BACKGROUNDAccumulation of senescent cells is increasingly recognized as a mechanism of aging and is considered an attractive therapeutic target for various age-associated diseases. The prevalence and severity of periodontitis increase with age, and preclinical studies have demonstrated that senescent cells could be a potential therapeutic target for age-associated periodontitis. However, clinical data linking cellular senescence and periodontitis are limited.METHODSGingival tissues affected with periodontitis and healthy controls were collected from patients with or without periodontitis in a cross-sectional study. RNA isolated from these samples was analyzed for senescence gene expression by quantitative polymerase chain reaction (qPCR) assays. The associations of the gene expression levels with periodontal diagnosis, presence or absence of attachment loss or bleeding on probing, and age were examined. Additionally, we analyzed the expression of senescence genes in the gingival tissues of mice with or without ligature-induced periodontitis.RESULTSA total of 54 human gingival tissue samples were included in the study. Among the genes analyzed, p16, TP53, MMP2, and MMP14 exhibited significantly higher expression in the periodontitis group compared to the control group. Furthermore, these genes were associated with clinical signs of periodontitis, such as bleeding score and attachment loss at diagnosis. There were no statistically significant positive correlations between gene expression levels and age. The ligature-induced periodontitis significantly increased expression levels of p16 and other senescence genes in mouse gingival tissues.CONCLUSIONGene expression analysis indicates the accumulation of senescent cells in gingival tissue affected with periodontitis, supporting the concept that senotherapeutics could be effective in treating periodontitis.PLAIN LANGUAGE SUMMARYBiological stressors cause cells to age, known as cellular senescence. These senescent cells play a significant role in age-related diseases and are considered a key target for treatment. Periodontitis, a gum disease, damages the tissues that support teeth and is a leading cause of tooth loss worldwide. When people get older, they have a higher chance of being affected by periodontitis. Studies using animal models have shown that the accumulation of senescent cells may be driving periodontitis in older individuals. Therefore, targeting senescent cells may be a potential treatment approach for periodontitis. However, clinical evidence showing the accumulation of senescent cells in gum tissue affected with periodontitis is limited. This study aimed to investigate whether periodontitis is accompanied by senescent cell accumulation in the gum tissue by examining gene expression in tissues with and without periodontitis. A total of 54 human gum tissues (27 healthy and 27 diseased) were collected during gum surgeries. Our analysis found that four genes related to cellular senescence (
{"title":"Upregulation of senescence-associated gene expression levels in human gingival tissue affected by periodontitis.","authors":"Su Jung Kim,Chandni Batra,Hiroki Yoshii,Yusuke Hamada,Yasuyoshi Ueki,George J Eckert,Vanchit John,Mizuho Kittaka","doi":"10.1002/jper.11393","DOIUrl":"https://doi.org/10.1002/jper.11393","url":null,"abstract":"BACKGROUNDAccumulation of senescent cells is increasingly recognized as a mechanism of aging and is considered an attractive therapeutic target for various age-associated diseases. The prevalence and severity of periodontitis increase with age, and preclinical studies have demonstrated that senescent cells could be a potential therapeutic target for age-associated periodontitis. However, clinical data linking cellular senescence and periodontitis are limited.METHODSGingival tissues affected with periodontitis and healthy controls were collected from patients with or without periodontitis in a cross-sectional study. RNA isolated from these samples was analyzed for senescence gene expression by quantitative polymerase chain reaction (qPCR) assays. The associations of the gene expression levels with periodontal diagnosis, presence or absence of attachment loss or bleeding on probing, and age were examined. Additionally, we analyzed the expression of senescence genes in the gingival tissues of mice with or without ligature-induced periodontitis.RESULTSA total of 54 human gingival tissue samples were included in the study. Among the genes analyzed, p16, TP53, MMP2, and MMP14 exhibited significantly higher expression in the periodontitis group compared to the control group. Furthermore, these genes were associated with clinical signs of periodontitis, such as bleeding score and attachment loss at diagnosis. There were no statistically significant positive correlations between gene expression levels and age. The ligature-induced periodontitis significantly increased expression levels of p16 and other senescence genes in mouse gingival tissues.CONCLUSIONGene expression analysis indicates the accumulation of senescent cells in gingival tissue affected with periodontitis, supporting the concept that senotherapeutics could be effective in treating periodontitis.PLAIN LANGUAGE SUMMARYBiological stressors cause cells to age, known as cellular senescence. These senescent cells play a significant role in age-related diseases and are considered a key target for treatment. Periodontitis, a gum disease, damages the tissues that support teeth and is a leading cause of tooth loss worldwide. When people get older, they have a higher chance of being affected by periodontitis. Studies using animal models have shown that the accumulation of senescent cells may be driving periodontitis in older individuals. Therefore, targeting senescent cells may be a potential treatment approach for periodontitis. However, clinical evidence showing the accumulation of senescent cells in gum tissue affected with periodontitis is limited. This study aimed to investigate whether periodontitis is accompanied by senescent cell accumulation in the gum tissue by examining gene expression in tissues with and without periodontitis. A total of 54 human gum tissues (27 healthy and 27 diseased) were collected during gum surgeries. Our analysis found that four genes related to cellular senescence (","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"6 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305626","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}
Verbênia Silva Conceição, Isaac Suzart Gomes‐Filho, Simone Seixas da Cruz, Michelle Santana Xavier Ramos, Ana Claudia Morais Godoy Figueiredo, Soraya Castro Trindade, Daiane Silva Sampaio, Maria Clara Azevedo Moreira, Eneida de Moraes Marcílio Cerqueira, Josicélia Estrela Tuy Batista, Alexandre Marcelo Hintz, Gregory John Seymour, Frank Andrew Scannapieco, Peter Michael Loomer, Johelle de Santana Passos‐Soares
BackgroundThis study investigates how poor oral health impacts metabolic alterations, specifically evaluating the effects of periodontitis and tooth loss, either individually or in combination, on the number of metabolic syndrome (MetS) indicators.MethodsA cross‐sectional study was conducted with 1281 individuals aged 18 and older, attending public health clinics. Physical exams and laboratory tests were performed to diagnose and determine MetS indicators as defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP‐ATP III) and the Joint Interim Statement (JIS). Oral exams assessed tooth loss and periodontitis severity. Multinomial regression analysis was used, and adjusted prevalence ratios (PRadjusted) with 95% confidence intervals (95%CI) were calculated.ResultsMetS prevalence ranged 32.3–40.7%. Periodontitis distribution was no (n = 202), mild (stage I; n = 7), moderate (stage II; n = 649), severe (stage III/IV; n = 412). Multinomial regression models revealed that periodontitis occurrence and severity, along with tooth loss, were independently associated with MetS, with stronger associations in individuals with 4 to 5 negative metabolic indicators (PRadjusted for periodontitis = 2,09; [95%CI:1.20–3.67]; PRadjusted for severe periodontitis = 2.11; [95%CI:1.04–4.29]; PRadjusted for tooth loss = 2.13; [95%CI:1.38–3.28]). The combined effect of periodontitis and tooth loss significantly increased the likelihood of having 4 to 5 MetS indicators (PRadjusted = 3.59; [95%CI:1.47–8.78]; PRadjusted = 5.58; [95%CI:2.45–12.75] for NCEP‐ATP III and JIS criteria, respectively).ConclusionsPeriodontitis and tooth loss are positively associated with MetS, with stronger associations observed in individuals with more severe metabolic alterations. The combined presence of these oral conditions increases the likelihood of greater metabolic impairment.Plain Language SummaryThis study examines the impact of poor oral health on metabolic syndrome (MetS). It finds that both periodontitis and tooth loss are associated with a higher number of MetS indicators. These associations are particularly stronger in individuals with more severe metabolic alterations. Additionally, individuals with both periodontitis and tooth loss are more likely to exhibit metabolic dysfunctions, including hypertension, hyperglycemia, obesity, and dyslipidemia. This highlights the critical need for integrated care addressing both periodontal and metabolic health in clinical practice.
