Christina Zachariadou,Anuja Doshi,Dimitris N Tatakis,Brian L Foster
BACKGROUNDEpithelium is the periodontal first line of defense against microbes. Discoidin domain receptor 1 (DDR1) is a collagen receptor expressed in epithelium. Ddr1 knockout (Ddr1-/-) mice develop periodontitis-like defects, including junctional epithelium (JE) downgrowth, bacterial invasion, and alveolar bone loss. The objective of this study was to investigate epithelial responses in the absence of DDR1. We hypothesized that Ddr1-/- mice exhibit increased JE permeability and delayed epithelial wound healing.METHODSEpithelium was analyzed in Ddr1-/- and wild-type (Ddr1+/+) mice. JE permeability was studied in vivo by applying a fluorescent dye and measuring dye penetration. Immunohistochemistry (IHC) was used to identify the localization of E-cadherin and collagens IV, VIII, and XVII in oral epithelium. DDR1 expression in wound healing was confirmed by histology. Epithelial wound healing responses were assessed by creating skin and oral wounds and measuring epithelial migration and wound closure.RESULTSNo differences in JE permeability were observed between Ddr1-/- and Ddr1+/+ mice, although a trend in the means was observed toward decreased dye surface area (p = 0.07) and intensity (p = 0.08-0.09) in the periodontium of the former mice. IHC did not reveal differences in the localization of E-cadherin or collagens IV, VIII, and XVII between genotypes. In human gingiva, DDR1 was expressed at the epithelial front, migrating to cover palatal wounds. Wound healing experiments revealed a higher % wound healing of dorsal skin in Ddr1-/- than Ddr1+/+ mice at 5 days post-wounding (dpw) (p = 0.01).CONCLUSIONSDDR1 does not affect JE permeability but may play a role in effective epithelial cell migration during cutaneous wound healing.PLAIN LANGUAGE SUMMARYEpithelium is the periodontal first line of defense against microbial attacks. Discoidin domain receptor 1 (DDR1) is a collagen receptor expressed at the epithelium. Mice not expressing the receptor (Ddr1-/- mice) develop defects consistent with periodontitis, including epithelium downgrowth and bone loss. In this study, we investigated periodontal epithelial permeability by applying a fluorescent dye in the mouth of Ddr1+/+ and Ddr1-/- mice. Additionally, we used histological methods to reveal differences in the localization of gingival proteins between Ddr1+/+ and Ddr1-/-. Finally, we investigated the role of DDR1 in wound healing in human sections and in a live animal model. No differences in junctional epithelium (JE) permeability were observed between Ddr1+/+ and Ddr1-/- mice, as expressed by the comparable presence of dye in the periodontal tissues of both types of mice. There were no differences in the localization of E-cadherin or collagens IV, VIII, and XVII between Ddr1+/+ and Ddr1-/-. In human gingiva, DDR1 was expressed at the epithelial front, migrating to cover palatal wounds. The animal wound healing study revealed higher healing of skin wounds in Ddr1-/- than Ddr1+/+ mice at 5 dpw. In
{"title":"Evaluation of Discoidin domain receptor 1 (DDR1) in junctional epithelial permeability and wound healing.","authors":"Christina Zachariadou,Anuja Doshi,Dimitris N Tatakis,Brian L Foster","doi":"10.1002/jper.70031","DOIUrl":"https://doi.org/10.1002/jper.70031","url":null,"abstract":"BACKGROUNDEpithelium is the periodontal first line of defense against microbes. Discoidin domain receptor 1 (DDR1) is a collagen receptor expressed in epithelium. Ddr1 knockout (Ddr1-/-) mice develop periodontitis-like defects, including junctional epithelium (JE) downgrowth, bacterial invasion, and alveolar bone loss. The objective of this study was to investigate epithelial responses in the absence of DDR1. We hypothesized that Ddr1-/- mice exhibit increased JE permeability and delayed epithelial wound healing.METHODSEpithelium was analyzed in Ddr1-/- and wild-type (Ddr1+/+) mice. JE permeability was studied in vivo by applying a fluorescent dye and measuring dye penetration. Immunohistochemistry (IHC) was used to identify the localization of E-cadherin and collagens IV, VIII, and XVII in oral epithelium. DDR1 expression in wound healing was confirmed by histology. Epithelial wound healing responses were assessed by creating skin and oral wounds and measuring epithelial migration and wound closure.RESULTSNo differences in JE permeability were observed between Ddr1-/- and Ddr1+/+ mice, although a trend in the means was observed toward decreased dye surface area (p = 0.07) and intensity (p = 0.08-0.09) in the periodontium of the former mice. IHC did not reveal differences in the localization of E-cadherin or collagens IV, VIII, and XVII between genotypes. In human gingiva, DDR1 was expressed at the epithelial front, migrating to cover palatal wounds. Wound healing experiments revealed a higher % wound healing of dorsal skin in Ddr1-/- than Ddr1+/+ mice at 5 days post-wounding (dpw) (p = 0.01).CONCLUSIONSDDR1 does not affect JE permeability but may play a role in effective epithelial cell migration during cutaneous wound healing.PLAIN LANGUAGE SUMMARYEpithelium is the periodontal first line of defense against microbial attacks. Discoidin domain receptor 1 (DDR1) is a collagen receptor expressed at the epithelium. Mice not expressing the receptor (Ddr1-/- mice) develop defects consistent with periodontitis, including epithelium downgrowth and bone loss. In this study, we investigated periodontal epithelial permeability by applying a fluorescent dye in the mouth of Ddr1+/+ and Ddr1-/- mice. Additionally, we used histological methods to reveal differences in the localization of gingival proteins between Ddr1+/+ and Ddr1-/-. Finally, we investigated the role of DDR1 in wound healing in human sections and in a live animal model. No differences in junctional epithelium (JE) permeability were observed between Ddr1+/+ and Ddr1-/- mice, as expressed by the comparable presence of dye in the periodontal tissues of both types of mice. There were no differences in the localization of E-cadherin or collagens IV, VIII, and XVII between Ddr1+/+ and Ddr1-/-. In human gingiva, DDR1 was expressed at the epithelial front, migrating to cover palatal wounds. The animal wound healing study revealed higher healing of skin wounds in Ddr1-/- than Ddr1+/+ mice at 5 dpw. In ","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"21 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Timothy Treat, Dylan Jones, Natalie Lorenzano, Scott Umberfield, Andrew Bartels, Titus Schleyer, Heather Taylor
Background Evidence for whether and how non‐surgical periodontal treatment (NSPT) improves systemic outcomes remains equivocal. Inconclusive findings may in part be due to design variations of randomized controlled trials (RCTs) in this field. The objective of this study was to describe the study design characteristics of RCTs that have evaluated the effect of non‐surgical periodontal treatment on systemic health outcomes. Methods We searched Medline via Ovid and EMBASE for RCTs published through January 1, 2024, for terms indicating NSPT (i.e., scaling and root planing) and selected chronic diseases. We developed a standardized coding sheet for systematically extracting data from studies, including the definition of periodontal disease (PD) among study participants, the length of study duration, and whether the effect of NSPT was found to have a statistically significant beneficial, detrimental, or null effect on systemic outcomes. Results Eighty‐two RCTs, which reported the effect of NSPT on systemic outcomes in 816 individual analyses, met our inclusion criteria. Fifty‐six studies (68.3%) had at least 1 of 4 variations in study design that may contribute to biased results. Studies that restricted their inclusion criteria to participants with severe PD were more likely to measure a beneficial effect than a non‐beneficial effect on specific systemic outcomes following NSPT (62.7% vs. 49.2%, p < 0.001). Conclusion Variation in study designs of RCTs may be contributing to mixed and inconclusive findings investigating the effect of NSPT on systemic disease outcomes. Plain Language Summary This study reviewed clinical trials to understand why the evidence on whether non‐surgical periodontal treatment (NSPT) can improve overall health is inconclusive. Eighty‐two clinical trials were analyzed to identify patterns in how these studies were designed. While most trials found that NSPT had some benefits, more than two‐thirds of the studies had design features that could skew results. Trials involving participants with severe gum disease were more likely to show benefits than those including people with milder forms. How clinical trials are set up—such as who is included and how long the study lasts—may heavily affect overall findings. The study highlights the need for more standardized approaches to research in this area to better understand whether and how dental treatments can improve overall health. These findings are important for designing future studies and ensuring reliable evidence for medical and dental professionals.
