Evidence map›Paper›PMID 41101348›Full record

ArticleJournal of clinical periodontology2026

Exhaled Carbon Monoxide Indicates Persistent Subgingival Dysbiosis After Periodontal Therapy.

Sophie Koehlen, Inga Harks, Johannes Matern, Karola Prior, Peter Eickholz, Katrin Lorenz, Ti-Sun Kim, Thomas Kocher, Jörg Meyle, Doğan Kaner and 5 more

Abstract read
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In one paragraph

Article in Journal of clinical periodontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Sophie KoehlenDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.ORCID 0009-0003-4798-5329
Inga HarksDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.
Johannes MaternDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.ORCID 0000-0003-0679-5759
Karola PriorDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.
Peter EickholzDepartment of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Katrin LorenzPoliclinic of Operative Dentistry, Periodontology, and Pediatric Dentistry, Division of Periodontology, Faculty of Medicine, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany.
Ti-Sun KimSection of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany.
Thomas KocherDepartment of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany.ORCID 0000-0001-9605-2822
Jörg MeyleDepartment of Periodontology, University of Giessen, Giessen, Germany.
Doğan KanerDepartments of Periodontology and Synoptic Dentistry, Charite-Universitätsmedizin, Berlin, Germany.
Yvonne Jockel-SchneiderDepartment of Periodontology, University Hospital Würzburg, Würzburg, Germany.
Dag HarmsenDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.
Benjamin EhmkeDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.
Sven Kleine BardenhorstDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.ORCID 0000-0002-7661-6931
Daniel HagenfeldDepartment of Periodontology and Operative Dentistry, Münster University Hospital, Münster, Germany.ORCID 0000-0003-1072-4865

Funding

Deutsche Forschungsgemeinschaft 468857272
6 · The paper itself

Abstract

aimTo investigate whether exhaled carbon monoxide (CO) is dose-dependently associated with subgingival polymicrobial clusters before and after non-surgical periodontal therapy. MATERIAL AND

methodsWe followed 163 adults with periodontitis, measuring CO before and at 2, 14 and 26 months after therapy. Subgingival plaque samples were analysed using 16S rRNA gene sequencing. We applied topic models and regression analysis, adjusted for age, sex, treatment group, pocket probing depth and plaque levels.

resultsSmokers had generally higher mean CO levels at every visit and showed significant declines at 14 and 26 months after therapy (p < 0.01). Before therapy, CO was not associated with dysbiosis; after therapy, higher levels were positively associated. In sensitivity analyses, self-reported smoking status explained more variance in dysbiosis than CO alone, with only marginal gains when both were combined. Among smokers, a distinct polymicrobial cluster dominated by Fusobacterium and Prevotella increased with higher exhaled CO. Every 10 parts per million increase in CO was associated with an estimated 16% increase in cluster abundance (95% confidence interval: 8%-26%).

conclusionExhaled CO may help monitor persistent dysbiosis and select an anaerobe-dominated subgingival community after periodontal therapy among smokers.

Indexed as

Carbon MonoxideDysbiosisPeriodontitisAdultBreath TestsFemaleHumansMaleMiddle AgedRNA, Ribosomal, 16SSmokingCarbon MonoxideRNA, Ribosomal, 16S16S rRNA gene sequencingcarbon monoxidedysbiosisperiodontitissmokingsubgingival microbiome

Identifiers

PMID41101348
PMCPMC12803674

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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.