, which were then validated by immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR). Next, we applied drug prediction and molecular docking to identify candidate drugs for the key druggable target. Finally, pharmacological analyses were conducted to evaluate the efficacy of these drugs in vitro and in vivo.</p><p><strong>Results: </strong>A total of six genes (CACNB4, PSMA4, GAA, FGF2, AURKAIP1, and ADAM12) were found to be causally associated with periodontitis in the MR analysis, of which two (CACNB4 and PSMA4) were further supported by colocalization analyses. CACNB4 was significant in both cohorts in MR analysis and supported by localization and experimental evidence. Moreover, the reliability of this target was confirmed in patient samples. We then identified drugs with repurposing potential that target CACNB4, namely verapamil and safinamide. Pharmacological analyses showed that both agents attenuated osteoclast differentiation, indicating therapeutic potential. Importantly, validation at the cellular level confirmed the activity of these candidate drug targets.</p><p><strong>Conclusion: </strong>Through MR analysis, we identified CACNB4 as a potential druggable gene for periodontitis. Among the drugs targeting CACNB4, verapamil and safinamide emerged as the most promising candidates for periodontitis treatment. Pharmacological studies further demonstrated that these agents may inhibit osteoclast differentiation by targeting CACNB4, thereby offering potential therapeutic options for periodontitis.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Massimo Costalonga, Vivek Thumbigere-Math, Mark C Herzberg
<p><p>Autoimmunity arises when central and peripheral immune tolerance fails, allowing self-reactive T and B cells to attack host tissues. Immune attack on host tissues gives rise to a spectrum of autoimmune diseases. This narrative review explains the basic immune mechanisms that may contribute to systemic autoimmunity and exacerbate periodontitis. Current evidence suggests that during T cell development in the thymus, the risk of overt self-reactivity is reduced by the elimination of thymocytes that recognize self-epitopes with high affinity. Despite this stringent editing, some T cells specific for self-peptides escape deletion and persist as dormant cells in the circulation. Dormant cells can remain functionally inactive or anergic due to insufficient co-stimulatory signals, maintaining peripheral self-tolerance. During infection or tissue injury, neutrophil activation, microbial enzymes, and host peptidyl-arginine deiminases (PADs) can catalyze citrullination of self-proteins, generating structurally altered epitopes (neoantigens). In periodontitis, the neoantigen pool is expanded during NETosis, inflammation-driven post-translational modifications of proteins. Modifications are made collectively by peptidyl-arginine deiminases (PADs) produced by Porphyromonas gingivalis and the host. Hence, dormant autoreactive T cells are activated by antigen-presenting cells (APCs) displaying these modified self-antigens or cross-reactive microbial peptides on MHC molecules in the presence of microbial- or danger-associated molecular pattern molecules (MAMPs/DAMPs). Once activated, these autoreactive CD4<sup>+</sup> T cells differentiate into effector cells. These effector T cells can break tolerance, providing cognate help to B cells to promote autoantibody production. Autoreactive B cells arise stochastically during early B cell development through random somatic recombination of immunoglobulin genes. Affinity maturation and epitope spreading broaden the B cell receptor (BCR) repertoire generating autoreactive B cells. Normally restrained, these B cells become activated when their BCRs engage self-antigens in the presence of strong proinflammatory cues (MAMPs/DAMPs). With cognate help from autoreactive T helper cells, B cells undergo class-switching and sustained autoantibody production. Together, autoreactive T cells and B cell-derived autoantibodies drive cellular and humoral autoimmunity, respectively. Compelling mechanistic and clinical evidence support a model in which periodontal pathobionts like P. gingivalis and A. actinomycetemcomitans contribute to systemic autoimmunity via processes including protein citrullination, epitope spreading and molecular mimicry between microbial and host antigens, which further amplify cross-reactivity. These interactions are most clearly illustrated in RA but increasingly implicated in other diseases such as IBD and AD. Thus, periodontitis not only causes local immune-mediated tissue destruction but also facilitat
