Severe Periodontitis Research Articles

Periodontitis Progression During Cardiac Rehabilitation After Acute Coronary Syndrome: Cohort Study.

To assess changes in periodontal status and factors related to periodontitis progression in acute coronary syndrome patients who undergo a cardiovascular rehabilitation program following an acute coronary incident. Fifty-two acute coronary syndrome patients with periodontitis were evaluated during a six-month follow-up period. Periodontal indices were taken at baseline and at 3 and 6 months. Progression of periodontitis was established as clinical attachment loss > 3 mm in two or more teeth at nonadjacent sites. Baseline clinical conditions, microbiological concentration of subgingival biofilm, and risk factors for cardiovascular disease were associated with the incidence of periodontitis progression by a linear mixed-effects model. 57.69% of the patients had severe periodontitis upon admission, and 64.58% presented a progression of periodontitis during the follow-up periods. Hypertension, low HDL, and high levels of T. forsythia in patients with elevated total cholesterol were the best predictors of clinical attachment loss, with a predictability of 99%. At 6 months, 35.41% of patients' high-sensitivity C-reactive protein (hs-CRP) levels remained over the cardiovascular risk range. Periodontal condition deterioration was observed. Hypertension and poor metabolic control were associated with the progression of periodontitis. T. forsythia was the most critical local factor in periodontitis progression.

A Comparative Elemental and Surface Analysis of Root Cementum in Severe Periodontitis and Healthy Teeth.

This study aims to compare the elemental composition and surface characteristics of root cementum in teeth affected by severe periodontitis with those of healthy teeth.Forty-seven teeth, including 25 teeth affected by stage III, grade C periodontitis and 22 healthy teeth, were extracted from patients aged 17 to 34 years. The cementum surfaces were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) to evaluate surface morphology and elemental composition.SEM images revealed that healthy teeth exhibited a homogenous, smooth cementum surface, while teeth affected by periodontitis showed an irregular, uneven surface with deep crack lines and resorption areas. EDX analysis indicated significant differences in elemental composition; periodontitis-affected teeth had lower calcium and phosphorus but higher magnesium, sodium, and sulfur levels than healthy teeth.Periodontitis significantly alters the surface characteristics and elemental composition of root cementum, which may contribute to disease progression and impaired periodontal health.

Oral Microbiome Profile of the US Population

The oral microbiome likely plays key roles in human health. Yet, population-representative characterizations are lacking. To characterize the composition, diversity, and correlates of the oral microbiome in US adults. This cross-sectional study analyzed data from the population-representative National Health and Nutrition Examination Survey (NHANES) from 2009 to 2012. Microbiome data were made publicly available in 2024. NHANES participants were aged 18 to 69 years and provided oral rinse samples in 1 of 2 consecutive NHANES cycles (2009-2010 and 2011-2012). Demographic, socioeconomic, behavioral, anthropometric, metabolic, and clinical characteristics. Oral microbiome measures, characterized through 16S ribosomal RNA gene sequencing, included α diversity (observed amplicon sequence variants [ASVs], Faith phylogenetic diversity, Shannon-Weiner Index, and Simpson Index); β diversity (unweighted UniFrac, weighted UniFrac, and Bray-Curtis dissimilarity); and prevalence and relative abundance at phylum level through genus level. Analyses accounted for the NHANES complex sample design. This study included 8237 US adults aged 18 to 69 years, representing 202 314 000 individuals (102 813 000 men [50.8%]; mean [SD] age, 42.3 [14.4] years; 9.3% self-reported as Mexican American, 12.1% as non-Hispanic Black, 64.7% as non-Hispanic White, 5.9% as other Hispanic, and 8.1% as other non-Hispanic individuals). The oral microbiome encompassed 37 bacterial phyla, 99 classes, 212 orders, 446 families, and 1219 genera. Five phyla (Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, and Fusobacteria) and 6 genera (Veillonella, Streptococcus, Prevotella 7, Rothia, Actinomyces, and Gemella) were present in nearly all US adults (weighted prevalence, >99%). These genera were the most abundant, accounting for 65.7% of total abundance. Observed ASVs showed a quadratic pattern with age (peak at 30 years), were similar by sex, significantly lower among non-Hispanic White individuals, and increased with greater body mass index (BMI), alcohol use, and periodontal disease severity. All covariates together accounted for a modest proportion of oral microbiome variability as measured by β diversity: R2 = 8.7% (95% CI, 8.4%-9.1%) for unweighted UniFrac, R2 = 7.2% (95% CI, 6.6%-7.7%) for weighted UniFrac, and R2 = 6.3% (95% CI, 3.1%-6.7%) for Bray-Curtis matrices. By contrast, relative abundance of a few genera explained a high percentage of variability in β diversity for weighted UniFrac: Aggregatibacter (R2 = 22.4%; 95% CI, 22.1%-22.8%), Lactococcus (R2 = 21.6%; 95% CI, 20.9%-22.3%), and Haemophilus (R2 = 18.4%; 95% CI, 18.1%-18.8%). Prevalence and relative abundance of numerous genera were associated with age, race and ethnicity, smoking, BMI categories, alcohol use, and periodontal disease severity. This cross-sectional study of the oral microbiome in US adults showed that a few genera were universally present and a different set of genera explained a high percentage of oral microbiome diversity across the population. This comprehensive characterization provides a contemporary reference standard for future studies.

Biomechanical effects of periodontal status on molar sequential distalization with clear aligners: a finite element study

ObjectiveMolar sequential distalization with clear aligners was advantageous. However, the effect of periodontal status on it has yet to be investigated. This study aimed to analyze the influence of the different periodontal states on molar distalization to reduce the adverse mechanical stimulation caused by periodontal states by the different stagings of movement and further explore therapeutic recommendations for clinical practice.MethodsTo ascertain the initial displacement of dentition and periodontal ligament (PDL) hydrostatic stress, finite element models (FEMs) were developed. These models included the distalization of the second molars (Step A) and the first molar (Step B) in three distinct periodontal conditions (simulating the periodontal state of mild, moderate, and severe periodontitis) and three distinct distances (0.10 mm, 0.18 mm, 0.25 mm).ResultsPeriodontal status affected the tooth movement during molar distalization. During the molar distalization with 0.25 mm step distance, the initial displacement of the molar was greater in the model with worse periodontal condition. However, it did not increase the efficiency of tooth movement because the initial displacement is accompanied by tipping. Moreover, the second molar relapse to mesialization for a reaction from the first molar distalization affected efficiency. Fortunately, reducing the step distance could control those undesired tooth movements positively associated with alveolar bone resorption.Limitations The finite element method cannot simulate complex periodontal conditions in clinical practice.ConclusionTo reduce the undesired tipping and relapse, the personalized staging of movement should be designed according to the periodontal condition. Designing 0.18 mm step distance for patients with 1/3 alveolar bone resorption is recommended, whereas patients with 1/2 alveolar bone resorption need 0.1 mm. These recommendations can guide orthodontists in designing effective treatment plans for patients with varying degrees of periodontal disease.

Association Between Periodontal Pathogens and Inflammation in Patients with Acute Coronary Syndromes.