{"title":"Design characteristics of studies evaluating the effect of non‐surgical periodontal treatment on systemic health outcomes","authors":"Timothy Treat, Dylan Jones, Natalie Lorenzano, Scott Umberfield, Andrew Bartels, Titus Schleyer, Heather Taylor","doi":"10.1002/jper.24-0847","DOIUrl":"https://doi.org/10.1002/jper.24-0847","url":null,"abstract":"Background Evidence for whether and how non‐surgical periodontal treatment (NSPT) improves systemic outcomes remains equivocal. Inconclusive findings may in part be due to design variations of randomized controlled trials (RCTs) in this field. The objective of this study was to describe the study design characteristics of RCTs that have evaluated the effect of non‐surgical periodontal treatment on systemic health outcomes. Methods We searched Medline via Ovid and EMBASE for RCTs published through January 1, 2024, for terms indicating NSPT (i.e., scaling and root planing) and selected chronic diseases. We developed a standardized coding sheet for systematically extracting data from studies, including the definition of periodontal disease (PD) among study participants, the length of study duration, and whether the effect of NSPT was found to have a statistically significant beneficial, detrimental, or null effect on systemic outcomes. Results Eighty‐two RCTs, which reported the effect of NSPT on systemic outcomes in 816 individual analyses, met our inclusion criteria. Fifty‐six studies (68.3%) had at least 1 of 4 variations in study design that may contribute to biased results. Studies that restricted their inclusion criteria to participants with severe PD were more likely to measure a beneficial effect than a non‐beneficial effect on specific systemic outcomes following NSPT (62.7% vs. 49.2%, <jats:italic>p</jats:italic> < 0.001). Conclusion Variation in study designs of RCTs may be contributing to mixed and inconclusive findings investigating the effect of NSPT on systemic disease outcomes. Plain Language Summary This study reviewed clinical trials to understand why the evidence on whether non‐surgical periodontal treatment (NSPT) can improve overall health is inconclusive. Eighty‐two clinical trials were analyzed to identify patterns in how these studies were designed. While most trials found that NSPT had some benefits, more than two‐thirds of the studies had design features that could skew results. Trials involving participants with severe gum disease were more likely to show benefits than those including people with milder forms. How clinical trials are set up—such as who is included and how long the study lasts—may heavily affect overall findings. The study highlights the need for more standardized approaches to research in this area to better understand whether and how dental treatments can improve overall health. These findings are important for designing future studies and ensuring reliable evidence for medical and dental professionals.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"165 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145554453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The potential of hydrogen sulfide (H 2 S) gas as a biomarker for periodontitis has been suggested, but the evidence remains inconclusive. This preliminary study aimed to explore the relationship between periodontitis, defined according to the 2018 classification by the American Academy of Periodontology and the European Federation of Periodontology and exhaled H 2 S gas in the Thai population. Methods In 2023, a cross‐sectional study was conducted involving 172 systemically healthy, non‐smoking individuals aged 18 years or older who were included from three healthcare centers, Chiang Mai, Thailand. Participants underwent interviews, oral and periodontal examinations, and exhaled H 2 S gas detection using an innovative LTCC‐GASSET device. H 2 S levels and periodontal status were analyzed statistically. Results H 2 S levels significantly increased in groups with periodontitis compared to those without, with the magnitude of the increase corresponding to the stage of periodontitis. This trend was particularly pronounced in the older group (≥41 years). Moderate positive linear correlations were observed between H 2 S levels and clinical periodontal parameters, with the strongest correlation found for clinical attachment loss (CAL). Multiple regression analysis confirmed significant associations between H 2 S levels, CAL, and periodontal probing depth, after adjusting for confounders. Additionally, a threshold of 177.5 ppb for H 2 S levels was found to differentiate severe periodontitis, with AUC, sensitivity, and specificity of 0.733, 0.722, and 0.720, respectively. Conclusions Exhaled H 2 S levels were associated with periodontitis severity in non‐smoking, systemically healthy individuals. Given its limitations, the LTCC‐GASSET device may have potential for non‐invasive detection of periodontitis. Plain Language Summary This study examined the association between periodontitis, diagnosed using the 2018 AAP/EFP classification, and exhaled hydrogen sulfide (H 2 S) levels in 172 non‐smoking, systemically healthy adults. H 2 S levels were measured with the LTCC‐GASSET device, revealing higher levels in individuals with periodontitis, especially in more severe cases. Older participants (aged ≥41 years) had higher H 2 S levels, particularly if they had periodontitis. The H 2 S cut‐off level appeared to help distinguish between severe and non‐severe periodontitis cases. Within the limitations of a cross‐sectional study, these findings suggest that H 2 S levels could be useful for identifying individuals at higher risk for periodontal disease.
