Periodontal Health Profile in Multiple Sclerosis Patients

Evaluation of Periodontal Status in Patients With Multiple Sclerosis: A Clinical, Microbiological, and Biochemical Study

This study aims to evaluate the periodontal status of patients with Multiple Sclerosis (MS) through clinical, microbiological, and biochemical parameters. Multiple sclerosis and periodontal diseases are both chronic inflammatory conditions that may share common immunopathological pathways. The primary objective is to investigate the relationship between MS and periodontal health by comparing clinical measurements with the microbial composition and biochemical markers found in saliva samples of patients followed by the Neurology Department.

Study Overview

• Status: Not yet recruiting
• Conditions: Multiple Sclerosis; Periodontitis

Detailed Description

The research is designed as a multidimensional study involving patients from the Neurology and Periodontology Departments. Participants will undergo a comprehensive periodontal examination to record clinical parameters (such as probing depth, clinical attachment level, and bleeding on probing). In addition to clinical assessments, the study includes:

Saliva Collection and Analysis: Whole unstimulated saliva samples will be collected from all participants under standardized conditions.

Microbiological Evaluation: The collected saliva will be analyzed to determine the microbial profile and identify specific periodontal pathogens associated with MS.

Biochemical Evaluation: Salivary samples will be further analyzed for biochemical markers (such as inflammatory cytokines or enzymes) to evaluate their role in the relationship between systemic inflammation in MS and oral health.

The study will be conducted at the Health Sciences University Gulhane Faculty of Dentistry and Ankara Bilkent City Hospital to provide a thorough understanding of how MS affects the oral ecosystem.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Nuriye Işıl SAYGUN, Professor; Phone Number: +903125671500; Email: nuriyeisil.saygun@sbu.edu.tr
• Study Contact Backup: Name: Merve İNCEÖZ, Research Assistant; Phone Number: +903125671500; Email: merve.inceoz@sbu.edu.tr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population consists of patients diagnosed with Multiple Sclerosis who are followed by the Neurology Department of Ankara Bilkent City Hospital, and age-and-gender-matched systemically healthy volunteers as a control group.

Description

Inclusion Criteria (Test Group):

• Voluntarily agreeing to participate in the study.
• Being over 18 years of age.
• Diagnosed with Multiple Sclerosis (MS) according to the 2017 McDonald criteria.
• Being able to communicate clearly and effectively.

Inclusion Criteria (Control Group):

• Voluntarily agreeing to participate in the study.
• Being over 18 years of age.
• Not having a diagnosis of Multiple Sclerosis (MS) according to the 2017 McDonald criteria.
• Being able to communicate clearly and effectively.

Exclusion Criteria (Test Group):

• Being under 18 years of age.
• Patients whose MS diagnosis is not yet definitive.
• Being pregnant or in the lactation (breastfeeding) period.
• Having received antibiotic treatment within the last 3 months.
• Having received periodontal treatment within the last 6 months.
• Patients undergoing radiotherapy or chemotherapy.

Exclusion Criteria (Control Group):

• Being under 18 years of age.
• Being diagnosed with Multiple Sclerosis (MS) according to the 2017 McDonald criteria.
• Being pregnant or in the lactation (breastfeeding) period.
• Having received antibiotic treatment within the last 3 months.
• Having received periodontal treatment within the last 6 months.
• Patients undergoing radiotherapy or chemotherapy.

Study Plan

How is the study designed?

