{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T13:10:22Z","timestamp":1779973822220,"version":"3.53.1"},"reference-count":189,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Extensive epidemiological evidence links psychosis (PZ)\u2014particularly schizophrenia (SCZ)\u2014with disproportionate periodontal destruction, suggesting shared biological vulnerability. Beyond local tissue damage, periodontitis provides a clinically accessible translational paradigm for systemic redox dysregulation, where sustained inflammatory activation coincides with measurable oxidative injury and exhaustion of antioxidant (AO) defenses across cardiometabolic and neuropsychiatric domains. In this critical narrative review, we argue that the excess periodontal burden in PZ reflects a \u201cpathological confluence\u201d shaped by antipsychotic-associated iatrogenic factors, rapid metabolic deterioration, and chronic oxidative distress. We appraise the thioredoxin-interacting protein (TXNIP)\u2013NOD-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) axis as a metabolic\u2013redox sensor linking dysglycemia to periodontal inflammasome activation and downstream cytokine signaling, and address the advanced glycation end-products (AGEs)\u2013receptor for advanced glycation end-products (RAGE) axis as a key immunometabolic redox pathway. We further discuss mitochondrial dysfunction, impaired mitophagy, and mitochondrial deoxyribonucleic acid (mtDNA) leakage as damage-associated molecular patterns (DAMPs) that can amplify systemic \u201csilent inflammation\u201d. Integrating evidence on periodontal pathogen\u2013host interactions and redox-sensitive neuroimmune pathways (including NADPH oxidase 4 (NOX4)-linked microglial activation), we propose periodontitis as a plausible upstream amplifier that may exacerbate vascular dysfunction and compromise blood\u2013brain barrier (BBB) integrity. Finally, we outline clinically measurable biomarker readouts to operationalize redox-informed integrated care and highlight the need for pragmatic trials targeting clinically meaningful endpoints to improve somatic longevity in PZ-spectrum populations. We acknowledge that current human evidence is largely associative and that the proposed mechanistic links remain hypothesis generating.<\/jats:p>","DOI":"10.3390\/antiox15060679","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T12:09:07Z","timestamp":1779970147000},"page":"679","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Silent Inflammation: A Critical Narrative Review of the Relationship Between Periodontal Disease and Psychosis\u2014The Role of Oxidative Stress and Iatrogenic Comorbidities"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9689-0012","authenticated-orcid":false,"given":"Brindusa E.","family":"Focseneanu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8070-6681","authenticated-orcid":false,"given":"Roxana M.","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Pangica","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petru T.","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodora M.","family":"Pangica","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Marian","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, Section of Medical Sciences, 050044 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina C.","family":"Biclesanu","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Titu Maiorescu University, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kang, J., Wu, J., Aggarwal, V.R., Shiers, D., Doran, T., and Palmier-Claus, J. 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