{"title":"Association between periodontitis severity and exhaled hydrogen sulfide measured using LTCC‐GASSET device in healthy Thai patients","authors":"Chanyanuch Wechwithayakhlung, Matawee Punginsang, Kanittha Inyawilert, Kata Jaruwongrungsee, Anurat Wisitsoraat, Siriporn Chattipakorn, Chaikarn Liewhiran, Teerat Sawangpanyangkura","doi":"10.1002/jper.70025","DOIUrl":"https://doi.org/10.1002/jper.70025","url":null,"abstract":"Background The potential of hydrogen sulfide (H <jats:sub>2</jats:sub> S) gas as a biomarker for periodontitis has been suggested, but the evidence remains inconclusive. This preliminary study aimed to explore the relationship between periodontitis, defined according to the 2018 classification by the American Academy of Periodontology and the European Federation of Periodontology and exhaled H <jats:sub>2</jats:sub> S gas in the Thai population. Methods In 2023, a cross‐sectional study was conducted involving 172 systemically healthy, non‐smoking individuals aged 18 years or older who were included from three healthcare centers, Chiang Mai, Thailand. Participants underwent interviews, oral and periodontal examinations, and exhaled H <jats:sub>2</jats:sub> S gas detection using an innovative LTCC‐GASSET device. H <jats:sub>2</jats:sub> S levels and periodontal status were analyzed statistically. Results H <jats:sub>2</jats:sub> S levels significantly increased in groups with periodontitis compared to those without, with the magnitude of the increase corresponding to the stage of periodontitis. This trend was particularly pronounced in the older group (≥41 years). Moderate positive linear correlations were observed between H <jats:sub>2</jats:sub> S levels and clinical periodontal parameters, with the strongest correlation found for clinical attachment loss (CAL). Multiple regression analysis confirmed significant associations between H <jats:sub>2</jats:sub> S levels, CAL, and periodontal probing depth, after adjusting for confounders. Additionally, a threshold of 177.5 ppb for H <jats:sub>2</jats:sub> S levels was found to differentiate severe periodontitis, with AUC, sensitivity, and specificity of 0.733, 0.722, and 0.720, respectively. Conclusions Exhaled H <jats:sub>2</jats:sub> S levels were associated with periodontitis severity in non‐smoking, systemically healthy individuals. Given its limitations, the LTCC‐GASSET device may have potential for non‐invasive detection of periodontitis. Plain Language Summary This study examined the association between periodontitis, diagnosed using the 2018 AAP/EFP classification, and exhaled hydrogen sulfide (H <jats:sub>2</jats:sub> S) levels in 172 non‐smoking, systemically healthy adults. H <jats:sub>2</jats:sub> S levels were measured with the LTCC‐GASSET device, revealing higher levels in individuals with periodontitis, especially in more severe cases. Older participants (aged ≥41 years) had higher H <jats:sub>2</jats:sub> S levels, particularly if they had periodontitis. The H <jats:sub>2</jats:sub> S cut‐off level appeared to help distinguish between severe and non‐severe periodontitis cases. Within the limitations of a cross‐sectional study, these findings suggest that H <jats:sub>2</jats:sub> S levels could be useful for identifying individuals at higher risk for periodontal disease.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"93 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Periodontitis (PD) occurring during orthodontic treatment may interfere with the bone remodeling process. This study investigated the impact of PD on bone remodeling during orthodontic tooth movement (OTM) and explored the potential role of C‐reactive protein (CRP) and the IL‐6/JAK2/STAT3 signaling pathway in this process. Methods Models for PD, OTM, and combined PD with OTM (PD+OTM) were created in Sprague–Dawley rats. Alveolar bone loss and activation of the CRP and IL‐6/JAK2/STAT3 signaling pathway in periodontal tissues were observed at 7‐ and 14‐ days post‐modeling. CRP knockout rats and local injection of the tyrosine kinase inhibitor AG490 used to downregulate the IL‐6/JAK2/STAT3 pathway were applied to verify their regulatory roles in bone remodeling during OTM in the presence of PD. Results Alveolar bone resorption was significantly higher in the PD+OTM group than in the PD and OTM groups. Histological analysis revealed increased osteoclast accumulation and a higher RANKL/OPG ratio in the PD+OTM group, along with elevated CRP expression and activation of the IL‐6/JAK2/STAT3 pathway. Both CRP knockout and AG490 treatment led to a reduction in osteoclasts and a decreased RANKL/OPG ratio in the PD+OTM model, as well as decreased expression of IL‐6/JAK2/STAT3‐related molecules. Conclusion PD during OTM impairs bone remodeling, enhancing osteoclastic activity. CRP interactive with IL‐6/JAK2/STAT3 expression in periodontal tissues during OTM, contributing to the imbalance in bone remodeling during OTM with PD. Plain language summary This study explored how periodontitis (PD) affects the way bone adjusts around teeth when the tooth is moving. Researchers used rats to mimic three situations: PD only, tooth movement only, and both conditions together. They found that when PD and tooth movement happened at the same time, it caused significantly more bone loss around the teeth than either condition alone. This was linked to more bone‐removing cells and changes in key signaling molecules in the periodontal tissue, specifically CRP and a pathway involving IL‐6, JAK2, and STAT3. Importantly, when the researchers either removed CRP or blocked the IL‐6/JAK2/STAT3 pathway, they saw less bone loss and fewer bone‐removing cells in the rats experiencing both PD and tooth movement. This shows that active PD disrupts healthy bone remodeling during orthodontic treatment, and that CRP and the IL‐6/JAK2/STAT3 pathway play a key role in causing this extra damage. The findings highlight why treating periodontal disease is crucial before or during tooth movement treatment and point to potential targets for protecting bone health in orthodontic patients with periodontal problems.
