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From Dysbiosis to Tissue Destruction: Periodontal Pathogens as Inducers of Gingival Epithelial–Mesenchymal Transition (A Narrative Review)
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Periodontitis is a dysbiosis-driven inflammatory disease in which a pathogenic subgingival biofilm disrupts the host–microbe equilibrium and promotes progressive loss of tooth-supporting tissues. While periodontal destruction has traditionally been explained mainly through the host immune response, increasing experimental and clinical evidence suggests that epithelial–mesenchymal transition (EMT)-like changes in the gingival epithelium may contribute to barrier failure and tissue remodeling during disease progression. EMT is characterized by reduced epithelial adhesion and polarity, alongside a shift toward a mesenchymal-like phenotype with enhanced motility and impaired epithelial barrier function. This narrative review focuses on how periodontal pathogens, particularly red complex organisms and keystone species, may trigger gingival EMT through virulence factors such as gingipains, fimbriae, lipopolysaccharide, and outer membrane vesicles. These microbial signals can hijack host pathways including TGF-β/Smad, Wnt/β-catenin, and Notch to drive EMT-associated transcriptional changes and downstream functional consequences. Collectively, pathogen-induced gingival EMT may facilitate deeper microbial invasion, perpetuate chronic inflammation, impair wound healing, and contribute to fibrotic remodeling, ultimately linking microbial dysbiosis to connective tissue destruction. Understanding these mechanisms may support the development of EMT-related biomarkers and targeted interventions aimed at preserving epithelial barrier stability in periodontitis.

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Publication Date
Fri Jun 16 2023
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Role of Fasting Mimicking Diet in Farnesoid x Receptor for Suppressing Epithelial-to-Mesenchymal Transition, Cell Cycle Progression, and Viability of Prostate Cancer Cells
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The systemic and resistant nature of metastatic castration-resistant prostate cancers (mCRPC) renders it largely incurable even after intensive multimodal therapy. Proliferation, survival, and epithelial-mesenchymal transition (EMT) are three fundamental events that are deeply linked to carcinogenesis.  Hence, it is necessary to find a new combination of several therapies, targeting those vital mechanisms without causing side effects. Significant research works have shown differential low expression of the metabolic Farnesoid X receptor (FXR) in primary and metastatic prostate cancer suggesting their importance in prostate pathogenesis. Obticholic acid (INT 747), a potent FXR agonist is widely used in primary biliary chola

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Publication Date
Thu Sep 13 2018
Journal Name
Baghdad Science Journal
The Prognostic Value of some Epithelial-Mesenchymal Transition Markers and Metastasis-Related Markers in Human Transitional Cell Carcinoma of the Bladder
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Recent reports provided evidence that epithelial to mesenchymal transition (EMT) and some matrix metalloproteinases (MMPs) contribute to the invasion and metastasis of cancer cells. This study investigated the expression pattern of some EMT markers (E-cadherin and Vimentin) and some MMPs (MMP-2 and MMP-9) in transitional cell carcinoma (TCC). Fifty five paraffin embedded biopsies were included in this study. Expression pattern of E-cadherin and Vimentin was evaluated by immunohistochemistry while cytoplasmic mRNA expression of both MMP-2 and MMP-9 were determined by in situ hybridization. The expression of all markers were significantly increased with the increase of patient's age (? 50 years), and furthermore an increase in men expression

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of Baghdad College Of Dentistry
Gingival recession and periodontal therapy
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Background: Gingival recession is defined as the apical migration of the gingival margin below the cementoenamel junction (CEJ), resulting in exposure of the root surface and it is one of the main esthetic complaints of patients. The management of gingival recession and its sequelae is based on a thorough assessment of the etiological factors and the degree of tissue involvement.

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Publication Date
Mon Mar 03 2014
Journal Name
Journal Of Baghdad College Of Dentistry
Stem Cells a Novel Approach to Periodontal Regeneration: A Review of Literature
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Publication Date
Wed May 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Stem cells a novel approach to periodontal regeneration (A review of literature)
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In this review of literature, the light will be concentrated on the role of stem cells as an approach in periodontal regeneration.

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Publication Date
Wed May 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
An Evaluation of the Efficacy of Different Gingival Retraction Materials on the Gingival Tissue Displacement (A Comparative In Vivo Study)
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Background: An accurate adaptation of the crown to the finish line is essential to minimize cement dissolution and to preserve periodontium in fixed partial denture cases. An accurate adaptation of crown is possible only when preparation details are captured adequately in the impression and transferred to cast. For these reasons, gingival displacement is necessary to capture subgingival preparation details.The aim of the present study is to measure in vivo the horizontal displacement of the gingival sulcus obtained by using three new cordless retraction materials (Magic Foam Cord®, Racegel and Astringent Retraction Paste) in comparison to medicated retraction cord. Materials and method: Thirty-two patients requiring porcelain fused to me

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Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Oral Microbiology
Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
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Publication Date
Sun Apr 02 2023
Journal Name
Journal Of Oral Microbiology
Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
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Publication Date
Mon Jul 03 2017
Journal Name
University Of Sheffield
The interaction of Porphyromonas gingivalis with host epithelial cells and its relevance to periodontal disease
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Periodontitis is one of the most prevalent bacterial diseases affecting man with up to 90% of the global population affected. Its severe form can lead to the tooth loss in 10-15% of the population worldwide. The disease is caused by a dysbiosis of the local microbiota and one organism that contributes to this alteration in the bacterial population is Prophyromonas gingivalis. This organism possesses a range of virulence factors that appear to contribute to its growth and survival at a periodontal site amongst which is its ability to invade oral epithelial cells. Such an invasion strategy provides a means of evasion of host defence mechanisms, persistence at a site and the opportunity for dissemination to other sites in the mouth. However, p

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Publication Date
Wed May 20 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Assessment of transforming growth factor beta one (TGF-?1) immunohistochemical (IHC) expression profile in the gingival tissue of patients with different forms of periodontal diseases
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Background: This study evaluate the immunohistochemical expression profile of transforming growth factor beta-1 in inflamed gingival tissue of patients with gingivitis and chronic periodontitis compared to healthy subjects and, determine the correlation between this cytokine and the clinical periodontal parameters, intensity of inflammation and chronic periodontitis severity. Materials and methods: Gingival tissue specimens were taken from 23 chronic periodontitis patients, 20 gingivitis patients and 20 periodontally healthy subjects. The periodontal status was evaluated by dichotomous measurements of the clinical periodontal parameters (PLI, GI, BOP, PPD, CAL). The gingival specimens were fixed immediately in 10% formalin and processed ro

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