Inflammatory and immune pathways in the pathogenesis of periodontal disease
Open accessAbstract
The pathogenesis of periodontitis involves a complex immune/inflammatory cascade that is initiated by the bacteria of the oral biofilm that forms naturally on the teeth. The susceptibility to periodontitis appears to be determined by the host response; specifically, the magnitude of the inflammatory response and the differential activation of immune pathways. The purpose of this review was to delineate our current knowledge of the host response in periodontitis. The role of innate immunity, the failure of acute inflammation to resolve (thus becoming chronic), the cytokine pathways that regulate the activation of acquired immunity and the cells and products of the immune system are considered. New information relating to regulation of both inflammation and the immune response will be reviewed in the context of susceptibility to, and perhaps control of, periodontitis.
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The slow group presented upregulation of proteins related to immunomodulation, such as innate immune response, positive regulation of B cell activation, antigen binding and immunoglobulin receptor binding, which are quintessential for oral health because they prevent adherence, colonisation and penetration of pathogens into the oral mucosa.
“In contrast, the slow group presented upregulation of proteins related to immunomodulation, such as those involved in the ‘innate immune response’, ‘positive regulation of B cell activation’, ‘antigen binding’ and ‘immunoglobulin receptor binding’. These proteins are quintessential for oral health because they prevent adherence, colonisation and penetration of pathogens into the oral mucosa (Cekic”
From Dental Calculus Formation Rate: The Role of Salivary Proteome and Metaproteome (2025) · cites this paper as Cekici et al. 2014
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Experimental — accuracy not yet measuredBacterial biofilms are linked to the aetiology of periodontal diseases, triggering host inflammatory immune response that leads to chronic inflammation and tissue destruction if unresolved.
“Bacterial biofilms are linked to the aetiology of periodontal diseases, since their growth and maturation on dental surfaces trigger the host inflammatory immune response characterized by upregulated cytokines and chemokines that lead to chronic inflammation and to tissue destruction -if the inflammatory process is not resolved [1,2].”
From In vitro biomimetic development of artificial dental calculus: a proof of concept study (2025) · cites this paper as [2]
Dysbiosis is prompted by various factors, including host diet, inflammatory responses, systemic disruptions, and habits such as alcohol intake, smoking tobacco and consuming alcohol.
“Such dysbiosis is prompted by various factors, including host diet, inflammatory responses, systemic disruptions, and habits such as alcohol intake, smoking tobacco and consuming alcohol.50, 180, 181, 182, 183, 184, 185, 186”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [183]
Diseased periodontal tissues additionally store pro-inflammatory mediators associated with periodontitis.
“Diseased periodontal tissues additionally stores pro‐inflammatory mediators associated with periodontitis.51, 183, 202”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [183]
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The Ligands of CXC Chemokine Receptor 3, I-TAC, Mig, and IP10, Are Natural Antagonists for CCR3
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“These include limiting the migration of polymorphonuclear neutrophils into sites of inflammation and modulating the phenotype of macrophages to stimulate the uptake of apoptotic polymorphonuclear neutrophils without secreting proinflammatory cytokines (156, 157, 217).”
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“identified in human periodontal tissues, and their expression, distribution and ligand specificities have been characterized (125, 145, 195, 228) (Table 1).”
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“macrophage colony-stimulating factor (27).”
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“It has become clear that CD4 T-cells and certain innate immune cells, such as dendritic cells, monocytes and neutrophils, are in perfect communication through cytokine networks (7, 66, 108, 220, 231).”
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BackgroundCytokines in periodontal disease: where to from here?
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“Regulation of immune–inflammatory mechanisms governs patient susceptibility and is modified by environmental factors (219, 220, 241).”
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“It is now clear that RANKL and osteoprotegerin are the key regulators of bone remodeling and are directly in- volved in the differentiation, activation and survival of osteoclasts and osteoclast precursors (2, 129, 261).”
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“The expression and pathologic release of matrix metalloproteinases was originally thought to be limited to neutrophils (241), but it is now clear that a broad range of cell types present in normal and diseased human periodontium (including gingival epithelial cells, fibroblasts, endothelial cells, monocytes ⁄ macropha…”
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“The discovery of protease-activated receptors revealed that protease-activated receptor 2 has an especially important role in chronic inflammation (246).”
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“Also, calcitonin generelated peptide enhances interleukin-1-induced accumulation of neutrophils and induces T-cell cytokine secretion (26, 137).”
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Structure, function and regulation of the Toll/IL‐1 receptor adaptor proteins
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“T-helper 17 lymphocytes, like T-helper 1 cells, are also noted for their stimulatory role in osteoclastogenesis (258).”
BackgroundThe potential role of interleukin‐17 in the immunopathology of periodontal disease
Takahashi, K., Azuma, T., Motohira, H., Kinane, D. F., & Shin, K. (2005) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2005.00676.x · Cited by 208 · cited 1× · see citing works
“T-helper 17 cells are observed in chronic periodontitis sites, and T-helper 17-related cytokines are produced in periodontal lesions (180, 226, 247).”
BackgroundPeptides encoded by the calcitonin gene inhibit macrophage function.
Nong, Y., Titus, R. G., Ribeiro, J. M. C., & Remold, H. G. (1989) · The Journal of Immunology · doi:10.4049/jimmunol.143.1.45 · Cited by 206 · cited 1× · see citing works
“It inhibits hydrogen peroxide production by macrophages in response to interferon gamma and presenting antigen (177, 185).”
BackgroundAspects of adaptive host response in periodontitis
Berglundh, T., & Donati, M. (2005) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2005.00820.x · Cited by 206 · cited 2× · see citing works
“For a recent detailed review of acquired immune mechanisms in periodontitis, see Berglundh & Donati (17).”
BackgroundD estructive P eriodontitis L esions are D etermined by the N ature of the L ymphocytic R esponse
Gemmell, E., Yamazaki, K., & Seymour, G. J. (2002) · Critical Reviews in Oral Biology & Medicine · doi:10.1177/154411130201300104 · Cited by 199 · cited 1× · see citing works
“It has become clear that CD4 T-cells and certain innate immune cells, such as dendritic cells, monocytes and neutrophils, are in perfect communication through cytokine networks (7, 66, 108, 220, 231).”
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“colony-stimulating factor is also required, which is produced by osteoblasts ⁄ stromal cells (155, 230).”
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“Aspirin-triggered lipoxin, the epimer of native lipoxin, possesses more powerful proresolving properties (32, 218, 245).”
BackgroundPatterns of matrix metalloproteinase and TIMP expression in chronic ulcers
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“glands, and its secretion is observed in suprabasal epithelial cells (203, 255).”
BackgroundThe non‐peptide tachykinin antagonist, CP‐96,345, is a potent inhibitor of neurogenic inflammation
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“Accordingly, edema induced by substance P is primarily caused by increased vascular permeability mediated through its action on neurokinin 1 receptors on endothelial cells (136).”