(1) The link between periodontal disease (PD) and acute coronary syndromes (ACSs) is predominantly attributed to the atherosclerotic process, mediated by systemic inflammation. However, the correlation between the severity of PD, characterized by the presence of periodontal pathogens, and systemic inflammation in patients with ACS remains inadequately clarified. (2) This study aims to assess the association between the severity of PD and systemic inflammatory biomarkers, along with lipid profiles, in patients with ACS. (3) In total, 42 patients with ACS and concomitant PD were divided into two groups based on the presence of periodontal pathogens belonging to the red or red-orange complexes. Group 1-29 patients displayed pathogens from the red complex (RC) and group 2-13 patients displayed pathogens from the red-orange complex (ROC). All participants underwent a comprehensive dental examination, including DNA sampling from the periodontal pockets for pathogen detection. Systemic inflammation was evaluated alongside assessments of lipid profiles. (4) Inflammatory markers were more pronounced in the RC group compared with the ROC group. Moreover, patients in the RC group showed significantly higher monocyte-to-lymphocyte ratios (0.41 ± 0.20 vs. 0.28 ± 0.12; p = 0.002), platelet-to-lymphocyte ratios (139.50 ± 33.85 vs. 100.90 ± 8.84; p = 0.02), serum C-reactive protein levels (9.34 ± 1.08 mg/L vs. 5.46 ± 1.03 mg/L; p = 0.03), and serum uric acid levels (6.9 ± 0.49 mg/dL vs. 5.4 ± 0.26 mg/dL; p = 0.006). Concerning lipid profiles, the RC group exhibited significantly higher low-density lipoprotein cholesterol (LDL) levels (169.60 ± 12.63 mg/dL vs. 106.70 ± 9.34 mg/dL; p = 0.0007) and significantly lower high-density lipoprotein cholesterol (HDL) levels (29.29 ± 3.50 mg/dL vs. 39.56 ± 2.07 mg/dL; p = 0.002). (5) The severity of PD, indicated by the concomitant presence of pathogens from the red and orange complexes, is associated with an unfavorable lipid profile and elevated inflammatory biomarkers. These findings highlight the potential importance of periodontal intervention in the prevention of ACS.

Periodontitis is a modifier of cardiovascular disease

Chronic generalized periodontitis (CGP) can contribute to vascular atherosclerosis and the development of cardiovascular pathology, but the degree of diagnosis of this relationship in the clinic has not been sufficiently studied. Purpose. To assess the diagnostic significance of the high-sensitivity C-reactive protein (hs-CRP) score in patients with CGP and cardiovascular diseases (CVD). Material and methods. 35 patients aged 40 to 80 years with a combined pathology of CGP and CVD were examined. All patients were assessed for cardiac and dental status. Results. It was found that with an increase in the serum level of hs-CRP content of more than 3 mg/l, the frequency of severe periodontitis increases sharply among patients. In the group of patients with severe periodontitis, complications (heart attack, stroke) of CVD and their unstable course are much more often determined. It was found that patients with severe periodontitis, for the most part, do not regularly visit a dentist and do not regularly take basic CVD therapy. At the same time, in the group of patients taking antihypertensive drugs with statins, the lowest values of hs-CRP were noted in the blood serum; in the same group, the lowest incidence of severe periodontitis was diagnosed. Conclusions. Definition of hs-CRP should be introduced into the practice of an internist and dentist as a screening indicator of cardio-vascular conflict in patients with combined pathology of the cardiovascular system and periodontal diseases, in order to timely carry out preventive dental treatment and rational selection of effective cardiological agents. In addition, monitoring this indicator at the reception of a dentist-therapist or periodontist will motivate patients with severe CGP to regularly visit a dentist to improve not only the oral cavity, but also the body as a whole.

Association between serum levels of inflammatory mediators and periodontitis severity in people with down syndrome.

Association between serum levels of inflammatory mediators and periodontitis severity in people with down syndrome.

Association of smokeless tobacco with periodontal health of patients seeking treatment at a Dental Hospital setting in Sri Lanka.

Association of smokeless tobacco with periodontal health of patients seeking treatment at a Dental Hospital setting in Sri Lanka.

Systemic administration of polyphenols from dealcoholized red wine reduces inflammation and bone resorption in established apical periodontitis in male rats.

Systemic administration of polyphenols from dealcoholized red wine reduces inflammation and bone resorption in established apical periodontitis in male rats.

To evaluate the effect of oral zinc supplementation on salivary MMP-8 levels in periodontitis: A randomized, double-blind, placebo-controlled study.

To evaluate the effect of oral zinc supplementation on salivary MMP-8 levels in periodontitis: A randomized, double-blind, placebo-controlled study.

Clinical evaluation of full mouth disinfection and azithromycin in chronic periodontitis: randomized clinical trial.

