ReviewNature reviews. Microbiology2012
The keystone-pathogen hypothesis.
Review in Nature reviews. Microbiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07634341 (Clinical and Radiographic Evaluation of Doxycycline and Atorvastatin Loaded Chitosan Nanoparticles as an Adjunctive to Scaling and Root Planning in the Management of Chronic Periodontitis), which is not on this map. Cited by 985 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical and Radiographic Evaluation of Doxycycline and Atorvastatin Loaded Chitosan Nanoparticles as an Adjunctive to Scaling and Root Planning in the Management of Chronic Periodontitis: A Randomized Controlled Clinical Trial.
Who cites it
985 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Effectiveness of oxidative therapies in mature oral biofilms: A systematic review and meta-analysis.Clinical oral investigations · 2026Pooled it
- Immunomodulation as a novel treatment strategy for periodontal disease: a systematic review.BMC oral health · 2026Pooled it
- Systematic review of prophylactic antibacterial agents for radiation-induced oral mucositis in head and neck cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- Pooled it
- Bioregulatory periodontal medicine: could the molecular networks, inflammation and system biology modify the auto-regulatory capacity of the patients?Frontiers in physiology · 2026Pooled it
- The Effect of Non-Surgical Periodontal Therapy on Subgingival Microbiota: A Systematic Review and Meta-Analysis.Journal of periodontal research · 2025Pooled it
- Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis.GeroScience · 2024Pooled it
- Improvement of post-periodontitis-therapy inflammatory state in diabetics: a meta-analysis of randomized controlled trials.Clinical oral investigations · 2024Pooled it
- Adjunctive effect of gaseous ozone on inflammatory biomarkers and microbial profile in grade C molar-incisor pattern periodontitis: a randomized split-mouth placebo-controlled clinical trial.BMC oral health · 2026Trial
- The protease code of the bacterial gut microbiota: ecological regulation, barrier disruption, and rewiring host defense and signaling.Gut microbes · 2026Review
- Antibiotic Resistance and Biofilm-Forming Capacity of Oral Biofilm Bacteria in Patients With Periodontitis and Healthy Individuals.MicrobiologyOpen · 2026Article
- Gut microbiome dynamics in acute infectious diarrhea: A conceptual framework from acute dysbiosis toward precision restoration (Review).Experimental and therapeutic medicine · 2026Review
- Diagnostic Accuracy of Salivary Thiols Point-of-Care Test for Detecting Subgingival Dysbiosis in Adults: A Cross-Sectional Study.Clinical and experimental dental research · 2026Article
- Direct cellular contact byScience advances · 2026Article
- Obstructive sleep apnea, GLP-1 receptor agonist pharmacotherapy, and the oral microbiome: competing biological influences and implications for oral health monitoring.Clinical oral investigations · 2026Review
- The Role ofAntibiotics (Basel, Switzerland) · 2026Review
- Microbial Signals in Cancer: Dissecting Host-Microbiota-Tumor Interactions and Potential Therapeutic Strategy.MedComm · 2026Review
- Role of Oral-Lung Infection Axis on Respiratory Health.Biomedicines · 2026Review
- Does permanent tooth eruption introduce periodontal pathogens? A preliminary study.Odontology · 2026Article
- Correlating bacterial load and periodontal disease severity: A large-scale study of the microbial landscape.Journal of periodontology · 2026Article
925 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Recent studies have highlighted the importance of the human microbiome in health and disease. However, for the most part the mechanisms by which the microbiome mediates disease, or protection from it, remain poorly understood. The keystone-pathogen hypothesis holds that certain low-abundance microbial pathogens can orchestrate inflammatory disease by remodelling a normally benign microbiota into a dysbiotic one. In this Opinion article, we critically assess the available literature that supports this hypothesis, which may provide a novel conceptual basis for the development of targeted diagnostics and treatments for complex dysbiotic diseases.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.