BackgroundMolecular Pathogenicity of the Oral Opportunistic PathogenActinobacillus actinomycetemcomitans
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“Complex inflammatory signals and cytokine networks regulate osteoclastogenesis through RANKL, interleukin1beta, interleukin-6, tumor necrosis factor alpha and prostaglandin E2 (84) (Fig.”
BackgroundThe Involvement of IL-23 and the Th17 Pathway in Periodontitis
Ohyama, H., Kato‐Kogoe, N., Kuhara, A., Nishimura, F., Nakasho, K., Yamanegi, K., Yamada, N., Hata, M., Yamane, J., & Terada, N. (2009) · Journal of Dental Research · doi:10.1177/0022034509339889 · Cited by 182 · cited 1× · see citing works
“T-helper 17 cells are observed in chronic periodontitis sites, and T-helper 17-related cytokines are produced in periodontal lesions (180, 226, 247).”
BackgroundStimulation of bone resorption by various prostaglandins in organ culture
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“notably the neuropeptides substance P and calcitonin gene-related peptide (67).”
BackgroundMatrix Metalloproteinase 2 (Gelatinase A) Is Related to Migration of Keratinocytes
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“Matrix metalloproteinase-2 (gelatinase A) has been shown to be strongly expressed in inflamed pocket epithelium and to be important in epithelial cell migration (159).”
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“15-lipoxygenase catalyzes a second reaction with hydroxyeicosatetraenoic acid products generated earlier by neutrophils or other cells (213).”
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“Lipopolysaccharide-induced production of interleukin-1beta through toll-likereceptor pathways can up-regulate RANKL and can also inhibit the expression of osteoprotegerin by osteoblasts, resulting in osteoclast formation in a prostaglandin E2-dependent manner (224).”
BackgroundRegulatory T-cells Infiltrate Periodontal Disease Tissues
Nakajima, T. E., Ueki‐Maruyama, K., Oda, T., Ohsawa, Y., Ito, H., Seymour, G. J., & Yamazaki, K. (2005) · Journal of Dental Research · doi:10.1177/154405910508400711 · Cited by 170 · see citing works
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“by up-regulating major histocompatibility complex class I and class II expression (199, 238).”
BackgroundDutzan, N., Gamonal, J. A., Silva, A., Sanz, M., & Vernal, R. (2009) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.2009.01390.x · Cited by 162 · cited 1× · see citing works
“In active periodontal lesions, the levels of transforming growth factor beta are negatively correlated with the levels of RANKL, reinforcing its protective role against tissue destruction (45, 46, 223).”
BackgroundGenetic Control of Susceptibility toPorphyromonas gingivalis-Induced Alveolar Bone Loss in Mice
Baker, P. J., Dixon, M., & Roopenian, D. C. (2000) · Infection and Immunity · doi:10.1128/iai.68.10.5864-5868.2000 · Cited by 162 · cited 1× · see citing works
“It has become clear that CD4 T-cells and certain innate immune cells, such as dendritic cells, monocytes and neutrophils, are in perfect communication through cytokine networks (7, 66, 108, 220, 231).”
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“tumor necrosis factor alpha and parathyroid hormone (196, 205, 206).”
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“toxic T-lymphocyte-associated antigen 4 are reported to decrease periodontal disease progression (30).”
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“osteoclast precursor cultures containing osteoblasts and ⁄ or stromal cells (94).”
BackgroundChemokines in human periodontal disease tissues
Gemmell, E., Carter, C. L., & Seymour, G. J. (2001) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2001.01511.x · Cited by 155 · cited 2× · see citing works
“Together with regulated and normal T cell expressed and secreted ⁄ chemokine (C-C motif) ligand 5, macrophage inflammatory protein 1 alpha ⁄ chemokine (C-C motif) ligand 3 may also be involved in the migration of macrophages to periodontal tissues (64, 102).”
BackgroundFunctional TLRs and NODs in Human Gingival Fibroblasts
Uehara, A., & Takada, H. (2007) · Journal of Dental Research · doi:10.1177/154405910708600310 · Cited by 153 · cited 2× · see citing works
“For a complete review of toll-like receptors and their pathways, see Uehara & Takada (239).”
BackgroundBalance of inflammatory response in stable gingivitis and progressive periodontitis lesions
Honda, T., Domon, H., Okui, T., Kajita, K., Amanuma, R., & Yamazaki, K. (2006) · Clinical & Experimental Immunology · doi:10.1111/j.1365-2249.2006.03028.x · Cited by 151 · cited 1× · see citing works
“In periodontal disease, interferon gamma is present at high levels in periodontal lesions, and is associated with progressive lesions or severe forms of periodontitis (46, 61, 88).”
BackgroundAnti-inflammatory cytokine IL-10 and T cell cytokine profile in periodontitis granulation tissue
Lappin, D. F., MacLeod, C., Kerr, A. R., Mitchell, T., & Kinane, D. F. (2001) · Clinical & Experimental Immunology · doi:10.1046/j.1365-2249.2001.01448.x · Cited by 150 · cited 1× · see citing works
“It is widely expressed in inflamed periodontal tissues, where it is thought to limit disease severity (60, 62, 133).”
BackgroundLean, J. M., Murphy, C., Fuller, K., & Chambers, T. J. (2002) · Journal of Cellular Biochemistry · doi:10.1002/jcb.10319 · Cited by 150 · see citing works
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The role of Toll-like receptors in combating mycobacteria
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“identified in human periodontal tissues, and their expression, distribution and ligand specificities have been characterized (125, 145, 195, 228) (Table 1).”
BackgroundCalcitonin gene-related peptide inhibits interleukin 2 production by murine T lymphocytes.
Wang, F., Millet, I., Bottomly, K., & Vignery, A. (1992) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(19)36796-1 · Cited by 146 · cited 19× · see citing works
“Receptor Location Cells Bacteria Toll-like receptor 1 Cell membrane Myeloid dendritic cells, monocytes Not specified Toll-like receptor 2 Cell membrane Monocytes, natural killer cells, myeloid dendritic cells,mast cells, T-cells, epithelial cells Porphyromonas gingivalis Escherichia coli Tannerella forsythia Prevotell…”
BackgroundInfluentialUitto, V. J., Airola, K., Vaalamo, M., Johansson, N., Putnins, E. E., Firth, J. D., Salonen, J. I., López-Otı́n, C., Saarialho‐Kere, U., & Kähäri, V. (1998) · Europe PMC (PubMed Central) · Cited by 145 · see citing works
N europeptides and N eurogenic M echanisms in O ral and P eriodontal I nflammation
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“Sources of substance P, in addition to neurons, include monocytes, dendritic cells, eosinophils, T-lymphocytes and mast cells (130, 150).”