{"title":"C‐reactive protein interactive with IL‐6 mediates alveolar bone remodeling imbalance during orthodontic tooth movement with periodontitis","authors":"Qin Xue, Xuyang Zhang, Mei Hu, Yao He","doi":"10.1002/jper.70030","DOIUrl":"https://doi.org/10.1002/jper.70030","url":null,"abstract":"Background Periodontitis (PD) occurring during orthodontic treatment may interfere with the bone remodeling process. This study investigated the impact of PD on bone remodeling during orthodontic tooth movement (OTM) and explored the potential role of C‐reactive protein (CRP) and the IL‐6/JAK2/STAT3 signaling pathway in this process. Methods Models for PD, OTM, and combined PD with OTM (PD+OTM) were created in Sprague–Dawley rats. Alveolar bone loss and activation of the CRP and IL‐6/JAK2/STAT3 signaling pathway in periodontal tissues were observed at 7‐ and 14‐ days post‐modeling. CRP knockout rats and local injection of the tyrosine kinase inhibitor AG490 used to downregulate the IL‐6/JAK2/STAT3 pathway were applied to verify their regulatory roles in bone remodeling during OTM in the presence of PD. Results Alveolar bone resorption was significantly higher in the PD+OTM group than in the PD and OTM groups. Histological analysis revealed increased osteoclast accumulation and a higher RANKL/OPG ratio in the PD+OTM group, along with elevated CRP expression and activation of the IL‐6/JAK2/STAT3 pathway. Both CRP knockout and AG490 treatment led to a reduction in osteoclasts and a decreased RANKL/OPG ratio in the PD+OTM model, as well as decreased expression of IL‐6/JAK2/STAT3‐related molecules. Conclusion PD during OTM impairs bone remodeling, enhancing osteoclastic activity. CRP interactive with IL‐6/JAK2/STAT3 expression in periodontal tissues during OTM, contributing to the imbalance in bone remodeling during OTM with PD. Plain language summary This study explored how periodontitis (PD) affects the way bone adjusts around teeth when the tooth is moving. Researchers used rats to mimic three situations: PD only, tooth movement only, and both conditions together. They found that when PD and tooth movement happened at the same time, it caused significantly more bone loss around the teeth than either condition alone. This was linked to more bone‐removing cells and changes in key signaling molecules in the periodontal tissue, specifically CRP and a pathway involving IL‐6, JAK2, and STAT3. Importantly, when the researchers either removed CRP or blocked the IL‐6/JAK2/STAT3 pathway, they saw less bone loss and fewer bone‐removing cells in the rats experiencing both PD and tooth movement. This shows that active PD disrupts healthy bone remodeling during orthodontic treatment, and that CRP and the IL‐6/JAK2/STAT3 pathway play a key role in causing this extra damage. The findings highlight why treating periodontal disease is crucial before or during tooth movement treatment and point to potential targets for protecting bone health in orthodontic patients with periodontal problems.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"65 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Varkha Rattu, Tishani Patel, Jasmine Loke, Hari Petsos, Luigi Nibali
Background Periodontitis requires long‐term management to prevent recurrence and tooth loss. While active periodontal therapy (APT) aims to reduce probing pocket depth (PPD) and improve clinical attachment level (CAL), strict supportive periodontal care (SPC) is essential for maintaining these clinical outcomes. This study systematically reviewed the long‐term benefits of APT interventions (test groups) compared to standard control interventions (control groups) in patients undergoing SPC as part of randomized controlled trials (RCTs). Methods A systematic search of databases and journals identified RCTs with a minimum follow‐up of 10 years. Studies comparing APT interventions, such as regenerative techniques, to standard care in patients adhering to SPC were included. Primary outcomes assessed included tooth loss, and secondary outcomes included PPD reduction, CAL gain, and patient‐reported outcome measures (PROMs). Descriptive analyses were undertaken on all studies, and meta‐analyses were conducted to analyze the weighted mean differences (WMDs) for PPD, CAL, and tooth loss between test and control interventions when appropriate. Results From an initial screening of 4582 articles, 9 were deemed suitable and included for descriptive analyses. Four publications of 3 studies were included in meta‐analyses comparing guided tissue regeneration (GTR) and open flap debridement (OFD) over a 10‐to 20‐year SPC follow‐ups. Regenerative techniques demonstrated significant CAL gains at 1‐year follow‐up compared to control groups. At 10 to 20 years, PPD and CAL outcomes were comparable between groups. Tooth loss was minimal across all groups. Variability in SPC protocols and operator experience may have influenced outcomes. Conclusions Long‐term periodontal stability does not appear to be affected by the choice of initial intervention in patients who adhere to a rigorous SPC program. While regenerative techniques offer short‐term advantages, their long‐term benefits may reduce in comparison to non‐regenerative methods under SPC. Future research should focus on standardized SPC protocols and cost‐effectiveness to optimize periodontal care. Plain language summary Periodontitis is a chronic immune‐inflammatory condition that can lead to increased risk of tooth loss if not managed. Treatment such as non‐surgical periodontal therapy (NSPT), adjunctive therapies, or various surgeries can improve periodontal health. This systematic review examined randomized controlled trials (RCTs) where patients received different periodontal treatments and were then followed up for ≥10 years while attending maintenance visits. Periodontal surrogate and true endpoints were compared between the test and control groups. The findings suggest that long‐term outcomes were similar between groups, provided patients remained in consistent maintenance care. This highlights that the key to long‐term success is not necessarily which active treatment is used, but possibly the adherence to s
{"title":"Long‐term clinical benefits of periodontal interventions in strict supportive periodontal care: A systematic review","authors":"Varkha Rattu, Tishani Patel, Jasmine Loke, Hari Petsos, Luigi Nibali","doi":"10.1002/jper.70027","DOIUrl":"https://doi.org/10.1002/jper.70027","url":null,"abstract":"Background Periodontitis requires long‐term management to prevent recurrence and tooth loss. While active periodontal therapy (APT) aims to reduce probing pocket depth (PPD) and improve clinical attachment level (CAL), strict supportive periodontal care (SPC) is essential for maintaining these clinical outcomes. This study systematically reviewed the long‐term benefits of APT interventions (test groups) compared to standard control interventions (control groups) in patients undergoing SPC as part of randomized controlled trials (RCTs). Methods A systematic search of databases and journals identified RCTs with a minimum follow‐up of 10 years. Studies comparing APT interventions, such as regenerative techniques, to standard care in patients adhering to SPC were included. Primary outcomes assessed included tooth loss, and secondary outcomes included PPD reduction, CAL gain, and patient‐reported outcome measures (PROMs). Descriptive analyses were undertaken on all studies, and meta‐analyses were conducted to analyze the weighted mean differences (WMDs) for PPD, CAL, and tooth loss between test and control interventions when appropriate. Results From an initial screening of 4582 articles, 9 were deemed suitable and included for descriptive analyses. Four publications of 3 studies were included in meta‐analyses comparing guided tissue regeneration (GTR) and open flap debridement (OFD) over a 10‐to 20‐year SPC follow‐ups. Regenerative techniques demonstrated significant CAL gains at 1‐year follow‐up compared to control groups. At 10 to 20 years, PPD and