This randomized, double-blind clinical trial assessed the clinical and microbiological effects of systemic azithromycin (AZ) as an adjunct to one-stage full-mouth disinfection (OSFMD) in patients with moderate to severe chronic periodontitis. Forty-two patients were assigned to OSFMD with either AZ or placebo. Clinical parameters and bacterial counts were evaluated at baseline, 90, and 180days. Both groups showed significant reductions in probing pocket depth (PPD), attachment loss, bleeding, and plaque scores over time; however, no statistically significant intergroup differences were observed in clinical outcomes (p > 0.05). In contrast, the AZ group showed a statistically significant reduction in total bacterial counts and specific periodontopathogens (p < 0.05). Oral health-related quality of life (OHQOL) improved significantly in both groups 2weeks post-treatment. Although AZ provided enhanced microbiological benefits, its adjunctive use did not yield additional clinical improvements. These findings suggest that routine use of AZ may not be justified for all patients undergoing OSFMD, though benefits may exist for selected high-risk cases.

In vivo periodontal ultrasound imaging via a hockey-stick transducer and comparison to periodontal probing: a proof-of-concept study

ObjectiveThe objective of this study is to evaluate a compact ultrasound transducer to image anatomical biomarkers for periodontal diagnosis of teeth, including difficult-to-reach posterior teeth.Materials and methodsA 9-MHz hockey-stick transducer was used to image 53 premolars, 30 molars, and 79 incisors and canines from 13 subjects. The alveolar bone crest (ABC), cementoenamel junction (CEJ), and gingival margin (GM) were identified by ultrasound imaging. The image-based distances between these anatomic landmarks were measured for iABC (ABC to CEJ), iGR (GM to CEJ) and iGH (ABC to GM). The measurements were compared to corresponding parameters obtained from clinical examination. The measurements were also used to assess periodontal health and were compared with clinical diagnosis.ResultsThe average iGR measurements were − 1.12 mm (i.e., 1.12 mm above the CEJ) for gingivitis and Stage I periodontitis, and − 0.56 mm for Stage III periodontitis, demonstrating a significant increase in gingival recession in patients with severe periodontitis (Student t-test, unpaired, two-tailed, p < 0.0001). The iGH measurements distinguished gingivitis, Stage I periodontitis group, and the Stage III periodontitis group (unpaired, two-tailed t-test, p < 0.05 for PPD, and p = 0.05 for iGH).ConclusionNon-invasive periodontal ultrasound imaging can be used to stratify subjects with differing periodontal disease severity. The clinical parameters obtained from ultrasound imaging with the hockey-stick transducer are reproducible.Clinical relevanceThe compact ultrasound transducer can be used as a screening tool for patients affected by periodontitis for clinical examination and treatment.

The Association Between Periodontal Disease and Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

Background: Periodontal disease (PD) and polycystic ovary syndrome (PCOS) are two prevalent conditions that have been independently associated with systemic inflammation and hormonal dysregulation. Emerging evidence suggests a potential bidirectional relationship between these conditions, but the nature and strength of this association remain unclear. Objective: This systematic review aimed to evaluate and synthesize the existing evidence on the association between periodontal disease and polycystic ovary syndrome, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methods: A comprehensive literature search was conducted in multiple databases, including PubMed, Scopus, and Web of Science, from 1990 to 2025. Studies investigating the association between PD and PCOS in terms of prevalence, severity, and shared pathophysiological mechanisms were included. Two independent reviewers screened studies for eligibility, extracted data, and assessed methodological quality using validated tools. Discrepancies were resolved through consensus. Meta-analysis was conducted where appropriate. Results: A total of nine studies were included. Most studies reported a higher prevalence and severity of periodontal disease among women with PCOS compared to controls. Shared mechanisms, including systemic inflammation, insulin resistance, and hormonal dysregulation, were frequently proposed as underlying factors. However, heterogeneity in study designs, diagnostic criteria, and confounding adjustments limited the comparability of findings. Conclusions: This systematic review supports a potential association between periodontal disease and polycystic ovary syndrome, likely mediated by common inflammatory and metabolic pathways. However, the evidence is limited by heterogeneity and methodological biases. Further well-designed longitudinal studies are needed to clarify causal relationships and explore the clinical implications of integrating periodontal health management into PCOS care.