{"title":"Autoimmunity and Periodontitis.","authors":"Massimo Costalonga, Vivek Thumbigere-Math, Mark C Herzberg","doi":"10.1111/jre.70058","DOIUrl":"https://doi.org/10.1111/jre.70058","url":null,"abstract":"<p><p>Autoimmunity arises when central and peripheral immune tolerance fails, allowing self-reactive T and B cells to attack host tissues. Immune attack on host tissues gives rise to a spectrum of autoimmune diseases. This narrative review explains the basic immune mechanisms that may contribute to systemic autoimmunity and exacerbate periodontitis. Current evidence suggests that during T cell development in the thymus, the risk of overt self-reactivity is reduced by the elimination of thymocytes that recognize self-epitopes with high affinity. Despite this stringent editing, some T cells specific for self-peptides escape deletion and persist as dormant cells in the circulation. Dormant cells can remain functionally inactive or anergic due to insufficient co-stimulatory signals, maintaining peripheral self-tolerance. During infection or tissue injury, neutrophil activation, microbial enzymes, and host peptidyl-arginine deiminases (PADs) can catalyze citrullination of self-proteins, generating structurally altered epitopes (neoantigens). In periodontitis, the neoantigen pool is expanded during NETosis, inflammation-driven post-translational modifications of proteins. Modifications are made collectively by peptidyl-arginine deiminases (PADs) produced by Porphyromonas gingivalis and the host. Hence, dormant autoreactive T cells are activated by antigen-presenting cells (APCs) displaying these modified self-antigens or cross-reactive microbial peptides on MHC molecules in the presence of microbial- or danger-associated molecular pattern molecules (MAMPs/DAMPs). Once activated, these autoreactive CD4<sup>+</sup> T cells differentiate into effector cells. These effector T cells can break tolerance, providing cognate help to B cells to promote autoantibody production. Autoreactive B cells arise stochastically during early B cell development through random somatic recombination of immunoglobulin genes. Affinity maturation and epitope spreading broaden the B cell receptor (BCR) repertoire generating autoreactive B cells. Normally restrained, these B cells become activated when their BCRs engage self-antigens in the presence of strong proinflammatory cues (MAMPs/DAMPs). With cognate help from autoreactive T helper cells, B cells undergo class-switching and sustained autoantibody production. Together, autoreactive T cells and B cell-derived autoantibodies drive cellular and humoral autoimmunity, respectively. Compelling mechanistic and clinical evidence support a model in which periodontal pathobionts like P. gingivalis and A. actinomycetemcomitans contribute to systemic autoimmunity via processes including protein citrullination, epitope spreading and molecular mimicry between microbial and host antigens, which further amplify cross-reactivity. These interactions are most clearly illustrated in RA but increasingly implicated in other diseases such as IBD and AD. Thus, periodontitis not only causes local immune-mediated tissue destruction but also facilitat","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian-Edgar Baumeister, Thomas Kocher, Panos N Papapanou, Birte Holtfreter, Ryan T Demmer
Cross-sectional studies capture health states, exposures, and risk factors at a single time point, providing essential data for estimating disease prevalence and informing public health planning. These studies serve multiple epidemiological purposes: characterizing population health, monitoring temporal trends through repeated surveys, and evaluating interventions via interrupted time series designs. They also offer practical advantages for validating self-reported measures and creating diagnostic models. Cross-sectional designs are efficient and well-suited to descriptive epidemiology, but they have limited utility for causal inference. The simultaneous measurement of exposures and outcomes creates temporal ambiguity that fundamentally constrains etiologic interpretation. However, causal inferences can be strengthened under specific conditions-when temporal sequence is unambiguous (e.g., genetic variants preceding outcomes) or when valid instrumental variables are available. This methodological tutorial equips readers with concepts and tools to critically appraise cross-sectional studies across the application domains outlined and to design and analyze their own cross-sectional studies that yield high-quality epidemiologic descriptions.
