{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:32Z","timestamp":1786978112155,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T00:00:00Z","timestamp":1642550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100011970","name":"International Team for Implantology","doi-asserted-by":"publisher","award":["1577_2021"],"award-info":[{"award-number":["1577_2021"]}],"id":[{"id":"10.13039\/501100011970","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To determine whether patients who had undergone tonsillectomy would have higher risks of postoperative periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were collected from the Taiwan Longitudinal Health Insurance Dataset from 1999 to 2013, a population\u2010based cohort study consisting of cases of newly\u2010onset sleep apnoea, chronic diseases of tonsils and adenoids, peritonsillar abscess, and periodontal diseases. A total of 1482 tonsillectomy cases and 14,796 non\u2010tonsillectomy controls were selected. Propensity score matching\n                      <jats:sup>37<\/jats:sup>\n                      between the tonsillectomy group and the non\u2010tonsillectomy group was conducted to exclude the confounding effect resulting from indications of tonsillectomy. Cox proportional hazard model and subgroup analyses were conducted to identify subpopulations at risk of tonsillectomy\u2010associated periodontitis, and a sub\u2010outcome analysis was applied to identify the subtype of tonsillectomy\u2010associated periodontitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 648 patients who had undergone tonsillectomy and 648 out of 6509 propensity score\u2010matched controls were retrieved, among which 230 cases in the tonsillectomy group were associated with post\u2010surgical periodontitis (adjusted HR\u00a0=\u00a01.31, 95% CI\u00a0=\u00a01.08 to 1.59). The association persisted in a subpopulation of patients with periodontitis who received mechanical and surgical treatments for periodontitis (adjusted HR\u00a0=\u00a01.33, 95% CI\u00a0=\u00a01.09 to 1.63). The incidence of periodontitis was significantly high in the individuals who underwent tonsillectomy and was particularly high in those that were below 12 years of age (HR\u00a0=\u00a01.58, 95% CI\u00a0=\u00a01.10 to 2.27). The risk of periodontitis increased 4 years after tonsillectomy (HR\u00a0=\u00a01.82; 95% CI\u00a0=\u00a01.29 to 2.59). The majority of post\u2010tonsillectomy periodontitis was aggressive and acute periodontitis (HR\u00a0=\u00a01.37; 95% CI\u00a0=\u00a01.10 to 1.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tonsillectomy performed in pediatric patients of &lt; 12 years old, increased the risk of developing periodontitis. Aggressive and acute periodontitis as a long\u2010term, postoperative adverse event took place at 4 years or longer after tonsillectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.21-0215","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T14:58:36Z","timestamp":1635433116000},"page":"721-731","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Tonsillectomy as a risk factor of periodontitis: A population\u2010based cohort study"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9394-4144","authenticated-orcid":false,"given":"Kevin Sheng\u2010Kai","family":"Ma","sequence":"first","affiliation":[{"name":"Center for Global Health, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science National Taiwan University  Taipei Taiwan"},{"name":"Department of Dentistry Chung Shan Medical University and Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng\u2010Che","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Children's Medical Center Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6371-3196","authenticated-orcid":false,"given":"Eshwar","family":"Thota","sequence":"additional","affiliation":[{"name":"Department of Dentistry Chung Shan Medical University and Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Hsun","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3422-5091","authenticated-orcid":false,"given":"Hend E.","family":"Alqaderi","sequence":"additional","affiliation":[{"name":"Department of Oral Health Policy and Epidemiology Harvard School of Dental Medicine  Boston Massachusetts USA"},{"name":"The Forsyth Institute  Cambridge Massachusetts USA"},{"name":"Dasman Diabetes Institute  Kuwait City Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1235-0679","authenticated-orcid":false,"given":"James Cheng\u2010Chung","family":"Wei","sequence":"additional","affiliation":[{"name":"Graduate Institute of Integrated Medicine China Medical University Hospital  Taichung Taiwan"},{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Division of Allergy, Immunology and Rheumatology Department of Internal Medicine, Chung Shan Medical University Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,1,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201011-1783OC"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689008300216"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-35272-z"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0117535"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/cjab050"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.121852"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-3491"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.0614"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238242"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.13273"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2021.39.15_suppl.10568"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2020.38.15_suppl.e20015"},{"key":"e_1_2_11_14_1","first-page":"220345211037220","article-title":"Dementia and the risk of periodontitis: a population\u2010based cohort study","author":"Ma KS","year":"2021","journal-title":"J Dent Res"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.21-0256"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-219255"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12032"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.121318"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27497"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1998.69.2.269"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1999.4.1.39"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1981.00790410021004"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.26-6-199"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.7326\/m21\u20101499"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2016.06.007"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.3634"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0236806"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2007.02.004"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00181969"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1479-666X(03)80018-5"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/915864"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-018-0521-7"},{"key":"e_1_2_11_34_1","first-page":"1","volume-title":"Identifying Medically\u2010compromised Patients with Periodontitis\u2010Associated Cardiovascular Diseases Using Convolutional Neural Network\u2010facilitated Multilabel Classification of Panoramic Radiographs","author":"Ma KS","year":"2021"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2020.154478"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.10.038"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287\u2010021\u201002564\u20107"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep36266"},{"key":"e_1_2_11_39_1","first-page":"CD001802","article-title":"Tonsillectomy or adenotonsillectomy versus non\u2010surgical treatment for chronic\/recurrent acute tonsillitis","volume":"2014","author":"Burton MJ","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.14115"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000020632"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1152\/advan.00057.2021"}],"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/JPER.21-0215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/JPER.21-0215","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/JPER.21-0215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T14:02:53Z","timestamp":1760882573000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1002\/JPER.21-0215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,19]]},"references-count":41,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["10.1002\/JPER.21-0215"],"URL":"https:\/\/doi.org\/10.1002\/jper.21-0215","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"value":"0022-3492","type":"print"},{"value":"1943-3670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,19]]},"assertion":[{"value":"2021-04-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}