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Published on: August 8, 2014
PISA: Inflamed Surface Area of Gums Triggering Systemic Hyperinflammation.
Himani1, Shalini Kapoor1, Amit Bhardwaj1
1Department of Periodontology, Faculty of Dental Sciences, SGT University, Gurugram, Haryana, India.
Journal of Mid-Life Health
|May 13, 2026
Summary
Periodontal Inflamed Surface Area (PISA) better measures gum inflammation than traditional methods. Higher PISA scores link to systemic diseases like cardiovascular disease, diabetes, and dementia, highlighting periodontitis
Area of Science:
- Periodontology and Oral Medicine
- Systemic Health
- Inflammatory Diseases
Background:
- Periodontitis is a chronic inflammatory condition leading to periodontal tissue destruction.
- Traditional clinical metrics like probing depth and attachment loss inadequately reflect the inflammatory burden.
- The Periodontal Inflamed Surface Area (PISA) offers a more precise quantification of gingival inflammation.
Purpose of the Study:
- To review the association between Periodontal Inflamed Surface Area (PISA) and various systemic disorders.
- To explore the link between PISA and cardiovascular disease, diabetes mellitus, dementia, and rheumatoid arthritis (RA).
- To assess the utility of PISA as a marker for systemic inflammation originating from periodontal disease.
Main Methods:
- Systematic literature review of studies investigating PISA.
- Analysis of correlations between PISA measurements and systemic inflammatory markers.
- Examination of PISA's association with specific systemic conditions like Type 2 diabetes mellitus, dementia, and RA.
Main Results:
- Higher PISA levels correlate with increased systemic inflammatory markers (e.g., hs-CRP) and vascular stiffness.
- A positive association exists between PISA and HbA1c in Type 2 diabetes mellitus, suggesting a dose-response relationship.
- PISA has demonstrated links to dementia, rheumatoid arthritis, and diabetic complications, indicating broader systemic implications.
Conclusions:
- Periodontal Inflamed Surface Area (PISA) is a valuable tool for assessing the systemic impact of periodontitis.
- Findings support the integration of PISA assessment into comprehensive patient care.
- Further research is recommended to standardize PISA measurement and application in clinical practice.
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