{"title":"Cross-Sectional Studies: Strengths, Limitations, and Methodological Considerations.","authors":"Sebastian-Edgar Baumeister, Thomas Kocher, Panos N Papapanou, Birte Holtfreter, Ryan T Demmer","doi":"10.1111/jre.70063","DOIUrl":"https://doi.org/10.1111/jre.70063","url":null,"abstract":"<p><p>Cross-sectional studies capture health states, exposures, and risk factors at a single time point, providing essential data for estimating disease prevalence and informing public health planning. These studies serve multiple epidemiological purposes: characterizing population health, monitoring temporal trends through repeated surveys, and evaluating interventions via interrupted time series designs. They also offer practical advantages for validating self-reported measures and creating diagnostic models. Cross-sectional designs are efficient and well-suited to descriptive epidemiology, but they have limited utility for causal inference. The simultaneous measurement of exposures and outcomes creates temporal ambiguity that fundamentally constrains etiologic interpretation. However, causal inferences can be strengthened under specific conditions-when temporal sequence is unambiguous (e.g., genetic variants preceding outcomes) or when valid instrumental variables are available. This methodological tutorial equips readers with concepts and tools to critically appraise cross-sectional studies across the application domains outlined and to design and analyze their own cross-sectional studies that yield high-quality epidemiologic descriptions.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorenzo Tavelli, Daniel Thoma, Maria Elisa Galarraga Vinueza, Mario Romandini, Shayan Barootchi
Soft tissue augmentation around teeth and dental implants is a central aspect of periodontal and peri-implant plastic surgery. Autogenous soft tissue grafts are generally regarded as the gold standard for increasing keratinized mucosa, mucosal thickness, and soft tissue height, supported by extensive long-term evidence. However, limitations such as restricted tissue availability, increased surgical time, and donor-site morbidity have encouraged the development of soft tissue graft substitutes, including xenogeneic and allogeneic matrices, and collagen derivatives, among other biomaterials. Over the past two decades, these alternatives have shown promising results, particularly in sites with favorable anatomical conditions, including optimal bone support, tall and wide papillae, and adequate hard and soft tissue phenotype; although their predictability remains variable across the literature and is often lower than that of autogenous grafts in complex defects and esthetically demanding areas. Nevertheless, the growing emphasis on patient-reported outcomes has led several authors to explore the use of graft substitutes in different clinical scenarios, sometimes in combination with smaller autogenous grafts. This manuscript aims to summarize the current state-of-the-art on soft tissue graft substitutes for managing deficiencies at both teeth and implant sites. A comprehensive literature review is provided, together with clinical decision trees designed to guide clinicians in selecting autogenous grafts versus substitutes across different scenarios. These tools highlight the main factors influencing treatment selection, including baseline keratinized mucosa, buccal bone conditions, site anatomy, esthetic requirements, and patient preference. By integrating current evidence with practical algorithms, this review seeks to support clinicians in making informed, patient-centered decisions regarding soft tissue augmentation at teeth and implants.
{"title":"Soft Tissue Substitutes: Current Biomaterials and Indications at Teeth and Implant Sites.","authors":"Lorenzo Tavelli, Daniel Thoma, Maria Elisa Galarraga Vinueza, Mario Romandini, Shayan Barootchi","doi":"10.1111/jre.70066","DOIUrl":"https://doi.org/10.1111/jre.70066","url":null,"abstract":"<p><p>Soft tissue augmentation around teeth and dental implants is a central aspect of periodontal and peri-implant plastic surgery. Autogenous soft tissue grafts are generally regarded as the gold standard for increasing keratinized mucosa, mucosal thickness, and soft tissue height, supported by extensive long-term evidence. However, limitations such as restricted tissue availability, increased surgical time, and donor-site morbidity have encouraged the development of soft tissue graft substitutes, including xenogeneic and allogeneic matrices, and collagen derivatives, among other biomaterials. Over the past two decades, these alternatives have shown promising results, particularly in sites with favorable anatomical conditions, including optimal bone support, tall and wide papillae, and adequate hard and soft tissue phenotype; although their predictability remains variable across the literature and is often lower than that of autogenous grafts in complex defects and esthetically demanding areas. Nevertheless, the growing emphasis on patient-reported outcomes has led several authors to explore the use of graft substitutes in different clinical scenarios, sometimes in combination with smaller autogenous grafts. This manuscript aims to summarize the current state-of-the-art on soft tissue graft substitutes for managing deficiencies at both teeth and implant sites. A comprehensive literature review is provided, together with clinical decision trees designed to guide clinicians in selecting autogenous grafts versus substitutes across different scenarios. These tools highlight the main factors influencing treatment selection, including baseline keratinized mucosa, buccal bone conditions, site anatomy, esthetic requirements, and patient preference. By integrating current evidence with practical algorithms, this review seeks to support clinicians in making informed, patient-centered decisions regarding soft tissue augmentation at teeth and implants.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145863252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-05-09DOI: 10.1111/jre.13416
Shengming Xu, Cheng Zheng, Jianmin Huang, Bin Lu, Hanxin Que, Leyan Xu, Yubo Hou, Linlin He, Xia Fan, Ke Deng, Rongdang Hu, Hui Deng, Yi Wang
Aims: To investigate how Porphyromonas gingivalis induces endothelial dysfunction, focusing on the regulatory role of Sirtuin 3 (Sirt3) in mitochondrial function.