CAL outcomes were comparable between groups. Tooth loss was minimal across all groups. Variability in SPC protocols and operator experience may have influenced outcomes. Conclusions Long‐term periodontal stability does not appear to be affected by the choice of initial intervention in patients who adhere to a rigorous SPC program. While regenerative techniques offer short‐term advantages, their long‐term benefits may reduce in comparison to non‐regenerative methods under SPC. Future research should focus on standardized SPC protocols and cost‐effectiveness to optimize periodontal care. Plain language summary Periodontitis is a chronic immune‐inflammatory condition that can lead to increased risk of tooth loss if not managed. Treatment such as non‐surgical periodontal therapy (NSPT), adjunctive therapies, or various surgeries can improve periodontal health. This systematic review examined randomized controlled trials (RCTs) where patients received different periodontal treatments and were then followed up for ≥10 years while attending maintenance visits. Periodontal surrogate and true endpoints were compared between the test and control groups. The findings suggest that long‐term outcomes were similar between groups, provided patients remained in consistent maintenance care. This highlights that the key to long‐term success is not necessarily which active treatment is used, but possibly the adherence to s","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"120 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUNDThis study investigated the association of inflammatory markers in saliva, plasma, and cerebrospinal fluid (CSF) with cognitive decline and periodontitis.METHODSPatients with Alzheimer disease (AD, n = 52), mild cognitive impairment (MCI, n = 51), subjective cognitive decline (SCD, n = 51), and controls (n = 76) between 50 and 80 years were included. Participants underwent an oral examination, and blood and stimulated saliva were collected. In addition, CSF samples were collected from patients but not controls. Levels of interleukin (IL)-1β, IL-8, IL-10, IL-17A, and tumor necrosis factor-alpha (TNF-α) were analyzed by multiplex immunoassays.RESULTSIncreased salivary levels of IL-1β, IL-10, and IL-17A were found in MCI compared to controls, while in plasma increased IL-8 levels were seen in all 3 patient groups compared to controls (p < 0.001). TNF-α plasma levels were higher in SCD and AD (p < 0.05). IL-17A levels in CSF were higher in participants with no/mild periodontitis compared to generalized periodontitis (p = 0.023). Participants with severe periodontitis showed higher levels of IL-8 both in saliva (p = 0.027) and plasma (p < 0.001), as well as higher TNF-α levels in plasma (p = 0.041).CONCLUSIONSInflammation markers could indicate an increased risk for cognitive decline, especially in cases of more severe periodontitis.PLAIN LANGUAGE SUMMARYEvidence has indicated an association between periodontitis and cognitive impairment. Hence, this study investigated whether inflammatory markers in saliva, plasma, and cerebrospinal fluid are associated with cognitive decline. Cases with mild or more severe signs of cognitive impairment had more signs of periodontal disease. Levels of some, but not all, inflammation markers were elevated among patients compared to cognitively healthy controls. Oral inflammation could indicate an increased risk for cognitive decline, and chronic inflammation may act as a common pathway. Early periodontal intervention and maintaining oral health may contribute to cognitive well-being.
本研究调查了唾液、血浆和脑脊液（CSF）中炎症标志物与认知能力下降和牙周炎的关系。方法纳入年龄在50 ~ 80岁的阿尔茨海默病（AD, n = 52）、轻度认知障碍（MCI, n = 51）、主观认知能力下降（SCD, n = 51）和对照组（n = 76）患者。参与者接受了口腔检查，并收集了血液和刺激唾液。此外，收集了患者的脑脊液样本，而不是对照组。采用多重免疫分析法分析白细胞介素(IL)-1β、IL-8、IL-10、IL- 17a和肿瘤坏死因子-α (TNF-α)的水平。结果与对照组相比，MCI患者唾液中IL-1β、IL-10和IL-17A水平均升高，血浆中IL-8水平均升高（p < 0.001）。SCD和AD患者血浆TNF-α水平较高（p < 0.05）。与全身性牙周炎患者相比，无/轻度牙周炎患者脑脊液中IL-17A水平较高（p = 0.023）。患有严重牙周炎的参与者在唾液（p = 0.027）和血浆（p < 0.001）中显示出较高的IL-8水平，以及血浆中较高的TNF-α水平（p = 0.041）。结论：炎症标志物可能表明认知能力下降的风险增加，特别是在牙周炎较严重的情况下。有证据表明牙周炎和认知障碍之间存在关联。因此，本研究调查了唾液、血浆和脑脊液中的炎症标志物是否与认知能力下降有关。轻度或更严重的认知障碍患者有更多的牙周病症状。与认知健康的对照组相比，患者中一些（但不是全部）炎症标志物的水平有所升高。口腔炎症可能表明认知能力下降的风险增加，而慢性炎症可能是一个常见的途径。早期牙周干预和保持口腔健康可能有助于认知健康。
{"title":"The association of periodontal inflammation and inflammatory markers with cognitive dysfunction: A case-control study.","authors":"Kåre Buhlin,Maria Eriksdotter,Leif Jansson,Pirkko J Pussinen,Marianne Schultzberg,Ronaldo Lira-Junior","doi":"10.1002/jper.70020","DOIUrl":"https://doi.org/10.1002/jper.70020","url":null,"abstract":"BACKGROUNDThis study investigated the association of inflammatory markers in saliva, plasma, and cerebrospinal fluid (CSF) with cognitive decline and periodontitis.METHODSPatients with Alzheimer disease (AD, n = 52), mild cognitive impairment (MCI, n = 51), subjective cognitive decline (SCD, n = 51), and controls (n = 76) between 50 and 80 years were included. Participants underwent an oral examination, and blood and stimulated saliva were collected. In addition, CSF samples were collected from patients but not controls. Levels of interleukin (IL)-1β, IL-8, IL-10, IL-17A, and tumor necrosis factor-alpha (TNF-α) were analyzed by multiplex immunoassays.RESULTSIncreased salivary levels of IL-1β, IL-10, and IL-17A were found in MCI compared to controls, while in plasma increased IL-8 levels were seen in all 3 patient groups compared to controls (p < 0.001). TNF-α plasma levels were higher in SCD and AD (p < 0.05). IL-17A levels in CSF were higher in participants with no/mild periodontitis compared to generalized periodontitis (p = 0.023). Participants with severe periodontitis showed higher levels of IL-8 both in saliva (p = 0.027) and plasma (p < 0.001), as well as higher TNF-α levels in plasma (p = 0.041).CONCLUSIONSInflammation markers could indicate an increased risk for cognitive decline, especially in cases of more severe periodontitis.PLAIN LANGUAGE SUMMARYEvidence has indicated an association between periodontitis and cognitive impairment. Hence, this study investigated whether inflammatory markers in saliva, plasma, and cerebrospinal fluid are associated with cognitive decline. Cases with mild or more severe signs of cognitive impairment had more signs of periodontal disease. Levels of some, but not all, inflammation markers were elevated among patients compared to cognitively healthy controls. Oral inflammation could indicate an increased risk for cognitive decline, and chronic inflammation may act as a common pathway. Early periodontal intervention and maintaining oral health may contribute to cognitive well-being.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"13 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaetano Isola, Marco Annunziata, Angela Angjelova, Angela Alibrandi, Gianluca Martino Tartaglia, Frank A. Scannapieco
