Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review

Regulated cell death (RCD) and survival pathways have emerged as critical factors in periodontal tissue breakdown. However, their precise roles and interactions remain poorly understood. This systematic review aimed to synthesize current evidence regarding the involvement of RCD and survival mechani...

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Main Authors: Alfredo Torres, Leonardo Díaz, Jaime Oyarzún, M. Angélica Michea, Xiaowei Xu, Flavio Salazar-Onfray, Fermín E. González
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:Japanese Dental Science Review
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Online Access:http://www.sciencedirect.com/science/article/pii/S188276162500016X
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author Alfredo Torres
Leonardo Díaz
Jaime Oyarzún
M. Angélica Michea
Xiaowei Xu
Flavio Salazar-Onfray
Fermín E. González
author_facet Alfredo Torres
Leonardo Díaz
Jaime Oyarzún
M. Angélica Michea
Xiaowei Xu
Flavio Salazar-Onfray
Fermín E. González
author_sort Alfredo Torres
collection DOAJ
description Regulated cell death (RCD) and survival pathways have emerged as critical factors in periodontal tissue breakdown. However, their precise roles and interactions remain poorly understood. This systematic review aimed to synthesize current evidence regarding the involvement of RCD and survival mechanisms in the progression of periodontitis. A systematic literature search was conducted in PubMed/MEDLINE, Web of Science and Scopus, complemented by manual searching in Google Scholar, following PRISMA guidelines. After removing duplicates, 549 studies underwent title and abstract screening. Of these, 56 articles were selected for full-text review and 18 studies met the eligibility criteria and were included in the final synthesis. Ferroptosis, pyroptosis and necroptosis were consistently associated with inflammatory exacerbation, alveolar bone loss and disease progression. In contrast, autophagy and apoptosis exhibited dual roles—protective or destructive—depending on cell types, disease stage and experimental conditions. Most studies utilized ligature-induced periodontitis animal models. Several studies also demonstrated the therapeutic potential of modulating specific RCD pathways to control inflammation and promote periodontal tissue regeneration, highlighting possible translational strategies for host-modulation therapy of periodontitis. This systematic review consolidates the pivotal role of RCD in the progression of periodontitis. Targeting RCD pathways may represent novel therapeutic strategies to reduce periodontal inflammation and tissue destruction.
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spelling doaj-art-8ba1d9b862ef43f2a46809925101c5b22025-08-24T05:12:01ZengElsevierJapanese Dental Science Review1882-76162025-12-016121322610.1016/j.jdsr.2025.08.001Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic reviewAlfredo Torres0Leonardo Díaz1Jaime Oyarzún2M. Angélica Michea3Xiaowei Xu4Flavio Salazar-Onfray5Fermín E. González6Laboratory of Experimental Immunology & Cancer, Faculty of Dentistry, University of Chile, Santiago, Chile; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, ChileDepartment of Prosthodontics, Faculty of Dentistry, University of Chile, Santiago, Chile; Department of Stomatology, Faculty of Dentistry, Universidad de Sevilla, Sevilla, Spain; Perioplastic Institute, Santiago, ChileLaboratory of Experimental Immunology & Cancer, Faculty of Dentistry, University of Chile, Santiago, ChileDepartment of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, ChileDepartment of Periodontology, Hospital of Stomatology, Jilin University, Changchun, PR ChinaInstitute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile; Millennium Institute for Immunology and Immunotherapy, Faculty of Medicine, University of Chile, Santiago, ChileLaboratory of Experimental Immunology & Cancer, Faculty of Dentistry, University of Chile, Santiago, Chile; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile; Correspondence to: Laboratory of Experimental Immunology & Cancer, Faculty of Dentistry, University of Chile, Olivos 943, Independencia, Santiago 8380492, Chile.Regulated cell death (RCD) and survival pathways have emerged as critical factors in periodontal tissue breakdown. However, their precise roles and interactions remain poorly understood. This systematic review aimed to synthesize current evidence regarding the involvement of RCD and survival mechanisms in the progression of periodontitis. A systematic literature search was conducted in PubMed/MEDLINE, Web of Science and Scopus, complemented by manual searching in Google Scholar, following PRISMA guidelines. After removing duplicates, 549 studies underwent title and abstract screening. Of these, 56 articles were selected for full-text review and 18 studies met the eligibility criteria and were included in the final synthesis. Ferroptosis, pyroptosis and necroptosis were consistently associated with inflammatory exacerbation, alveolar bone loss and disease progression. In contrast, autophagy and apoptosis exhibited dual roles—protective or destructive—depending on cell types, disease stage and experimental conditions. Most studies utilized ligature-induced periodontitis animal models. Several studies also demonstrated the therapeutic potential of modulating specific RCD pathways to control inflammation and promote periodontal tissue regeneration, highlighting possible translational strategies for host-modulation therapy of periodontitis. This systematic review consolidates the pivotal role of RCD in the progression of periodontitis. Targeting RCD pathways may represent novel therapeutic strategies to reduce periodontal inflammation and tissue destruction.http://www.sciencedirect.com/science/article/pii/S188276162500016XPeriodontitisRegulated cell deathDisease progression
spellingShingle Alfredo Torres
Leonardo Díaz
Jaime Oyarzún
M. Angélica Michea
Xiaowei Xu
Flavio Salazar-Onfray
Fermín E. González
Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
Japanese Dental Science Review
Periodontitis
Regulated cell death
Disease progression
title Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
title_full Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
title_fullStr Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
title_full_unstemmed Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
title_short Interplay between survival and regulated cell death mechanisms during periodontitis progression: a systematic review
title_sort interplay between survival and regulated cell death mechanisms during periodontitis progression a systematic review
topic Periodontitis
Regulated cell death
Disease progression
url http://www.sciencedirect.com/science/article/pii/S188276162500016X
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