{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:07:13Z","timestamp":1779361633152,"version":"3.51.4"},"reference-count":50,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82370975"],"award-info":[{"award-number":["No. 82370975"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To investigate whether the subgingival microbiota or the systemic immune\u2010inflammation index (SII) is more closely associated with the periodontal inflamed surface area (PISA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Ninety participants were enrolled in this cross\u2010sectional study for subgingival microbiota sequencing, SII, and PISA assessment. Restricted cubic spline and regression analyses examined the SII\u2013PISA relationship. Microbiota analyses (LEfSe, alpha\u2010diversity, partitioning around medoids clustering) and interaction analyses were used to evaluate whether microbiota\u2013SII interactions were associated with PISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A nonlinear relationship between PISA and SII was observed with a significant inflection point. In the High_SII group (log\n                      <jats:sub>2<\/jats:sub>\n                      SII\u00a0&gt;\u00a09.13), higher SII values were significantly associated with increased PISA (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.003). In the Low_SII group (log\n                      <jats:sub>2<\/jats:sub>\n                      SII \u2264 9.13), increased PISA was linked to greater microbial richness (\n                      <jats:italic>P<\/jats:italic>\n                      =\u00a00.031) and a\n                      <jats:italic>Porphyromonas<\/jats:italic>\n                      \u2010dominant microbial type. Stratified and interaction analyses provided additional support for these findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>At low SII levels, the periodontitis severity showed significant associations with microbial dysbiosis\u2010related features, whereas at higher SII levels, it was closely related to systemic immune cell imbalance, indicating that immune\u2013inflammatory modulation may be particularly important for patients with a high SII level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>This study explored the links between a person's immune cell imbalance (assessed by the systemic immune\u2010inflammation index, SII), subgingival microbiota, and periodontitis severity. Ninety participants were tested for their blood cell markers of inflammation and the composition of microbiota. A nonlinear relationship between the SII and the periodontal inflamed surface area (PISA) was observed. There was a turning point: when SII was low, periodontitis severity was strongly linked to an imbalanced subgingival microbiota. However, when SII was high, periodontitis severity was more strongly related to an imbalance in immune cells. These findings indicate heterogeneity in the association among SII, oral microbiota, and periodontal inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70150","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:31:29Z","timestamp":1779359489000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic immune\u2010inflammation index and its role in the relationship between subgingival microbiota and periodontal inflammation"],"prefix":"10.1002","author":[{"given":"Lijie","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Periodontics Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingxuan","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology National Center for Stomatology National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai Jiao Tong University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-7450","authenticated-orcid":false,"given":"Ruoyan","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Periodontics Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Periodontics Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology China Medical University  Shenyang 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