Global variations and socioeconomic inequalities in lifetime risk of lip, oral cavity, and pharyngeal cancer: a population-based systematic analysis of GLOBOCAN 2022.

Global variations and socioeconomic inequalities in lifetime risk of lip, oral cavity, and pharyngeal cancer: a population-based systematic analysis of GLOBOCAN 2022.

A prospective case series study of alveolar ridge preservation using different bone graft materials in molars with severe periodontitis

Objective: To compare the clinical effects of using xenogenic bone graft materials with or without collagen components for tooth micro crestal flap-alveolar ridge preservation (MCF-ARP) at molars with severe periodontitis. Methods: This study included patients who visited Department of Periodontology, Peking University School and Hospital of Stomatology from May to November 2023 due to severe periodontitis, requiring tooth extraction and planning for implant-retained prostheses. A total of 24 molars from 24 patients with severe periodontitis were assigned into two groups: the deproteinized bovine bone mineral (DBBM) group and the deproteinized bovine bone mineral with collagen (DBBM-C) group. Twelve affected teeth from 12 patients were included in each group. Both groups underwent minimally invasive tooth extraction and MCF-ARP, with DBBM and DBBM-C implanted in the extraction socket, respectively. Cone-beam CT (CBCT) was performed before and 6 months after the surgery for assessing changes of hard tissue. Intraoral scanning was performed before and at 2 weeks, 1 month, 3 months, and 6 months after the surgery for assessing soft tissue contour changes and patterns in both groups. Results: After 6 months of healing, the central bone height increased by (8.35±2.25) mm in the DBBM group and (7.70±2.36) mm in the DBBM-C group. The ridge width at 1 mm apically from the higher bone crest increased by (4.43±6.14) mm in the DBBM group and (5.15±3.84) mm in the DBBM-C group. There was no statistically significant difference in the changes of bone height and width between the two groups (P>0.05). In terms of soft tissue contour changes, although the buccal contour collapses were less in the DBBM-C group, the two groups showed no statistically significant difference (P>0.05). Conclusions: Within the limitations of this study, it was demonstrated that the clinical effects of MCF-ARP using xenogenic bone graft materials with or without collagen components in molars with severe periodontitis were comparable.

Intentional replantation to preserve natural teeth in patients with severe periodontitis: a case report

Intentional replantation to preserve natural teeth in patients with severe periodontitis: a case report

A 10-year follow-up of multidisciplinary combined treatment for severe chronic periodontitis: a case report

A 10-year follow-up of multidisciplinary combined treatment for severe chronic periodontitis: a case report

Antibacterial effects of rosella petal extract (Hibiscus sabdariffa L.) in mouthwash formulation against Streptococcus sanguinis and Porphyromonas gingivalis Biofilms: An in vitro study

Antibacterial effects of rosella petal extract (Hibiscus sabdariffa L.) in mouthwash formulation against Streptococcus sanguinis and Porphyromonas gingivalis Biofilms: An in vitro study

Abstract 7417: Biological, clinical and epidemiological risk factors for oropharyngeal cancers in people with HIV in Puerto Rico

