Growth differentiation factor-15 and circulating biomarkers as predictors of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial

Association Between Serum Albumin and Periodontitis Across Disease Subgroups: A Cross-Sectional Study

PURPOSE

This study examines the association between serum albumin (sALB) levels and periodontitis severity, focusing on subgroup differences and nonlinear relationships. It extends previous findings, which were limited to chronic kidney disease (CKD) patients.

MATERIALS AND METHODS

This cross-sectional study utilized data from 8352 participants in the NHANES 2009 to 2014 survey cycles. sALB and periodontitis were the exposure and outcome variables. Logistic regression models and restricted cubic spline curves were used to investigate the relationship between the two. Additionally, subgroup and interaction analyses were conducted to assess the stability of the findings. All statistical analyses considered the complex survey design.

RESULTS

A significant negative association was observed between sALB and periodontitis status (aOR 0.94, 95% confidence intervals: 0.93-0.96, P value <.001). The strength of this association may be influenced by participants' gender, CKD status, and hypertension status. Among participants with sALB levels below 35 g/L (defined as hypoalbuminemia), no significant association with periodontitis was observed, even in those with CKD. Restricted cubic spline analysis demonstrated an inverted U-shaped relationship between sALB levels and periodontitis, with a threshold effect at 38 g/L. Above this inflection point, higher sALB levels were significantly associated with a lower prevalence of periodontitis (P < .001).

CONCLUSIONS

ALB levels were inversely associated with moderate and severe periodontitis, with an inverted U-shaped relationship observed in this study. The differences among subgroups warrant further research.

CLINICAL RELEVANCE

Maintaining appropriate sALB levels may be beneficial for periodontal health. Further research is needed to confirm its role in periodontitis prevention and treatment.

Therapeutic effects of tripterygium glycosides on periodontitis: Exploring the role of ursolic acid and the RIPK3/NLRP3 signaling pathway

BACKGROUND

Periodontitis, a chronic inflammatory disease, poses challenges in treatment due to its complex etiology. Tripterygium glycosides (TGs), renowned for their immunosuppressive and anti-inflammatory capabilities, present a prospective therapeutic option for the management of periodontitis. This study delves into the therapeutic efficacy of TGs in periodontitis and reveals the fundamental mechanisms involved.

MATERIALS AND METHODS

Animal experiments were conducted to observe the therapeutic effects of TGs. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was employed to identify the optimal components. Proteomic technology was used to identify differentially expressed proteins, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Molecular docking and experimental verification of core components and targets were also performed.

RESULTS

TGs markedly attenuated periodontal damage and alveolar bone resorption and significantly reduced the expression of inflammatory factors. Ursolic acid (UA) was identified as a crucial active ingredient. Among the signaling pathways, the nucleotide-binding oligomerization domain-like receptor (NLR) pathway was the most prominently enriched pathway. The binding of UA to receptor-interacting protein kinase 3 (RIPK3) was demonstrated to have therapeutic efficacy. In vitro experiments verified that UA exerts anti-inflammatory effects through the RIPK3/NLRP3 signaling pathway.

CONCLUSION

This study demonstrated that TGs effectively treat periodontitis by mitigating alveolar bone loss and suppressing inflammation. As the primary component of TGs, UA exerts therapeutic effects by inhibiting the expression of RIPK3, which in turn influences the activation of the NLRP3 inflammasome and the subsequent expression of downstream inflammatory factors. The findings of this study offer a theoretical foundation for the clinical application of TGs in the management of periodontitis.

Relationship between periodontitis and systemic diseases: A bibliometric and visual study

