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Association of torque teno virus in periodontitis: a systematic review, meta-analysis, and trial sequential analysis

Luis Chauca-Bajaña1, Mario Pérez-Sayáns2,3,4, Alejandro Ismael Lorenzo-Pouso2

  • 1Periodontics and Implantology Oral Research, College Dentistry, Ecuador, Faculty of Medicine and Dentistry, University of Guayaquil, Guayas, Ecuador.

Frontiers in Oral Health
|December 8, 2025
PubMed
Abstract

Insights

Torque Teno virus (TTV) is 67% more likely in periodontitis patients. While this association is consistent, more research is needed to confirm causality and clinical significance in periodontitis management.

Area of Science:

  • Oral microbiology
  • Viral co-infections
  • Periodontal disease pathogenesis

Background:

  • Periodontitis affects 38.5% of adults globally, a multifactorial inflammatory disease.
  • Traditionally linked to bacterial pathogens, emerging evidence suggests viral cofactors.
  • Torque Teno virus (TTV), a common anellovirus, shows high prevalence in general populations.

Purpose of the Study:

  • To systematically review and meta-analyze the prevalence of TTV in periodontitis patients compared to controls.
  • To assess the association between TTV and periodontitis.

Main Methods:

  • Systematic review and meta-analysis following PRISMA guidelines.
  • Searched multiple databases for observational studies (2000-2024) on TTV detection in oral samples.
  • Random-effects meta-analysis calculated pooled relative risk (RR); Trial Sequential Analysis assessed evidence sufficiency.

Main Results:

  • Four studies included 583 participants (300 periodontitis, 283 controls).
  • Significant association found between TTV and periodontitis (RR=1.67, 95%CI: 1.28-2.17), indicating a 67% increased likelihood.
  • Minimal heterogeneity (I²=0%) and no publication bias; however, evidence sufficiency is low (31.6% of required information size).

Conclusions:

  • A consistent association exists between TTV and periodontitis.
  • Current evidence is insufficient to establish causality or clinical significance.
  • Larger prospective studies with standardized criteria are necessary for validation.
Keywords:
meta-analysismolecular diagnosticsperiodontitistorque teno virusvirome

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