Journal of periodontology最新文献

{"title":"Gingival inflammation and plaque accumulation affect therapeutic outcomes in patients with acne vulgaris.","authors":"Ömer Faruk Okumuş,Mustafa Yazıcı,Alpdoğan Kantarci","doi":"10.1002/jper.70137","DOIUrl":"https://doi.org/10.1002/jper.70137","url":null,"abstract":"BACKGROUNDWe hypothesized that acne vulgaris (AV) and gingivitis were associated through systemic inflammatory mechanisms, sharing common etiological factors. This study aimed to identify the association between AV and gingivitis and to assess changes in acne severity in relation to changes in the plaque index (PI).METHODSThis prospective, observational study included 150 patients aged 13 to 19 years, divided into three equal groups based on acne severity. The PI and the gingival index (GI) of all participants were recorded, followed by oral hygiene instruction and scaling. The severe acne group was re-evaluated after 1.5 months, constituting the follow-up stage of the study. These patients were then divided into two subgroups based on the degree of change in their acne scores. Changes in PI and GI were calculated from repeated measurements.RESULTSAt baseline, although no significant difference was observed between the groups in terms of PI scores (p > 0.05), the GI scores were significantly higher in the severe acne group compared with the mild acne group (p < 0.001). At the re-evaluation, the subgroup with more pronounced improvement in acne scores showed significantly greater changes in both GI and PI values (p < 0.001), and the magnitude of these changes demonstrated good discriminative performance for acne improvement (AUCs = 0.896-0.903; p < 0.001).CONCLUSIONSThe findings suggested that gingival inflammation was associated with the severity of AV lesions, independent of plaque accumulation. Thus, improvements in gingival inflammation and plaque accumulation were associated with AV-associated symptom improvement.TRIAL REGISTRATIONThis study was registered in ClinicalTrials.gov under the number NCT06237387 on May 24, 2024.PLAIN LANGUAGE SUMMARYAcne vulgaris and gingivitis are common inflammatory diseases. Etiological factors such as nutrition, hormonal changes associated with puberty, and hygiene habits are effective in both diseases. This study aimed to examine the relationships among plaque accumulation, gingivitis, and acne vulgaris. A total of 150 adolescents were included in the study, and participants were divided into three groups based on acne severity: mild, moderate, and severe. All participants were assessed for plaque and gingival inflammation, and all received oral hygiene instruction and dental scaling. Greater reductions in plaque levels and gingival inflammation were observed in patients who showed more pronounced regression of acne lesions.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"114 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147708515","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}

{"title":"Periodontitis during pregnancy: The effect on the gut microbiome and intestinal inflammation.","authors":"Richard Bright,Matthew G Macowan,Keyuan Tian,Tracy Fitzsimmons,Rebecca L Wilson,Claire T Roberts,Claus T Christophersen,Peter M Bartold,Stephen P Kidd,Peter S Zilm","doi":"10.1002/jper.70132","DOIUrl":"https://doi.org/10.1002/jper.70132","url":null,"abstract":"BACKGROUNDPeriodontitis has been epidemiologically associated with adverse pregnancy outcomes, but causality remains difficult to establish in humans due to confounding factors. This study uses a controlled murine model to examine the effects of experimentally induced periodontitis on the composition of the gut microbiota and gastrointestinal inflammation during pregnancy.METHODSPeriodontitis was induced in pregnant BALB/c mice via oral inoculation with Porphyromonas gingivalis and Fusobacterium nucleatum before conception (n = 20 per group). Pregnancy outcomes, gut histology, systemic inflammatory markers, and microbiome composition, assessed by 16S rRNA sequencing, were evaluated at gestational Day 18.RESULTSPeriodontitis was confirmed by significant alveolar bone loss. While fetal and placental weights were modestly increased in periodontitis-positive mice, there were no changes in implantation rates or placental efficiency. Systemic inflammatory markers, including C-reactive protein and interleukin-33, were reduced, suggesting pregnancy-specific immunomodulation. Histological analysis revealed significant inflammation in the jejunum and colon of periodontitis-exposed mice. Despite this, alpha and beta diversity metrics of the gut microbiota remained essentially unchanged. Taxonomic shifts were observed at the genus level, with reductions in protective taxa, such as Akkermansia muciniphila and increases in potentially pro-inflammatory genera, like Desulfovibrio.CONCLUSIONSPeriodontitis during pregnancy alters gut microbial composition and increases gastrointestinal inflammation without overtly impairing pregnancy outcomes in mice. These findings suggest an association between oral inflammation, intestinal inflammatory changes, and systemic inflammatory modulation during pregnancy. Further studies are warranted to explore long-term maternal and offspring consequences