To provide a comprehensive and updated mapping of observational studies assessing the relationship between periodontitis and systemic diseases through a bibliometric and visual analysis. A search was conducted using the Web of Science database, covering the period 1989 to 2024. The Medical Subject Headings (MeSH) from the US National Library of Medicine was used to categorize systemic conditions, focusing on terms unrelated to stomatognathic diseases. The analysis included keyword co-occurrence mapping, co-authorship, bibliographic coupling, and co-citation analysis. Quality indicators such as silhouette score, modularity, and centrality were considered to assess the network's quality. The research strategy identified 6106 records, of which 1519 met the inclusion criteria. The analysis revealed that 46.73% of the literature on the topic was published in the last 5 years and that the annual publication trend peaked in 2023. Nutritional & Metabolic Diseases (n = 398), Cardiovascular Diseases (n = 335), Female Urogenital Diseases & Pregnancy Complications (n = 244), and Musculoskeletal Diseases (n = 182) were the most representative categories of systemic diseases associated with periodontitis. The most co-cited journals on the topic were the Journal of Periodontology (n = 1412), the Journal of Clinical Periodontology (n = 1343), the Journal of Dental Research (n = 940), and Periodontology 2000 (n = 849). The USA, China, Brazil, and Sweden were the countries that contributed the most to the number of publications. The analysis conducted in the present study revealed a growing trend of observational studies evaluating the association between periodontitis and systemic diseases, highlighting the negative impact of periodontitis on a plethora of systemic conditions and a rising translational interest in this relationship. With an aging population, periodontitis is expected to affect a growing number of people in the coming decades, presenting significant challenges to public health. Improved knowledge is, therefore, essential to enable more comprehensive care, preventive strategies, and optimal oral health for patients with periodontitis.

Single-Cell and Transcriptome Analysis of Periodontitis: Molecular Subtypes and Biomarkers Linked to Mitochondrial Dysfunction and Immunity

Background

Periodontitis represents an inflammatory disease with multiple contributing factors, affecting both oral and systemic health. The mechanisms linking mitochondrial dysfunction to immune responses in periodontitis remain unclear, limiting the development of individualized diagnostic and therapeutic approaches.

Objective

 This study aims to elucidate the roles of mitochondrial dysfunction and immune responses in the pathogenesis of periodontitis, identify distinct molecular subtypes, and discover robust diagnostic biomarkers to support precision medicine approaches.

Methods

Single-cell RNA sequencing and transcriptome data from periodontitis patients were analyzed to identify gene signatures linked to macrophages and mitochondria. Consensus clustering was applied to classify molecular subtypes. Potential biomarkers were identified using five machine learning algorithms and validated in clinical samples through qPCR and IHC.

Results

Four molecular subtypes were identified: quiescent, macrophage-dominant, mitochondria-dominant, and mixed, each exhibiting unique gene expression patterns. From 13 potential biomarkers, eight were shortlisted using machine learning, and five (BNIP3, FAHD1, UNG, CBR3, and SLC25A43) were validated in clinical samples. Among them, BNIP3, FAHD1, and UNG were significantly downregulated (p < 0.05).

Conclusion

This study identifies novel molecular subtypes and biomarkers that elucidate the interplay between immune responses and mitochondrial dysfunction in periodontitis. These findings provide insights into the disease's heterogeneity and lay the foundation for developing non-invasive diagnostic tools and personalized therapeutic strategies.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of select 2023 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertize in their subject areas that include (in order of appearance here): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine, oral and maxillofacial surgery, and oral radiology; and dental caries and cariology. The authors have focused their efforts on presenting information likely to influence the daily dental treatment decisions of the reader with an emphasis on current innovations, new materials and processes, emerging technology, and future trends in dentistry. With the overwhelming volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to inform and update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope readers find this work helpful in providing evidence-based care to patients seeking healthier and happier lives.

Proteome-Wide Mendelian Randomisation Identifies Causal Links of Plasma Proteins With Periodontitis

OBJECTIVE

Periodontitis is a complex and multifactorial disease and it is challenging to decipher its underlying causes and mechanisms. This study attempted to explore potential circulating proteins in connection to periodontitis through proteome-wide Mendelian randomisation (MR).

METHODS

We analysed 1722 circulating proteins to identify prospective drug targets for tackling periodontitis, using the genomic dataset from the FinnGen study. Two-sample MR was conducted to evaluate the bidirectional relationship between circulating proteins and periodontitis risk. A dataset from the UK Biobank was used to validate the findings. Single-cell analysis was performed to assess the cellular expression of the identified proteins within gingival tissues.

