BackgroundObservational studies have demonstrated a link between shortened telomere lengths(TL) and chronic periodontitis. However, whether the shortened TL is the cause or the result of periodontitis is unknown.Therefore, our objective was to investigate a bidirectional causal relationship between periodontitis and TL using a two-sample Mendel randomized (MR) study.MethodsA two-sample bidirectional MR analysis using publicly available genome-wide association study (GWAS) data was used. As the primary analysis, inverse variance weighting (IVW) was employed. To identify pleiotropy, we used leave-one-out analysis, MR-Egger, Weighted median, Simple mode, Weighted mode, and MR pleiotropy residual sum and outlier (MR-PRESSO).ResultsIn reverse MR results, a genetic prediction of short TL was causally associated with a higher risk of periodontitis (IVW: odds ratio [OR]: 1.0601, 95% confidence interval [CI]: 1.0213 to 1.1002; P =0.0021) and other complementary MR methods. In the forward MR analysis, periodontitis was shown to have no significant effect on TL (IVW: p = 0.7242), with consistent results for the remaining complementary MR. No pleiotropy was detected in sensitivity analysis (all P>0.05).ConclusionOur MR studies showed a reverse causal relationship, with shorten TL being linked to a higher risk of periodontitis, rather than periodontitis shorten that TL. Future research is needed to investigate the relationship between cell senescence and the disease.

Background and objective Bone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011–2012 and 2013–2014. Materials and methods From NHANES 2011–2014, 3802 participants aged 30–59 were selected. We divided the skull BMD level into quartiles to check the distribution of variables. Periodontitis was defined by the Centers for Disease Control and Prevention (CDC) and the American Association of Periodontology (AAP) in 2012. Multivariate logical regression analysis was used to explore the independent relationship between skull BMD and periodontitis. The generalized additive model (GAM), smooth curve fitting (penalty spline) and threshold effect analysis was used to evaluate dose-response relationship between skull BMD and periodontitis and the potential nonlinear relationship between skull BMD and periodontitis. Finally, subgroup analysis and interaction test were conducted to determine the role of covariates between skull BMD and periodontitis. Results The overall average skull BMD of 3802 participants was 2.24g/cm2, the average age was 43.94 years, and the prevalence of periodontitis was 41.03%. In the fully adjusted logistic regression model, skull BMD and periodontitis showed an independent negative correlation (OR 0.73, 95% CI 0.59–0.90, P = 0.0032) and a linear relationship. Compared with the lowest quartile array (Q1:1.22–1.98) of skull BMD, the highest quartile array(Q4: 2.47–3.79) had a significantly lower risk of periodontitis (OR 0.70,95% CI 0.56–0.87, P = 0.0014). Subgroup analysis showed a highly consistent negative correlation between skull BMD and periodontitis. In the interaction test, people with moderate poverty income ratio (1.57–3.62) and those who had more than 12 alcohol drinks in the past year had a lower risk of periodontitis. Conclusions This result suggested that periodontal disease can be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.

Background and ObjectiveBone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011-2012 and 2013-2014.Materials and MethodsFrom 19,931 participants, 3,802 were screened and included with no missing values in the study. We examined the distribution of variables by grouping the skull BMD levels into quartiles. Periodontitis is defined by the Centers for Disease Control and Prevention (CDC) and the American Periodontal Association (AAP) in 2012. An interaction test was conducted using stratified and adjusted logistic regression models, and multivariate logistic regression analysis was performed, along with curve fitting and a threshold effect analysis were performed on the relationship between skull BMD and periodontitis.ResultsThe results showed a negatively relationship between skull BMD and the risk of periodontitis. Although the inflection point was found (the skull BMD= 2.89g/cm2), it was not statistically significant, indicating that the skull BMD and periodontitis are linearly related, which 1 unit increase in the skull BMD (g/cm2) was associated with a 30% (OR=0.70; CI=0.57, 0.87; p=0.0010) reduction in the risk of periodontitis events.ConclusionsPeriodontal disease may be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.