Methods: Differentially expressed Sirtuin family genes in P. gingivalis-infected human aortic endothelial cells (HAECs) were identified through RNA sequencing and validated by quantitative real-time PCR and Western blot. Mitochondrial and endothelial functions were assessed in P. gingivalis-infected HAECs with or without Sirt3-specific agonist Honokiol. Cyclophilin D (CypD) K167 point mutation plasmids were constructed, and Co-immunoprecipitation was performed to investigate the Sirt3-CypD interaction. The vasorelaxation of aortas from mice orally administrated with P. gingivalis was also evaluated.
Results: Porphyromonas gingivalis infection in HAECs resulted in mitochondrial and endothelial dysfunction. Mechanistic studies revealed that Sirt3-mediated deacetylation of CypD at K167 was pivotal in alleviating P. gingivalis-induced mitochondrial and endothelial dysfunction. Oral inoculation of P. gingivalis in mice significantly impaired endothelial-dependent vasodilation, disrupted aortic endothelial integrity, increased endothelial cell apoptosis, and elevated mitochondrial reactive oxygen species production. Notably, Sirt3 activation reversed mitochondrial and endothelial dysfunction induced by P. gingivalis both in vivo and in vitro.
Conclusion: The present study demonstrated that P. gingivalis induced mitochondrial and endothelial dysfunction, which was mediated through Sirt3-dependent CypD deacetylation.
{"title":"Porphyromonas gingivalis Induces Endothelial Dysfunction Through Sirt3-Dependent CypD Acetylation.","authors":"Shengming Xu, Cheng Zheng, Jianmin Huang, Bin Lu, Hanxin Que, Leyan Xu, Yubo Hou, Linlin He, Xia Fan, Ke Deng, Rongdang Hu, Hui Deng, Yi Wang","doi":"10.1111/jre.13416","DOIUrl":"10.1111/jre.13416","url":null,"abstract":"<p><strong>Aims: </strong>To investigate how Porphyromonas gingivalis induces endothelial dysfunction, focusing on the regulatory role of Sirtuin 3 (Sirt3) in mitochondrial function.</p><p><strong>Methods: </strong>Differentially expressed Sirtuin family genes in P. gingivalis-infected human aortic endothelial cells (HAECs) were identified through RNA sequencing and validated by quantitative real-time PCR and Western blot. Mitochondrial and endothelial functions were assessed in P. gingivalis-infected HAECs with or without Sirt3-specific agonist Honokiol. Cyclophilin D (CypD) K167 point mutation plasmids were constructed, and Co-immunoprecipitation was performed to investigate the Sirt3-CypD interaction. The vasorelaxation of aortas from mice orally administrated with P. gingivalis was also evaluated.</p><p><strong>Results: </strong>Porphyromonas gingivalis infection in HAECs resulted in mitochondrial and endothelial dysfunction. Mechanistic studies revealed that Sirt3-mediated deacetylation of CypD at K167 was pivotal in alleviating P. gingivalis-induced mitochondrial and endothelial dysfunction. Oral inoculation of P. gingivalis in mice significantly impaired endothelial-dependent vasodilation, disrupted aortic endothelial integrity, increased endothelial cell apoptosis, and elevated mitochondrial reactive oxygen species production. Notably, Sirt3 activation reversed mitochondrial and endothelial dysfunction induced by P. gingivalis both in vivo and in vitro.</p><p><strong>Conclusion: </strong>The present study demonstrated that P. gingivalis induced mitochondrial and endothelial dysfunction, which was mediated through Sirt3-dependent CypD deacetylation.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":"1296-1307"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2024-11-22DOI: 10.1111/jre.13365
Stefan Reichert, Selina Rehm, Axel Schlitt, Susanne Schulz
Aim: The study aimed to elucidate a putative association between severe periodontitis and the incidence of recurrent cardiovascular events in patients with cardiovascular disease (CVD) within 10 years after their initial hospitalisation.