and their relevance to human pregnancy.PLAIN LANGUAGE SUMMARYThis study explored how periodontitis during pregnancy can influence the gut and immune system. Periodontitis is already associated with poor pregnancy outcomes, but establishing cause and effect in humans is difficult. To investigate this, the researchers used a controlled mouse model. We induced periodontitis in pregnant mice and examined its impact on the gut microbiome, intestinal health, and immune responses. The results revealed that periodontitis does not stay confined to the mouth; it disrupts gut bacterial balance, causes gut inflammation, and modifies immune pathways. Notably, these effects occurred during pregnancy, a time when the immune system is already adapting. The findings suggest that oral infections during pregnancy can have widespread effects, impacting gut health and immune regulation. This may help explain the link between periodontitis and human pregnancy complications. Overall, the study underscores the importance of oral health during pregnancy and supports the idea that treating periodontitis mig","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"36 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680331","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}

{"title":"Betaine-, xylitol-, and extra virgin olive oil-based toothpaste modulates inflammation and oral nitric oxide pathway: Clinical trial in gingivitis.","authors":"Francisco Mesa,Alejandro Rodríguez-Agurto,Marco Bonilla,Debora Rodríguez-Vilaboa,Beatriz Rodríguez-Vilaboa,Manuel Bravo","doi":"10.1002/jper.70135","DOIUrl":"https://doi.org/10.1002/jper.70135","url":null,"abstract":"BACKGROUNDGingivitis is a prevalent and reversible inflammatory condition driven by microbial dysbiosis. Beyond plaque control, interest has grown in oral hygiene formulations capable of modulating inflammation while preserving key microbial functions. Extra virgin olive oil (EVOO), together with xylitol and betaine, has demonstrated clinical benefits in gingivitis; however, its effects on neutrophil-driven tissue inflammation and on the oral nitrate-nitrite pathway have not been previously evaluated.METHODSThis randomized, double-blind clinical trial compared an EVOO-, xylitol-, and betaine-based toothpaste with a placebo formulation and a commercially available anti-gingivitis toothpaste. Participants used the assigned toothpaste three times daily for 4 months. Neutrophil elastase concentrations were measured in gingival crevicular fluid by enzyme-linked immunosorbent assay, and salivary nitrate and nitrite levels were quantified by ion chromatography at baseline and follow-up.RESULTSA total of 96 patients with gingivitis completed the study. Elastase levels increased over time in both control groups, reaching statistical significance in the commercial control, whereas the test group showed a slight reduction. The difference in elastase change between the test group and the commercial control was statistically significant (p = 0.050). Nitrite-to-nitrate ratio was significantly higher compared with both the placebo and commercial control groups (p = 0.040 and p = 0.006, respectively).CONCLUSIONThe toothpaste containing EVOO, xylitol, and betaine maintained stable elastase levels in gingival crevicular fluid and significantly increased the salivary nitrite-to-nitrate ratio after 4 months of use. Compared with the placebo and commercial toothpastes, this formulation demonstrated superior anti-inflammatory effects and enhanced nitrate-to-nitrite reduction, indicating a dual benefit in patients with gingivitis.TRIAL REGISTRATIONClinicalTrials.gov identifier: NCT05463484 PLAIN LANGUAGE SUMMARY: A toothpaste containing extra virgin olive oil, xylitol, and betaine reduced gum inflammation and improved nitric oxide-related markers in patients with gingivitis.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"24 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680328","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}

{"title":"Advancing the diagnosis of peri-implant diseases: From histological foundations to next-generation ultrasonographic diagnostic markers.","authors":"Maria Elisa Galarraga-Vinueza,Jae-Kook Cha,Lorenzo Tavelli,Magda Feres","doi":"10.1002/jper.70113","DOIUrl":"https://doi.org/10.1002/jper.70113","url":null,"abstract":"BACKGROUNDThis critical review provides a comprehensive analysis of the histological foundations, current clinical diagnostic standards, and emerging ultrasonographic methods for diagnosing peri-implant diseases.METHODSAn electronic search in Medline (PubMed) database was conducted to identify original and review articles focused on the histological foundation and diagnostic approaches of peri-implant diseases. This review provides an integrated perspective on the evolution of peri-implant diseases diagnostics, focusing on the clinical and radiographic criteria established by the latest consensus guidelines. It outlines the histological features of peri-implant diseases and discusses recent advancements in ultrasonographic imaging approaches for their characterization and diagnosis. This review further explores elements such as peri-implant anatomical landmarks, echo intensity, tissue perfusion, and