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort
Multiple Sclerosis - Clinical Health Periodontium; This group consists of patients diagnosed with Multiple Sclerosis (MS) based on clinical, biochemical, and radiological features according to the 2017 McDonald Criteria. The cohort includes various clinical types: Relapsing-Remitting (RRMS), Secondary Progressive (SPMS), Primary Progressive (PPMS), and Progressive-Relapsing (PRMS). The participants in this group must have a clinically healthy periodontium. The term clinically healthy should be adopted to cover the absence of (or very significant reduction in) clinical periodontal inflammation on either an anatomically intact periodontium or a reduced periodontium. Participants will undergo clinical periodontal examinations and provide saliva samples for microbiological and biochemical analysis
Multiple Sclerosis - Periodontal Disease; This group consists of patients diagnosed with Multiple Sclerosis (MS) based on clinical, biochemical, and radiological features according to the 2017 McDonald Criteria. The cohort includes various clinical types: Relapsing-Remitting (RRMS), Secondary Progressive (SPMS), Primary Progressive (PPMS), and Progressive-Relapsing (PRMS). Periodontal disease comprises a spectrum of pathological conditions involving the tooth-supporting tissues, namely the gingiva, periodontal ligament, cementum, and alveolar bone. The disease often initially manifests as gingivitis, a plaque-induced and reversible inflammatory condition affecting a large proportion of the population. In the absence of appropriate management, gingivitis may advance to periodontitis, a chronic and destructive disorder marked by irreversible attachment loss, progressive alveolar bone resorption, and potential tooth loss.
Systemically Health - Clinical Healthy Periodontium; This group consists of systemically healthy volunteers who do not have any systemic diseases, including Multiple Sclerosis. The participants in this group must have a clinically healthy periodontium. The term clinically healthy should be adopted to cover the absence of (or very significant reduction in) clinical periodontal inflammation on either an anatomically intact periodontium or a reduced periodontium. Participants will undergo clinical periodontal examinations and provide saliva samples for microbiological and biochemical analysis
Systemically health - Periodontal Disease; This group consists of systemically healthy volunteers without any systemic diseases. However, these participants are diagnosed with periodontal disease (gingivitis or periodontitis). Periodontal disease comprises a spectrum of pathological conditions involving the tooth-supporting tissues, namely the gingiva, periodontal ligament, cementum, and alveolar bone. The disease often initially manifests as gingivitis, a plaque-induced and reversible inflammatory condition affecting a large proportion of the population. In the absence of appropriate management, gingivitis may advance to periodontitis, a chronic and destructive disorder marked by irreversible attachment loss, progressive alveolar bone resorption, and potential tooth loss.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical Attachment Level (CAL)	Measurement of the distance from the cemento-enamel junction to the base of the periodontal pocket in millimeters. Higher values indicate greater attachment loss.	Baseline
Probing Pocket Depth (PPD)	Measurement of the distance from the gingival margin to the base of the periodontal pocket in millimeters using a periodontal probe.	Baseline
Plaque Index (PI)	An index used to assess the thickness of plaque at the gingival margin. It evaluates oral hygiene status on a scale from 0 to 3 for each tooth surface, measured according to the criteria of Silness and Löe.	Baseline
Gingival Index (GI)	A clinical index used to assess the severity of gingival inflammation and bleeding tendency. It evaluates the color, consistency, and bleeding of the gums on a scale from 0 to 3, measured according to the criteria of Silness and Löe.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Salivary P.gingivalis Levels	P.gingivalis in saliva samples using Real-time PCR to assess their correlation with MS disease status.	Baseline
Salivary F.nucleatum Levels	F.nucleatum in saliva samples using Real-time PCR to assess their correlation with MS disease status.	Baseline
Salivary EBV Levels	EBV in saliva samples using Real-time PCR to assess their correlation with MS disease status.	Baseline
Salivary IL-17 Levels	The concentration of IL-17 in saliva samples will be measured to evaluate the Th17-mediated inflammatory response. IL-17 is a key pro-inflammatory cytokine linked to both the pathogenesis of Multiple Sclerosis (MS) and the severity of periodontal tissue destruction.	Baseline
Salivary IL-11 Levels	Concentration of IL-11 in saliva samples will be measured using the ELISA method. IL-11 is an anti-inflammatory cytokine from the IL-6 family; its levels will be evaluated to understand its potential regulatory role in periodontal inflammation and its systemic reflection in patients with Multiple Sclerosis.	Baseline
Salivary TNF-alpha Levels	The concentration of TNF-alpha in saliva samples will be quantified using the ELISA technique. As a potent pro-inflammatory cytokine, TNF-alpha levels will be analyzed to assess the degree of local inflammation in the oral cavity and its potential correlation with systemic inflammatory activity in patients with Multiple Sclerosis.	Baseline
Salivary SIRT-1 Levels	The concentration of SIRT-1 in saliva samples will be measured using the ELISA technique. SIRT-1 is a NAD+-dependent deacetylase known for its role in cellular homeostasis, neuroprotection, and anti-inflammatory pathways. This outcome aims to evaluate the potential of SIRT-1 as a biomarker for disease activity in Multiple Sclerosis and its association with periodontal health status.	Baseline

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi

Study record dates

Study Major Dates

• Study Start (Estimated): February 3, 2026
• Primary Completion (Estimated): October 5, 2026
• Study Completion (Estimated): March 9, 2027

Study Registration Dates

• First Submitted: February 3, 2026
• First Submitted That Met QC Criteria: February 11, 2026
• First Posted (Actual): February 17, 2026

Study Record Updates

• Last Update Posted (Actual): February 17, 2026
• Last Update Submitted That Met QC Criteria: February 11, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: multiple sclerosis; periodontal diseases; inflamation; Microbiological; host modulation; p.gingivalis
• Additional Relevant MeSH Terms: Mouth Diseases; Stomatognathic Diseases; Nervous System Diseases; Autoimmune Diseases; Immune System Diseases; Demyelinating Autoimmune Diseases, CNS; Autoimmune Diseases of the Nervous System; Demyelinating Diseases; Periodontitis; Multiple Sclerosis; Periodontal Diseases
• Other Study ID Numbers: 2025-405

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The individual participant data will not be shared to protect participant privacy.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No