Methods: A cohort of 1002 stationary patients with angiographically proven CVD was included. They were examined regarding prevalence of severe periodontitis (≥ 30% of the teeth with proximal attachment loss of ≥ 5 mm), probing depth, clinical attachment loss, bleeding on probing, number of missing teeth and oral care habits. Recurrent events were summarised as combined end point (myocardial infarction, stroke/transitory ischemic attack, cardiovascular death and death caused by stroke). Survival analyses were carried out after a 10-year follow-up period. Hazard ratios (HRs) were adjusted for known cardiac risk factors using Cox regression.
Results: The follow-up was completed by 792 patients. The overall incidence of the combined end point was 42.8%. Severe periodontitis was associated with recurrent cardiovascular events (adjusted hazard ratio [HR] = 1.26, 95% confidence interval [CI] 1.0-1.58 and Standard error [SE] 0.11), whereas both, tooth brushing more than once a day (adjusted HR = 0.74, 95% CI 0.57-0.97, SE 0.13) and performing interdental hygiene (adjusted HR = 0.71, 95% CI 0.52-0.99, SE 0.16) decreased this risk.
Conclusions: Severe periodontitis is a putative risk factor for recurrent cardiovascular events.
{"title":"Severe Periodontitis is Associated With Recurrent Cardiovascular Events-A 10-Year Longitudinal Cohort Study.","authors":"Stefan Reichert, Selina Rehm, Axel Schlitt, Susanne Schulz","doi":"10.1111/jre.13365","DOIUrl":"10.1111/jre.13365","url":null,"abstract":"<p><strong>Aim: </strong>The study aimed to elucidate a putative association between severe periodontitis and the incidence of recurrent cardiovascular events in patients with cardiovascular disease (CVD) within 10 years after their initial hospitalisation.</p><p><strong>Methods: </strong>A cohort of 1002 stationary patients with angiographically proven CVD was included. They were examined regarding prevalence of severe periodontitis (≥ 30% of the teeth with proximal attachment loss of ≥ 5 mm), probing depth, clinical attachment loss, bleeding on probing, number of missing teeth and oral care habits. Recurrent events were summarised as combined end point (myocardial infarction, stroke/transitory ischemic attack, cardiovascular death and death caused by stroke). Survival analyses were carried out after a 10-year follow-up period. Hazard ratios (HRs) were adjusted for known cardiac risk factors using Cox regression.</p><p><strong>Results: </strong>The follow-up was completed by 792 patients. The overall incidence of the combined end point was 42.8%. Severe periodontitis was associated with recurrent cardiovascular events (adjusted hazard ratio [HR] = 1.26, 95% confidence interval [CI] 1.0-1.58 and Standard error [SE] 0.11), whereas both, tooth brushing more than once a day (adjusted HR = 0.74, 95% CI 0.57-0.97, SE 0.13) and performing interdental hygiene (adjusted HR = 0.71, 95% CI 0.52-0.99, SE 0.16) decreased this risk.</p><p><strong>Conclusions: </strong>Severe periodontitis is a putative risk factor for recurrent cardiovascular events.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT01045070.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":"1201-1211"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-07-29DOI: 10.1111/jre.70022
Araceli Valverde, Raza Ali Naqvi, Yinghua Chen, Alireza Moshaverinia, Anne George, Deepak Shukla, Gloria Martinez, Gabriella Chapa, Salvador Nares, Afsar R Naqvi
Aims: Elevated levels of Herpes Simplex Virus 1 (HSV-1) have been reported in periodontitis, however, the tropism and relationship with periodontal inflammation are poorly characterized. This study investigated how inflammation affects viral tropism toward human periodontal ligament stem cells (hPDLSCs).