BackgroundInfluentialInformational Paper: The Pathogenesis of Periodontal Diseases
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“The expression and pathologic release of matrix metalloproteinases was originally thought to be limited to neutrophils (241), but it is now clear that a broad range of cell types present in normal and diseased human periodontium (including gingival epithelial cells, fibroblasts, endothelial cells, monocytes ⁄ macropha…”
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“are synthesized and released from inflammatory cells (168).”
BackgroundGanea, D., & Delgado, M. (2002) · Critical Reviews in Oral Biology & Medicine · doi:10.1177/154411130201300303 · Cited by 136 · cited 1× · see citing works
“interleukin-6 and interleukin-12 in activated macrophages, it stimulates the production of the potent anti-inflammatory cytokine, interleukin-10, and suppresses T-cell proliferation (57).”
BackgroundNeuropeptides and the puzzle of bone remodeling: State of the art
Konttinen, Y. T., Imai, S., & Suda, A. (1996) · Acta Orthopaedica Scandinavica · doi:10.3109/17453679608997772 · Cited by 135 · see citing works
Modulation of macrophage recruitment into wounds by monocyte chemoattractant protein‐1
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“motif) ligand 2-deficient mice demonstrated delayed wound re-epithelialization (43, 149).”
BackgroundAwawdeh, L., Lundy, F. T., Shaw, C. E., Lamey, P. J., Linden, G. J., & Kennedy, J. G. (2002) · International Endodontic Journal · doi:10.1046/j.1365-2591.2002.00451.x · Cited by 132 · cited 1× · see citing works
“This molecule is transformed into 5(6)-epoxytetraene with the help of 5-lipoxygenase, and the product is 15-epi-LXs or”
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Differential regulation of IL-1 production in human monocytes by IFN-gamma and IL-4.
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“Interferon gamma also plays a major role in B-cell maturation, and, accordingly, in immunoglobulin secretion (179).”
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“Stromal cell-derived factor-1 alpha ⁄ chemokine (C-X-C motif) ligand 12 increases the activity of matrix metalloproteinase 9 in human osteoclasts, resulting in increased bone resorption (70).”
BackgroundThe significance of vasoactive intestinal polypeptide (VIP) in immunomodulation
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“In active periodontal lesions, the levels of transforming growth factor beta are negatively correlated with the levels of RANKL, reinforcing its protective role against tissue destruction (45, 46, 223).”
BackgroundInterleukin‐1 alpha, interleukin‐8 and interferon‐alpha levels in gingival crevicular fluid
Mathur, A., Michalowicz, B. S., Castillo, M., & Aeppll, D. (1996) · Journal of Periodontal Research · doi:10.1111/j.1600-0765.1996.tb01414.x · Cited by 114 · cited 1× · see citing works
“with subclinical inflammation of the initial lesion, which is comprised of polymorphonuclear neutrophils (163, 188, 263).”
BackgroundImmunobiology of vasoactive intestinal peptide (VIP)
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“It is known that toll-like receptor 2 and toll-like receptor 4 predominate in periodontal tissues (82).”
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“These include limiting the migration of polymorphonuclear neutrophils into sites of inflammation and modulating the phenotype of macrophages to stimulate the uptake of apoptotic polymorphonuclear neutrophils without secreting proinflammatory cytokines (156, 157, 217).”
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Type 2 cytokines and negative immune regulation in human infections
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“kin-4, suppresses cell-mediated responses (170).”
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“There is some evidence that regulated and normal T cell expressed and secreted ⁄ chemokine (C-C motif) ligand 5 acts on osteoblasts, resulting in chemotaxis and promoting cell survival (260).”
BackgroundEffect of Sensory Denervation on the Response of Rat Molar Pulp to Exposure Injury
Byers, M. R., & Taylor, P. E. (1993) · Journal of Dental Research · doi:10.1177/00220345930720031001 · Cited by 104 · see citing works
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“the up-regulation of tissue inhibitor of metalloproteinases, which inhibit the matrix metalloproteinase family of proteins (31, 33, 62).”
Background
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- [51]Fiorellini JP Ishikawa SO Kim DM Gingival inflammation Carranza FA Clinical periodontology Philadelphia Elsevier Saunders 2006 355 361
- [154]Novak JM Novak KF Chronic periodontitis Carranza FA Clinical periodontology Philadelphia Saunders Elsevier 2006 494 499
- [160]Ryan ME Preshaw PM Host modulation Carranza FA Clinical periodontology Philadelphia Saunders Elsevier 2006 275 283
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The immune response to <i>Prevotella</i> bacteria in chronic inflammatory disease
Larsen, J. M. (2017) · Immunology · doi:10.1111/imm.12760 · Cited by 1,343 · see citing works
Periodontitis: facts, fallacies and the future
Slots, J. (2017) · Periodontology 2000 · doi:10.1111/prd.12221 · Cited by 1,157 · see citing works
“Hyperactive, as well as insufficient, immune responses are parts of the complex etiopathology of periodontitis (212) and may constitute potential therapeutic targets (35, 248).”
BackgroundPeriodontitis: A Multifaceted Disease of Tooth-Supporting Tissues
Könönen, E., Gürsoy, M., & Gürsoy, U. K. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8081135 · Cited by 871 · see citing works
“Proinflammatory cytokines (IL-1β, IL-6, IL-23, TNF-α), chemokines (IL-8), and antimicrobial peptides produced by keratinocytes, fibroblasts, and dendritic cells are chemoattractant gradients for neutrophils, which migrate into inflamed tissues and stimulate the chemotaxis of nonresident cells (macrophages, lymphocytes…”
BackgroundGlobal burden of oral diseases: emerging concepts, management and interplay with systemic health
Jin, L., Lamster, I. B., Greenspan, J. S., Pitts, N. B., Scully, C. M., & Warnakulasuriya, S. (2015) · Oral Diseases · doi:10.1111/odi.12428 · Cited by 766 · see citing works
“…severity of periodontal disease are largely determined by the bacteriainitiated and dysregulated hyperimmuno-inflammatory response, modulated by various genetic, epigenetic, environmental and host factors such as tobacco use and uncontrolled DM (Page et al, 1997; Kornman, 2008; Cekici et al, 2014).”
BackgroundThe oral microbiome: Role of key organisms and complex networks in oral health and disease
Sedghi, L., DiMassa, V., Harrington, A., Lynch, S. V., & Kapila, Y. L. (2021) · Periodontology 2000 · doi:10.1111/prd.12393 · Cited by 755 · see citing works
The cytokine network involved in the host immune response to periodontitis
Pan, W., Wang, Q., & Chen, Q. (2019) · International Journal of Oral Science · doi:10.1038/s41368-019-0064-z · Cited by 709 · see citing works
Ramesh, A., Varghese, S. S., Jayakumar, N. D., & Malaiappan, S. (2018) · Journal of Periodontology · doi:10.1002/jper.17-0445 · Cited by 545 · see citing works
Kaymaz, K., & Beikler, T. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20143394 · Cited by 543 · see citing works
“In periodontitis, however, a dysbiotic oral microbiome is known to contribute to the disease onset and progression [11].”
BackgroundPeriodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease
Liccardo, D., Cannavò, A., Spagnuolo, G., Ferrara, N., Cittadini, A., Rengo, C., & Rengo, G. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20061414 · Cited by 509 · see citing works
“It is worth stressing that in an effective and healthy immune system, there is no damage to the tissue surrounding the tooth and the bacterial insult is efficiently removed [29,30].”
BackgroundThe Nexus Between Periodontal Inflammation and Dysbiosis
Dyke, T. E. V., Bartold, P. M., & Reynolds, E. C. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00511 · Cited by 465 · see citing works
“With time, there is an acquired immune response that can be either destructive or reparative in different circumstances (11).”
BackgroundAn experimental murine model to study periodontitis
Marchesan, J. T., Girnary, M., Li, J., Miao, M. Z., Zhang, S., Sun, L., Morelli, T., Schoenfisch, M. H., Inohara, N., Offenbacher, S., et al. (2018) · Nature Protocols · doi:10.1038/s41596-018-0035-4 · Cited by 389 · see citing works
Periodontal Disease: The Good, The Bad, and The Unknown
Sedghi, L. M., Bacino, M. S., & Kapila, Y. L. (2021) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2021.766944 · Cited by 385 · see citing works
Di Stefano, M., Polizzi, A., Santonocito, S., Romano, A., Lombardi, T., & Isola, G. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23095142 · Cited by 292 · see citing works
“In this phase, cytokines produced by the residential cell population such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and interleukin (IL)-6 have the main function to stimulate cells migration to sites of infection and enhance the expression of adhesion molecules for neutrophils on the internal vessel surfa…”
BackgroundInfluentialActivation and resolution of periodontal inflammation and its systemic impact
Hastürk, H., & Kantarcı, A. (2015) · Periodontology 2000 · doi:10.1111/prd.12105 · Cited by 240 · see citing works
“This process usually eliminates the bacterial insult (14, 41).”
Gingival crevicular fluid levels of cytokines/chemokines in chronic periodontitis: a meta‐analysis
Stadler, A. F., Angst, P. D. M., Arce, R. M., Gomes, S. C., Oppermann, R. V., & Susin, C. (2016) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12557 · Cited by 235 · see citing works
Oral Microbes, Biofilms and Their Role in Periodontal and Peri-Implant Diseases
Lasserre, J. F., Brecx, M., & Toma, S. (2018) · Materials · doi:10.3390/ma11101802 · Cited by 229 · see citing works
“This low-grade inflammation is complex and involves both innate and acquired immunity as well as the complement system, the major link between the two arms of the immune system [71,72].”
BackgroundPeriodontal disease: A systemic condition
Villoria, G. E. M., Fischer, R. G., Tinoco, E. M. B., Meyle, J., & Loos, B. G. (2024) · Periodontology 2000 · doi:10.1111/prd.12616 · Cited by 242 · see citing works
Modifiable risk factors in periodontitis: at the intersection of aging and disease
Reynolds, M. A. (2013) · Periodontology 2000 · doi:10.1111/prd.12047 · Cited by 225 · see citing works
New insights into protein–protein interaction modulators in drug discovery and therapeutic advance
Nada, H., Choi, Y., Kim, S.-D., Jeong, K. S., Meanwell, N. A., & Lee, K. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-024-02036-3 · Cited by 233 · see citing works
The Power of Phytochemicals Combination in Cancer Chemoprevention
Rizeq, B. R., Gupta, I., Ilesanmi, J., Alsafran, M. H. S. A., Rahman, M. M., & Ouhtit, A. (2020) · Journal of Cancer · doi:10.7150/jca.34374 · Cited by 210 · see citing works
“However, despite all these immunity-boosting effects, administration of IL2 in therapeutically active doses is still hampered by excessive toxicities [16].”
BackgroundDisruption of Monocyte and Macrophage Homeostasis in Periodontitis
AlMubarak, A. M., Tanagala, K. K. K., Papapanou, P. N., Lalla, E., & Momen‐Heravi, F. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.00330 · Cited by 206 · see citing works
“In recent years, it has been shown that the disease is a result of complex interactions between a dysbiotic bacterial biofilm and the host immune response that lead to a dysregulation of the inflammatory response and an imbalance between osteoblastic and osteoclastic activities (3, 4).”
BackgroundHost modulation therapy with anti‐inflammatory agents
Preshaw, P. M. (2017) · Periodontology 2000 · doi:10.1111/prd.12148 · Cited by 188 · see citing works
Immunomodulatory microneedle patch for periodontal tissue regeneration
Zhang, X., Hasani‐Sadrabadi, M. M., Zarubova, J., Dashtimighadam, E., Haghniaz, R., Khademhosseini, A., Butte, M. J., Moshaverinia, A., Aghaloo, T. L., & Li, S. (2021) · Matter · doi:10.1016/j.matt.2021.11.017 · Cited by 183 · see citing works
Manresa, C., Sanz‐Miralles, E., Twigg, J., & Bravo, M. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009376.pub2 · Cited by 179 · see citing works
Ghallab, N. A. (2018) · Archives of Oral Biology · doi:10.1016/j.archoralbio.2017.12.022 · Cited by 174 · see citing works
de Araújo, A. A., Pereira, A. D. S. B. F., de Medeiros, C. A. C. X., Brito, G. A. D. C., Leitão, R. F. D. C., Araújo, L. D. S., Guedes, P. M. D. M., Hiyari, S., Pirih, F. Q. M., & Júnior, R. F. D. A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0183506 · Cited by 175 · see citing works
Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited
Zardawi, F. M. M., Gul, S. S., Abdulkareem, A. A., Sha, A. M., & Yates, J. M. (2021) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2020.625579 · Cited by 178 · see citing works
“The hallmark of periodontitis is elevation in the levels of Gram-negative bacteria that are characterized by their ability to trigger an intense immune response via their mechanism of pathogenicity, such as lipopolysaccharide (LPS) (20).”
BackgroundInfluentialLin, P., Niimi, H., Ohsugi, Y., Tsuchiya, Y., Shimohira, T., Komatsu, K., Liu, A., Shiba, T., Aoki, A., Iwata, T., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22168900 · Cited by 162 · see citing works
“Epithelial tissue, saliva, gingival crevicular fluid, phagocytes, dendritic cells, and receptors identifying pathogenic microbes are all components of the periodontal innate immune system [16].”