{"title":"Relationships between periodontitis, tooth loss, and metabolic syndrome indicators","authors":"Verbênia Silva Conceição, Isaac Suzart Gomes‐Filho, Simone Seixas da Cruz, Michelle Santana Xavier Ramos, Ana Claudia Morais Godoy Figueiredo, Soraya Castro Trindade, Daiane Silva Sampaio, Maria Clara Azevedo Moreira, Eneida de Moraes Marcílio Cerqueira, Josicélia Estrela Tuy Batista, Alexandre Marcelo Hintz, Gregory John Seymour, Frank Andrew Scannapieco, Peter Michael Loomer, Johelle de Santana Passos‐Soares","doi":"10.1002/jper.70022","DOIUrl":"https://doi.org/10.1002/jper.70022","url":null,"abstract":"BackgroundThis study investigates how poor oral health impacts metabolic alterations, specifically evaluating the effects of periodontitis and tooth loss, either individually or in combination, on the number of metabolic syndrome (MetS) indicators.MethodsA cross‐sectional study was conducted with 1281 individuals aged 18 and older, attending public health clinics. Physical exams and laboratory tests were performed to diagnose and determine MetS indicators as defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP‐ATP III) and the Joint Interim Statement (JIS). Oral exams assessed tooth loss and periodontitis severity. Multinomial regression analysis was used, and adjusted prevalence ratios (PR<jats:sub>adjusted</jats:sub>) with 95% confidence intervals (95%CI) were calculated.ResultsMetS prevalence ranged 32.3–40.7%. Periodontitis distribution was no (<jats:italic>n</jats:italic> = 202), mild (stage I; <jats:italic>n</jats:italic> = 7), moderate (stage II; <jats:italic>n</jats:italic> = 649), severe (stage III/IV; <jats:italic>n</jats:italic> = 412). Multinomial regression models revealed that periodontitis occurrence and severity, along with tooth loss, were independently associated with MetS, with stronger associations in individuals with 4 to 5 negative metabolic indicators (PR<jats:sub>adjusted</jats:sub> for periodontitis = 2,09; [95%CI:1.20–3.67]; PR<jats:sub>adjusted</jats:sub> for severe periodontitis = 2.11; [95%CI:1.04–4.29]; PR<jats:sub>adjusted</jats:sub> for tooth loss = 2.13; [95%CI:1.38–3.28]). The combined effect of periodontitis and tooth loss significantly increased the likelihood of having 4 to 5 MetS indicators (PR<jats:sub>adjusted</jats:sub> = 3.59; [95%CI:1.47–8.78]; PR<jats:sub>adjusted</jats:sub> = 5.58; [95%CI:2.45–12.75] for NCEP‐ATP III and JIS criteria, respectively).ConclusionsPeriodontitis and tooth loss are positively associated with MetS, with stronger associations observed in individuals with more severe metabolic alterations. The combined presence of these oral conditions increases the likelihood of greater metabolic impairment.Plain Language SummaryThis study examines the impact of poor oral health on metabolic syndrome (MetS). It finds that both periodontitis and tooth loss are associated with a higher number of MetS indicators. These associations are particularly stronger in individuals with more severe metabolic alterations. Additionally, individuals with both periodontitis and tooth loss are more likely to exhibit metabolic dysfunctions, including hypertension, hyperglycemia, obesity, and dyslipidemia. This highlights the critical need for integrated care addressing both periodontal and metabolic health in clinical practice.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"13 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145311259","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}
Maliha Shahbaz, Anis Rageh Al‐Maleki, Chia Wei Cheah, Jazli Aziz, Karuthan Chinna, Peter Mark Bartold, Rathna Devi Vaithilingam
BackgroundThe association between periodontitis (PD) and rheumatoid arthritis (RA) has been linked to autoantibodies. In recent years, Arg‐gingipain (Rgp) triggered myeloperoxidase (MPO) release, which mediates protein carbamylation to form anti‐carbamylated proteins (anti‐CarP), perpetuating RA progression has gained interest. This study assessed the association between Rgp with MPO and anti‐CarP in pre‐clinical RA (preRA), early RA (eRA), and established RA (RA) participants with PD.MethodsA total of 108 participants were categorized into preRA, eRA, RA, and nonRA controls with and without PD. Periodontal and rheumatological parameters were assessed. <jats:italic>Rgp‐B</jats:italic> gene expression from subgingival plaque and MPO and anti‐CarP in saliva and serum were assessed. Data were analyzed with SPSS Version 26.Results<jats:italic>Rgp‐B</jats:italic> gene expressions were similar across PD groups. In eRA‐PD, serum and saliva MPO and saliva anti‐CarP levels were highest; strong correlations were present between <jats:italic>rgp‐B</jats:italic> with clinical attachment loss (CAL) (<jats:italic>r</jats:italic> = 0.783), salivary MPO with visible plaque index (VPI) (<jats:italic>r</jats:italic> = 0.667), and gingival bleeding index (GBI) (<jats:italic>r</jats:italic> = 0.767), and salivary anti‐CarP with CAL (<jats:italic>r</jats:italic> = 0.667) and GBI (<jats:italic>r</jats:italic> = 0.850). Strong positive correlations were detected between salivary MPO and anti‐CarP in preRA‐PD (<jats:italic>r</jats:italic> = 0.903), eRA‐PD (<jats:italic>r </jats:italic>= 0.783), RA‐PD (<jats:italic>r</jats:italic> = 0.726), and nonRA‐PD (<jats:italic>r </jats:italic>= 0.470).Conclusion<jats:italic>Rgp‐B</jats:italic> gene expression was associated with PD status. Periodontal inflammation, particularly in early RA, was linked to elevated MPO and anti‐CarP levels, suggesting that local inflammation may amplify immune responses via MPO‐mediated carbamylation. These associations highlight the clinical relevance of periodontal assessment and management in RA patients and at‐risk individuals.Plain Language SummaryPeriodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory diseases that may be linked through immune system activity. Studies suggest RA can begin developing before symptoms appear (preRA), with early immune changes occurring in the body. One possible trigger is the occurrence of myeloperoxidase (MPO)‐mediated carbamylation in the inflamed periodontium during the earliest phases of RA, which may precede the occurrence of autoantibodies, particularly anti‐carbamylated proteins (anti‐CarP). To date, these changes due to PD at different stages of RA have not been studied. This study investigated whether the <jats:italic>Porphyromonas gingivalis</jats:italic> enzyme, Arg‐gingipain (Rgp) is linked to MPO and anti‐CarP levels in individuals at different stages of RA. A total of 108 participants were recruited for this study, including preRA,
