The goal of this observational study is to investigate cellular heterogeneity and inflammatory microenvironment features in gingival tissues from patients with aggressive periodontitis compared to chronic periodontitis and healthy controls, using single-cell and spatial transcriptomics combined with whole-genome sequencing.
The main question(s) it aims to answer are:
What are the differences in cellular composition, mesenchymal stem cell subpopulations, and gene expression profiles between aggressive periodontitis, chronic periodontitis, and healthy gingival tissues? Which key molecular markers, signaling pathways, and spatially resolved microenvironment patterns distinguish aggressive periodontitis from the more common chronic form? Are there disease-specific genetic variants associated with aggressive periodontitis identified through whole-genome sequencing of peripheral blood DNA?
Participants (already scheduled for tooth extraction or periodontal surgery as part of routine clinical care) will undergo:
Standard clinical periodontal examination and CBCT imaging Collection of a small gingival tissue sample (\~1×3×1 mm) during the planned extraction/surgery under local anesthesia Collection of 5 mL peripheral blood for DNA extraction No additional intervention, treatment, or follow-up visit is required beyond routine dental care.
Last updated: December 23, 2025
Aged 20-35 years
Radiographic evidence of at least 30% vertical bone loss at ≥2 tooth sites
Can be classified as Stage III/IV, Grade C periodontitis according to the 2018 new classification of periodontitis
With or without family history of periodontitis
Use of antibiotics within the past 3 months
Smoking >10 cigarettes per day
Uncontrolled severe diabetes (HbA1c level ≥6.7%)
Planning pregnancy, currently pregnant, or breastfeeding
This cross-sectional observational study will recruit 9 adults (n=3 per group) from the Department of Periodontology, Second Affiliated Hospital, Zhejiang University School of Medicine. All participants are already scheduled for routine tooth extraction or periodontal surgery, allowing incidental collection of a small gingival tissue sample (\~1×3×1 mm) and 5 mL peripheral blood during standard care. No extra procedures are added. Aggressive Periodontitis (AP) Group (n=3) Age 20-35 years * 30% vertical bone loss at ≥2 sites on radiographs Stage III/IV, Grade C (2018 classification) With or without family history Minimal local factors (negligible calculus/trauma) Chronic Periodontitis (CP) Group (n=3) Age 30-40 years * 3 sites with probing depth ≥5 mm Stage I/II, Grade A/B (2018 classification) No family history Disease driven by plaque/calculus Healthy Controls (n=3) Age 20-40 years No significant bone loss on radiographs Clinically healthy periodontium (no gingivitis/periodontitis)
Other
Cross-sectional
Not listed
Landscape of Cellular Heterogeneity in Periodontal Tissues
Single-cell RNA sequencing (scRNA-seq) will be used to evaluate the cellular heterogeneity of gingival tissues from patients with aggressive periodontitis (AP group), chronic periodontitis (CP group), and healthy controls, with a particular focus on mesenchymal stem cells. This includes identification of cell subpopulations and quantification of these subpopulations based on gene expression profiles.
Identification of Key Molecular Markers and Signaling Pathways
To discover differentially expressed molecular markers and signaling pathways between the AP group, CP group, and healthy group. By integrating single-cell RNA sequencing and spatial transcriptomics data, the analysis will identify potential therapeutic targets.
Spatial Transcriptomic Expression Profiles
Evaluation of the spatial distribution patterns of gene expression in gingival tissues from the aggressive periodontitis (AP) group, chronic periodontitis (CP) group, and healthy controls, as well as treatment-induced spatial changes. Spatial transcriptomics technology will be used to map cell-cell interactions and differences in the microenvironment.
Genetic Variants Identified by Whole-Genome Sequencing
Through whole-genome resequencing (WGS) of peripheral blood DNA, identification of genetic susceptibility variants associated with aggressive periodontitis and chronic periodontitis, with a particular focus on variants related to familial aggregation, genetic predisposition, disease progression, and treatment response.
Click on the lead sponsor to view all of their trials.