Methods: HSV-1 gB and gD transcripts in healthy and diseased human gingiva were measured by RT-qPCR and confirmed in HSV-1-infected murine gingiva. HSV-1 infection in hPDLSCs was analyzed by imaging and flow cytometry. hPDLSCs were individually treated with IL-6, TNF-α, GMCSF, IL-10, or PgLPS, and HSV-1 replication was assessed by infecting with the 17 GFP strain. Lineage markers in virally infected hPDLSCs during osteogenic differentiation were measured by RT-qPCR and immunofluorescence in vitro and validated in vivo. Mice subjected to ligature-induced periodontitis (LIP) and infected with HSV-1 were examined for gingival histology, inflammatory cytokines, and alveolar bone loss.
Results: Inflamed human gingiva showed higher expression of viral transcripts compared to healthy controls. In mouse oral HSV-1 infection, gB and gD expression increased over time, with higher levels in mice with ligature-induced periodontitis. Virus infected hPDLSCs challenged with inflammatory mediators or PgLPS showed higher GFP, while IL-10 treatment attenuated GFP levels. Importantly, HSV-1 17 GFP infection affected osteoblast lineage commitment by promoting the expression of key transcription factors in vitro and in vivo. Compared to the LIP alone group, higher levels of inflammatory markers and bone loss were evident in HSV-1 infected with LIP.
Conclusion: hPDLSCs are trophic to HSV-1 in vitro and in vivo, with periodontal inflammation playing a significant role in viral tropism.
{"title":"Herpesvirus Simplex Virus-1 Exploits Inflammation to Infect Periodontal Stem Cells and Disrupt Lineage Commitment.","authors":"Araceli Valverde, Raza Ali Naqvi, Yinghua Chen, Alireza Moshaverinia, Anne George, Deepak Shukla, Gloria Martinez, Gabriella Chapa, Salvador Nares, Afsar R Naqvi","doi":"10.1111/jre.70022","DOIUrl":"10.1111/jre.70022","url":null,"abstract":"<p><strong>Aims: </strong>Elevated levels of Herpes Simplex Virus 1 (HSV-1) have been reported in periodontitis, however, the tropism and relationship with periodontal inflammation are poorly characterized. This study investigated how inflammation affects viral tropism toward human periodontal ligament stem cells (hPDLSCs).</p><p><strong>Methods: </strong>HSV-1 gB and gD transcripts in healthy and diseased human gingiva were measured by RT-qPCR and confirmed in HSV-1-infected murine gingiva. HSV-1 infection in hPDLSCs was analyzed by imaging and flow cytometry. hPDLSCs were individually treated with IL-6, TNF-α, GMCSF, IL-10, or PgLPS, and HSV-1 replication was assessed by infecting with the 17 GFP strain. Lineage markers in virally infected hPDLSCs during osteogenic differentiation were measured by RT-qPCR and immunofluorescence in vitro and validated in vivo. Mice subjected to ligature-induced periodontitis (LIP) and infected with HSV-1 were examined for gingival histology, inflammatory cytokines, and alveolar bone loss.</p><p><strong>Results: </strong>Inflamed human gingiva showed higher expression of viral transcripts compared to healthy controls. In mouse oral HSV-1 infection, gB and gD expression increased over time, with higher levels in mice with ligature-induced periodontitis. Virus infected hPDLSCs challenged with inflammatory mediators or PgLPS showed higher GFP, while IL-10 treatment attenuated GFP levels. Importantly, HSV-1 17 GFP infection affected osteoblast lineage commitment by promoting the expression of key transcription factors in vitro and in vivo. Compared to the LIP alone group, higher levels of inflammatory markers and bone loss were evident in HSV-1 infected with LIP.</p><p><strong>Conclusion: </strong>hPDLSCs are trophic to HSV-1 in vitro and in vivo, with periodontal inflammation playing a significant role in viral tropism.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":"1265-1279"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12881881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-15DOI: 10.1111/jre.70030
Hongrui Liu, Yujun Jiang, Changyun Sun, Jie Guo, Minqi Li
Aims: Diabetes induces disorders in macrophage immunometabolism, leading to increased destruction of periodontal tissue. Identifying key factors to restore metabolic alterations and promote resolution of inflammation remains an unmet objective.