{"title":"Arg‐gingipain, myeloperoxidase, and anti‐CarP across the rheumatoid arthritis spectrum","authors":"Maliha Shahbaz, Anis Rageh Al‐Maleki, Chia Wei Cheah, Jazli Aziz, Karuthan Chinna, Peter Mark Bartold, Rathna Devi Vaithilingam","doi":"10.1002/jper.70009","DOIUrl":"https://doi.org/10.1002/jper.70009","url":null,"abstract":"BackgroundThe association between periodontitis (PD) and rheumatoid arthritis (RA) has been linked to autoantibodies. In recent years, Arg‐gingipain (Rgp) triggered myeloperoxidase (MPO) release, which mediates protein carbamylation to form anti‐carbamylated proteins (anti‐CarP), perpetuating RA progression has gained interest. This study assessed the association between Rgp with MPO and anti‐CarP in pre‐clinical RA (preRA), early RA (eRA), and established RA (RA) participants with PD.MethodsA total of 108 participants were categorized into preRA, eRA, RA, and nonRA controls with and without PD. Periodontal and rheumatological parameters were assessed. <jats:italic>Rgp‐B</jats:italic> gene expression from subgingival plaque and MPO and anti‐CarP in saliva and serum were assessed. Data were analyzed with SPSS Version 26.Results<jats:italic>Rgp‐B</jats:italic> gene expressions were similar across PD groups. In eRA‐PD, serum and saliva MPO and saliva anti‐CarP levels were highest; strong correlations were present between <jats:italic>rgp‐B</jats:italic> with clinical attachment loss (CAL) (<jats:italic>r</jats:italic> = 0.783), salivary MPO with visible plaque index (VPI) (<jats:italic>r</jats:italic> = 0.667), and gingival bleeding index (GBI) (<jats:italic>r</jats:italic> = 0.767), and salivary anti‐CarP with CAL (<jats:italic>r</jats:italic> = 0.667) and GBI (<jats:italic>r</jats:italic> = 0.850). Strong positive correlations were detected between salivary MPO and anti‐CarP in preRA‐PD (<jats:italic>r</jats:italic> = 0.903), eRA‐PD (<jats:italic>r </jats:italic>= 0.783), RA‐PD (<jats:italic>r</jats:italic> = 0.726), and nonRA‐PD (<jats:italic>r </jats:italic>= 0.470).Conclusion<jats:italic>Rgp‐B</jats:italic> gene expression was associated with PD status. Periodontal inflammation, particularly in early RA, was linked to elevated MPO and anti‐CarP levels, suggesting that local inflammation may amplify immune responses via MPO‐mediated carbamylation. These associations highlight the clinical relevance of periodontal assessment and management in RA patients and at‐risk individuals.Plain Language SummaryPeriodontitis (PD) and rheumatoid arthritis (RA) are chronic inflammatory diseases that may be linked through immune system activity. Studies suggest RA can begin developing before symptoms appear (preRA), with early immune changes occurring in the body. One possible trigger is the occurrence of myeloperoxidase (MPO)‐mediated carbamylation in the inflamed periodontium during the earliest phases of RA, which may precede the occurrence of autoantibodies, particularly anti‐carbamylated proteins (anti‐CarP). To date, these changes due to PD at different stages of RA have not been studied. This study investigated whether the <jats:italic>Porphyromonas gingivalis</jats:italic> enzyme, Arg‐gingipain (Rgp) is linked to MPO and anti‐CarP levels in individuals at different stages of RA. A total of 108 participants were recruited for this study, including preRA,","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"3 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282794","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}
Hamdi S. Adam, Weihua Guan, Abigail J. Johnson, Sanaz Sedaghat, Charlene Goh, James S. Pankow, Ryan T. Demmer
BackgroundAlthough periodontitis and oral microbiota are linked to cardiometabolic diseases (CMD), it is unclear if they similarly predict CMD mortality. We compared the predictive ability of salivary microbiota and periodontal disease measures for CMD mortality in the National Health and Nutrition Examination Survey (NHANES).MethodsWe included 5,037 adults aged ≥30 years (mean age [± standard deviation (SD)]: 48[± 14]; 50% male) from the 2009–2010 and 2011–2012 NHANES cycles. We used 16S rRNA sequencing data from saliva to operationalize microbial composition and diversity. We calculated the relative abundance log‐ratio of Treponema (linked with periodontal disease) to Corynebacterium (linked with periodontal health) to compute the Microbial Indicator of Periodontitis (MIP). Interproximal periodontal probing depth and clinical attachment loss were measured from periodontal examinations. Mortality was ascertained through 2019. Survey‐weighted Cox models regressed mortality rates on MIP, microbial diversity, and periodontal measures to estimate hazard ratios and 95% confidence intervals (HR [95% CI]).ResultsOver 8.8 median follow‐up years, there were 81 CMD and 267 all‐cause deaths. After multivariable adjustment, MIP was associated with increased CMD mortality risk (HR per 1‐SD: 2.10 [1.30–3.38]). Neither microbial diversity nor periodontitis measures were associated with CMD mortality. MIP was associated with periodontitis in multivariable modeling (risk ratio per 1‐SD: 1.29 [1.22–1.39]).ConclusionsIn a nationally representative cohort, greater baseline salivary Treponema to Corynebacterium ratio predicted increased CMD mortality risk, while microbial diversity metrics and periodontal parameters were not significantly associated with CMD mortality. Longitudinal studies that further contextualize the oral microbiota are warranted.Plain Language SummaryBacteria in the mouth that cause gum disease are linked to cardiometabolic diseases (e.g., diabetes, cardiovascular disease, kidney disease). However, it is not well understood if bacteria of the mouth can predict the risk of death due to cardiometabolic diseases. We used data from a nationwide survey of US adults to explore whether bacteria from saliva, collected from a single time point, are associated with the future risk of cardiometabolic disease death. We found that people with higher levels of gum disease bacteria were more likely to die from cardiometabolic diseases. Future studies are needed to better understand the role of gum disease bacteria in the development of cardiometabolic diseases and the risk of death.
