{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T21:19:35Z","timestamp":1778534375390,"version":"3.51.4"},"reference-count":51,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Periodontitis is characterized by low-grade inflammation of the periodontal tissues, the structures that support and connect the teeth to the maxilla and mandible. This inflammation is caused by the accumulation of subgingival bacterial biofilm and gradually leads to the extensive damage of these tissues and the consequent loss of teeth. Hepatitis B is a major global health concern; infection with the hepatitis B virus causes significant inflammation of the liver and the possibility of its gradual evolution to cirrhosis. Hepatitis D, caused by infection with the delta hepatitis virus, is manifest only in patients already infected with the type B virus in a simultaneous (co-infected) or superimposed (superinfected) manner. The dental and periodontal status of patients with hepatitis B\/D could exhibit significant changes, increasing the risk of periodontitis onset. Moreover, the progression of liver changes in these patients could be linked to periodontitis; therefore, motivating good oral and periodontal health could result in the prevention and limitation of pathological effects. Given that both types of diseases have a significant inflammatory component, common pro-inflammatory mediators could drive and augment the local inflammation at both a periodontal and hepatic level. This suggests that integrated management of these patients should be proposed, as therapeutical means could deliver an improvement to both periodontal and hepatic statuses. The aim of this review is to gather existing information on the proposed subject and to organize significant data in order to improve scientific accuracy and comprehension on this topic while generating future perspectives for research.<\/jats:p>","DOI":"10.3390\/jpm12101580","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T01:41:58Z","timestamp":1664156518000},"page":"1580","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Oral and Periodontal Implications of Hepatitis Type B and D. Current State of Knowledge and Future Perspectives"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1569-1601","authenticated-orcid":false,"given":"Dorin Nicolae","family":"Gheorghe","sequence":"first","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6528-2681","authenticated-orcid":false,"given":"Francesco","family":"Bennardo","sequence":"additional","affiliation":[{"name":"School of Dentistry, Department of Health Sciences, Magna Graecia University of Catanzaro, Viale Europa, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora Maria","family":"Popescu","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4675-4292","authenticated-orcid":false,"given":"Flavia Mirela","family":"Nicolae","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5675-1741","authenticated-orcid":false,"given":"Claudiu Marinel","family":"Ionele","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-6138","authenticated-orcid":false,"given":"Mihail Virgil","family":"Boldeanu","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Camen","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ion","family":"Rogoveanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petra","family":"Surlin","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Nomura, Y., Okada, A., and Hanada, N. (2022). Future Prospective of Oral Microbiome Research. Appl. Sci., 12.","DOI":"10.3390\/app12010055"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Schulz, S., Stein, J.M., Schumacher, A., Kupietz, D., Yekta-Michael, S.S., Schittenhelm, F., Conrads, G., Schaller, H.-G., and Reichert, S. (2022). Nonsurgical Periodontal Treatment Options and Their Impact on Subgingival Microbiota. J. Clin. Med., 11.","DOI":"10.3390\/jcm11051187"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/prd.12147","article-title":"Microbial colonization of the periodontal pocket and its significance for periodontal therapy","volume":"76","author":"Mombelli","year":"2017","journal-title":"Periodontology 2000"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Fiorillo, L., Cervino, G., Laino, L., D\u2019Amico, C., Mauceri, R., Tozum, T.F., Gaeta, M., and Cicci\u00f9, M. (2019). Porphyromonas gingivalis, Periodontal and Systemic Implications: A Systematic Review. Dent. J., 7.","DOI":"10.3390\/dj7040114"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Cecoro, G., Annunziata, M., Iuorio, M.T., Nastri, L., and Guida, L. (2020). Periodontitis, Low-Grade Inflammation and Systemic Health: A Scoping Review. Medicina, 56.","DOI":"10.3390\/medicina56060272"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/prd.12221","article-title":"Periodontitis: Facts, fallacies and the future","volume":"75","author":"Slots","year":"2017","journal-title":"Periodontology 2000"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Guarnieri, R., Zanza, A., D\u2019Angelo, M., Di Nardo, D., Del Giudice, A., Mazzoni, A., Reda, R., and Testarelli, L. (2022). Correlation between Peri-Implant Marginal Bone Loss Progression and Peri-Implant Sulcular Fluid Levels of Metalloproteinase-8. J. Pers. Med., 12.","DOI":"10.3390\/jpm12010058"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/prd.12153","article-title":"The periodontal pocket: Pathogenesis, histopathology and consequences","volume":"76","author":"Bosshardt","year":"2017","journal-title":"Periodontology 2000"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1002\/jemt.10006","article-title":"Lymphatic networks in the periodontal tissue and dental pulp as revealed by histochemical study","volume":"56","author":"Matsumoto","year":"2002","journal-title":"Micros. Res. Tech."