Periodontal Inflammation and Epigenetics in Obese Individuals

Periodontitis is an inflammatory disease process primarily caused by microorganisms, which affects the tooth-supporting structures and can eventually lead to tooth loss. Oral health is a reflection of general health. Accordingly, obesity can influence periodontitis and increase its severity. The study participants will be categorized into two groups as described above. Enrolled participants will be balanced for distribution of age, gender, ethnicity, and general health.

The objective of this pilot study is to investigate the cross-sectional and longitudinal changes in host epigenetic modifications in obese individuals with periodontitis. The investigators intend to examine these host epigenetic changes in obese and non-obese individuals with both periodontal health and periodontitis. The study will primarily evaluate longitudinal changes following non-surgical periodontal therapy (considered the gold standard for the initial treatment of periodontitis) to determine whether any modifications occur with treatment.

To control for other factors affecting periodontitis, the investigators plan to exclude diabetic participants, document oral hygiene habits, and monitor periodontal microorganisms and inflammatory mediators in the groups for further associations. In summary, the study will identify important epigenetic signatures in obese participants with periodontal disease compared to those with periodontal health as a potential causal factor linking the two conditions.

The investigators hypothesize that epigenetic programs in obese individuals will influence the severity of periodontal disease by altering inflammatory pathways and the microbial environment.

• Non-surgical periodontal therapy will be administered (Procedure), also known as Scaling and root planing: Non-surgical periodontal therapy (Deep cleaning-SRP): The deep cleaning by a scaling and root planing (SRP) procedure, is the standard initial treatment for all individuals diagnosed with periodontitis (periodontal disease). At the initial treatment planning appointment, each subject will receive intra-oral and extra-oral examination along with full mouth examination of the periodontal status, followed by diagnosis and treatment planning. The subject will then be scheduled for a deep cleaning procedure. The Deep cleaning procedure are carried out using hand instruments and ultrasonic instruments.

Primary outcomes

• Host-specific epigenetic signatures [Baseline/Day 1]: Gingival crevicular fluid and saliva will be analyzed to study epigenetic signatures
• Inflammatory cytokine profiles [Baseline/Day 1]: Gingival crevicular fluid and saliva will be analyzed to study inflammatory cytokine profiles.
• Periodontal microbial composition [Baseline/Day 1]: Subgingival plague will be analyzed to study periodontal microbial composition

Secondary outcomes

• Host epigenetic modifiers pre- and post-therapy [Baseline/Day 1, Day 30, Day 90]: Gingival crevicular fluid and saliva will be analyzed to study epigenetic changes.
• Inflammatory cytokine changes pre- and post-therapy [Baseline/Day 1, Day 30, Day 90]: Gingival crevicular fluid and saliva will be analyzed to study inflammatory cytokine changes.
• Periodontal microbial changes pre- and post-therapy [Baseline/Day 1, Day 30, Day 90]: Subgingival plague will be analyzed to study periodontal microbial changes.

Sex: All, ages: 18 Years to 75 Years, accepts healthy volunteers

Inclusion Criteria:

* Adults aged ≥18 years,
* No history of periodontal therapy in the last 6 months,
* No use of tobacco,
* No history of pregnancy lactation or contraceptive medication.
* Need to have a minimum of 20 teeth.

Exclusion Criteria:

* Had antimicrobial/antiviral therapy in the previous 3 months,
* History of uncontrolled diabetes,
* History of rheumatoid arthritis,
* History of osteoporosis,
* History of oral cancer,
* Currently taking hormonal contraception,
* If pregnant or lactating currently or prior 6 months,
* Subjects on current weight loss drugs
* If planning weight reduction surgery during the time of the study
* Any other condition, disease or therapy with documented influence on oral inflammation and/or oral microbial environment.