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Periodontium

Anatomy and Physiology · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed9 referencesApproximately 3 min read

The structures surrounding and supporting the tooth.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 3 complete abstracts (634 words), 9 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

The structures surrounding and supporting the tooth. Periodontium includes the gum (gingiva), the alveolar bone (alveolar process), the dental cementum, and the periodontal ligament.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Periodontiums; Paradentium; Paradentiums; Tooth Supporting Structures; Structures, Tooth Supporting; Structure, Tooth Supporting; Supporting Structures, Tooth; Supporting Structure, Tooth.

Where it fits in the MeSH classification

Broader topics
Dentition
Narrower topics
Alveolar Process; Dental Cementum; Epithelial Attachment; Gingiva; Periapical Tissue; Periodontal Ligament

Related concepts

  • Gingiva
  • Alveolar Process
  • Dental Cementum
  • Periodontal Ligament

Research landscape

PubMed indexes 53,077 records tagged with the MeSH heading “Periodontium” (counts retrieved 2026-10-31). 7,841 of them (14.8%) were published from 2020 onward, and the busiest period so far is through 1999 with 23,478 records.

Reviews account for 3,865 records (7.3%) and meta-analyses for 325. Randomized controlled trials number 1,965 (3.7%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 23,478 records; 2000-2009: 8,754 records; 2010-2019: 13,004 records; 2020 onward: 7,841 records23,478through 19998,7542000-200913,0042010-20197,8412020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 199923,478
2000-20098,754
2010-201913,004
2020 onward7,841
Share of records by publication typeReviews: 7.3 percent; Meta-analyses: 0.6 percent; Randomized controlled trials: 3.7 percentReviews7.3% (3,865)Meta-analyses0.6% (325)Randomized controlled trials3.7% (1,965)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 53,077 PubMed records
TypeRecordsShare
Reviews3,8657.3%
Meta-analyses3250.6%
Randomized controlled trials1,9653.7%

Method: PubMed query "Periodontium"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in anatomy and physiology

Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective Cohort Study
Roccuzzo A, Imber JC, Stähli A, Romandini M, Sculean A, Salvi GE, et al.
2025Research article
Design not recorded in structured metadata
16cc by
PMID 40689718 · DOI · PMC12881885
Single-cell transcriptomics identifies PDGFRA+ progenitors orchestrating angiogenesis and periodontal tissue regeneration
Liu J, He J, Zhang Z, Liu L, Cao Y, Zhang X, et al.
2025Research article
Design not recorded in structured metadata
13cc by
PMID 40707447 · DOI · PMC12289874
Matrix Stiffness Governs Fibroblasts' Regulation of Gingival Immune Homeostasis
Makkar H, Tran N, Chen YC, Ko KI, Wells RG, Vining KH
2026Research article
Design not recorded in structured metadata
11cc by
PMID 41656824 · DOI · PMC12983442

Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective Cohort Study [1]

Research article Roccuzzo A, Imber JC, Stähli A, Romandini M, Sculean A, Salvi GE, et al. · · 2025 · cited 16 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
AimTo evaluate the 20-year outcomes of tissue-level implants placed in the posterior mandible, comparing implants surrounded by keratinized tissue (KT) or alveolar mucosa (AM).
Closing excerpt
Additional treatment was required in 11 AM patients (50%) versus 2 KT patients (5%) (p ConclusionTissue level implants placed in the posterior mandible without KT showed greater marginal bone loss, bleeding on probing, soft tissue recession, and peri-implant diseases compared to implants with KT at 20 years.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (191 words)

AimTo evaluate the 20-year outcomes of tissue-level implants placed in the posterior mandible, comparing implants surrounded by keratinized tissue (KT) or alveolar mucosa (AM).MethodsAt baseline, 128 patients (128 implants) were rehabilitated with implant-supported fixed dental prostheses in the posterior mandible and enrolled in a supportive periodontal/peri-implant care (SPC) program. Patients were categorized based on the presence (KT) or absence (AM) of keratinized mucosa. During the first 10 years of SPC, 11 AM patients underwent free gingival grafting (FGG), identifying a third group (AM + FGG). At the 20-year follow-up, peri-implant health status and soft-tissue dehiscence were assessed according to the 2018 Case Definitions. The need for additional treatment between the 10- and 20-year examinations was also recorded.ResultsOf the 98 patients evaluated at the 10-year follow-up, 64 (KT = 42; AM = 16; AM + FGG = 6; drop-out rate: 35%) attended the 20-year examination. Additional treatment was required in 11 AM patients (50%) versus 2 KT patients (5%) (p ConclusionTissue level implants placed in the posterior mandible without KT showed greater marginal bone loss, bleeding on probing, soft tissue recession, and peri-implant diseases compared to implants with KT at 20 years.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40689718 · DOI · PMC12881885