Background A randomized, controlled trial was conducted to evaluate the effectiveness of two supportive periodontal care (SPC) approaches in patients with periodontitis and to evaluate possible predictors influencing bleeding on probing (BoP) changes at 24‐month follow‐up. Methods Fifty‐six periodontitis patients who first received active periodontal treatment by means of quadrant‐wise subgingival instrumentation were subsequently assigned to either a control group (oral hygiene instruction with supragingival instrumentation and dental polishing, <jats:italic>n</jats:italic> = 28) or a test group (oral hygiene instruction with both supra‐ and subgingival instrumentation and dental polishing, <jats:italic>n</jats:italic> = 28). BoP was the primary outcome, and probing pocket depth (PPD), clinical attachment level (CAL), full‐mouth plaque score (FMPS), gingival bleeding index (GBI), and the number of pocket sites were secondary outcome measures, recorded up to 24 months of follow‐up. A mixed generalized linear regression analysis also assessed the potential confounding factors that influenced BoP changes at 24 months. Results At 24 months, both groups showed significant improvement in periodontal outcomes ( <jats:italic>p</jats:italic> < 0.05). The test intervention was more effective than the control in reducing median BoP ( <jats:italic>p</jats:italic> = 0.033), GBI ( <jats:italic>p</jats:italic> = 0.023), the number of pockets ≥4 mm with BoP ( <jats:italic>p</jats:italic> = 0.018), 4–5 mm ( <jats:italic>p</jats:italic> = 0.048), 5–6 mm ( <jats:italic>p</jats:italic> = 0.011), and >6 mm ( <jats:italic>p</jats:italic> = 0.023). Among all follow‐up sessions, the reduced BoP was significantly negatively influenced by the number of median PPD ( <jats:italic>p</jats:italic> = 0.031), the number of pockets 4–5 mm ( <jats:italic>p</jats:italic> = 0.029), PPD 5–6 mm ( <jats:italic>p</jats:italic> = 0.036), smoking ( <jats:italic>p</jats:italic> = 0.039), and by the number of cigarettes/day ( <jats:italic>p</jats:italic> = 0.042) and positively by test treatment ( <jats:italic>p</jats:italic> = 0.033). Conclusion SPC that included subgingival instrumentation yielded better results than the control to reduce BoP at 24‐month follow‐up. Smoking and deep pockets negatively influenced the BoP reduction in patients who underwent SPC. Plain Language Summary Supportive periodontal care (SPC) is a series of individualized, site‐specific treatments aimed at preventing periodontitis recurrence/progression after successful completion of active periodontal therapy. SPC approaches performed by means of oral hygiene instruction with supra‐ and subgingival instrumentation and dental polishing (test group) compared to oral hygiene with supragingival instrumentation alone and dental polishing (control group) were both effective in reducing median periodontal outcomes, such as bleeding on probing (BoP), probing pocket depth (PPD), clinical attachment level (CAL), and
{"title":"Effectiveness of two supportive periodontal care protocols and outcome predictors during periodontitis: A randomized controlled trial","authors":"Gaetano Isola, Marco Annunziata, Angela Angjelova, Angela Alibrandi, Gianluca Martino Tartaglia, Frank A. Scannapieco","doi":"10.1002/jper.70007","DOIUrl":"https://doi.org/10.1002/jper.70007","url":null,"abstract":"Background A randomized, controlled trial was conducted to evaluate the effectiveness of two supportive periodontal care (SPC) approaches in patients with periodontitis and to evaluate possible predictors influencing bleeding on probing (BoP) changes at 24‐month follow‐up. Methods Fifty‐six periodontitis patients who first received active periodontal treatment by means of quadrant‐wise subgingival instrumentation were subsequently assigned to either a control group (oral hygiene instruction with supragingival instrumentation and dental polishing, <jats:italic>n</jats:italic> = 28) or a test group (oral hygiene instruction with both supra‐ and subgingival instrumentation and dental polishing, <jats:italic>n</jats:italic> = 28). BoP was the primary outcome, and probing pocket depth (PPD), clinical attachment level (CAL), full‐mouth plaque score (FMPS), gingival bleeding index (GBI), and the number of pocket sites were secondary outcome measures, recorded up to 24 months of follow‐up. A mixed generalized linear regression analysis also assessed the potential confounding factors that influenced BoP changes at 24 months. Results At 24 months, both groups showed significant improvement in periodontal outcomes ( <jats:italic>p</jats:italic> < 0.05). The test intervention was more effective than the control in reducing median BoP ( <jats:italic>p</jats:italic> = 0.033), GBI ( <jats:italic>p</jats:italic> = 0.023), the number of pockets ≥4 mm with BoP ( <jats:italic>p</jats:italic> = 0.018), 4–5 mm ( <jats:italic>p</jats:italic> = 0.048), 5–6 mm ( <jats:italic>p</jats:italic> = 0.011), and >6 mm ( <jats:italic>p</jats:italic> = 0.023). Among all follow‐up sessions, the reduced BoP was significantly negatively influenced by the number of median PPD ( <jats:italic>p</jats:italic> = 0.031), the number of pockets 4–5 mm ( <jats:italic>p</jats:italic> = 0.029), PPD 5–6 mm ( <jats:italic>p</jats:italic> = 0.036), smoking ( <jats:italic>p</jats:italic> = 0.039), and by the number of cigarettes/day ( <jats:italic>p</jats:italic> = 0.042) and positively by test treatment ( <jats:italic>p</jats:italic> = 0.033). Conclusion SPC that included subgingival instrumentation yielded better results than the control to reduce BoP at 24‐month follow‐up. Smoking and deep pockets negatively influenced the BoP reduction in patients who underwent SPC. Plain Language Summary Supportive periodontal care (SPC) is a series of individualized, site‐specific treatments aimed at preventing periodontitis recurrence/progression after successful completion of active periodontal therapy. SPC approaches performed by means of oral hygiene instruction with supra‐ and subgingival instrumentation and dental polishing (test group) compared to oral hygiene with supragingival instrumentation alone and dental polishing (control group) were both effective in reducing median periodontal outcomes, such as bleeding on probing (BoP), probing pocket depth (PPD), clinical attachment level (CAL), and ","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"91 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Patients with periodontitis can exhibit persistent periodontal pockets with bleeding representative of inflammation. This clinical study aimed to evaluate the effectiveness of a chitosan brush in improving residual periodontal pockets in patients who had already undergone causative therapy for periodontitis. Methods Thirty‐six patients with stage III or IV periodontitis, showing residual pockets that bled on probing, were randomly assigned to 2 groups. The test group received debridement using both an ultrasonic scaler and a chitosan brush, while the control group received only ultrasonic scaling. Clinical parameters—probing pocket depth (PPD), clinical attachment level (CAL), recession (REC), and bleeding on probing (BoP)—were assessed at baseline, 6 weeks, 3 months, and 6 months posttreatment. Gingival crevicular fluid (GCF) was also collected to measure matrix metalloproteinase‐8 (MMP‐8) levels, a marker of inflammation. Results Results showed significant improvements in clinical parameters over time in both groups. Probing depth and clinical attachment loss significantly improved from baseline to 3 months, with slight increases observed from 3 to 6 months. However, no significant differences between groups were found in these parameters. Gingival recession increased in both groups, with no group difference. BoP improved gradually in the test group, while in the control group, it initially decreased but increased again by 6 months, with a significant difference between groups at 6 months ( p = 0.007). MMP‐8 levels decreased in both groups from baseline to 3 months but increased thereafter, with no significant difference between groups. Conclusion In conclusion, the chitosan brush, when added to mechanical debridement, led to better improvement in BoP compared to ultrasonic scaling alone, but did not show superior results for other clinical parameters or MMP‐8 levels. Clinical Trial Registration The trial is registered at the US National Library of Medicine ClinicalTrials.gov (NCT06127069). Plain Language Summary After periodontal therapy, patients with periodontitis may still have persistent periodontal pockets with bleeding on probing, indicating ongoing inflammation. However, retreating these pockets can be unpredictable. This study investigated the effectiveness of a new chitosan brush for treating these pockets. Results showed that its use did not improve all clinical parameters, but significantly reduced bleeding—indicating less inflammation—at the treated sites 6 months after therapy. The absence of bleeding is crucial in preventing disease progression. Maintaining clinically healthy sites during the maintenance phase is essential for long‐term positive outcomes and helps reduce the risk of further gum disease progression.