RESULTS

MR analyses found that genetically predicted circulating levels of von Willebrand factor A domain-containing 1 (von Willebrand factor A domain containing 1 [VWA1], odds ratios: 0.94, 95% CI 0.92-0.97, P = 1.28 × 10-5) were inversely associated with periodontitis. In contrast, the level of growth differentiation factor 15 (growth differentiation factor 15 [GDF15], odds ratios: 1.05, 95% CI 1.02-1.07, P = 2.12 × 10-5) might be associated with an increased risk of periodontitis. Single-cell analysis indicated that VWA1 was primarily expressed in endothelial cells of healthy gingival tissues, while the main source of GDF15 was not derived from periodontal cells.

CONCLUSIONS

The present study suggests that certain plasma proteins like VWA1 and GDF15 may be potentially indicative of the risk and susceptibility to periodontitis. These proteins could possibly be the potential therapeutic targets for treating periodontitis, and further investigation is highly warranted.

Reactive Oxygen Species-Responsive Pillararene-Embedded Covalent Organic Frameworks with Amplified Antimicrobial Photodynamic Therapy for the Targeted Elimination of Periodontitis Pathogens

Reactive oxygen species (ROS)-responsive drug delivery systems possess immense potential for targeted delivery and controlled release of therapeutics. However, the rapid responsiveness to ROS and sustained release of antibacterial drugs are often limited by the challenging microenvironment of periodontitis. Integrating ROS-responsive drug delivery systems with photocatalytic technologies presents a strategic approach to overcome these limitations. Herein, a pillararene-embedded covalent organic framework (PCOF) incorporating the antibacterial prodrug thioacetal (TA) has been developed to treat periodontitis. This drug-loaded nanoplatform, namely TA-loaded PCOF, utilizes the self-amplifying ROS property to enhance therapeutic efficacy. PCOFs demonstrate exceptional photosensitivity and ROS generation capabilities when employed as drug carriers. When exposed to ROS, TA within the nanoplatform was activated and cleaved into cinnamaldehyde (CA), a highly potent antibacterial compound. By leveraging visible light to activate the site-specific infection targeting, TA-loaded PCOF effectively alleviated periodontitis, thereby advancing the field of antibacterial drug delivery systems.

Association between high-density lipoprotein-related inflammation index and periodontitis: insights from NHANES 2009-2014

BACKGROUND

Periodontitis, a persistent inflammatory condition, significantly impairs individuals' overall quality of life. Lymphocyte-to-high-density lipoprotein cholesterol ratio (LHR), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), neutrophil-to-high-density lipoprotein cholesterol ratio (NHR), and platelet-to-high-density lipoprotein cholesterol ratio (PHR) are new convenient and economical biomarkers. However, whether the above high-density lipoprotein-related inflammatory biomarkers are associated with periodontitis has rarely been investigated. Therefore, the research endeavor focused on uncovering potential relationships.

METHODS

The research encompassed a diverse and extensive sample, comprising 9,470 participants, selected from the National Health and Nutrition Examination Survey spanning the years 2009 to 2014. The association between high-density lipoprotein-related inflammatory biomarkers and periodontitis was explored utilizing a multivariable logistic regression model with weighted analysis. Additionally, the study employed smoothed curve fitting to explore potential nonlinear relationships. Further stratified analyses and interaction tests were performed.

RESULTS

This study indicated no apparent association between MHR and PHR with periodontitis, whereas LHR and NHR demonstrated a statistically significant positive relationship with the prevalence of periodontitis. In the fully adjusted model, participants belonging to the highest tertile of both LHR and NHR showed a notably higher likelihood of having periodontitis compared to those in the lowest tertile (LHR: OR = 1.22, 95% CI: 1.06, 1.39; NHR: OR = 1.27, 95% CI: 1.09, 1.49). Furthermore, smooth curve fitting was employed to investigate the potential nonlinear relationship between LHR, NHR, and periodontitis. The results indicated that there was a significant increase in the occurrence of periodontitis when Log2 (LHR) exceeded 1.01 and Log2(NHR) surpassed 2.16 (Log2(LHR): OR = 1.42; 95% CI: 1.19, 1.69; Log2(NHR): OR = 1.40; 95% CI: 1.15, 1.71). The subgroup analysis revealed that the associations between periodontitis and either LHR or NHR, separately, were more pronounced among individuals under the age of 50 and those without hypertension.