strain elastography.RESULTSHistological studies have defined the peri-implant mucosal architecture and inflammatory patterns characteristic of disease progression. While conventional diagnostics have relied on clinical examination and radiographic imaging, high-frequency ultrasound (HFUS) has recently emerged as a promising noninvasive imaging tool enabling detailed assessment of peri-implant tissue dimensions, echo intensity, vascular perfusion, and the extent of inflammatory involvement. Echo intensity mapping aids in the visualization and quantification of peri-implant lesions and the identification of associated bone defects. These imaging advancements not only complement current diagnostic methods but also deepen our understanding of peri-implant disease dynamics. Observed correlations between histological findings and ultrasonographic features can support the development of a new diagnostic framework incorporating HFUS-derived markers for detecting peri-implant lesions and evaluating the severity of inflammation.CONCLUSIONSIntegrating HFUS and power Doppler imaging into peri-implant diagnostics allows real-time, noninvasive visualization of key structures such as the supracrestal adherent connective tissue, buccal bone levels, and tissue perfusion. These modalities can complement existing standards and enhance diagnostic precision by identifying the extent of peri-implant lesions and quantifying the severity of inflammation.PLAIN LANGUAGE SUMMARYPeri-implant diseases can affect the tissues around dental implants and can lead to inflammation and bone loss. Understanding how these diseases develop and how best to diagnose them is essential for improving patient care. The present narrative review looked at scientific studies that examined the tissues around implants and the methods used to diagnose peri-implant diseases. It explains what researchers have learned from tissue (histological) studies and summarizes the current clinical and X-ray based diagnostic standards. It also highlights new advances in high-frequency ultrasound (HFUS), a technolog","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"55 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663672","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}

{"title":"Correlating bacterial load and periodontal disease severity: A large-scale study of the microbial landscape.","authors":"Naomi B Gizaw,Nicholas Gomez,Ronald C McGlennen,Mohammad-Zaman Nouri","doi":"10.1002/jper.70122","DOIUrl":"https://doi.org/10.1002/jper.70122","url":null,"abstract":"BACKGROUNDPeriodontitis is an inflammatory disease of the oral cavity driven by bacterial dysbiosis that progressively breaks down the tooth-supporting structures.METHODSThis study leverages a uniquely large dataset of up to 34,000 patient records in the United States analyzed using standardized real-time polymerase chain reaction-based molecular testing to quantify bacterial profiles associated with periodontitis. Our analysis focused on 11 bacterial taxa from the red, orange, and green complexes. We assessed bacterial abundance, expressed as genome copies per milliliter, across periodontitis stages and associations with age and systemic conditions.RESULTSAcross stages 1-4 (according to the American Academy of Periodontology classification), the concentration of the three red complex bacteria, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola increased up to 11-fold, the highest increase observed among all studied bacteria. A substantial microbial shift in younger patients was observed, while older individuals exhibited a higher prevalence of red complex pathogens. The relative abundance of P. gingivalis increased significantly, from 4% in stage 1 periodontitis to 17% in stage 4. Cumulative bacterial load analysis based on the presence or absence of red complex bacteria revealed that the median bacterial load was 5-fold higher in samples where red complex bacteria were present. The inter-bacterial correlations increased with demographic and clinical variables as periodontitis advanced.CONCLUSIONThe findings revealed a significant positive association between increased bacterial loads, particularly red complex bacteria and higher periodontitis stages, positioning them as a key indicator of dysbiosis and a potential biomarker for disease advancement.PLAIN LANGUAGE SUMMARYPeriodontitis is a serious gum disease that damages the tissues supporting the teeth. It is caused by harmful bacteria in the mouth and becomes worse over time if not treated. In this study, we analyzed oral rinse samples collected from more than 34,000 people using a DNA-based method to measure the levels of different bacteria. We focused on 11 bacteria known to be involved in gum disease and compared their presence in healthy versus mild to severe cases. We found that three bacteria, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola, became much more common as the disease got worse, with one of them, P. gingivalis, increasing 4-fold in severe cases compared with mild ones. Older adults were more likely to have these harmful bacteria, but younger patients showed notable shifts in their bacterial makeup as well. These results suggest that certain bacteria, especially P. gingivalis, may serve as warning signs for more advanced gum disease. Our findings could help to improve how gum disease is diagnosed and tracked, leading to better care and prevention. This is the largest study of its kind and offers new insight into the role of bacteria","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"67 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663676","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}