{"title":"Management of residual periodontal pockets using an oscillating chitosan device: A randomized clinical trial","authors":"Georgia Tseleki, Leonidas Batas, Sotiria Davidopoulou, Johan Caspar Wohlfahrt, Georgios Menexes, Lazaros Tsalikis","doi":"10.1002/jper.70010","DOIUrl":"https://doi.org/10.1002/jper.70010","url":null,"abstract":"Background Patients with periodontitis can exhibit persistent periodontal pockets with bleeding representative of inflammation. This clinical study aimed to evaluate the effectiveness of a chitosan brush in improving residual periodontal pockets in patients who had already undergone causative therapy for periodontitis. Methods Thirty‐six patients with stage III or IV periodontitis, showing residual pockets that bled on probing, were randomly assigned to 2 groups. The test group received debridement using both an ultrasonic scaler and a chitosan brush, while the control group received only ultrasonic scaling. Clinical parameters—probing pocket depth (PPD), clinical attachment level (CAL), recession (REC), and bleeding on probing (BoP)—were assessed at baseline, 6 weeks, 3 months, and 6 months posttreatment. Gingival crevicular fluid (GCF) was also collected to measure matrix metalloproteinase‐8 (MMP‐8) levels, a marker of inflammation. Results Results showed significant improvements in clinical parameters over time in both groups. Probing depth and clinical attachment loss significantly improved from baseline to 3 months, with slight increases observed from 3 to 6 months. However, no significant differences between groups were found in these parameters. Gingival recession increased in both groups, with no group difference. BoP improved gradually in the test group, while in the control group, it initially decreased but increased again by 6 months, with a significant difference between groups at 6 months ( <jats:italic>p</jats:italic> = 0.007). MMP‐8 levels decreased in both groups from baseline to 3 months but increased thereafter, with no significant difference between groups. Conclusion In conclusion, the chitosan brush, when added to mechanical debridement, led to better improvement in BoP compared to ultrasonic scaling alone, but did not show superior results for other clinical parameters or MMP‐8 levels. Clinical Trial Registration The trial is registered at the US National Library of Medicine ClinicalTrials.gov (NCT06127069). Plain Language Summary After periodontal therapy, patients with periodontitis may still have persistent periodontal pockets with bleeding on probing, indicating ongoing inflammation. However, retreating these pockets can be unpredictable. This study investigated the effectiveness of a new chitosan brush for treating these pockets. Results showed that its use did not improve all clinical parameters, but significantly reduced bleeding—indicating less inflammation—at the treated sites 6 months after therapy. The absence of bleeding is crucial in preventing disease progression. Maintaining clinically healthy sites during the maintenance phase is essential for long‐term positive outcomes and helps reduce the risk of further gum disease progression.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"28 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Numerous studies have reported an association between depression and periodontitis, though results are inconsistent and highly heterogeneous. The present study aimed to examine the potential confounding role of poor socioeconomic status (SES) in the association between depression and periodontitis by performing a secondary analysis of the National Health and Nutrition Examination Survey (NHANES) data. Methods Among participants of the 2009–2014 NHANES cycles, those who fulfilled sociodemographic (education level, household income, ethnicity, marital status), medical, and depression questionnaires, and underwent full‐mouth periodontal examination were selected. Periodontitis (mild, moderate, and severe) was assessed based on the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) criteria. Depression was defined by a Patient Health Questionnaire (PHQ‐9) total score ≥10. Weighted multivariable regressions for complex design models were used to assess the association between periodontitis and depression accounting for the role of SES. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were provided. Results Among 9537 participants [mean age: 51.9 years (SD: 14.1), 50.1% females], 4768 (41.2%) and 830 (7.3%) presented with periodontitis and depression, respectively. Depression was significantly associated with periodontitis (weighted OR [95% CI]: 1.26 [1.01–1.56]). However, this association was no longer significant when adjusting for SES indicators (0.94 [0.75–1.18]), especially poverty (91.4% of OR reduction when adjusting for poverty only). Conclusion The association between depression and periodontitis may largely be explained by SES, which should thus be considered at both the population‐ and individual levels in preventive and management strategies. Plain Language Summary Depression and periodontitis are two common health problems, and some studies suggest they might be linked. But could this connection actually be due to other factors, like low income or education levels? To find out, we analyzed data from a national US health survey involving over 9500 adults who answered questions about their mental health, income, education, and lifestyle, and who also underwent a full‐mouth periodontal examination. We found that depression and periodontitis appeared to be connected at first glance. However, when we considered socioeconomic factors—especially low income—the link between the two disappeared. This suggests that financial challenges and limited access to resources might play a bigger role than previously thought. Our findings highlight the need for health professionals to look beyond individual conditions and consider a person's broader life circumstances when providing care. At a public health level, addressing social inequalities could help improve both mental and oral health outcomes.
