ArticleTrials2020
Efficacy and safety of PERIOdontal treatment versus usual care for Nonalcoholic liver disease: protocol of the PERION multicenter, two-arm, open-label, randomized trial.
Article in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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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.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Trained immunity as a systemic bridge: the liver-gut-immune-oral axis in the comorbidity of chronic liver disease and periodontitis.Frontiers in immunology · 2026Review
- Liver Disease and Periodontal Pathogens: A Bidirectional Relationship Between Liver and Oral Microbiota.Dentistry journal · 2025Review
- Role of Nonalcoholic Fatty Liver Disease in Periodontitis: A Bidirectional Relationship.Cureus · 2024Review
- Multifunctional role of oral bacteria in the progression of non-alcoholic fatty liver disease.World journal of hepatology · 2024Review
- Identifying MS4A6AHeliyon · 2024Article
- Oral Pathogenic Bacteria and the Oral-Gut-Liver Axis: A New Understanding of Chronic Liver Diseases.Diagnostics (Basel, Switzerland) · 2023Review
- The role of microbiome in the pathogenesis of oral-gut-liver axis between periodontitis and nonalcoholic fatty liver disease.Journal of dental sciences · 2023Review
- Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis.World journal of gastroenterology · 2023Review
- Periodontal and Hepatic Parameters in Obese Patients Undergoing Bariatric Surgery.Oral health & preventive dentistry · 2022Article
- Periodontitis, chronic liver diseases, and the emerging oral-gut-liver axis.Periodontology 2000 · 2022Review
- Oral Health and Liver Disease: Bidirectional Associations-A Narrative Review.Dentistry journal · 2022Review
- Periodontal disease-related nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: An emerging concept of oral-liver axis.Periodontology 2000 · 2021Review
- The pathogenic oral-gut-liver axis: new understandings and clinical implications.Expert review of clinical immunology · 2021Review
- Relationship between NAFLD and Periodontal Disease from the View of Clinical and Basic Research, and Immunological Response.International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
22 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundWe report the first protocol for a multicenter, randomized comparison study to compare the efficacies of periodontal scaling and root-planing treatment against that of tooth-brushing treatment for nonalcoholic fatty liver disease (NAFLD) (PERION: PERIOdontal treatment for NAFLD). Nonalcoholic steatohepatitis (NASH) is an advanced form of NAFLD, which can progress to cirrhosis and hepatocellular carcinoma. Increased endotoxemia is associated with the progression of NAFLD. Periodontal bacteria possess endotoxins; Porphyromonas gingivalis is well-known as a major pathogenic bacterium in periodontitis, and serum antibody levels for P. gingivalis are high in patients with periodontitis. Several reports have indicated that P. gingivalis is related to NAFLD. This study aims to investigate the effect of periodontal treatment for liver damage, P. gingivalis infection, and endotoxemia on patients with NAFLD.
methodsWe will include adult patients (20-85 years old) with NAFLD, alanine aminotransferase (ALT) ≥ 40 IU/L, and equivalent steatosis grade ≥ 1 (target sample size, n = 40 patients; planned number of patients with outcome data, n = 32). Participants will be randomly assigned to one of two groups: a scaling and root-planing group or tooth-brushing as the usual group. The primary outcome will be the change in ALT levels from baseline to 12 weeks; the key secondary outcome will be the change in the serum immunoglobulin G (IgG) antibody titer for P. gingivalis at 12 weeks. DISCUSSION: This study should determine whether periodontal treatment decreases liver damage, P. gingivalis infection, and endotoxemia in patients with NAFLD.
trial registrationUniversity Hospital Medical Information Network (UMIN) Clinical Trials Registry, ID: UMIN000022079.
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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.