Angiogenesis in Periodontal Disease

Gum disease (gingivitis and periodontitis) is a common inflammatory condition affecting the tissues that support the teeth. Smoking is known to make gum disease worse and to affect blood vessel health in the gums. This study looks at two proteins, KLF2 and FBXW7, which are involved in blood vessel formation, to understand their role in gum disease and whether smoking changes their levels. Researchers measured these proteins, along with two other markers of inflammation and blood vessel activity (VEGF and NF-κB), in fluid collected from around the teeth and in saliva from healthy adults who were either smokers or non-smokers, with healthy gums, gingivitis, or periodontitis. The goal is to better understand how smoking and gum disease affect blood vessel-related proteins in the mouth.

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Key information

Conditions

Gingivitis Behavior Gingival Diseases Infections Mouth Diseases Periodontal Diseases Periodontitis Smoking Stomatognathic Diseases

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Inonu University, Faculty of Dentistry, Deparment of Periodontology

Malatya, 44100, Turkey (Türkiye)

About this study

Angiogenesis, the formation of new blood vessels, is considered an early host response involved in the progression of periodontal disease. KLF2 is a transcription factor that negatively regulates angiogenesis and endothelial activation, while FBXW7 contributes to vascular development and has been reported to modulate KLF2 expression. Smoking is a major modifiable risk factor for periodontal disease and is known to affect periodontal vascularity, although the underlying molecular mechanisms remain incompletely understood. This study evaluates the potential involvement of KLF2 and FBXW7, alongside the established angiogenic and inflammatory mediators VEGF and NF-κB, in periodontal disease pathogenesis, and examines whether smoking modifies their expression in gingival crevicular fluid and saliva.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for the Healthy Control group:

presence of ≥ 20 teeth in the mouth
probing pocket depth (PPD) ≤ 3 mm
the percentage of bleeding sites for the whole mouth < 10%,
on radiographic examination, a distance of ≤ 3 mm between the cemento-enamel junction and the alveolar bone crest in 95% of all teeth.

Inclusion criteria

for the Gingivitis group were

presence of ≥ 20 teeth in the mouth
PPD ≤ 3 mm,

-% of bleeding sites for the whole mouth ≥ 10%,

on radiographic examination, a distance of ≤ 3 mm between the cemento-enamel junction and the alveolar bone crest in 95% of all teeth.

Inclusion criteria

for the Stage 3 Periodontitis group

presence of ≥ 15 teeth in the mouth
more than 30% of teeth affected by periodontal disease
affected teeth exhibiting probing depths of 6 mm or more
clinical attachment loss (CAL) of ≥ 5 mm,
vertical bone loss of 3 mm or more
class 2 or 3 furcation involvement
radiographic evidence of alveolar bone loss extending to the middle third and beyond (33%) in the relevant teeth

Exclusion criteria

presence of any systemic disease
regular use of any medication
pregnancy or lactation
periodontal treatment within the last 6 months
antibiotic use within the last 6 months
the presence of prosthetic restorations on the teeth to be sampled

Treatment and study plan

Primary outcomes

GCF and Salivary VEGF, NF-κB, KLF2, and FBXW7 Protein Levels

Time frame: March to September 2024

Total amounts and concentrations of VEGF, NF-κB, KLF2, and FBXW7 were measured by ELISA in gingival crevicular fluid (GCF) and unstimulated whole saliva samples, and compared across participants with periodontal health, gingivitis, and periodontitis, in both smokers and non-smokers.

Sponsors and collaborators

Lead sponsor

Inonu University

Other

Registry information

Official study title

Smoking is Associated With Angiogenesis Through the Expression of FBXW7 and KLF2 in Periodontal Disease

Important dates

Study start: 2024
Primary completion: 2024
Study completion: 2024
First posted: Aug 14, 2026
Registry last updated: Aug 14, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed