{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:18:11Z","timestamp":1783588691701,"version":"3.55.0"},"reference-count":37,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Clinical Research Program of Health Care Industry, the Shanghai Municipal Health Commission","award":["20224Y0353"],"award-info":[{"award-number":["20224Y0353"]}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2506300"],"award-info":[{"award-number":["2023YFC2506300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Research Program of 9th People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["JYLJ202403"],"award-info":[{"award-number":["JYLJ202403"]}]},{"name":"Clinical Research Program of 9th People\u2019s Hospital, Shanghai Jiao Tong University School of Medicine","award":["JYLJ2025018"],"award-info":[{"award-number":["JYLJ2025018"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82401195"],"award-info":[{"award-number":["82401195"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,30]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Periodontitis and chronic kidney disease (CKD) are inter-related conditions that can significantly impact patient health. This study aims to evaluate the efficacy of active non-surgical periodontal therapy (NSPT) combined with supportive periodontal care (SPC) in reducing tooth loss and improving masticatory function in patients with CKD and stage III periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This randomised controlled trial will recruit 86 patients diagnosed with both stage III periodontitis and CKD. Participants will be randomly assigned at a 1:1 ratio to either an experimental group receiving active NSPT supplemented with SPC or a control group receiving oral hygiene instruction with scheduled periodontal monitoring. The intervention will last for 24 months, with assessments conducted at baseline and 3, 6, 12, 18 and 24 months. The primary outcome is the incidence of tooth loss due to periodontitis over the 2-year follow-up period. Secondary outcomes include the number of lost teeth, masticatory function, clinical periodontal parameters and oral health-related quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study protocol and informed consent form were approved by the Institutional Ethics Committee of Ninth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (SH9H-2022-T404-1). Findings will be disseminated to participants and published in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2300068923.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-103880","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:40:38Z","timestamp":1776271238000},"page":"e103880","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of periodontal therapy in preventing tooth loss and improving masticatory function in patients with chronic kidney disease: a protocol for a single-centre randomised controlled trial in China"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7534-5748","authenticated-orcid":false,"given":"Yining","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yining","family":"He","sequence":"additional","affiliation":[{"name":"Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingli","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongchen","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiwen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"2026070902002728000_16.4.e103880.1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12221"},{"key":"2026070902002728000_16.4.e103880.2","first-page":"S162","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45 Suppl 20","author":"Papapanou","year":"2018","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.3","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12431"},{"key":"2026070902002728000_16.4.e103880.4","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/S0140-6736(20)30045-3","article-title":"Global, regional, and national burden of chronic kidney disease, 1990\u20132017: a systematic analysis for the Global Burden of Disease Study 2017","volume":"395","author":"Bikbov","year":"2020","journal-title":"The Lancet"},{"key":"2026070902002728000_16.4.e103880.5","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.kint.2020.09.003","article-title":"Executive summary for China Kidney Disease Network (CK-NET) 2016 Annual Data Report","volume":"98","author":"Yang","year":"2020","journal-title":"Kidney Int"},{"key":"2026070902002728000_16.4.e103880.6","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.147"},{"key":"2026070902002728000_16.4.e103880.7","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12421"},{"key":"2026070902002728000_16.4.e103880.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2015.12.004"},{"key":"2026070902002728000_16.4.e103880.9","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1002\/jbmr.4203","article-title":"Chronic Kidney Disease-Induced Vascular Calcification Impairs Bone Metabolism","volume":"36","author":"Mace","year":"2021","journal-title":"J Bone Miner Res"},{"key":"2026070902002728000_16.4.e103880.10","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/jcpe.13755","article-title":"Association between periodontitis and chronic kidney disease by functional atherosclerosis status among older Japanese individuals: A cross-sectional study","volume":"50","author":"Shimizu","year":"2023","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.11","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/odi.13236","article-title":"Association between severe periodontitis and chronic kidney disease severity in predialytic patients: A cross-sectional study","volume":"26","author":"Sch\u00fctz","year":"2020","journal-title":"Oral Dis"},{"key":"2026070902002728000_16.4.e103880.12","doi-asserted-by":"crossref","DOI":"10.3389\/fphys.2021.759056","article-title":"Assessment of Alveolar Bone and Periodontal Status in Peritoneal Dialysis Patients","volume":"12","author":"Sun","year":"2021","journal-title":"Front Physiol"},{"key":"2026070902002728000_16.4.e103880.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-019-0778-5","article-title":"Relationship between tooth loss, low masticatory ability, and nutritional indices in the elderly: a cross-sectional study","volume":"19","author":"Okamoto","year":"2019","journal-title":"BMC Oral Health"},{"key":"2026070902002728000_16.4.e103880.14","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1111\/jcpe.13588","article-title":"Food intake, masticatory function, tooth mobility, loss of posterior support, and diminished quality of life are associated with more advanced periodontitis stage diagnosis","volume":"49","author":"Uy","year":"2022","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.15","doi-asserted-by":"crossref","DOI":"10.1902\/jop.2000.71.5.845","article-title":"Tooth loss significantly reduced with non-surgical therapy","volume":"71","author":"Becker","year":"2000","journal-title":"J Periodontol"},{"key":"2026070902002728000_16.4.e103880.16","doi-asserted-by":"crossref","first-page":"4123","DOI":"10.1007\/s00784-019-02851-x","article-title":"Risk factors associated with long-term outcomes after active and supporting periodontal treatments: impact of various compliance definitions on tooth loss","volume":"23","author":"Petit","year":"2019","journal-title":"Clin Oral Investig"},{"key":"2026070902002728000_16.4.e103880.