{"title":"Salivary microbiota and clinical periodontal measures predicting cardiometabolic disease mortality: A nationwide survey","authors":"Hamdi S. Adam, Weihua Guan, Abigail J. Johnson, Sanaz Sedaghat, Charlene Goh, James S. Pankow, Ryan T. Demmer","doi":"10.1002/jper.11395","DOIUrl":"https://doi.org/10.1002/jper.11395","url":null,"abstract":"BackgroundAlthough periodontitis and oral microbiota are linked to cardiometabolic diseases (CMD), it is unclear if they similarly predict CMD mortality. We compared the predictive ability of salivary microbiota and periodontal disease measures for CMD mortality in the National Health and Nutrition Examination Survey (NHANES).MethodsWe included 5,037 adults aged ≥30 years (mean age [± standard deviation (SD)]: 48[± 14]; 50% male) from the 2009–2010 and 2011–2012 NHANES cycles. We used 16S rRNA sequencing data from saliva to operationalize microbial composition and diversity. We calculated the relative abundance log‐ratio of <jats:italic>Treponema</jats:italic> (linked with periodontal disease) to <jats:italic>Corynebacterium</jats:italic> (linked with periodontal health) to compute the Microbial Indicator of Periodontitis (MIP). Interproximal periodontal probing depth and clinical attachment loss were measured from periodontal examinations. Mortality was ascertained through 2019. Survey‐weighted Cox models regressed mortality rates on MIP, microbial diversity, and periodontal measures to estimate hazard ratios and 95% confidence intervals (HR [95% CI]).ResultsOver 8.8 median follow‐up years, there were 81 CMD and 267 all‐cause deaths. After multivariable adjustment, MIP was associated with increased CMD mortality risk (HR per 1‐SD: 2.10 [1.30–3.38]). Neither microbial diversity nor periodontitis measures were associated with CMD mortality. MIP was associated with periodontitis in multivariable modeling (risk ratio per 1‐SD: 1.29 [1.22–1.39]).ConclusionsIn a nationally representative cohort, greater baseline salivary <jats:italic>Treponema</jats:italic> to <jats:italic>Corynebacterium</jats:italic> ratio predicted increased CMD mortality risk, while microbial diversity metrics and periodontal parameters were not significantly associated with CMD mortality. Longitudinal studies that further contextualize the oral microbiota are warranted.Plain Language SummaryBacteria in the mouth that cause gum disease are linked to cardiometabolic diseases (e.g., diabetes, cardiovascular disease, kidney disease). However, it is not well understood if bacteria of the mouth can predict the risk of death due to cardiometabolic diseases. We used data from a nationwide survey of US adults to explore whether bacteria from saliva, collected from a single time point, are associated with the future risk of cardiometabolic disease death. We found that people with higher levels of gum disease bacteria were more likely to die from cardiometabolic diseases. Future studies are needed to better understand the role of gum disease bacteria in the development of cardiometabolic diseases and the risk of death.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"2 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261021","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}
BACKGROUNDHypoxia modulates inflammation and oxidative stress through hypoxia-inducible factor-1α (HIF-1α). Ferroptosis, an iron-dependent cell death process, is regulated by glutathione peroxidase-4 (GPX4) and involves lipid peroxidation markers like malondialdehyde (MDA). This study evaluates HIF-1α, GPX4, and MDA levels in peri-implant crevicular fluid (PICF) across peri-implant health, mucositis, and peri-implantitis.METHODSPICF samples were collected from 62 implants of 45 participants categorized into peri-implant health (PH), mucositis (PM), and peri-implantitis (PP) groups. Enzyme-linked immunosorbent assay (ELISA) quantified HIF-1α, GPX4, and MDA levels. Statistical analyses, including Kruskal-Wallis and Spearman correlation, assessed biomarker differences and associations.RESULTSTotal MDA levels were significantly lower in PM and PP compared to PH (p = 0.014, p = 0.046). GPX4 levels were elevated in PM compared to PH (p = 0.034) but lower in PP than in PM (p < 0.001). While HIF-1α levels did not significantly differ among groups, their concentrations were notably higher in PH. A significant positive correlation was found between the total amounts of HIF-1𝛼 and GPX4 (r = 0.460, p < 0.01).CONCLUSIONOur findings demonstrated increased GPX4 and decreased MDA levels in peri-implant mucositis and peri-implantitis compared to peri-implant health, suggesting that ferroptosis may be inhibited in the peri-implant environment. Moreover, the positive correlation between HIF-1α and GPX4 levels indicates a potential regulatory role of hypoxia in modulating ferroptotic pathways in peri-implant tissues.PLAIN LANGUAGE SUMMARYBone loss around dental implants can lead to serious problems, putting the success of these implants at risk. Understanding how these issues develop is key to preventing and treating them. In the human body, cells can sometimes get damaged and die due to iron and stress caused by harmful molecules. This process, called "ferroptosis," has recently gained attention in oral health research. Our study looked at whether low oxygen levels around dental implants might affect this process. We collected fluid samples from 45 people and measured 3 important substances linked to cell health and stress. We found that in diseased areas, the levels of molecules showing cell damage were lower, while the levels of substances that help protect cells were higher. This suggests that low oxygen conditions might actually help protect tissues around dental implants by preventing cell damage. These insights could help guide better ways to prevent and treat problems related to dental implants in the future.
背景：缺氧通过缺氧诱导因子-1α (HIF-1α)调节炎症和氧化应激。铁死亡是一种铁依赖性细胞死亡过程，由谷胱甘肽过氧化物酶-4 （GPX4）调控，涉及丙二醛（MDA）等脂质过氧化标志物。本研究评估了种植体周围健康、粘膜炎和种植体周围炎期间种植体周围沟液（PICF）中HIF-1α、GPX4和MDA的水平。方法从45名受试者的62颗种植体中采集spicf样本，分为种植体周围健康（PH）组、黏膜炎（PM）组和种植体周围炎（PP）组。酶联免疫吸附试验（ELISA）定量HIF-1α、GPX4和MDA水平。统计分析，包括Kruskal-Wallis和Spearman相关性，评估了生物标志物的差异和关联。结果PM和PP组总MDA水平显著低于PH组（p = 0.014, p = 0.046）。GPX4水平在PM中高于PH (p = 0.034)，而在PP中低于PM （p < 0.001）。各组间HIF-1α水平差异不显著，但ph值中HIF-1α浓度显著升高。HIF-1α总量与GPX4呈显著正相关（r = 0.460, p < 0.01）。结论：与种植体周围健康相比，种植体周围黏膜炎和种植体周围炎的GPX4水平升高，MDA水平降低，提示种植体周围环境可能抑制铁下垂。此外，HIF-1α和GPX4水平之间的正相关表明缺氧在调节种植体周围组织的铁迁移途径中具有潜在的调节作用。牙种植体周围的骨质流失会导致严重的问题，危及这些种植体的成功。了解这些问题是如何发展的是预防和治疗它们的关键。在人体中，细胞有时会因铁和有害分子造成的压力而受损和死亡。这个过程被称为“下垂铁”，最近在口腔健康研究中引起了人们的注意。我们的研究着眼于种植牙周围的低氧水平是否会影响这一过程。我们收集了45个人的体液样本，测量了3种与细胞健康和压力相关的重要物质。我们发现，在患病区域，显示细胞损伤的分子水平较低，而帮助保护细胞的物质水平较高。这表明，低氧条件实际上可能有助于通过防止细胞损伤来保护牙齿植入物周围的组织。这些见解可以帮助指导更好的方法来预防和治疗与种植牙有关的问题。
{"title":"Peri-implant hypoxia as a potential barrier against ferroptotic mechanisms during peri-implant diseases: A cross-sectional study.","authors":"Büşra Yılmaz,Ali Gürkan,Beral Afacan,Harika Atmaca,Timur Köse,Gülnur Emingil","doi":"10.1002/jper.70001","DOIUrl":"https://doi.org/10.1002/jper.70001","url":null,"abstract":"BACKGROUNDHypoxia modulates inflammation and oxidative stress through hypoxia-inducible factor-1α (HIF-1α). Ferroptosis, an iron-dependent cell death process, is regulated by glutathione peroxidase-4 (GPX4) and involves lipid peroxidation markers like malondialdehyde (MDA). This study evaluates HIF-1α, GPX4, and MDA levels in peri-implant crevicular fluid (PICF) across peri-implant health, mucositis, and peri-implantitis.METHODSPICF samples were collected from 62 implants of 45 participants categorized into peri-implant health (PH), mucositis (PM), and peri-implantitis (PP) groups. Enzyme-linked immunosorbent assay (ELISA) quantified HIF-1α, GPX4, and MDA levels. Statistical analyses, including Kruskal-Wallis and Spearman correlation, assessed biomarker differences and associations.RESULTSTotal MDA levels were significantly lower in PM and PP compared to PH (p = 0.014, p = 0.046). GPX4 levels were elevated in PM compared to PH (p = 0.034) but lower in PP than in PM (p < 0.001). While HIF-1α levels did not significantly differ among groups, their concentrations were notably higher in PH. A significant positive correlation was found between the total amounts of HIF-1𝛼 and GPX4 (r = 0.460, p < 0.01).CONCLUSIONOur findings demonstrated increased GPX4 and decreased MDA levels in peri-implant mucositis and peri-implantitis compared to peri-implant health, suggesting that ferroptosis may be inhibited in the peri-implant environment. Moreover, the positive correlation between HIF-1α and GPX4 levels indicates a potential regulatory role of hypoxia in modulating ferroptotic pathways in peri-implant tissues.PLAIN LANGUAGE SUMMARYBone loss around dental implants can lead to serious problems, putting the success of these implants at risk. Understanding how these issues develop is key to preventing and treating them. In the human body, cells can sometimes get damaged and die due to iron and stress caused by harmful molecules. This process, called \"ferroptosis,\" has recently gained attention in oral health research. Our study looked at whether low oxygen levels around dental implants might affect this process. We collected fluid samples from 45 people and measured 3 important substances linked to cell health and stress. We found that in diseased areas, the levels of molecules showing cell damage were lower, while the levels of substances that help protect cells were higher. This suggests that low oxygen conditions might actually help protect tissues around dental implants by preventing cell damage. These insights could help guide better ways to prevent and treat problems related to dental implants in the future.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"6 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241076","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}