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1177\/0022034519846113","article-title":"Periodontal Medicine: 100 Years of Progress","volume":"98","author":"Beck","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1034\/j.1600-0757.2000.2230101.x","article-title":"Periodontal medicine: The emergence of a new branch of periodontology","volume":"23","author":"Williams","year":"2000","journal-title":"Periodontology 2000"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1007\/s13300-020-00933-8","article-title":"Periodontal Disease in Diabetes Mellitus: A Case\u2013Control Study in Smokers and Non-Smokers","volume":"11","author":"Battancs","year":"2020","journal-title":"Diabetes Ther."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Antal, M., Battancs, E., Bocskai, M., Braunitzer, G., and Kov\u00e1cs, L. (2018). An observation on the severity of periodontal disease in past cigarette smokers suffering from rheumatoid arthritis- evidence for a long-term effect of cigarette smoke exposure?. BMC Oral Health, 18.","DOI":"10.1186\/s12903-018-0531-5"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Antal, M., Braunitzer, G., Mattheos, N., Gyulai, R., and Nagy, K. (2014). Smoking as a Permissive Factor of Periodontal Disease in Psoriasis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0092333"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1002\/JPER.18-0157","article-title":"A new classification scheme for periodontal and peri-implant diseases and conditions\u2014Introduction and key changes from the 1999 classification","volume":"89","author":"Caton","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tu, T., Block, J.M., Wang, S., Cohen, C., and Douglas, M.W. (2020). The Lived Experience of Chronic Hepatitis B: A Broader View of Its Impacts and Why We Need a Cure. Viruses, 12.","DOI":"10.3390\/v12050515"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.siny.2007.01.013","article-title":"Hepatitis B virus infection","volume":"12","author":"Chang","year":"2007","journal-title":"Semin. Fetal Neonatal Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"391","DOI":"10.33073\/pjm-2020-044","article-title":"Hepatitis B Virus: From Diagnosis to Treatment","volume":"69","author":"Guvenir","year":"2020","journal-title":"Pol. J. Microbiol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Herrscher, C., Roingeard, P., and Blanchard, E. (2020). Hepatitis B Virus Entry into Cells. Cells, 9.","DOI":"10.3390\/cells9061486"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Nicolini, L.A., Orsi, A., Tatarelli, P., Viscoli, C., Icardi, G., and Sticchi, L. (2019). A Global View to HBV Chronic Infection: Evolving Strategies for Diagnosis, Treatment and Prevention in Immunocompetent Individuals. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16183307"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Noverati, N., Bashir-Hamidu, R., Halegoua-DeMarzio, D., and Hann, H.-W. (2022). Hepatitis B Virus-Associated Hepatocellular Carcinoma and Chronic Stress. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23073917"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Rizzo, G.E.M., Cabibbo, G., and Crax\u00ec, A. (2022). Hepatitis B Virus-Associated Hepatocellular Carcinoma. Viruses, 14.","DOI":"10.3390\/v14050986"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Rizzetto, M., and Stroffolini, T. (2021). Forty-Five Years after the Discovery of the Hepatitis D Virus: Where Do We Stand?. Viruses, 13.","DOI":"10.3390\/v13040555"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"a021576","DOI":"10.1101\/cshperspect.a021576","article-title":"Hepatitis D Virus: Introduction and Epidemiology","volume":"5","author":"Rizzetto","year":"2015","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Brillanti, S. (2022). Management of Delta Hepatitis 45 Years after the Discovery of HDV. J. Clin. Med., 11.","DOI":"10.3390\/jcm11061587"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Taylor, J.M. (2020). Infection by Hepatitis Delta Virus. Viruses, 12.","DOI":"10.3390\/v12060648"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1093\/infdis\/jiz633","article-title":"Estimating the Global Prevalence, Disease Progression, and Clinical Outcome of Hepatitis Delta Virus Infection","volume":"221","author":"Miao","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Gheorghe, D.N., Camen, A., Popescu, D.M., Sincar, C., Pitru, A., Ionele, C.M., Nicolae, F.M., Danilescu, C.M., Roman, A., and Florescu, C. (2022). Periodontitis, Metabolic and Gastrointestinal Tract Diseases: Current Perspectives on Possible Pathogenic Connections. J. Pers. Med., 12.","DOI":"10.3390\/jpm12030341"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Surlin, P., Gheorghe, D.N., Foia, L., Surdu, A., Toma, V., Solomon, S.M., and Rogoveanu, I. (2018). Periodontal Implications of Hepatitis C Infection. Hepatitis C\u2014From Infection to Cure, IntechOpen.","DOI":"10.5772\/intechopen.76135"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/0030-4220(84)90307-4","article-title":"Direct measurement of hepatitis B viral antibody and antigen markers in gingival crevicular fluid","volume":"57","author":"Pollock","year":"1984","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/0003-9969(85)90032-9","article-title":"The relationship between antigenaemia and excretion of hepatitis B surface antigen in human whole saliva and in gingival crevicular fluid","volume":"30","author":"Ur","year":"1985","journal-title":"Arch. Oral Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1196\/annals.1384.027","article-title":"Analysis of Gingival Crevicular Fluid as Applied to the Diagnosis of Oral and Systemic Diseases","volume":"1098","author":"Lamster","year":"2007","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3109\/00016358409041132","article-title":"Hepatitis B serum markers and oral health in a group of Norwegian male prisoners","volume":"42","author":"Hurlen","year":"1984","journal-title":"Acta Odontol. Scand."