{"title":"Association between self-reported oral symptoms and irritable bowel syndrome: A prospective cohort study based on UK Biobank.","authors":"Zhuoya Sun,Laifu Li,Yan Zhuang,Xiaoting Hu,Jiamiao Chen,Shiwei Lu,Fei Dai","doi":"10.1002/jper.70125","DOIUrl":"https://doi.org/10.1002/jper.70125","url":null,"abstract":"BACKGROUNDAlthough periodontal disease (PD) has been linked to an increased risk of several gastrointestinal diseases such as inflammatory bowel disease and celiac disease, research on the association between PD and irritable bowel syndrome (IBS) is still insufficiently explored, with conflicting results. We aimed to investigate the potential association between self-reported oral symptoms and IBS based on the UK Biobank cohort.METHODSOral symptoms were assessed via questionnaire. Participants reporting at least one of gum pain, gum bleeding, or loose teeth were classified as being at high risk of PD. The primary outcome was incident IBS. Cox proportional hazards regression, incorporating multiple covariates, was applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) in examining the links between oral symptoms, high PD risk, and IBS incidence. Subgroup and sensitivity analyses were conducted.RESULTSThis longitudinal cohort study was conducted among 420,371 participants, 8642 incident cases of IBS (2.1%) were identified. Cox regression analyses showed that several oral symptoms, including mouth ulcers, gum pain, gum bleeding, toothache, and denture use, were significantly associated with an increased risk of IBS. No significant association was observed between loose teeth and IBS in any model. Compared with the low PD risk group, individuals at high risk of PD had an elevated likelihood of IBS onset (HR = 1.19, 95% CI: 1.13-1.25). Subgroup and sensitivity analyses strengthened the validity of these findings.CONCLUSIONOral symptoms (mouth ulcers, gum pain, gum bleeding, toothache, and denture use) and high risk of PD were both associated with an increased incidence of IBS. Incorporating oral health management into comprehensive strategies may contribute to the prevention of IBS.PLAIN LANGUAGE SUMMARYThere is a close connection between oral health and gut health. This long-term study of more than 420,000 UK adults found that individuals experiencing mouth ulcers, gum pain, gum bleeding, toothache, or denture use had a higher risk of developing irritable bowel syndrome (IBS) later in life. Additionally, participants classified as being at high risk for periodontal disease (PD; those with at least one symptom of gum pain, gum bleeding, or loose teeth) had about a 19% higher risk of developing IBS compared with the low PD risk group. Therefore, incorporating active management of oral problems into personal health practices could offer a new perspective for IBS prevention. Caring for oral health is not just about maintaining local wellness but is a crucial part of overall bodily health.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"21 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663670","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}

{"title":"AI-based evaluation of implant abutment screw torque decay: A periapical radiograph pilot study.","authors":"Guanqi Liu,Junda Li,Xiaoyan Chen,Jiahui Lin,Runzhong Liu,Zhuofan Chen,Runheng Liu","doi":"10.1002/jper.70127","DOIUrl":"https://doi.org/10.1002/jper.70127","url":null,"abstract":"BACKGROUNDTo develop a deep learning framework for non-invasive detection of implant abutment central screw torque decay using periapical radiographs, addressing the clinical challenge of mechanical screw loosening without invasive intervention.METHODSA controlled ex vivo dataset (2600 radiographs of Nobel CC RP implants in porcine ribs under torque: 15-35 N·cm) and a clinical dataset (n = 501 patient radiographs) were constructed. Five transfer learning strategies across three convolutional neural network (CNN) architectures (Custom CNN, VGG16, InceptionV3) were evaluated. Optimal models were validated on an independent test set (n = 100) and benchmarked against three experienced dentists. Gradient-weighted Class Activation Mapping (Grad-CAM) visualized decision rationale.RESULTSThe VGG16 model with ex vivo pre-training and clinical fine-tuning achieved 88.0% accuracy (95% confidence interval [CI]: 80.0-93.2), 88.0% sensitivity/specificity, and area under the curve (AUC) 88.0%, significantly outperforming dentists' near-random accuracy (42.0-52.0%, all p < 0.05).KEY FINDINGS(1) Transfer learning sequence critically influenced performance (ex vivo→clinical fine-tuning exceeded inverse strategy by 30.0% accuracy); (2) Dentists exhibited no diagnostic advantage over chance (F1 = 43.0%-52.0% vs. 50.0% baseline); (3) Grad-CAM confirmed model focus on biomechanically critical screw-implant