BACKGROUNDAccurate communication of periodontal stage and grade by general dentists in primary care is critical for patient understanding and engagement, yet patient retention and self-reporting of this information upon referral to secondary care remains unclear.METHODSA total of 372 periodontal patients referred were informed about their diagnosis by their general dentists and then referred to secondary care level. Data were collected through an eight-item periodontal staging and grading (PSG) questionnaire, along with demographic, medical, and dental records. Periodontal diagnoses were classified by a specialist using the 2018 classification system. Associations between clinical diagnosis and patient perception were analyzed using Chi-square tests and Spearman's rank correlation.RESULTSWhile 46.9% of patients diagnosed with periodontitis reported to be informed of their condition, only 19.3% reported knowing their specific stage and grade. Among patients with advanced periodontitis (stage III/IV), self-reported severity often aligned with clinical staging. However, for early-stage disease (stage I/II), perceptions were less accurate, and only 30.2% of grade C patients recognized rapid progression. Significant correlations were found between patient-reported symptoms and clinician-assigned staging: tooth loss (ρ = 0.69, p < 0.0001), root exposure (ρ = 0.638, p < 0.0001), and tooth mobility (ρ = 0.55, p < 0.0001).CONCLUSIONMost patients referred to secondary care lacked information on their disease stage and grade. Severe stages and grades were better perceived by patients compared with mild forms of periodontitis. The PSG questionnaire offers a valuable tool for identifying knowledge gaps and guiding tailored discussions in clinical practice.PLAIN LANGUAGE SUMMARYOur study asked 372 people referred for gum disease to fill out a simple eight-question survey about how they see their own gum health and compared their answers to the detailed diagnosis made by periodontists. We found that fewer than one in five patients knew exactly how severe their disease was or how fast it was progressing. People with more advanced gum damage generally understood their condition, but those with mild disease often thought they were healthier than they really were. When patients reported losing teeth, seeing root surfaces, or noticing loose teeth, these experiences matched closely with the clinical measures of disease severity. These results show that many patients lack clear information about their gum health and that a brief questionnaire can help dentists pinpoint misunderstandings, improve patient education, and support better treatment decisions.
背景：在初级保健中，普通牙医对牙周分期和等级的准确沟通对患者的理解和参与至关重要，但患者在转诊到二级保健时对这些信息的保留和自我报告尚不清楚。方法372例牙周病患者由其普通牙医告知其诊断，然后转介至二级保健级别。数据通过一份包含8个项目的牙周分期和分级（PSG）问卷以及人口统计、医疗和牙科记录收集。牙周诊断由专家使用2018年分类系统进行分类。采用卡方检验和Spearman秩相关分析临床诊断与患者感知之间的关系。结果46.9%的牙周炎患者被告知自己的病情，只有19.3%的患者知道自己的具体分期和分级。在晚期牙周炎（III/IV期）患者中，自我报告的严重程度通常与临床分期一致。然而，对于早期疾病（I/II期），感知不太准确，只有30.2%的C级患者认识到快速进展。患者报告的症状与临床医生指定的分期之间存在显著相关性：牙齿脱落（ρ = 0.69, p < 0.0001）、牙根暴露（ρ = 0.638, p < 0.0001）和牙齿活动性（ρ = 0.55, p < 0.0001）。结论大多数到二级医疗机构就诊的患者缺乏疾病分期和分级信息。与轻度牙周炎相比，患者对严重牙周炎的分期和分级有更好的认识。PSG问卷为识别知识差距和指导临床实践中量身定制的讨论提供了有价值的工具。你的研究要求372名牙周病患者填写一份简单的8个问题的调查问卷，了解他们如何看待自己的牙龈健康，并将他们的回答与牙周病医生的详细诊断进行比较。我们发现，不到五分之一的患者确切知道他们的疾病有多严重或进展有多快。患有严重牙龈损伤的人通常了解自己的状况，但那些患有轻微疾病的人往往认为自己比实际情况更健康。当患者报告牙齿脱落、看到牙根表面或注意到牙齿松动时，这些经历与疾病严重程度的临床指标密切相关。这些结果表明，许多患者对自己的牙龈健康缺乏明确的信息，一份简短的调查问卷可以帮助牙医找出误解，改善患者教育，并支持更好的治疗决策。
{"title":"From primary to secondary care level: Assessing patient retention of periodontal staging and grading information.","authors":"Pasquale Santamaria,Rohan Mangalpara,Thamara Kumar,Tina Lipovec,Luigi Nibali","doi":"10.1002/jper.70008","DOIUrl":"https://doi.org/10.1002/jper.70008","url":null,"abstract":"BACKGROUNDAccurate communication of periodontal stage and grade by general dentists in primary care is critical for patient understanding and engagement, yet patient retention and self-reporting of this information upon referral to secondary care remains unclear.METHODSA total of 372 periodontal patients referred were informed about their diagnosis by their general dentists and then referred to secondary care level. Data were collected through an eight-item periodontal staging and grading (PSG) questionnaire, along with demographic, medical, and dental records. Periodontal diagnoses were classified by a specialist using the 2018 classification system. Associations between clinical diagnosis and patient perception were analyzed using Chi-square tests and Spearman's rank correlation.RESULTSWhile 46.9% of patients diagnosed with periodontitis reported to be informed of their condition, only 19.3% reported knowing their specific stage and grade. Among patients with advanced periodontitis (stage III/IV), self-reported severity often aligned with clinical staging. However, for early-stage disease (stage I/II), perceptions were less accurate, and only 30.2% of grade C patients recognized rapid progression. Significant correlations were found between patient-reported symptoms and clinician-assigned staging: tooth loss (ρ = 0.69, p < 0.0001), root exposure (ρ = 0.638, p < 0.0001), and tooth mobility (ρ = 0.55, p < 0.0001).CONCLUSIONMost patients referred to secondary care lacked information on their disease stage and grade. Severe stages and grades were better perceived by patients compared with mild forms of periodontitis. The PSG questionnaire offers a valuable tool for identifying knowledge gaps and guiding tailored discussions in clinical practice.PLAIN LANGUAGE SUMMARYOur study asked 372 people referred for gum disease to fill out a simple eight-question survey about how they see their own gum health and compared their answers to the detailed diagnosis made by periodontists. We found that fewer than one in five patients knew exactly how severe their disease was or how fast it was progressing. People with more advanced gum damage generally understood their condition, but those with mild disease often thought they were healthier than they really were. When patients reported losing teeth, seeing root surfaces, or noticing loose teeth, these experiences matched closely with the clinical measures of disease severity. These results show that many patients lack clear information about their gum health and that a brief questionnaire can help dentists pinpoint misunderstandings, improve patient education, and support better treatment decisions.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"100 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140376","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}
Átila V V Nobre,Pedro H F Silva,Marina C G Del-Arco,Raquel F Gerlach,Rene S Oliezer,José E Tanus-Santos,Luciene C Figueiredo,Janaina S A M Evangelista,Flávia A C Furlaneto,Michel R Messora,Sérgio Luiz Salvador
BACKGROUNDBifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) is a probiotic bacterial strain with immunomodulatory properties. Its benefits have been observed in healthy and systemically compromised animals with periodontitis (PD). Our objective was to investigate the local and systemic effects of the systemic administration of B. lactis in pregnant rats with experimental periodontitis (EP).METHODSFor this, 48 pregnant rats were divided into four different groups (n = 12/group): Control (C), Probiotic (PROB), Periodontitis (PD), and Periodontitis + Probiotic (PD-PROB). EP was induced using a mixed model of cotton ligature placement and oral gavage of Porphyromonas gingivalis W83. On gestational day 19, the animals were euthanized for sample collection and analysis. Jaws, kidneys, and urine samples were collected for microtomographic, histological, histomorphometric, and biochemical analyses. The data were statistically analyzed (p < 0.05) using nonparametric tests (Kruskal-Wallis) and analysis of variance (ANOVA) followed by Tukey and Dunn post hoc tests.RESULTSEP resulted in local and systemic damage, such as alveolar bone loss (ABL) and kidney damage, and the consumption of B. lactis HN019 resulted in improvements in these parameters. Regarding mandibular analyses, the PD-PROB group showed greater bone volume in the furcation region, a greater number and thickness of bone trabeculae, and less bone porosity and separation between trabeculae compared to the PD group (p < 0.05). Regarding kidney analysis, the PD-PROB group showed lower glomerular and Bowman's capsule diameters and circumferences compared to the PD group (p < 0.05).CONCLUSIONProbiotic consumption reduced damage in mandibular bone and kidney tissues in pregnant rats with EP.PLAIN LANGUAGE SUMMARYPeriodontitis (PD) is a destructive periodontal disease that can lead to tooth loss. The treatment for PD consists of scaling and root planing to remove calculus and plaque deposits; however, some systemic conditions make it difficult to control this disease. Probiotic bacteria have emerged as adjuvants in the treatment of infectious diseases, and their benefits have been demonstrated in the management of PD. The aims of the present study were to evaluate whether PD has a negative impact on pregnancy and whether the probiotic strain Bifidobacterium animalis subsp. lactis HN019 can reduce this impact. For this purpose, 48 pregnant rats were divided into four experimental groups (Control, Probiotic, PD, and PD + Probiotic), and samples of maternal and pup weights, as well as placentas, mandibles, urine, and kidneys, were collected and analyzed. We observed that PD negatively impacted pregnant rats, resulting in greater alveolar bone loss, increased expression of proteinuria and creatinine in urine, and kidney damage; systemic probiotic administration reduced these harmful effects. In addition, pups, as well as mothers supplemented with probiotic, exhibited higher weights and larger
{"title":"Probiotic consumption reduces alveolar bone loss and kidney damage in pregnant rats with experimental periodontitis.","authors":"Átila V V Nobre,Pedro H F Silva,Marina C G Del-Arco,Raquel F Gerlach,Rene S Oliezer,José E Tanus-Santos,Luciene C Figueiredo,Janaina S A M Evangelista,Flávia A C Furlaneto,Michel R Messora,Sérgio Luiz Salvador","doi":"10.1002/jper.11389","DOIUrl":"https://doi.org/10.1002/jper.11389","url":null,"abstract":"BACKGROUNDBifidobacterium animalis subsp. lactis HN019 (B. lactis HN019) is a probiotic bacterial strain with immunomodulatory properties. Its benefits have been observed in healthy and systemically compromised animals with periodontitis (PD). Our objective was to investigate the local and systemic effects of the systemic administration of B. lactis in pregnant rats with experimental periodontitis (EP).METHODSFor this, 48 pregnant rats were divided into four different groups (n = 12/group): Control (C), Probiotic (PROB), Periodontitis (PD), and Periodontitis + Probiotic (PD-PROB). EP was induced using a mixed model of cotton ligature placement and oral gavage of Porphyromonas gingivalis W83. On gestational day 19, the animals were euthanized for sample collection and analysis. Jaws, kidneys, and urine samples were collected for microtomographic, histological, histomorphometric, and biochemical analyses. The data were statistically analyzed (p < 0.05) using nonparametric tests (Kruskal-Wallis) and analysis of variance (ANOVA) followed by Tukey and Dunn post hoc tests.RESULTSEP resulted in local and systemic damage, such as alveolar bone loss (ABL) and kidney damage, and the consumption of B. lactis HN019 resulted in improvements in these parameters. Regarding mandibular analyses, the PD-PROB group showed greater bone volume in the furcation region, a greater number and thickness of bone trabeculae, and less bone porosity and separation between trabeculae compared to the PD group (p < 0.05). Regarding kidney analysis, the PD-PROB group showed lower glomerular and Bowman's capsule diameters and circumferences compared to the PD group (p < 0.05).CONCLUSIONProbiotic consumption reduced damage in mandibular bone and kidney tissues in pregnant rats with EP.PLAIN LANGUAGE SUMMARYPeriodontitis (PD) is a destructive periodontal disease that can lead to tooth loss. The treatment for PD consists of scaling and root planing to remove calculus and plaque deposits; however, some systemic conditions make it difficult to control this disease. Probiotic bacteria have emerged as adjuvants in the treatment of infectious diseases, and their benefits have been demonstrated in the management of PD. The aims of the present study were to evaluate whether PD has a negative impact on pregnancy and whether the probiotic strain Bifidobacterium animalis subsp. lactis HN019 can reduce this impact. For this purpose, 48 pregnant rats were divided into four experimental groups (Control, Probiotic, PD, and PD + Probiotic), and samples of maternal and pup weights, as well as placentas, mandibles, urine, and kidneys, were collected and analyzed. We observed that PD negatively impacted pregnant rats, resulting in greater alveolar bone loss, increased expression of proteinuria and creatinine in urine, and kidney damage; systemic probiotic administration reduced these harmful effects. In addition, pups, as well as mothers supplemented with probiotic, exhibited higher weights and larger","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"18 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140378","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}
Ae Ri Kim,Min Seo Kim,Jiwon Seo,Eun-Jung Bak,Yun-Jung Yoo
BACKGROUNDPeriodontitis and high phosphate (HP) intake can negatively affect the kidney in the presence of renal disease. This study aimed to evaluate the effects of periodontitis or HP intake, either alone or concurrently, on the periodontal tissue and the kidney under normal renal conditions.METHODSRats were divided into normal diet (C), HP diet (HP), tooth ligation and normal diet (P), and tooth ligation and HP diet (P+HP) groups. The mandibular first molars were ligated, and a 0.9% HP diet was provided for 12 weeks from the day of ligation. An additional group (P+HP+IFX) was administered infliximab (IFX), a tumor necrosis factor-alpha (TNF-α) inhibitor, weekly to evaluate the TNF-α inhibitory effect.RESULTSAlveolar bone loss and periodontal inflammation did not differ between the P and P+HP groups or between the C and HP groups. In the kidney, interstitial fibrosis and Col1a1 expression increased in the HP group, and ED1 expression increased in the P group, compared to the C group. Tubular basophilia, interstitial fibrosis, and the expression of Col1a1 and ED1 increased in the P+HP group compared to the other groups. The P+HP+IFX group showed a decrease in periodontal inflammation and these renal alterations compared to the P+HP group.CONCLUSIONRegardless of periodontitis, 0.9% HP intake did not affect periodontal tissue. Renal fibrosis and macrophage infiltration induced by HP intake and periodontitis, respectively, worsened when combined, indicating a synergistic adverse effect. These changes were reversed by IFX, suggesting that TNF-α inhibition may alleviate renal injury caused by periodontitis and HP intake.PLAIN LANGUAGE SUMMARYOur study examined the impact of periodontitis and a 0.9% high phosphate (HP) diet, individually and together, on periodontal tissue and kidney. We divided rats into 4 groups: normal diet, HP diet, periodontitis with a normal diet, and periodontitis with an HP diet, and assessed various periodontal and renal parameters. Although we did not observe any effects of HP intake on periodontal tissue, we found that HP intake worsened kidney health by increasing fibrosis, while periodontitis did so by increasing macrophage infiltration. Combined, these conditions worsen kidney health more than when each condition exists alone, causing more tubular basophilia, fibrosis, and macrophage infiltration. However, these negative effects were reversed with TNF-α inhibition. These findings indicate that the combination of periodontitis and HP intake exacerbates renal damage, which can be ameliorated by TNF-α inhibition.