Methods: In the present study, the effect of macrophage efferocytosis on inflammatory regression and tissue repair was assessed using a diabetic periodontitis (DPD) model. The mitochondrial function of macrophages cultured under different conditions was assessed in vitro, and macrophage efferocytosis function and polarization phenotypes were examined. Osteogenic differentiation and migration capacity were examined using periodontal ligament stem cells (PDLSCs) co-cultured with macrophages to assess the effect on tissue repair.
Results: We demonstrated that the high-glucose inflammatory microenvironment exacerbated the pro-inflammatory metabolic profile of macrophages and disrupted mitochondrial dynamics. Rats with DPD exhibited heightened periodontal tissue damage during the ligation period, characterized by increased neutrophil infiltration and apoptotic cells. Following ligature removal, the transition to the repair phase was inhibited. Impaired efferocytosis in macrophages led to reduced expression of anti-inflammatory cytokines. Inhibiting excessive mitochondrial division mitigated macrophage damage, ultimately improving the osteogenic differentiation and migration of PDLSCs.
Conclusions: This research suggested the critical role of mitochondria in the resolution of inflammation in diabetic periodontitis through regulating macrophage efferocytosis and interaction with PDLSCs.
{"title":"Macrophage Efferocytosis Controls Tissue Repair via Mitochondrial Dynamics in Diabetic Periodontitis.","authors":"Hongrui Liu, Yujun Jiang, Changyun Sun, Jie Guo, Minqi Li","doi":"10.1111/jre.70030","DOIUrl":"10.1111/jre.70030","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes induces disorders in macrophage immunometabolism, leading to increased destruction of periodontal tissue. Identifying key factors to restore metabolic alterations and promote resolution of inflammation remains an unmet objective.</p><p><strong>Methods: </strong>In the present study, the effect of macrophage efferocytosis on inflammatory regression and tissue repair was assessed using a diabetic periodontitis (DPD) model. The mitochondrial function of macrophages cultured under different conditions was assessed in vitro, and macrophage efferocytosis function and polarization phenotypes were examined. Osteogenic differentiation and migration capacity were examined using periodontal ligament stem cells (PDLSCs) co-cultured with macrophages to assess the effect on tissue repair.</p><p><strong>Results: </strong>We demonstrated that the high-glucose inflammatory microenvironment exacerbated the pro-inflammatory metabolic profile of macrophages and disrupted mitochondrial dynamics. Rats with DPD exhibited heightened periodontal tissue damage during the ligation period, characterized by increased neutrophil infiltration and apoptotic cells. Following ligature removal, the transition to the repair phase was inhibited. Impaired efferocytosis in macrophages led to reduced expression of anti-inflammatory cytokines. Inhibiting excessive mitochondrial division mitigated macrophage damage, ultimately improving the osteogenic differentiation and migration of PDLSCs.</p><p><strong>Conclusions: </strong>This research suggested the critical role of mitochondria in the resolution of inflammation in diabetic periodontitis through regulating macrophage efferocytosis and interaction with PDLSCs.</p>","PeriodicalId":16715,"journal":{"name":"Journal of periodontal research","volume":" ","pages":"1280-1295"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}