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1016\/j.jiac.2020.10.028","article-title":"Relationship between detection of hepatitis B virus in saliva and periodontal disease in hepatitis B virus carriers in Japan","volume":"27","author":"Kamimura","year":"2021","journal-title":"J. Infect. Chemother."},{"key":"ref_35","first-page":"707","article-title":"Hepatitis B and C virus infections among patients with gingivitis and adult periodontitis: Seroprevalence and public health importance","volume":"73","author":"Farghaly","year":"1998","journal-title":"J. Egypt. Public Health Assoc."},{"key":"ref_36","first-page":"S149","article-title":"Risk factors of transmission and natural history of chronic hepatitis B infection in Iranian patients","volume":"12","author":"Sharifian","year":"2019","journal-title":"Gastroenterol. Hepatol. Bed Bench"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s10552-017-0906-y","article-title":"Tooth loss and liver cancer incidence in a Finnish cohort","volume":"28","author":"Yang","year":"2017","journal-title":"Cancer Causes Control"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e23264","DOI":"10.5812\/hepatmon.23264","article-title":"Association of Periodontal Diseases and Liver Fibrosis in Patients with HCV and\/or HBV infection","volume":"14","author":"Nagao","year":"2014","journal-title":"Hepat. Mon."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S0377-1237(01)80085-X","article-title":"Dental caries and periodontal disorders in chronic liver disease","volume":"57","author":"Anand","year":"2001","journal-title":"Med. J. Armed Forces India"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"274","DOI":"10.3109\/00016357.2013.823645","article-title":"Association between viral hepatitis B infection and halitosis","volume":"72","author":"Han","year":"2013","journal-title":"Acta Odontol. Scand."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2209\/tdcpublication.2015-0041","article-title":"Periodontal Regenerative Therapy in Patient with Chronic Periodontitis and Type 2 Diabetes Mellitus: A Case Report","volume":"57","author":"Seshima","year":"2016","journal-title":"Bull. Tokyo Dent. Coll."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/eos.12239","article-title":"Systematic review of the in vitro effects of statins on oral and perioral microorganisms","volume":"124","author":"Ting","year":"2015","journal-title":"Eur. J. Oral. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/j.1601-0825.2012.01922.x","article-title":"Dental postoperative bleeding complications in patients with suspected and documented liver disease","volume":"18","author":"Hong","year":"2012","journal-title":"Oral Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"069S","DOI":"10.3855\/jidc.10919","article-title":"Evaluation of IL-2, IL-10, IL-4 and \u03b3-interferon levels in the oral fluids of patients with hepatitis C, B and HIV","volume":"13","author":"Azatyan","year":"2019","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_45","first-page":"101","article-title":"Evaluation of HBs-Ag and anti-HBc levels in serum and saliva of patients with hepatitis B","volume":"34","author":"Gharavi","year":"2020","journal-title":"Med. J. Islam. Repub. Iran"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"47","DOI":"10.14219\/jada.archive.1986.0005","article-title":"Delta hepatitis: Another concern for dentistry","volume":"112","author":"Cottone","year":"1986","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"12","DOI":"10.20411\/pai.v1i1.72","article-title":"Hepatitis Delta Virus Detected in Salivary Glands of Sj\u00f6gren\u2019s Syndrome Patients and Recapitulates a Sj\u00f6gren\u2019s Syndrome-Like Phenotype in Vivo","volume":"1","author":"Weller","year":"2016","journal-title":"Pathog. Immun."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"95","DOI":"10.18821\/0869-2084-2020-65-2-95-99","article-title":"Detection of markers of hepatitis b and d virus infection in biological media and dried blood spots","volume":"65","author":"Isaeva","year":"2020","journal-title":"Klin. Lab. Diagn."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/j.1600-0714.2011.01123.x","article-title":"Oral fluid and hepatitis A, B and C: A literature review","volume":"41","author":"Mahboobi","year":"2011","journal-title":"J. Oral Pathol. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Lim, G., Janu, U., Chiou, L.-L., Gandhi, K.K., Palomo, L., and John, V. (2020). Periodontal Health and Systemic Conditions. Dent. J., 8.","DOI":"10.3390\/dj8040130"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"413","DOI":"10.15403\/jgld.2014.1121.244.dtv","article-title":"Hepatitis Delta Virus Infection in Romania: Prevalence and Risk Factors","volume":"24","author":"Gheorghe","year":"2015","journal-title":"J. Gastrointest. Liver Dis."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/10\/1580\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:39:23Z","timestamp":1760143163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/10\/1580"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,26]]},"references-count":51,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jpm12101580"],"URL":"https:\/\/doi.org\/10.3390\/jpm12101580","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,26]]}}}