Effect of GLP-1 Receptor Agonists on Periodontal Health and Response to Nonsurgical Periodontal Therapy

This prospective, controlled clinical study aims to compare periodontal clinical parameters and gingival crevicular fluid inflammatory markers between individuals with obesity and periodontitis who use GLP-1 RAs and those who do not use pharmacological treatment for obesity. The study will also evaluate and compare the clinical response to non-surgical periodontal therapy between the two groups.

A total of 40 participants with obesity and periodontitis will be included and allocated to two groups. The GLP-1 RA group will consist of 20 participants who have been regularly using a GLP-1 RA (semaglutide, liraglutide, or dulaglutide) for at least 3 months because of obesity. The control group will consist of 20 participants with obesity and periodontitis who are not using any medication for obesity.

All participants will receive the same non-surgical periodontal treatment protocol. Following the baseline periodontal examination, participants will receive oral hygiene instructions, including instruction in the modified Bass toothbrushing technique. Non-surgical periodontal therapy will be completed in two sessions under local anesthesia and will include full-mouth subgingival instrumentation and scaling and root planing using ultrasonic instruments and Gracey curettes. No adjunctive antimicrobial agents will be used. Participants in the GLP-1 RA group will continue their existing systemic GLP-1 RA treatment without modification.

Periodontal clinical assessments will include probing depth, clinical attachment level, bleeding on probing, plaque index, and gingival index. Gingival crevicular fluid samples will be collected using sterile PerioPaper® strips and stored at -80°C until analysis. Body mass index, HbA1c, and fasting blood glucose will also be evaluated using the measurements and laboratory results specified in the study protocol.

Clinical periodontal measurements and gingival crevicular fluid sampling will be performed at baseline and repeated at 3 and 6 months following non-surgical periodontal therapy. During follow-up visits, oral hygiene instructions will be reinforced, and professional supragingival cleaning will be performed when supragingival calculus accumulation is detected.

Changes in periodontal clinical parameters and gingival crevicular fluid inflammatory markers will be compared between the GLP-1 RA and control groups. The study is designed to determine whether GLP-1 RA use is associated with differences in periodontal inflammatory status and clinical response to non-surgical periodontal therapy in individuals with obesity and periodontitis.

Inclusion criteria

• Age between 18 and 65 years
• Body mass index (BMI) ≥25 kg/m²
• Presence of at least 20 functional teeth
• Diagnosis of periodontitis
• For the GLP-1 receptor agonist group: regular use of a GLP-1 receptor agonist for at least 3 months

Exclusion criteria

• Age between 18 and 65 years
• Body mass index (BMI) ≥25 kg/m²
• Presence of at least 20 functional teeth
• Diagnosis of periodontitis
• For the GLP-1 receptor agonist group: regular use of a GLP-1 receptor agonist for at least 3 months