BackgroundOsteoimmunology: Inflammatory osteolysis and regeneration of the alveolar bone
Gruber, R. (2019) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13056 · Cited by 159 · see citing works
Linking chronic periodontitis and oral cancer: A review
Kavarthapu, A., & Kaarthikeyan, G. (2021) · Oral Oncology · doi:10.1016/j.oraloncology.2021.105375 · Cited by 156 · see citing works
Periodontal therapy and cardiovascular risk
Orlandi, M., Graziani, F., & D'Aiuto, F. (2020) · Periodontology 2000 · doi:10.1111/prd.12299 · Cited by 155 · see citing works
Fixed Prosthetic Restorations and Periodontal Health: A Narrative Review
Srimaneepong, V., Heboyan, A., Zafar, M. S., Khurshid, Z., Marya, A., Fernandes, G. V. O., & Rokaya, D. (2022) · Journal of Functional Biomaterials · doi:10.3390/jfb13010015 · Cited by 148 · see citing works
“Thus, self- and acquired immune mechanisms should be synchronized to return the damaged tissue to homeostasis [65].”
BackgroundThe multifaceted link between inflammation and human diseases
Rajendran, P., Chen, Y., Chen, Y., Chung, L.-C., Tamilselvi, S., Shen, C.-Y., Day, C. H., Chen, R., Viswanadha, V. P., Kuo, W., et al. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26479 · Cited by 154 · see citing works
“These additionally recruitmacrophages to confined localesof inflammationand specifically activate adifferent signal transductioncascadeand translationelements related to aggravation (Cekici et al., 2014).”
BackgroundIs weight gain associated with the incidence of periodontitis? A systematic review and meta‐analysis
Nascimento, G. G., Leite, F. R. M., Do, L., Peres, K. G., Corrêa, M. B., Demarco, F. F., & Peres, M. A. (2015) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12417 · Cited by 150 · see citing works
“The interplay between immune system and periodontal bacteria challenge determines not only the establishment but also the severity of disease progression (Cekici et al. 2014).”
BackgroundPeriodontal herpesviruses: prevalence, pathogenicity, systemic risk
Slots, J. (2015) · Periodontology 2000 · doi:10.1111/prd.12085 · Cited by 138 · see citing works
Mariotti, A. J., & Hefti, A. F. (2015) · BMC Oral Health · doi:10.1186/1472-6831-15-s1-s6 · Cited by 141 · see citing works
“) as well as those with hyperreactive immune responses can have their periodontal health affected [45].”
BackgroundKuraji, R., Sekino, S., Kapila, Y. L., & Numabe, Y. (2021) · Periodontology 2000 · doi:10.1111/prd.12387 · Cited by 137 · see citing works
Kumar, A., Panda, M., Das, A. K., Rahman, T., Das, R., Das, K., Sarma, A., Kataki, A., & Chattopadhyay, I. (2020) · Archives of Microbiology · doi:10.1007/s00203-020-02011-w · Cited by 135 · see citing works
Defining human mesenchymal and epithelial heterogeneity in response to oral inflammatory disease
Caetano, A. J., Yianni, V., Volponi, A. A., Booth, V., D’Agostino, E. M., & Sharpe, P. T. (2021) · eLife · doi:10.7554/elife.62810 · Cited by 134 · see citing works
“…teeth, and consists of a keratinised stratified squamous epithelium and an underlying connective tissue containing multiple cell types that collectively orchestrate tissue homeostasis during health and in response to mechanical and microbial challenges (Lindhe et al., 2008, Cekici et al., 2014).”
BackgroundWang, R. P., Huang, J., Chan, K. W. Y., Leung, W. K., Goto, T., Ho, J. Y. S., & Chang, R. C. (2023) · Journal of Neuroinflammation · doi:10.1186/s12974-023-02747-4 · Cited by 130 · see citing works
“Periodontitis is a pathological inflammatory condition of the teeth-supporting tissues characterized by the degradation of the connective tissue and alveolar bone resorption, ultimately resulting in tooth loss [3].”
BackgroundZhang, X., Zhang, S., Yan, X., Shan, Y., Liu, L., Zhou, J., Kuang, Q., Li, M., Long, H., & Lai, W. (2021) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.16469 · Cited by 128 · see citing works
Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases
Rajendiran, M., Trivedi, H. M., Chen, D., Gajendrareddy, P. K., & Chen, L. (2021) · Molecules · doi:10.3390/molecules26072001 · Cited by 135 · see citing works
“The susceptibility of an individual to develop periodontal diseases depends on the immune and inflammatory responses to the periodontopathogenic bacteria present in the dental plaque and is modified by environmental factors [6,7].”
BackgroundPeriodontal Health and Disease in the Context of Systemic Diseases
Isola, G., Santonocito, S., Lupi, S. M., Polizzi, A., Sclafani, R., Patini, R., & Marchetti, E. (2023) · Mediators of Inflammation · doi:10.1155/2023/9720947 · Cited by 140 · see citing works
“The LPS/TLR4 (Toll-like receptor 4) interaction induces in fl ammation and type 1 polarisation in T helper cells, suppressing IL-10 expression whose signaling de fi ciency increases the risk of carcinogenesis [94 – 96].”
BackgroundInfluentialPatrick, K. L., Bell, S. L., Weindel, C. G., & Watson, R. O. (2019) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2019.00138 · Cited by 110 · see citing works
“The immune response associated with periodontitis involves both innate and adaptive immune cells, with inflammatory mediators like IL1β, TNF-α, IL-6, contributing not only to tissue damage of the gums but also osteoclastogenesis (breakdown of bone tissue) (Cekici et al., 2014).”
BackgroundSystemic inflammation linking chronic periodontitis to cognitive decline
Wang, R. P., Ho, J. Y. S., Leung, W. K., Goto, T., & Chang, R. C. (2019) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2019.07.002 · Cited by 122 · see citing works
Potential Bidirectional Relationship Between Periodontitis and Alzheimer’s Disease
Liccardo, D., Marzano, F., Carraturo, F., Guida, M., Femminella, G. D., Bencivenga, L., Agrimi, J., Addonizio, A., Melino, I., Valletta, A., et al. (2020) · Frontiers in Physiology · doi:10.3389/fphys.2020.00683 · Cited by 137 · see citing works
“Some studies have demonstrated that people with periodontitis present a major risk of developing AD (Chen et al., 2017); however, other reports suggest that those with AD or dementia suffer from inadequate oral health, stemming from cognitive decline, and are, therefore, more likely to develop…”
BackgroundInfluentialPeriodontal disease and periodontal bacteria as triggers for rheumatoid arthritis
Cheng, Z., Meade, J. L., Mankia, K. S., Emery, P., & DeVine, D. (2017) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2017.08.001 · Cited by 120 · see citing works
Periodontal Bacteria and Prediabetes Prevalence in ORIGINS
Demmer, R. T., Jacobs, D. R., Singh, R., Zuk, A. M., ROSENBAUM, M. S., Papapanou, P. N., & Desvarieux, M. (2015) · Journal of Dental Research · doi:10.1177/0022034515590369 · Cited by 119 · see citing works
“periodontitis (Socransky and Haffajee 2005; Kistler et al. 2013; Cekici et al. 2014; Palmer 2014) have been hypothesized as cardiometabolic risk factors (Kebschull et al.”
BackgroundSesamol: a powerful functional food ingredient from sesame oil for cardioprotection
Jayaraj, P., Narasimhulu, C. A., Rajagopalan, S., Parthasarathy, S., & Desikan, R. (2020) · Food & Function · doi:10.1039/c9fo01873e · Cited by 123 · see citing works
MicroRNAs and immunity in periodontal health and disease
Luan, X., Zhou, X. C., Naqvi, A. R., Francis, M., Foyle, D., Nares, S., & Diekwisch, T. G. H. (2018) · International Journal of Oral Science · doi:10.1038/s41368-018-0025-y · Cited by 115 · see citing works
Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature
Chan, A. K. Y., Tsang, Y. C., Jiang, M., Leung, K., Lo, E. C. M., & Chu, C. H. (2023) · Dentistry Journal · doi:10.3390/dj11090222 · Cited by 115 · see citing works
Hobbins, S., Chapple, I., Sapey, E., & Stockley, R. A. (2017) · International Journal of COPD · doi:10.2147/copd.s127802 · Cited by 114 · see citing works
“19 This subsequently triggers priming and activation of peripheral blood neutrophils with an exaggerated release of reactive oxygen species (ROS) and pro-inflammatory cytokines.”
Hashim, N. T., Babiker, R. A., Padmanabhan, V., Ahmed, A. T., Chaitanya, N. C., Mohammed, R., Priya, S. P., Ahmed, A., Bahra, S. E., Islam, M. S., et al. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22040624 · Cited by 114 · see citing works
“Consequently, the persistent presence of bacteria in the periodontal pockets leads to continuous inflammation [79].”
Obaid, M., Udden, S. M. N., Deb, P., Shihabeddin, N., Zaki, H., & Mandal, S. S. (2018) · Scientific Reports · doi:10.1038/s41598-018-33722-2 · Cited by 113 · see citing works
Periodontal and inflammatory bowel diseases: Is there evidence of complex pathogenic interactions?
Lira‐Junior, R., & Figueredo, C. M. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i35.7963 · Cited by 111 · see citing works
Demmer, R. T., Breskin, A., Rosenbaum, M. S., Zuk, A. M., LeDuc, C. A., Leibel, R. L., Paster, B. J., Desvarieux, M., Jacobs, D. R., & Papapanou, P. N. (2016) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.12664 · Cited by 107 · see citing works
“…periodontitis to extra-oral outcomes hypothesizes that subgingival dysbiosis (Socransky & Haffajee 2005, Demmer et al. 2008b, Kistler et al. 2013, Cekici et al. 2014, Palmer 2014) is an important aetiological factor (Demmer & Desvarieux 2006, Kebschull et al. 2010, Lalla & Papapanou 2011,…”
Tobacco Use and Periodontal Disease—The Role of Microvascular Dysfunction
Silva, H. (2021) · Biology · doi:10.3390/biology10050441 · Cited by 107 · see citing works
“The resulting cytokine-rich pro-inflammatory environment reinforces the recruitment of more immune cells and the degradation of surrounding tissue [36].”
BackgroundElectrospun trilayer eccentric Janus nanofibers for a combined treatment of periodontitis
Zhao, P., Zhou, K., Xia, Y., Qian, C., Yu, D., Xie, Y., & Liao, Y. (2024) · Advanced Fiber Materials · doi:10.1007/s42765-024-00397-6 · Cited by 106 · see citing works
“…within 7 days result may be due to the fact that both the F1 and F4 nanofibers are loaded with the active substance KET, a non-steroidal anti-inflammatory drug that reduces the synthesis of prostaglandins, which are capable of inducing inflammatory responses by inhibiting the activity of COX [63].”
Harding, A., Gonder, U., Robinson, S. J., Crean, S., & Singhrao, S. K. (2017) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2017.00398 · Cited by 106 · see citing works
“In addition, psychosocial factors can influence disease onset and progression, with those reporting higher levels of anxiety being more susceptible to periodontal disease (Cekici et al., 2014).”
SOCS Proteins as Regulators of Inflammatory Responses Induced by Bacterial Infections: A Review
Duncan, S. A., Baganizi, D. R., Sahu, R., Singh, S. R., & Dennis, V. A. (2017) · Frontiers in Microbiology · doi:10.3389/fmicb.2017.02431 · Cited by 103 · see citing works
“Moreover, the same cytokines and chemokines present at the inflammatory site are also very critical in regulating the immune system and inflammation (Cekici et al., 2000).”
BackgroundInflammation in Periodontal Disease: Possible Link to Vascular Disease
Paul, O., Arora, P., Mayer, M. A., & Chatterjee, S. (2021) · Frontiers in Physiology · doi:10.3389/fphys.2020.609614 · Cited by 104 · see citing works
Quantitative metaproteomics of medieval dental calculus reveals individual oral health status
Jersie-Christensen, R., Lanigan, L. T., Lyon, D. B., Mackie, M., Belstrøm, D., Kelstrup, C. D., Fotakis, A. K., Willerslev, E., Lynnerup, N., Jensen, L. J., et al. (2018) · Nature Communications · doi:10.1038/s41467-018-07148-3 · Cited by 94 · see citing works
Osteoclastogenesis in Periodontal Diseases: Possible Mediators and Mechanisms
AlQranei, M. S., & Chellaiah, M. (2020) · Journal of Oral Biosciences · doi:10.1016/j.job.2020.02.002 · Cited by 82 · see citing works
“These structures are called pathogen-associated molecular patterns (PAMPs) and can be seen in the form of lipopolysaccharide (LPS), peptidoglycan, lipoprotein, bacterial DNA, or double-stranded RNA [2].”
BackgroundInfluentialVo, T. T. T., Chu, P., Tuan, V. P., Te, J. S.-L., & Lee, I. (2020) · Antioxidants · doi:10.3390/antiox9121211 · Cited by 98 · see citing works
“Otherwise speaking, periodontal disease also arises from the dysregulation or dysfunction of the activation and resolution pathways of inflammation, subsequently resulting in chronic and destructive inflammation [8].”
BackgroundInfluentialElectrospun Nanofibers for Periodontal Treatment: A Recent Progress
Zhao, P., Chen, W., Feng, Z., Liu, Y., Liu, P., Xie, Y., & Yu, D.-G. (2022) · International Journal of Nanomedicine · doi:10.2147/ijn.s370340 · Cited by 74 · see citing works
“Nonsteroidal anti-inflammatory drugs (NSAIDs) can mitigate periodontal inflammation by inhibiting the activity of cyclooxygenase (COX).(80) However, most NSAIDs have poor water solubility and cannot be fully utilized in periodontal treatment.”