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2011.01733.x"},{"key":"2026070902002728000_16.4.e103880.18","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1902\/jop.2000.71.5.736","article-title":"Non-surgical periodontal therapy and tooth loss. A cohort study","volume":"71","author":"Hujoel","year":"2000","journal-title":"J Periodontol"},{"key":"2026070902002728000_16.4.e103880.19","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/JPER.19-0679","article-title":"Tooth loss and risk of end-stage renal disease: A nationwide cohort study","volume":"92","author":"Han","year":"2021","journal-title":"J Periodontol"},{"key":"2026070902002728000_16.4.e103880.20","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jcpe.13290","article-title":"Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline","volume":"47 Suppl 22","author":"Sanz","year":"2020","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.21","first-page":"S159","article-title":"Staging and grading of periodontitis: Framework and proposal of a new classification and case definition","volume":"89 Suppl 1","author":"Tonetti","year":"2018","journal-title":"J Periodontol"},{"key":"2026070902002728000_16.4.e103880.22","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.kint.2021.06.028","article-title":"Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference","volume":"100","author":"Lameire","year":"2021","journal-title":"Kidney Int"},{"key":"2026070902002728000_16.4.e103880.23","doi-asserted-by":"publisher","DOI":"10.1177\/00220345960750020801"},{"key":"2026070902002728000_16.4.e103880.24","doi-asserted-by":"crossref","first-page":"104110","DOI":"10.1016\/j.jdent.2022.104110","article-title":"Tooth loss over 13 years of follow-up: Can regular dental visits reduce racial and socioeconomic inequalities?","volume":"122","author":"Celeste","year":"2022","journal-title":"J Dent"},{"key":"2026070902002728000_16.4.e103880.25","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1111\/jcpe.13835","article-title":"Prevalence of stable and successfully treated periodontitis subjects and incidence of subsequent tooth loss within supportive periodontal care: A systematic review with meta-analyses","volume":"50","author":"Rattu","year":"2023","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2842.2007.01773.x"},{"key":"2026070902002728000_16.4.e103880.27","first-page":"9","article-title":"Comparison of the Silness-Loe (1964) Index with gravimetric measurement of dental plaque","volume":"9","author":"Macgregor","year":"1964","journal-title":"Clin Prev Dent"},{"key":"2026070902002728000_16.4.e103880.28","doi-asserted-by":"crossref","first-page":"5897","DOI":"10.1007\/s00784-021-03895-8","article-title":"Tooth loss in complying and non-complying periodontitis patients with different periodontal risk levels during supportive periodontal care","volume":"25","author":"Farina","year":"2021","journal-title":"Clin Oral Investig"},{"key":"2026070902002728000_16.4.e103880.29","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1902\/jop.1992.63.12s.1072","article-title":"Measurement of attachment level in clinical trials: probing methods","volume":"63","author":"Pihlstrom","year":"1992","journal-title":"J Periodontol"},{"key":"2026070902002728000_16.4.e103880.30","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1007\/s00784-021-04155-5","article-title":"The role of surgical flap design (minimally invasive flap vs. extended flap with papilla preservation) on the healing of intrabony defects treated with an enamel matrix derivative: a 12-month two-center randomized controlled clinical trial","volume":"26","author":"Windisch","year":"2022","journal-title":"Clin Oral Investig"},{"key":"2026070902002728000_16.4.e103880.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12903-022-02441-6","article-title":"The Chinese version of the Oral Health Impact Profile-14 (OHIP-14) questionnaire among college students: factor structure and measurement invariance across genders","volume":"22","author":"Feng","year":"2022","journal-title":"BMC Oral Health"},{"key":"2026070902002728000_16.4.e103880.32","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1111\/jcpe.13348","article-title":"Tooth-related factors for tooth loss 20 years after active periodontal therapy-A partially prospective study","volume":"47","author":"Rahim-W\u00f6stefeld","year":"2020","journal-title":"J Clin Periodontol"},{"key":"2026070902002728000_16.4.e103880.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-024-18906-y","article-title":"Relationships between oral function, dietary intake and nutritional status in older adults aged 75 years and above: a cross-sectional study","volume":"24","author":"Wu","year":"2024","journal-title":"BMC Public Health"},{"key":"2026070902002728000_16.4.e103880.34","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.jds.2023.11.005","article-title":"Association between oral health status and occlusal bite force in young adults","volume":"19","author":"Su","year":"2024","journal-title":"J Dent Sci"},{"key":"2026070902002728000_16.4.e103880.35","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1007\/s00784-019-03066-w","article-title":"Effect of non-surgical periodontal therapy on renal function in chronic kidney disease patients with periodontitis: a systematic review and meta-analysis of interventional studies","volume":"24","author":"Zhao","year":"2020","journal-title":"Clin Oral Investig"},{"key":"2026070902002728000_16.4.e103880.36","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1111\/scd.12625","article-title":"A meta-analysis on the effect of periodontal treatment on the glomerular filtration rate of chronic kidney disease individuals: A systematic review and meta-analysis was conducted to assess the impact of the periodontal treatment on the glomerular filtration rate of individuals with chronic kidney disease","volume":"41","author":"da Silva","year":"2021","journal-title":"Spec Care Dentist"},{"key":"2026070902002728000_16.4.e103880.37","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/0022034520965958","article-title":"Does Nonsurgical Periodontal Treatment Improve Systemic Health?","volume":"100","author":"Taylor","year":"2021","journal-title":"J Dent Res"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-103880","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:01:03Z","timestamp":1783587663000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-103880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,15]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjopen-2025-103880"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-103880","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}