Single-cell transcriptomics identifies PDGFRA+ progenitors orchestrating angiogenesis and periodontal tissue regeneration [2]

Research article Liu J, He J, Zhang Z, Liu L, Cao Y, Zhang X, et al. · · 2025 · cited 13 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Periodontal bone defects, primarily caused by periodontitis, are highly prevalent in clinical settings and manifest as bone fenestration, dehiscence, or attachment loss, presenting a significant challenge to oral health.
Closing excerpt
These findings not only establish a framework for deciphering and promoting periodontal bone regeneration in potential clinical applications but also offer insights for future therapeutic strategies in dental or broader regenerative medicine.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (254 words)

Periodontal bone defects, primarily caused by periodontitis, are highly prevalent in clinical settings and manifest as bone fenestration, dehiscence, or attachment loss, presenting a significant challenge to oral health. In regenerative medicine, harnessing developmental principles for tissue repair offers promising therapeutic potential. Of particular interest is the condensation of progenitor cells, an essential event in organogenesis that has inspired clinically effective cell aggregation approaches in dental regeneration. However, the precise cellular coordination mechanisms during condensation and regeneration remain elusive. Here, taking the tooth as a model organ, we employed single-cell RNA sequencing to dissect the cellular composition and heterogeneity of human dental follicle and dental papilla, revealing a distinct Platelet-derived growth factor receptor alpha (PDGFRA) mesenchymal stem/stromal cell (MSC) population with remarkable odontogenic potential. Interestingly, a reciprocal paracrine interaction between PDGFRA+ dental follicle stem cells (DFSCs) and CD31+ Endomucin+ endothelial cells (ECs) was mediated by Vascular endothelial growth factor A (VEGFA) and Platelet-derived growth factor subunit BB (PDGFBB). This crosstalk not only maintains the functionality of PDGFRA+ DFSCs but also drives specialized angiogenesis. In vivo periodontal bone regeneration experiments further reveal that communication between PDGFRA+ DFSC aggregates and recipient ECs is essential for effective angiogenic-osteogenic coupling and rapid tissue repair. Collectively, our results unravel the importance of MSC-EC crosstalk mediated by the VEGFA and PDGFBB-PDGFRA reciprocal signaling in orchestrating angiogenesis and osteogenesis. These findings not only establish a framework for deciphering and promoting periodontal bone regeneration in potential clinical applications but also offer insights for future therapeutic strategies in dental or broader regenerative medicine.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40707447 · DOI · PMC12289874

Matrix Stiffness Governs Fibroblasts' Regulation of Gingival Immune Homeostasis [3]

Research article Makkar H, Tran N, Chen YC, Ko KI, Wells RG, Vining KH · · 2026 · cited 11 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Periodontal disease is characterized by inflamed gingival tissues and degradation of the gingival extracellular matrix (ECM), yet the role of mechanical cues remains poorly understood.
Closing excerpt
Gingival mechano-immune regulation offers a novel approach to biomaterial-based treatments for periodontitis.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (189 words)

Periodontal disease is characterized by inflamed gingival tissues and degradation of the gingival extracellular matrix (ECM), yet the role of mechanical cues remains poorly understood. Gingival ECM in periodontal disease showed reduced fibrillar collagen compared to healthy samples. We hypothesized that ECM softening in periodontal disease contributes to inflammation by dysregulating gingival fibroblasts (GFs). A mechanically tunable hydrogel model of the gingival ECM was developed to investigate the mechano-immune crosstalk. Stiff and soft collagen-alginate hydrogels matched the rheological properties of healthy and diseased gingival biopsies respectively. Human donor GFs encapsulated in these stiff hydrogels showed significantly suppressed toll-like receptor-mediated inflammatory responses compared to those in soft hydrogels. The non-canonical NFκB pathway and epigenetic nuclear organization directed stiffness-dependent inflammatory responses of GFs. The direct impact of mechanical cues on immune responses was investigated ex vivo by co-culture of donor-derived human GFs with myeloid cells and in human gingival explants. Myeloid progenitors co-cultured with GFs in stiff hydrogels differentiated into immunomodulatory dendritic cells. Ex vivo crosslinking of human gingival tissue increased stiffness and reduced the production of inflammatory cytokines. Gingival mechano-immune regulation offers a novel approach to biomaterial-based treatments for periodontitis.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41656824 · DOI · PMC12983442