{"title":"Periodontitis and high phosphate intake alone or in combination adversely affect the kidney.","authors":"Ae Ri Kim,Min Seo Kim,Jiwon Seo,Eun-Jung Bak,Yun-Jung Yoo","doi":"10.1002/jper.70013","DOIUrl":"https://doi.org/10.1002/jper.70013","url":null,"abstract":"BACKGROUNDPeriodontitis and high phosphate (HP) intake can negatively affect the kidney in the presence of renal disease. This study aimed to evaluate the effects of periodontitis or HP intake, either alone or concurrently, on the periodontal tissue and the kidney under normal renal conditions.METHODSRats were divided into normal diet (C), HP diet (HP), tooth ligation and normal diet (P), and tooth ligation and HP diet (P+HP) groups. The mandibular first molars were ligated, and a 0.9% HP diet was provided for 12 weeks from the day of ligation. An additional group (P+HP+IFX) was administered infliximab (IFX), a tumor necrosis factor-alpha (TNF-α) inhibitor, weekly to evaluate the TNF-α inhibitory effect.RESULTSAlveolar bone loss and periodontal inflammation did not differ between the P and P+HP groups or between the C and HP groups. In the kidney, interstitial fibrosis and Col1a1 expression increased in the HP group, and ED1 expression increased in the P group, compared to the C group. Tubular basophilia, interstitial fibrosis, and the expression of Col1a1 and ED1 increased in the P+HP group compared to the other groups. The P+HP+IFX group showed a decrease in periodontal inflammation and these renal alterations compared to the P+HP group.CONCLUSIONRegardless of periodontitis, 0.9% HP intake did not affect periodontal tissue. Renal fibrosis and macrophage infiltration induced by HP intake and periodontitis, respectively, worsened when combined, indicating a synergistic adverse effect. These changes were reversed by IFX, suggesting that TNF-α inhibition may alleviate renal injury caused by periodontitis and HP intake.PLAIN LANGUAGE SUMMARYOur study examined the impact of periodontitis and a 0.9% high phosphate (HP) diet, individually and together, on periodontal tissue and kidney. We divided rats into 4 groups: normal diet, HP diet, periodontitis with a normal diet, and periodontitis with an HP diet, and assessed various periodontal and renal parameters. Although we did not observe any effects of HP intake on periodontal tissue, we found that HP intake worsened kidney health by increasing fibrosis, while periodontitis did so by increasing macrophage infiltration. Combined, these conditions worsen kidney health more than when each condition exists alone, causing more tubular basophilia, fibrosis, and macrophage infiltration. However, these negative effects were reversed with TNF-α inhibition. These findings indicate that the combination of periodontitis and HP intake exacerbates renal damage, which can be ameliorated by TNF-α inhibition.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"1 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145140412","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}
Arwa Badahdah,Arwa Banjar,Amal Jamjoom,Mohammad Assaggaf,Lina Bahanan,Reem A Asiri,Reem Alsulami,Shatha Bamashmous,Brian L Mealey
BACKGROUNDAccurate periodontal disease diagnosis is essential for optimal treatment planning and patient care. However, variability in applying the 2017 Periodontal Classification may affect diagnostic reliability and treatment outcomes. This study investigated diagnostic accuracy and consistency among periodontists, periodontal residents, and dental interns in Saudi Arabia.METHODSForty-four participants, including 13 periodontists, 14 periodontal residents, and 17 dental interns, independently classified 25 periodontitis cases. Agreement with a gold-standard diagnosis, established by expert periodontists using the 2017 Classification System, was assessed using descriptive statistics. Chi-square tests with Bonferroni-adjusted z-tests were used to compare agreement levels between rater groups. Inter-rater reliability was calculated using Fleiss' kappa, while Cohen's kappa was used to assess intra-rater reliability.RESULTSPeriodontists demonstrated the highest agreement with the gold standard (92.0%) for periodontitis diagnosis. Staging agreement was highest among residents (51.7%) and periodontists (49.1%). Grading accuracy was highest for grade C cases across all groups (60.7%). Underestimation was common across rater groups, with interns exhibiting the highest rates in staging (49.6%) and grading (58.3%). The second assessment demonstrated improved diagnostic accuracy across all groups. Inter-rater reliability ranged from fair to moderate across rater groups (κ = 0.22-0.60). Intra-rater reliability was highest among interns, indicating substantial agreement (κ = 0.63-0.75).CONCLUSIONFindings highlight considerable variability in the application of the 2017 Periodontal Classification among dental professionals, underscoring the role of clinical experience and training in influencing diagnostic accuracy. Structured calibration and targeted educational strategies are essential to improve diagnostic consistency, minimize misclassification, and support optimal patient care.PLAIN LANGUAGE SUMMARYUnderstanding gum disease correctly is important for providing patients with the right treatments. This study looked at how accurately different groups of dental professionals - specialists in gum disease (periodontists), dentists in training (residents), and recent dental graduates (interns) - could diagnose cases of periodontitis using a new system called the 2017 Periodontal Classification. A group of expert periodontists created a "gold-standard" diagnosis for comparison. We found that periodontists were the most accurate, while interns had more difficulty correctly identifying disease severity. Across all groups, many participants underestimated how serious the cases were. Participants were better at recognizing advanced disease compared to milder forms. When the participants repeated the diagnosis of the cases later, their accuracy improved, suggesting that practice and training help. Our results show that diagnosing gum disease can vary depending on exp
{"title":"Evaluating diagnostic accuracy and consistency in applying the 2017 periodontal classification among dental professionals.","authors":"Arwa Badahdah,Arwa Banjar,Amal Jamjoom,Mohammad Assaggaf,Lina Bahanan,Reem A Asiri,Reem Alsulami,Shatha Bamashmous,Brian L Mealey","doi":"10.1002/jper.70011","DOIUrl":"https://doi.org/10.1002/jper.70011","url":null,"abstract":"BACKGROUNDAccurate periodontal disease diagnosis is essential for optimal treatment planning and patient care. However, variability in applying the 2017 Periodontal Classification may affect diagnostic reliability and treatment outcomes. This study investigated diagnostic accuracy and consistency among periodontists, periodontal residents, and dental interns in Saudi Arabia.METHODSForty-four participants, including 13 periodontists, 14 periodontal residents, and 17 dental interns, independently classified 25 periodontitis cases. Agreement with a gold-standard diagnosis, established by expert periodontists using the 2017 Classification System, was assessed using descriptive statistics. Chi-square tests with Bonferroni-adjusted z-tests were used to compare agreement levels between rater groups. Inter-rater reliability was calculated using Fleiss' kappa, while Cohen's kappa was used to assess intra-rater reliability.RESULTSPeriodontists demonstrated the highest agreement with the gold standard (92.0%) for periodontitis diagnosis. Staging agreement was highest among residents (51.7%) and periodontists (49.1%). Grading accuracy was highest for grade C cases across all groups (60.7%). Underestimation was common across rater groups, with interns exhibiting the highest rates in staging (49.6%) and grading (58.3%). The second assessment demonstrated improved diagnostic accuracy across all groups. Inter-rater reliability ranged from fair to moderate across rater groups (κ = 0.22-0.60). Intra-rater reliability was highest among interns, indicating substantial