BackgroundMicroRNAs and Periodontal Homeostasis
Luan, X., Zhou, X. C., Trombetta‐eSilva, J., Francis, M., Gaharwar, A. K., Atsawasuwan, P., & Diekwisch, T. G. H. (2017) · Journal of Dental Research · doi:10.1177/0022034516685711 · Cited by 97 · see citing works
“…turn stimulate the RANK-ligand (RANKL) receptor (RANK) on the osteoclast cell surface and its nuclear target NF-κB, as well as prompt the differentiation of osteoclast precursors into multinucleated osteoclasts (Wiebe et al. 1996; Boyce 2013; Cekici et al. 2014; Lee et al. 2014; Boyce et al. 2015).”
Backgroundde Andrade, K. Q., Almeida-da-Silva, C. L. C., & Coutinho‐Silva, R. (2019) · Mediators of Inflammation · doi:10.1155/2019/7241312 · Cited by 97 · see citing works
“The adaptive immune system acts in the context of the chronicity of PD, reinforcing the protection of the host through cellular and noncellular mechanisms [176].”
BackgroundA bibliometric analysis of Periodontology 2000
Ahmad, P., Asıf, J. A., Alam, M. K., & Slots, J. (2019) · Periodontology 2000 · doi:10.1111/prd.12328 · Cited by 102 · see citing works
Central Regulatory Role of Cytokines in Periodontitis and Targeting Options
Plemmenos, G., Evangeliou, E., Polizogopoulos, N., Chalazias, A., Deligianni, M. L., & Piperi, C. (2020) · Current Medicinal Chemistry · doi:10.2174/0929867327666200824112732 · Cited by 96 · see citing works
Systemic antibiotics increase microbiota pathogenicity and oral bone loss
Yuan, X., Zhou, F., Wang, H., Xu, X., Xu, S., Zhang, C., Zhang, Y., Lu, M., Zhang, Y., Zhou, M., et al. (2023) · International Journal of Oral Science · doi:10.1038/s41368-022-00212-1 · Cited by 94 · see citing works
“The inflammatory periodontal microenvironment then facilitated the reproduction of periodontitisrelated bacteria and increased periodontal tissue destruction.(42,43) FMT from healthy donor mice partially reconstructed the disturbed gut microbiota caused by antibiotics and might ameliorate the systemic inflammation and…”
BackgroundBatool, H., Nadeem, A., Kashif, M., Shahzad, F., Tahir, R., & Afzal, N. (2018) · BioMed Research International · doi:10.1155/2018/8531961 · Cited by 95 · see citing works
Local and Systemic Effects of Porphyromonas gingivalis Infection
Chen, W. A., Dou, Y., Fletcher, H. M., & Boskovic, D. S. (2023) · Microorganisms · doi:10.3390/microorganisms11020470 · Cited by 102 · see citing works
Lipopolysaccharide- TLR-4 Axis regulates Osteoclastogenesis independent of RANKL/RANK signaling
AlQranei, M. S., Senbanjo, L. T., Aljohani, H., Hamza, T., & Chellaiah, M. (2021) · BMC Immunology · doi:10.1186/s12865-021-00409-9 · Cited by 89 · see citing works
Linking mechanisms of periodontitis to Alzheimer's disease
Sadrameli, M., Bathini, P., & Alberi, L. A. (2020) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000797 · Cited by 90 · see citing works
“In gingivitis, the inflammatory response is the first line of defense to microbial invasion and can be reversed upon treatment, while protracted inflammatory state, plaque accumulation, connective tissue, and bone loss are typical signs of periodontitis [6].”
BackgroundContribution of Statins towards Periodontal Treatment: A Review
Petit, C., Batool, F., Bugueno, I. M., Schwinté, P., Benkirane-Jessel, N., & Huck, O. (2019) · Mediators of Inflammation · doi:10.1155/2019/6367402 · Cited by 87 · see citing works
“The pathogenesis of periodontitis involves a complex interaction of immune and inflammatory cascades initiated by bacteria of the oral biofilm [2].”
Neutrophil Extracellular Traps in Periodontitis
Magán‐Fernández, A., Al‐Bakri, S. M. R., O’Valle, F., Benavides‐Reyes, C., Abadía‐Molina, F., & Mesa, F. (2020) · Cells · doi:10.3390/cells9061494 · Cited by 87 · see citing works
“NET formation is also considered a potential factor changing the influence of the individual course of periodontitis [82].”
BackgroundArabacı, T., Kermen, E., Özkanlar, S., Köse, O., Kara, A., Kızıldağ, A., Duman, Ş. B., & İbişoğlu, E. (2015) · Journal of Periodontology · doi:10.1902/jop.2015.140599 · Cited by 87 · see citing works
Liang, G., Shi, H. S., Qi, Y., Li, J., Jing, A., Liu, Q., Feng, W., Li, G., & Gao, S. (2020) · International Journal of Nanomedicine · doi:10.2147/ijn.s253416 · Cited by 84 · see citing works
Maintenance therapy for teeth and implants
Mombelli, A. (2019) · Periodontology 2000 · doi:10.1111/prd.12255 · Cited by 84 · see citing works
The periodontal stem/progenitor cell inflammatory‐regenerative cross talk: A new perspective
El‐Sayed, K. M. F., ElAhmady, M., Adawi, Z., Aboushadi, N., Elnaggar, A., Eid, M. A., Hamdy, N., Sanaa, D., & Dörfer, C. E. (2018) · Journal of Periodontal Research · doi:10.1111/jre.12616 · Cited by 82 · see citing works
Chan, H., & Kripfgans, O. D. (2020) · Dentomaxillofacial Radiology · doi:10.1259/dmfr.20190445 · Cited by 82 · see citing works
Chen, M., Wang, Y., Sun, B., Yu, L., Chen, Q., Han, X., & Liu, Y. (2021) · International Immunopharmacology · doi:10.1016/j.intimp.2021.107901 · Cited by 82 · see citing works
Zhou, T., Xu, W., Wang, Q., Jiang, C., Li, H., Chao, Y., Sun, Y., & Lan, A. (2023) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2023.1132420 · Cited by 82 · see citing works
“, 2020); meanwhile, bacterial LPS can induce IL-1b production through the TLR pathway to upregulate RANKL, and binding of RANKL to its receptor RANK triggers nuclear factor kB (NF-ĸB) signaling pathway, which induces bone resorption (Cekici et al., 2013; Thummuri et al., 2015; Tsukasaki, 2020).”
