The 100 Most-Cited Articles on Periodontal Disease and Atherosclerosis: A Bibliometric Study (1989-2025)

The association between periodontal disease and atherosclerosis has gained significant attention, yet the intellectual structure and most influential works in this interdisciplinary field have not been systematically mapped. This study aimed to identify and analyze the characteristics, collaborative networks, and evolving research trends of the 100 most-cited articles concerning the relationship between periodontal disease and atherosclerosis.

A comprehensive search was performed in the Web of Science Core Collection on January 24, 2025. Bibliometric analysis and visualization were conducted using VOSviewer, CiteSpace, and the "bibliometrix" R package. Metrics included total citations, h-index, and keyword burst detection.

The 100 articles garnered a total of 13,968 citations (average: 195.6 citations per article). The United States was the leading contributor (n = 40), with the University of North Carolina identified as the most productive institution. The Journal of Periodontology and Circulation were the primary publication venues. Keyword clustering identified six research hotspots: risk factors, inflammatory responses, infection, confounding variables, Porphyromonas gingivalis, and related cardiovascular conditions. Burst analysis revealed a paradigm shift in research focus from mechanistic "infection" (2004-2005) to clinical "therapy" (2013-2020).

This study delineates the foundational literature and thematic evolution of the periodontal-atherosclerosis link. The observed shift in the literature from mechanistic to interventional studies may correlate with an increase in publications on periodontal treatment for cardiovascular prevention. These findings provide a data-driven roadmap for future longitudinal trials and clinical guidelines.