Research progress of ferroptosis in the occurrence and development of periodontitis

Periodontal disease is a chronic infectious disease characterized by chronic inflammation and progressive destruction of the periodontal tissue. Ferroptosis, an iron-dependent form of programmed cell death, is primarily characterized by altered iron homeostasis, weak antioxidant defense, and accumulation of lipid peroxides and plays an important role in a variety of diseases. Recent research has shown the correlation between ferroptosis and the occurrence and development of periodontal disease. Through in-depth research of relevant literature on periodontal ligament fibroblasts, periodontal ligament stem cells, human immortalized oral epithelial cells, human gingival fibroblasts, dental pulp stem cells, MLOY4 cells, mouse mandibular osteoblast, and macrophages, we found that ferroptosis is widely suppressed in periodontal disease. This phenomenon is primarily related to lipid metabolism, iron metabolism, cysteine/glutamate transporter system x_c^-/glutathione/glutathione peroxidase 4, nicotinamide adenine dinucleotide phosphate/ferroptosis suppressor protein 1/coenzyme Q10, kelch-like ECH-associated protein-1/nuclear factor E2 related factor 2, and p53. Current research indicates that ferroptosis plays an important role in regulating the destruction of periodontal soft and hard tissues, inflammatory response, and periodontopathogen-induced progression of systemic diseases. Although there are several studies on the mechanism of ferroptosis in periodontal disease, there are many uncertainties in the application of ferroptosis in periodontal therapy. Therefore, further studies are required to explore and develop ferroptosis-related drugs for the treatment of periodontal disease.