CONCLUSIONS

This cross-sectional study revealed a positive relationship between LHR、NHR and periodontitis, particularly when these indicators exceeded their thresholds. LHR and NHR may serve as potential inflammatory markers for identifying periodontitis, thereby facilitating early warning for both patients and dentists, and enabling early intervention in the oral environment. Besides, extensive prospective cohort investigations are essential to confirm and solidify this observation.

Anti-inflammatory effects and related mechanisms of naringenin in human periodontal ligament stem cells under lipopolysaccharide stimulation based on RNA sequencing

OBJECTIVES

RNA sequencing (RNA-seq) and bioinformatic analysis were combined and used to explore the anti-inflammatory effects and mechanisms of naringenin (Nar) in lipopolysaccharide (LPS)-stimulated human periodontal ligament stem cells (hPDLSCs).

METHODS

Cell counting kit-8, quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), and enzyme-linked immunosorbent assay (ELISA) were adopted to detect the effects of Nar on the proliferation and expression of inflammatory factors in LPS-stimulated hPDLSCs, screening for the optimal anti-inflammatory concentration of Nar. Differentially expressed genes (DEGs) were screened using |log2FC|≥1 and P≤0.05 as criteria. Volcano plot analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, the String database, and the MCODE module of Cytoscape were utilized to select core genes and enriched pathways. The effects on the nuclear factor κB (NF-κB) signaling pathway were verified using ELISA, qRT-PCR, and Western blot.

RESULTS

Appropriate concentrations of Nar could alleviate the expression of inflammatory factors and promote the proliferation of hPDLSCs stimulated by LPS. The best anti-inflammatory effect was achieved with 20 μmol/L Nar. RNA-seq showed significant enrichment of inflammation-related signaling pathways. The anti-inflammatory effect of Nar was mediated by inhibiting the NF-κB signaling pathway, similar to the effect of the NF-κB inhibitor BAY 11-7802.

CONCLUSIONS

Nar could exert its anti-inflammatory effects by inhibiting the NF-κB signaling pathway, making it a potential therapeutic option for the adjuvant treatment of periodontitis.

Efficacy of Rose Bengal-Mediated Antimicrobial Photodynamic Therapy as an Adjunct to Scaling and Root Planing on Clinical and Microbiological Parameters in the Management of Chronic Periodontitis: A Single-Blinded, Randomized Controlled Clinical Trial

Aim: The study aims to assess the efficacy of rose bengal (RB)-mediated antimicrobial photodynamic therapy (a-PDT) as an adjunct to scaling and root planing in the management of chronic periodontitis patients in terms of clinical parameters like gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and microbiological parameters like total microbial count, total red complex organism count, Porphyromonas gingivalis count, Treponema denticola count, and Tannerella forsythia count. Materials and Methods: In this randomized controlled clinical trial, a total of 30 patients were recruited who met the inclusion criteria. The participants were randomly allocated into group A with scaling and root planning (SRP) alone and group B with SRP + a-PDT. The clinical and microbiological parameters were measured at baseline and at 3-month follow-up. Intergroup and intragroup comparisons were performed using independent t test and paired t test, respectively. Value of p < 0.05 was considered as statistically significant. Results: At 3-month follow-up, group B treated with SRP + a-PDT showed statistically significant reduction in GI (0.58 ± 0.20) and PPD (1.81 ± 0.32 mm), gain in CAL (0.73 ± 0.04 mm), and reduction in total microbial count [2.80 ± 0.08 × 104 colony forming unit (CFU)], total red complex count (0.29 ± 0.14 × 102 CFU), P. gingivalis count (0.43 ± 0.13 × 102 CFU), T. denticola count (0.61 ± 0.04 × 102 CFU), and T. forsythia count (0.59 ± 0.04 × 102 CFU) as compared with group A (p < 0.05). Conclusion: RB-mediated a-PDT as an adjunct to SRP was significantly more effective in improving GI, PPD, and CAL and in reducing microbial count as compared with SRP alone in the management of chronic periodontitis.