Epigenetic Alterations In Periodontal Diseases: A Review

Binglan Xue

Xue, Binglan, Sahingur, Sinem, E
Faculty / Advisor: Sahingur, Sinem E.
University of Pennsylvania School of Dental Medicine, Department of Periodontics


Periodontitis is characterized by a non-resolving, self-perpetuating state of prolonged inflammation and impaired homeostasis that eventually lead to soft and hard tissue destruction. The etiology of the disease involves interaction between intrinsic and extrinsic elements including microenvironment, genetic predisposition, systemic disease, oral hygiene, medication and lifestyle factors, of which bacterial biofilm and host response are two major components. Epigenetics is the heritable molecular alteration that remodels chromatin and regulates gene expression without changing the DNA base pair sequence. Epigenetic makeup can alter upon extrinsic stimuli such as environment, social, psychological and nutritional factors. Therefore, they could explain the dynamic interactions between genes and environment in the context of disease susceptibility. In this review, we present different types of epigenetic alterations and their associations with the pathogenesis of periodontal diseases. We also highlight some of the studies that investigated the use of epidrugs as potential therapeutics.


A search was performed using PubMed as the database to find pertinent primary studies published in English between January, 2010 and July, 2020 using the keywords in combination with the MeSH terms including “Epigenesis, Genetic”, “Epigenomics”, “DNA Methylation”, “Methyltransferase”, “Demethylase”, "Acetylation", "Histones”, “Acetyltransferase”, “Deacetylase”, "MicroRNAs", and "Periodontal Diseases”.


Emerging studies report the association between periodontal disease and epigenetic alterations, via DNA methylation, histone modifications and microRNAs. It has been shown that epigenetics can participate in disease pathophysiology through modulating gene expression, and regulating key inflammatory signaling pathways and bone metabolism. Epidrugs, including DNMTis and HDACis and targeting miRNAs have been studied preclinically and showed some efficacy in experimental models. Yet, more studies are needed to fully define the epigenetic markers and their effect on periodontal disease susceptibility and potential use of epidrugs in clinical periodontics.


Epigenetics is still at its early stage and future studies are required to characterize epigenetic modifications and their impact on the periodontal disease pathogenesis to develop more effective and personalized preventive and therapeutic strategies.