Periodontitis, an oral infectious-inflammatory condition, can lead to tooth loss and may interfere with the course of various systemic conditions, including cardiovascular disease and diabetes. Consequently, comprehensive understanding and effective management of periodontitis are essential for both oral and systemic health. My research focuses on the diagnosis and treatment of periodontitis, with special emphasis on the following areas:

• Establishing the ecological basis and suggesting microbial endpoints for periodontitis treatment. Collectively, our studies have shown that a panel of 40 bacterial species serves as an excellent marker to determine subgingival dysbiosis or homeostasis. Our lab also examines oral cavity ecology using next-generation sequencing (NGS). We recently published the first study utilizing NGS to assess changes in the subgingival microbiome of young periodontitis patients treated with systemic antibiotics. An ongoing project aims to develop a chair-side molecular diagnostic tool to assess oral dysbiosis/ homeostasis.
• Using systemic antibiotics to treat periodontitis. Our research group pioneered the design and conduction of placebo-controlled randomized controlled trials (RCTs) to assess the clinical and microbiological effects of various antibiotic protocols for treating young patients, adults, smokers, and patients with type 2 diabetes with severe periodontitis. Three ongoing RCTs are testing the effects of combining metronidazole and amoxicillin with other adjuncts (e.g., probiotics and host modulators) in periodontitis treatment.
• Proposing innovative ways to translate research data into clinical practice, including validating an objective, patient-centered endpoint for periodontal treatment. As part of this ongoing project, we are consolidating large databases to test the effectiveness of different treatments in achieving this endpoint. The ultimate goal is to determine whether this parameter reflects disease remission and long-term tooth survival.
• Applying evidence synthesis to compile laboratory/animal study data, a method still underused in oral health research. We published the first systematic review of this type in the Journal of Dental Research in 2014, followed by six other studies and a recent commentary in the Journal of Clinical Periodontology. A highlight of this ongoing initiative is to encourage  the "weight of evidence" approach to avoid unnecessary studies, especially those conducted on animals.

Ongoing projects include:

Does Metabolic Syndrome Impact Periodontal Treatment Outcomes and Long-Term Stability?
In this study, we are analyzing Axium data to investigate the percentage of patients with or without metabolic syndrome who achieve the Clinical Endpoint for periodontal treatment, as suggested by Feres et al. (2020).

Impact of Host Modulation on the Lipid Profile
In this study, we are comparing the effects of omega-3 + aspirin and systemic metronidazole + amoxicillin on changing the lipid profile and inflammatory response of macrophages stimulated by Porphyromonas gingivalis LPS.

Treatment of Endo-Periodontal Lesions: A Scoping Review
The aim of this study is to answer the following focused question: “In patients with EPL, what is the best treatment strategy to improve the parameter of probing depth?”

Clinical and Microbiological Effects of Immunomodulation, With or Without Systemic Antibiotics, in the Treatment of Periodontitis
This multicenter placebo-controlled randomized clinical trial (RCT) aims to compare the clinical and microbiological effects of immunomodulation with omega-3 + low dose aspirin as adjuncts to mechanical treatment, with or without metronidazole + amoxicillin, in the treatment of systemically healthy patients with periodontitis.

Omega-3 and Aspirin Associated with Systemic Antibiotics in the Periodontal Treatment of Patients with Type 2 Diabetes Mellitus: Microbiological, Immunological, Clinical Effects, and Impact on Oral and Intestinal Microbiota
This multicenter placebo-controlled randomized clinical trial aims to compare the clinical and microbiological effects of immunomodulation with omega-3 + low dose aspirin as adjuncts to mechanical treatment, with or without metronidazole + amoxicillin, in the treatment of patients with type II Diabetes and periodontitis. The impact of treatment on the intestinal microbiota is also being assessed.

Surgical Access Combined with Systemically Administered Antibiotics in the Treatment of Peri-Implantitis: A 1-Year Randomized Double-Blinded Controlled Clinical Trial
The aim of this study is to test the hypothesis that treatment of peri-implantitis can be significantly improved by the addition of adjunctive metronidazole and amoxicillin to the anti-infective therapeutic protocol, consisting of open-flap debridement and Er:YAG irradiation.

Characterization of the Oral Microbiome in Healthy Individuals
The aim of this study is to investigate the diversity of the intra-sulcular microbiome of periodontally healthy individuals using next-generation sequencing techniques.

Systemic Probiotics in Periodontal Treatment
The aim of this randomized clinical trial (RCT) is to evaluate the clinical, microbiological, and immunological effects of probiotics as adjuncts to SRP alone or with MTZ+AMX in the treatment of periodontitis.