BackgroundObaid, M., Udden, S. M. N., Alluri, P. G., & Mandal, S. S. (2021) · Scientific Reports · doi:10.1038/s41598-020-80291-4 · Cited by 80 · see citing works
Characteristics of Periodontal Tissues in Prosthetic Treatment with Fixed Dental Prostheses
Avetisyan, A., Markaryan, M., Rokaya, D., Tovani-Palone, M. R., Zafar, M. S., Khurshid, Z., Vardanyan, A., & Heboyan, A. (2021) · Molecules · doi:10.3390/molecules26051331 · Cited by 79 · see citing works
Batool, F., Morand, D.-N., Thomas, L., Bugueno, I. M., Aragón, J., Irusta, S., Keller, L., Benkirane-Jessel, N., Tenenbaum, H., & Huck, O. (2018) · Materials · doi:10.3390/ma11040580 · Cited by 79 · see citing works
“NSAIDs block cyclooxygenase (COX), which converts AAs to PGs [22], and previous clinical studies have shown that their use during periodontal treatment leads to PPD reduction and improvement of CAL gain [23], as demonstrated for ibuprofen (IBU) or flurbiprofen.”
BackgroundKaymaz, K., Hensel, A., & Beikler, T. (2018) · Fitoterapia · doi:10.1016/j.fitote.2018.11.012 · Cited by 78 · see citing works
Microbial metabolites in the pathogenesis of periodontal diseases: a narrative review
Basic, A., & Dahlén, G. (2023) · Frontiers in Oral Health · doi:10.3389/froh.2023.1210200 · Cited by 84 · see citing works
DeLeon‐Pennell, K. Y., Iyer, R. P., Ero, O. K., Cates, C. A., Flynn, E. R., Cannon, P. L., Jung, M., Shannon, D., Garrett, M. R., Buchanan, W., et al. (2017) · JCI Insight · doi:10.1172/jci.insight.94207 · Cited by 78 · see citing works
Diet-Induced Obesity and Its Differential Impact on Periodontal Bone Loss
Muluke, M., Gold, T., Kiefhaber, K., Alsahli, A., Celenti, R. S., Jiang, H., Cremers, S., Dyke, T. E. V., & Schulze‐Späte, U. (2015) · Journal of Dental Research · doi:10.1177/0022034515609882 · Cited by 79 · see citing works
“More recently, the inflammatory host response has been shown to be crucial in the development and progression of the disease, and focus has been placed on defining determinants of the local host response to bacteria and bacterial products (Cekici et al. 2014).”
BackgroundHuang, S. W., He, T., Yue, F., Xu, X., Wang, L., Zhu, P., Teng, F., Sun, Z., Liu, X., Jing, G., et al. (2021) · mBio · doi:10.1128/mbio.03281-20 · Cited by 76 · see citing works
Periodontology and pregnancy: An overview of biomedical and epidemiological evidence
Raju, K., & Berens, L. (2021) · Periodontology 2000 · doi:10.1111/prd.12394 · Cited by 76 · see citing works
Shen, T., Wang, G., You, L., Zhang, L., Ren, H., Hu, W., Qiang, Q., Wang, X., Ji, L., Gu, Z., et al. (2017) · Food & Nutrition Research · doi:10.1080/16546628.2017.1344523 · Cited by 76 · see citing works
“Cytokines are peptides and low-molecular weight proteins that play a prominent role in cell–cell communication in the immune response.[53] As shown in Table 4, the administration of CTX can significantly (p < 0.”
BackgroundEmerging Concepts in the Resolution of Periodontal Inflammation: A Role for Resolvin E1
Balta, M. G., Loos, B. G., & Nicu, E. A. (2017) · Frontiers in Immunology · doi:10.3389/fimmu.2017.01682 · Cited by 76 · see citing works
“Toll-like receptors, present on host cells, detect molecules broadly shared by microorganisms; these molecules, such as lipopolysaccharides, lipoproteins, and lipoteichoic acids, are described using the term “pathogen-associated molecular patterns” (PAMPs) (41).”
Teng, K. T., McGreevy, P. D., Toribio, J.-A. L. M. L., Raubenheimer, D., Kendall, K., & Dhand, N. K. (2018) · Journal of Small Animal Practice · doi:10.1111/jsap.12905 · Cited by 73 · see citing works
Inflammation of the periodontium associates with risk of future cardiovascular events
Dyke, T. E. V., Kholy, K. E., Ishai, A., Takx, R. A. P., Mezue, K. N., Abohashem, S., Ali, A., Yuan, N., Hsue, P. Y., Osborne, M. T., et al. (2021) · Journal of Periodontology · doi:10.1002/jper.19-0441 · Cited by 74 · see citing works
“Herein, we tested the hypotheses that: (1) inflammation of the periodontium (PDinflammation) predicts future CVD independently of disease risk factors shared between CVD and PD, and (2) the mechanism linking the two diseases involves heightened arterial inflammation.”
BackgroundMethodBhattarai, G., Poudel, S. B., Kook, S., & Lee, J. (2017) · Journal of Biomedical Materials Research Part A · doi:10.1002/jbm.a.36109 · Cited by 72 · see citing works
Helmi, M. F., Huang, H., Goodson, J. M., Hastürk, H., Tavares, M. A., & Natto, Z. S. (2019) · BMC Oral Health · doi:10.1186/s12903-019-0925-z · Cited by 71 · see citing works
Pan, S., Lan, Y., Yang, Y., Zhang, Y., Yu, S., Wang, T., Zhu, Y., Yang, S., Yuan, X., Gao, X. Y., et al. (2025) · ACS Nano · doi:10.1021/acsnano.5c05266 · Cited by 71 · see citing works
Microbial and inflammatory‐based salivary biomarkers of head and neck squamous cell carcinoma
Vesty, A., Gear, K., Biswas, K., Radcliff, F. J., Taylor, M. W., & Douglas, R. G. (2018) · Clinical and Experimental Dental Research · doi:10.1002/cre2.139 · Cited by 71 · see citing works
- Authors
- Cekici, A., Kantarci, A., Hasturk, H., & Van Dyke, T. E.
- Venue
- Periodontology 2000
- Publisher
- Wiley
- Published
- 2013-12-09
- Volume
- 64
- Issue
- 1
- Pages
- 57-80
- ISSN
- 0906-6713 (ISSN-L)
- 1600-0757
- PMC
- PMC4500791
- OpenAlex
- W2160297100
- Cited by
- 1,415
- References
- 274
- Citations by year
- 2026: 97 · 2025: 146 · 2024: 188 · 2023: 210 · 2022: 131 · 2021: 194 · 2020: 124 · 2019: 97 · 2018: 72 · 2017: 77 · 2016: 31 · 2015: 34 · 2014: 11 · 2013: 1
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Periodontology 2000 (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Dental and Craniofacial Research (K23DE018917)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
- Keywords
- periodontitis, periodontal disease pathogenesis, host response, innate immunity, dental plaque, chronic inflammation, cytokine signaling pathways, adaptive immunity, immune regulation
- MeSH terms
- Bacteria, Disease Susceptibility, Humans, Immunity, Cellular, Immunity, Innate, Inflammation, Periodontitis, Cytokines, Biofilms, Host-Pathogen Interactions, Adaptive Immunity, Immunity, Humoral
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