interfaces.CONCLUSIONSThis first AI solution enables > 88.0% accurate non-invasive detection of early torque decay, demonstrating significant potential to prevent prosthetic complications through targeted retightening.PLAIN LANGUAGE SUMMARYLoosening of the tiny screws holding dental implants together is a common problem that can cause expensive repairs and hassle for patients. Currently, checking if these screws are loose requires dentists to physically tighten or loosen them, which is inconvenient and can weaken the screw over time. This study developed a new, non-invasive way to check screw tightness using standard dental x-ray pictures and artificial intelligence (AI). Researchers trained the AI system: first on detailed pictures of implant screws in a lab setting (pig ribs), and then fine-tuning it using real patient x-rays. When tested on a new set of 100 patient x-rays it had never seen before, the best AI tool (using a system called VGG16) correctly identified loose screws 88.0% of the time. This was much more accurate than experienced dentists looking at the same x-rays, who performed no better than random guessing (42.0%-52.0% accuracy). The AI reliably focused on the critical parts of the screw in the x-rays. This AI tool offers a promising way to easily monitor implant screw tightness during regular check-ups, helping dentists catch problems early before they cause bigger issues, potentially saving patients time, discomfort, and cost.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"34 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663673","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}

{"title":"Aging and periodontitis increase brain dissemination of oral bacteria.","authors":"Ozge Unlu,Tsute Chen,Nil Yakar,Zeliha Guney,Bruce Paster,Isabel Carreras,Alpaslan Dedeoglu,Alpdogan Kantarci","doi":"10.1002/jper.70118","DOIUrl":"https://doi.org/10.1002/jper.70118","url":null,"abstract":"BACKGROUNDThe microbiome is a dynamic system that changes throughout life. Studies have revealed the relationship between periodontal disease and the oral microbiota; however, the impact of periodontal disease on the expression of senescence markers and on the inflammaging of the oral and systemic microbiome remains unclear. We hypothesized that aging increases the periodontitis-induced changes in the oral and systemic microbiome and is accompanied by an altered inflammatory response.METHODSExperimental periodontitis was induced in 18-month-old (old) and 8-month-old (young) C57BL/6 mice by placing ligatures around the second maxillary molars. Bone morphometric analyses were conducted to assess bone loss. Senescence- and inflammatory-related gene expression in the gingiva was measured by quantitative polymerase chain reaction (qPCR). Serum inflammatory markers were evaluated via immunoassay. Oral, brain, and gut microbial content were analyzed using next-generation sequencing.RESULTSMaxillary bone loss was significantly higher in the old mice with periodontal disease than in young mice. Senescence and inflammatory markers were higher in old mice than in young ones, and periodontitis increased their expression. The alpha diversity of the oral and brain microbial communities differed significantly between old and young mice. Treponema denticola, Fusobacterium nucleatum, Porphyromonas gingivalis, P. pasteri, and Prevotella nigrescens were only detected in the brains of old animals with periodontitis.CONCLUSIONPeriodontopathogens and oral commensals are either only found in the brains of old animals with periodontal disease or are more prevalent in the brains of old animals, suggesting that aging and periodontitis may contribute to the dissemination of oral bacteria to the brain.PLAIN LANGUAGE SUMMARYAging may increase the periodontitis-induced changes in the oral and systemic microbiome, which an altered inflammatory response may accompany. Experimental periodontitis was created in old and young mouse models. Bone loss, senescence, and inflammatory gene expression and serum inflammatory markers were assessed in each model, and oral, brain, and gut microbial content was analyzed. Senescence and inflammatory markers were higher in old mice than in young ones, and periodontitis increased their expression. Our results suggested that aging and periodontitis may contribute to the dissemination of oral bacteria to the brain.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"430 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663671","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}

