{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T08:19:28Z","timestamp":1787559568384,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to evaluate the association between periodontitis and respiratory diseases using an umbrella meta\u2010analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Meta\u2010analyses (MAs) reporting odds ratios (OR) and mean differences (MD) for the association between periodontitis and respiratory diseases of COVID\u201019, chronic obstructive pulmonary disease (COPD), asthma, and pneumonia were included. Random\u2010effects meta\u2010analysis was performed. Egger's test and trim\u2010and\u2010fill method were used to assess publication bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen MAs encompassing more than 500,000 participants were included. A significant association was found between periodontitis and respiratory disease (OR 2.45, 95% CI 2.06\u20132.92,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), with substantial heterogeneity (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200982%). The pooled OR for the association between periodontitis with COVID\u201019, COPD, asthma, and pneumonia was 2.75, 1.42, 3.42, and 2.73, respectively. The association remained consistent even after adjustment for publication bias and among different study qualities and sample sizes. Notably, the association with COPD may not be independent of smoking. The GRADE assessment rated the certainty of evidence of the outcomes as \u201clow\u201d due to high heterogeneity and publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results suggest a statistical association between periodontitis and most of the studied respiratory diseases. However, these results should be interpreted with caution and be seen as exploratory and hypothesis\u2010generating, rather than definitive effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:styled-content style=\"fixed-case\">PROSPERO<\/jats:styled-content>\n                      Registration\n                    <\/jats:title>\n                    <jats:p>CRD420251250830<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70448","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T03:35:21Z","timestamp":1786505721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association Between Periodontitis and Respiratory Diseases: A Systematic Umbrella Meta\u2010Analysis"],"prefix":"10.1111","author":[{"given":"Shahen Hiwa","family":"Omer","sequence":"first","affiliation":[{"name":"Department of Dentistry Komar University of Science and Technology  Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8093-9514","authenticated-orcid":false,"given":"Mohammed Khalid","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Paramedical Sciences, Aix\u2010Marseille University, French National Center of Scientific Research (CNRS) French Blood Establishment (EFS), Bio\u2010Cultural Anthropology, Law, Ethics and Health Laboratory (ADES)  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1413-4934","authenticated-orcid":false,"given":"Sarhang Sarwat","family":"Gul","sequence":"additional","affiliation":[{"name":"Medical Laboratory Department, College of Health and Medical Technology Sulaimani Polytechnic University  Sulaimani Iraq"},{"name":"Department of Periodontics, College of Dentistry University of Sulaimani  Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yad Mariwan Mohammed","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Dentistry Tishk International University  Sulaimani Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Lan","sequence":"additional","affiliation":[{"name":"Faculty of Medical and Paramedical Sciences, Aix\u2010Marseille University, French National Center of Scientific Research (CNRS) French Blood Establishment (EFS), Bio\u2010Cultural Anthropology, Law, Ethics and Health Laboratory (ADES)  Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-023-03378-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.70057"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345221104725"},{"issue":"10","key":"e_1_2_12_5_1","first-page":"2659","article-title":"Periodontitis and Its Inflammatory Changes Linked to Various Systemic Diseases: A Review of Its Underlying Mechanisms","volume":"10","author":"Bhuyan R.","year":"2022","journal-title":"Biomedicine"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/froh.2021.801815"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910408300214"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2021.718222"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12249"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/64016"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lfs.2019.03.005"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmental-2018-300014"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12344"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13228"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39489.470347.AD"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470712184"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081086"},{"issue":"1","key":"e_1_2_12_20_1","article-title":"Association Between Periodontitis and Nosocomial Pneumonia: A Systematic Review and Meta\u2010Analysis of Observational Studies","volume":"18","author":"Jeronimo L. 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