agreement (κ = 0.63-0.75).CONCLUSIONFindings highlight considerable variability in the application of the 2017 Periodontal Classification among dental professionals, underscoring the role of clinical experience and training in influencing diagnostic accuracy. Structured calibration and targeted educational strategies are essential to improve diagnostic consistency, minimize misclassification, and support optimal patient care.PLAIN LANGUAGE SUMMARYUnderstanding gum disease correctly is important for providing patients with the right treatments. This study looked at how accurately different groups of dental professionals - specialists in gum disease (periodontists), dentists in training (residents), and recent dental graduates (interns) - could diagnose cases of periodontitis using a new system called the 2017 Periodontal Classification. A group of expert periodontists created a \"gold-standard\" diagnosis for comparison. We found that periodontists were the most accurate, while interns had more difficulty correctly identifying disease severity. Across all groups, many participants underestimated how serious the cases were. Participants were better at recognizing advanced disease compared to milder forms. When the participants repeated the diagnosis of the cases later, their accuracy improved, suggesting that practice and training help. Our results show that diagnosing gum disease can vary depending on exp","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"19 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068432","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}
BACKGROUNDRecent advancements in bone tissue biomarker research have identified 2 promising molecules: Dickkopf-1 and secreted Frizzled-Related Protein 5. This study aims to evaluate the levels of these biomarkers in gingival crevicular fluid in periodontal health, gingivitis, and periodontitis and to assess the effects of non-surgical periodontal treatment on these biomarkers.METHODSA total of 99 adult subjects were included in this study, divided into 3 groups: 33 periodontally healthy individuals, 33 with gingivitis, and 33 with periodontitis. Patients in the gingivitis and periodontitis groups received non-surgical periodontal treatment. Periodontal clinical parameters were recorded, and gingival crevicular fluid levels of biomarkers were analyzed by enzyme-linked immunosorbent assay at baseline and 6-8 weeks post-treatment.RESULTSPre-treatment Dickkopf-1 levels were found to be highest in the periodontitis group (p < 0.001). Conversely, secreted Frizzled-Related Protein 5 levels were highest in the healthy group (p < 0.001). Post-treatment, a statistically significant reduction in Dickkopf-1 levels was observed in the gingivitis (p = 0.015) and periodontitis (p < 0.001) groups, while secreted Frizzled-Related Protein 5 levels significantly increased (respectively, p = 0.008 and p < 0.001). A statistically significant weak negative correlation was identified between total Dickkopf-1 and secreted Frizzled-Related Protein 5 levels (τ = -0.117, p = 0.027). Receiver operating characteristic curve analysis to assess diagnostic performance between periodontal health and periodontitis revealed an area under the curve of 0.938 for Dickkopf-1 and 0.803 for secreted Frizzled-Related Protein 5.CONCLUSIONSThese biomarkers could serve as valuable biomarkers in the pathogenesis of periodontal disease. Non-surgical periodontal treatment significantly affects the levels of these biomarkers, indicating their potential utility in monitoring therapeutic outcomes.PLAIN LANGUAGE SUMMARYIn the human body, bone tissue is in a state of constant balance of production and destruction. This balance supports the maintenance of the mechanical integrity of the skeleton and the regulation of calcium and phosphorus levels. Bone markers have been developed to monitor various bone diseases and the effect of treatments without any interventional procedures. Dickkopf-1 (Dkk-1) and secreted Frizzled-Related Protein 5 (sFRP5) are two of the current bone markers that play a role in the balance of bone formation and destruction in the human body. The presence of these molecules in periodontal diseases, which cause inflammation and bone destruction in the gingiva surrounding the teeth, is not yet clear. In this study, Dkk-1 and sFRP5 levels were investigated in periodontal diseases, and the effect of treatment of periodontal diseases on these molecules was evaluated. In the transition from periodontal disease to health, Dkk-1 levels decreased while sFRP5 levels increased. Consistent
{"title":"The effect of non-surgical periodontal treatment on Dickkopf-1 and secreted Frizzled-Related Protein 5 levels.","authors":"Sukran Acipinar,Kubilay Baris","doi":"10.1002/jper.70005","DOIUrl":"https://doi.org/10.1002/jper.70005","url":null,"abstract":"BACKGROUNDRecent advancements in bone tissue biomarker research have identified 2 promising molecules: Dickkopf-1 and secreted Frizzled-Related Protein 5. This study aims to evaluate the levels of these biomarkers in gingival crevicular fluid in periodontal health, gingivitis, and periodontitis and to assess the effects of non-surgical periodontal treatment on these biomarkers.METHODSA total of 99 adult subjects were included in this study, divided into 3 groups: 33 periodontally healthy individuals, 33 with gingivitis, and 33 with periodontitis. Patients in the gingivitis and periodontitis groups received non-surgical periodontal treatment. Periodontal clinical parameters were recorded, and gingival crevicular fluid levels of biomarkers were analyzed by enzyme-linked immunosorbent assay at baseline and 6-8 weeks post-treatment.RESULTSPre-treatment Dickkopf-1 levels were found to be highest in the periodontitis group (p < 0.001). Conversely, secreted Frizzled-Related Protein 5 levels were highest in the healthy group (p < 0.001). Post-treatment, a statistically significant reduction in Dickkopf-1 levels was observed in the gingivitis (p = 0.015) and periodontitis (p < 0.001) groups, while secreted Frizzled-Related Protein 5 levels significantly increased (respectively, p = 0.008 and p < 0.001). A statistically significant weak negative correlation was identified between total Dickkopf-1 and secreted Frizzled-Related Protein 5 levels (τ = -0.117, p = 0.027). Receiver operating characteristic curve analysis to assess diagnostic performance between periodontal health and periodontitis revealed an area under the curve of 0.938 for Dickkopf-1 and 0.803 for secreted Frizzled-Related Protein 5.CONCLUSIONSThese biomarkers could serve as valuable biomarkers in the pathogenesis of periodontal disease. Non-surgical periodontal treatment significantly affects the levels of these biomarkers, indicating their potential utility in monitoring therapeutic outcomes.PLAIN LANGUAGE SUMMARYIn the human body, bone tissue is in a state of constant balance of production and destruction. This balance supports the maintenance of the mechanical integrity of the skeleton and the regulation of calcium and phosphorus levels. Bone markers have been developed to monitor various bone diseases and the effect of treatments without any interventional procedures. Dickkopf-1 (Dkk-1) and secreted Frizzled-Related Protein 5 (sFRP5) are two of the current bone markers that play a role in the balance of bone formation and destruction in the human body. The presence of these molecules in periodontal diseases, which cause inflammation and bone destruction in the gingiva surrounding the teeth, is not yet clear. In this study, Dkk-1 and sFRP5 levels were investigated in periodontal diseases, and the effect of treatment of periodontal diseases on these molecules was evaluated. In the transition from periodontal disease to health, Dkk-1 levels decreased while sFRP5 levels increased. Consistent","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"35 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068379","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}
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