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review [4]
    Van der Weijden F, Dell'Acqua F, Slot DE · J Clin Periodontol · 2009 · cited 498 times (Europe PMC)
  • Research article Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues [5]
    Galler KM, Weber M, Korkmaz Y, Widbiller M, Feuerer M · Int J Mol Sci · 2021 · cited 320 times (Europe PMC)
  • Research article Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis [6]
    Thoma DS, Naenni N, Figuero E, Hämmerle CHF, Schwarz F, Jung RE, et al. · Clin Oral Implants Res · 2018 · cited 309 times (Europe PMC)
  • Research article The significance of keratinized mucosa on implant health: a systematic review [7]
    Lin GH, Chan HL, Wang HL · J Periodontol · 2013 · cited 294 times (Europe PMC)
  • Research article Biomechanical and biological responses of periodontium in orthodontic tooth movement: up-date in a new decade [8]
    Li Y, Zhan Q, Bao M, Yi J, Li Y · Int J Oral Sci · 2021 · cited 243 times (Europe PMC)
  • Research article Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension: A Systematic Review and Meta-analysis [9]
    Sanz-Sánchez I, Ortiz-Vigón A, Sanz-Martín I, Figuero E, Sanz M · J Dent Res · 2015 · cited 196 times (Europe PMC)

References

  1. Roccuzzo A, Imber JC, Stähli A, Romandini M, Sculean A, Salvi GE, et al.. Role of Keratinized Mucosa on the Risk of Peri-Implant Diseases and Soft Tissue Dehiscence in the Posterior Mandible-A 20-Year Prospective Cohort Study. . 2025. PMID 40689718 · DOI · PMC12881885
  2. Liu J, He J, Zhang Z, Liu L, Cao Y, Zhang X, et al.. Single-cell transcriptomics identifies PDGFRA+ progenitors orchestrating angiogenesis and periodontal tissue regeneration. . 2025. PMID 40707447 · DOI · PMC12289874
  3. Makkar H, Tran N, Chen YC, Ko KI, Wells RG, Vining KH. Matrix Stiffness Governs Fibroblasts' Regulation of Gingival Immune Homeostasis. . 2026. PMID 41656824 · DOI · PMC12983442
  4. Van der Weijden F, Dell'Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol. 2009. PMID 19929956 · DOI
  5. Galler KM, Weber M, Korkmaz Y, Widbiller M, Feuerer M. Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues. Int J Mol Sci. 2021. PMID 33540711 · DOI · PMC7867227
  6. Thoma DS, Naenni N, Figuero E, Hämmerle CHF, Schwarz F, Jung RE, et al.. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res. 2018. PMID 29498129 · DOI
  7. Lin GH, Chan HL, Wang HL. The significance of keratinized mucosa on implant health: a systematic review. J Periodontol. 2013. PMID 23451989 · DOI
  8. Li Y, Zhan Q, Bao M, Yi J, Li Y. Biomechanical and biological responses of periodontium in orthodontic tooth movement: up-date in a new decade. Int J Oral Sci. 2021. PMID 34183652 · DOI · PMC8239047
  9. Sanz-Sánchez I, Ortiz-Vigón A, Sanz-Martín I, Figuero E, Sanz M. Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension: A Systematic Review and Meta-analysis. J Dent Res. 2015. PMID 26215467 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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Related research topics

  • Periodontal LigamentAnatomy and Physiology
  • ToothAnatomy and Physiology
  • Dental PulpAnatomy and Physiology
  • Dental EnamelAnatomy and Physiology
  • BicuspidAnatomy and Physiology
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All 542 articles in Anatomy and Physiology →

At a glance

53,077
PubMed records on this heading
15%
published since 2020
3,865
review articles
1,965
randomized trials
9
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • Periodontal LigamentAnatomy and Physiology
  • ToothAnatomy and Physiology
  • Dental PulpAnatomy and Physiology
  • Dental EnamelAnatomy and Physiology
  • BicuspidAnatomy and Physiology

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