{"title":"Grade C molar-incisor pattern periodontitis classification and its challenges.","authors":"Yasmin Teixeira das Graças,Manuela Maria Viana Miguel,Renato Corrêa Viana Casarin,Mauro Pedrine Santamaria,Pratishtha Mishra,Luciana Macchion Shaddox","doi":"10.1002/jper.70119","DOIUrl":"https://doi.org/10.1002/jper.70119","url":null,"abstract":"BACKGROUNDThe classification of periodontitis has changed, establishing not just the severity and extent of disease but also more comprehensive risk assessment for patients and hopefully guiding more tailored treatment approaches. Although the new classification presented several benefits to the severity and risk of progression of disease, some limitations remain. This review highlights key gaps in the grade C and molar-incisor pattern (C-MIP) classification, particularly the exclusion of primary dentition involvement, which limits early awareness, diagnosis, treatment, and research. Additionally, the current \"grade C\" category includes a broad spectrum of patients, ranging from systemically healthy young individuals with early onset and rapid disease progression to older adults whose disease is associated with modifying factors. This overlap masks key clinical and biological differences, complicating efforts to identify susceptibility profiles and tailor treatment. Moreover, cases extending beyond the molar-incisor pattern, including premolars or atypical presentations, pose challenges to the current classification system. These patients often exhibit early onset, familial aggregation, rapid progression, and absence of systemic risk factors, suggesting a unique susceptibility profile that may not be adequately captured by the current classification and deserve proper categorization to be better studied and treated.CONCLUSIONIn the conclusion of this paper, we suggest expansion and clarification of the current classification system to: (1) recognize periodontitis in the primary dentition; (2) distinguish patients with grade C periodontitis by the presence or absence of modifying factors; and (3) introduce a subclassification for grade C cases predominantly affecting young patients. These refinements may improve diagnostic accuracy and support more targeted research, prevention, and treatment for at-risk youth.","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"51 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663674","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}

{"title":"Unsupervised phenotyping of the periodontal architecture through high-dimensional clustering of electronic health records: A multicenter study.","authors":"Georgios S Chatzopoulos,Larry F Wolff","doi":"10.1002/jper.70123","DOIUrl":"https://doi.org/10.1002/jper.70123","url":null,"abstract":"BACKGROUNDTo identify novel periodontal phenotypes using unsupervised machine learning on a large-scale, multicenter cohort, specifically characterizing disease patterns based on the \"periodontal architecture\" of localized structural failures (tooth mobility and molar furcation defects) rather than global severity averages alone.METHODSThis cross-sectional study analyzed electronic health records from 15,723 adult patients with periodontitis. A high-dimensional feature vector (D = 72) was constructed for each patient, integrating tooth-specific ordinal grades for mobility and furcation, mean probing depths (PPD), clinical attachment loss (CAL), and systemic health variables. Unsupervised phenotyping was performed using principal component analysis (PCA), t-SNE visualization, and K-means clustering. Cluster validity was assessed via Silhouette Analysis, and phenotypes were compared using ANOVA and Chi-square (X2) tests.RESULTSFour distinct architectural phenotypes were identified: (1) Maintenance/Healthy, representing stability; (2) Anterior-Mobility dominant, defined by high-grade anterior mobility (52.4% prevalence), and the highest diabetes prevalence (12.2%); (3) Molar-Furcation Dominant, a male-dominated group (61%) characterized by advanced posterior furcation defects (93.8% prevalence) despite lower anterior mobility; and (4) Generalized severe, exhibiting global architectural collapse. The phenotypes demonstrated statistically significant separation across all clinical metrics (p &lt; 0.001).CONCLUSIONPeriodontitis manifests as distinct architectural archetypes-specifically \"Anterior-Mobility\" and \"Molar-Furcation\" phenotypes-that are often aggregated into a single severity category by traditional staging. These data-driven clusters have unique systemic risk profiles, suggesting that diagnosis and treatment planning should incorporate the specific localization of structural failure.PLAIN LANGUAGE SUMMARYSevere gum disease (periodontitis) is traditionally classified by overall severity, often grouping different types of tooth damage into the same broad category. To uncover hidden patterns, we used an artificial intelligence technique to analyze the detailed dental and medical records of more than 15,000 patients. Instead of simply grouping patients by how advanced their disease was, the computer identified four distinct patient profiles based on specific patterns of tooth damage and overall health. Interestingly, two of the most severe profiles were fundamentally different. One featured loose front teeth and was strongly linked to diabetes and systemic health issues. The other featured damage between the roots of back teeth (molars) and was primarily driven by local anatomical problems rather than general health. These findings demonstrate that severe gum disease is not a single condition, but rather develops through completely distinct biological pathways. Recognizing these unique patterns allows dental professionals to move beyond a \"one-siz","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":"52 1","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663677","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}