Abstract Background: People with HIV (PWH) are at a higher risk of developing cancers. Periodontal disease (PD), which is highly prevalent in PWH, is a chronic inflammatory disease associated with increased risk factor for oropharyngeal cancers as well as lung, pancreatic and colorectal cancers. Dysbiosis of the oral microbiome and oral human papillomavirus (HPV) infection can increase cancer risk. Puerto Rico (PR) has disparities in HIV infection and HPV-related malignancies, and socio-economic disadvantages that further increase cancer risk, but none of these risk factors have been evaluated altogether in PWH, particularly in PR. In this study, we evaluated the prevalence of PD in Puerto Rican PWH and analyzed other risk factors associated with oropharyngeal cancers in relation to PD. Methods: We collected saliva and oral rinse samples as well as PD status from 165 sexually active and virally suppressed PWH. We also collected sociodemographic, clinical and lifestyle variables through a questionnaire. In a subset of participants, we evaluated HPV infection and genotype (DNA ELISA kit HPV SPF10 and RHA kit HPV SPF10-LiPA2, n=135), the oral bacteriome (16s sequencing, n=98) and oral mycobiome (ITS sequencing, n=32), in relation to PD as factors for increased oral cancer risk. Diversity, taxonomic assignments, differential abundance analysis and statistical analysis were performed using QIIME2 and R-statistical software. Results: High prevalence of PD (86%) was observed, with moderate (60%) and severe (27%) being the most abundant. PWH with PD had significantly lower median CD4 count than PWH without PD (753cells/µl vs. 895cells/µl p=0.029). HPV+ PWH had a 95% prevalence of PD, with the prevalence of severe PD increasing to 35%. Furthermore, PD was also significantly associated with higher bacterial and fungal phylogenetic diversity (p=0.048 and p=0.028, respectively) and higher bacterial richness (p=0.063). In addition, significantly higher abundance of fungal pathogenic species was observed in PD, characterized by higher relative abundance of Candida. Conclusion: Overall, high prevalence of PD significantly associated with lower median of CD4 count was observed in Puerto Rican PWH, which may contribute to a higher risk for oropharyngeal cancers, as well as other distal cancers. Moreover, dysbiosis of the oral microbiome and oral HPV infection associated with PD could contribute to subsequent inflammation and oral tissue damage which can further increase cancer risk. Understanding the mechanistic interplay between these cancer risk factors is essential to establish targets for early prognosis and personalized treatment approaches and better preventive public health strategies to reduce oropharyngeal cancers. Citation Format: Juliana M. Serrano-Rodríguez, Jurelis Torres-Reyes, Yakshi N. Ortiz-Maldonado, Carlos A. Solá-Morlá, Gabriel Borges-Vélez, Jeannette Salgado-Montilla, María M. Sánchez-Vázquez, Magaly Martínez-Ferrer, Ramón F. González-Garcia, Josué Pérez-Santiago. Biological, clinical and epidemiological risk factors for oropharyngeal cancers in people with HIV in Puerto Rico [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7417.

Association between periodontitis and prostate cancer: A case-control study.

Recent evidence suggests that chronic inflammation may play a role in the development and clinical course of cancer. In this context, periodontitis (PE) has been associated with prostate cancer (PC), but the results are still inconsistent. Therefore, the aim of this study was to evaluate the potential association between PE and PC, and their shared risk factors. This case-control study comprised 152 cases with PC and 220 controls. All participants underwent a complete periodontal examination, and sociodemographic and medical variables of interest were collected. The association between occurrence and severity of PC and covariates was assessed by binary and multinomial multivariate logistic regression, respectively. The cases had a higher prevalence (p=0.012) and severity (p=0.007) of PE. The occurrence of PC was associated with an educational level <9 years (adjusted odds ratio [OR]=1.93), smoking (adjusted OR=2.62), alcohol consumption (adjusted OR=3.45), diabetes (adjusted OR=0.32), chronic hypertension (adjusted OR=2.03), and PE (adjusted OR=1.80). Regarding the severity of PC, Gleason grades 1 and 2 were associated with PE (adjusted OR=1.96), but Gleason grades 3-5 were not. PE was associated with the occurrence of PC. Males diagnosed with PE would potentially benefit from being screened for prostate alterations. Periodontitis is an infectious disease that affects the supporting structures of the teeth. It has been characterized as a chronic inflammatory stimulus with potential risk for the occurrence or worsening of the clinical course of cancer. We evaluated the potential relationship between periodontitis and prostate cancer, as well as their shared risk factors, in a case-control study comprising 372 male individuals. The participants were recruited in a urology outpatient clinic and underwent a complete periodontal examination. The results showed that individuals with prostate cancer presented a worse periodontal status and a higher prevalence and severity of periodontitis. Prostate cancer was mainly associated with educational level, smoking, alcohol consumption, and periodontitis. Individuals with periodontitis were 1.8 times more likely to have prostate cancer. Prostate-specific antigen levels in individuals with periodontitis were also significantly higher. We concluded that periodontitis was associated with the occurrence of prostate cancer. Therefore, males diagnosed with periodontitis would potentially benefit from being screened for prostate alterations.