{"title":"Cross‐sectional analysis of role of socioeconomic status in the association between depression and periodontitis","authors":"Sébastien Jungo, Violaine Smail‐Faugeron, Dominique Guez, Nicolas Hoertel, Cédric Lemogne, Maria‐Clotilde Carra","doi":"10.1002/jper.70012","DOIUrl":"https://doi.org/10.1002/jper.70012","url":null,"abstract":"Background Numerous studies have reported an association between depression and periodontitis, though results are inconsistent and highly heterogeneous. The present study aimed to examine the potential confounding role of poor socioeconomic status (SES) in the association between depression and periodontitis by performing a secondary analysis of the National Health and Nutrition Examination Survey (NHANES) data. Methods Among participants of the 2009–2014 NHANES cycles, those who fulfilled sociodemographic (education level, household income, ethnicity, marital status), medical, and depression questionnaires, and underwent full‐mouth periodontal examination were selected. Periodontitis (mild, moderate, and severe) was assessed based on the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP) criteria. Depression was defined by a Patient Health Questionnaire (PHQ‐9) total score ≥10. Weighted multivariable regressions for complex design models were used to assess the association between periodontitis and depression accounting for the role of SES. Adjusted odds ratio (OR) with 95% confidence intervals (CIs) were provided. Results Among 9537 participants [mean age: 51.9 years (SD: 14.1), 50.1% females], 4768 (41.2%) and 830 (7.3%) presented with periodontitis and depression, respectively. Depression was significantly associated with periodontitis (weighted OR [95% CI]: 1.26 [1.01–1.56]). However, this association was no longer significant when adjusting for SES indicators (0.94 [0.75–1.18]), especially poverty (91.4% of OR reduction when adjusting for poverty only). Conclusion The association between depression and periodontitis may largely be explained by SES, which should thus be considered at both the population‐ and individual levels in preventive and management strategies. Plain Language Summary Depression and periodontitis are two common health problems, and some studies suggest they might be linked. But could this connection actually be due to other factors, like low income or education levels? To find out, we analyzed data from a national US health survey involving over 9500 adults who answered questions about their mental health, income, education, and lifestyle, and who also underwent a full‐mouth periodontal examination. We found that depression and periodontitis appeared to be connected at first glance. However, when we considered socioeconomic factors—especially low income—the link between the two disappeared. This suggests that financial challenges and limited access to resources might play a bigger role than previously thought. Our findings highlight the need for health professionals to look beyond individual conditions and consider a person's broader life circumstances when providing care. At a public health level, addressing social inequalities could help improve both mental and oral health outcomes.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"77 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karina Mendes,Ana T P C Gomes,Dimitris N Tatakis,Tiago Marques,Marla Pinto,Pedro C Lopes,Maria J Correia,Nuno Rosa
BACKGROUNDThe identification of molecular biomarkers that help clinicians in early diagnosis is a key focus of periodontal research. The major aim of this cross-sectional observational study was to assess whether salivary TAM pathway protein levels have the potential to discriminate between periodontally healthy or gingivitis controls and periodontitis patients, including those with mild (I/II) or severe (III/IV) disease.METHODSTwenty-five periodontally healthy, 24 gingivitis, and 51 periodontitis patients further stratified into mild (stages I/II, n = 25) or severe (stages III/IV, n = 26) periodontitis were included. Salivary levels of tyrosine-protein kinase receptor UFO (AXL), TYRO3 protein tyrosine kinase (TYRO3), Proto-oncogene tyrosine-protein kinase MER (MERTK), and growth arrest-specific protein 6 (GAS6) were quantified using a multiplex immunoassay approach.RESULTSSalivary AXL, TYRO3, MERTK, and GAS6 levels were significantly elevated in periodontitis compared to periodontally healthy and gingivitis patients. Similar results for each periodontitis severity subgroup compared to control groups (except for MERTK, which was significantly different only for stage III/IV) were obtained. Supporting these findings, AXL, TYRO3, and GAS6 were the most accurate in differentiating between periodontally healthy/gingivitis and periodontitis, including mild or severe periodontitis (area under the curve [AUC] ranging from 0.72 to 0.89). Overall, combining biomarkers enhanced the predictive value for identifying periodontitis, including mild and severe disease, compared to using individual biomarkers alone (AUC values between 0.81 and 0.91).CONCLUSIONSalivary TAM pathway markers show promise as a potential noninvasive diagnostic screening tool to distinguish between controls (healthy/gingivitis) and periodontitis, including mild or severe periodontitis.PLAIN LANGUAGE SUMMARYSalivary TAM pathway biomarkers can distinguish between periodontally healthy/gingivitis and periodontitis patients, including mild or severe periodontitis.
{"title":"TAM pathway proteins as novel salivary biomarkers for periodontitis.","authors":"Karina Mendes,Ana T P C Gomes,Dimitris N Tatakis,Tiago Marques,Marla Pinto,Pedro C Lopes,Maria J Correia,Nuno Rosa","doi":"10.1002/jper.70021","DOIUrl":"https://doi.org/10.1002/jper.70021","url":null,"abstract":"BACKGROUNDThe identification of molecular biomarkers that help clinicians in early diagnosis is a key focus of periodontal research. The major aim of this cross-sectional observational study was to assess whether salivary TAM pathway protein levels have the potential to discriminate between periodontally healthy or gingivitis controls and periodontitis patients, including those with mild (I/II) or severe (III/IV) disease.METHODSTwenty-five periodontally healthy, 24 gingivitis, and 51 periodontitis patients further stratified into mild (stages I/II, n = 25) or severe (stages III/IV, n = 26) periodontitis were included. Salivary levels of tyrosine-protein kinase receptor UFO (AXL), TYRO3 protein tyrosine kinase (TYRO3), Proto-oncogene tyrosine-protein kinase MER (MERTK), and growth arrest-specific protein 6 (GAS6) were quantified using a multiplex immunoassay approach.RESULTSSalivary AXL, TYRO3, MERTK, and GAS6 levels were significantly elevated in periodontitis compared to periodontally healthy and gingivitis patients. Similar results for each periodontitis severity subgroup compared to control groups (except for MERTK, which was significantly different only for stage III/IV) were obtained. Supporting these findings, AXL, TYRO3, and GAS6 were the most accurate in differentiating between periodontally healthy/gingivitis and periodontitis, including mild or severe periodontitis (area under the curve [AUC] ranging from 0.72 to 0.89). Overall, combining biomarkers enhanced the predictive value for identifying periodontitis, including mild and severe disease, compared to using individual biomarkers alone (AUC values between 0.81 and 0.91).CONCLUSIONSalivary TAM pathway markers show promise as a potential noninvasive diagnostic screening tool to distinguish between controls (healthy/gingivitis) and periodontitis, including mild or severe periodontitis.PLAIN LANGUAGE SUMMARYSalivary TAM pathway biomarkers can distinguish between periodontally healthy/gingivitis and periodontitis patients, including mild or severe periodontitis.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"61 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：