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Bypass gastroplasty impacts oral health, salivary inflammatory biomarkers, and microbiota: a controlled study

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Knowledge about the impact of gastroplasty on oral health and salivary biomarkers is limited. The aim was to prospectively evaluate oral health status, salivary inflammatory markers, and microbiota in patients undergoing gastroplasty compared with a control group undergoing a dietary program.

Materials and methods

Forty participants with obesity class II/III were included (20 individuals in each sex-matched group; 23–44 years). Dental status, salivary flow, buffering capacity, inflammatory cytokines, and uric acid were assessed. Salivary microbiological analysis (16S-rRNA sequencing) assessed the abundance of genus, species, and alpha diversity. Cluster analysis and mixed-model ANOVA were applied.


Oral health status, waist-to-hip ratio, and salivary alpha diversity were associated at baseline. A subtle improvement in food consumption markers was observed, although caries activity increased in both groups, and the gastroplasty group showed worse periodontal status after three months. IFNγ and IL10 levels decreased in the gastroplasty group at 3 months, while a decrease was observed in the control group at 6 months; IL6 decreased in both groups (p < 0.001). Salivary flow and buffering capacity did not change. Significant changes in Prevotella nigrescens and Porphyromonas endodontalis abundance were observed in both groups, while alpha diversity (Sobs, Chao1, Ace, Shannon, and Simpson) increased in the gastroplasty group.


Both interventions changed in different degrees the salivary inflammatory biomarkers and microbiota, but did not improve the periodontal status after 6 months.

Clinical relevance

Although the observed discrete improvement in dietary habits, caries activity increased with no clinical improvement in the periodontal status, emphasizing the need of oral health monitoring during obesity treatment.

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Fig. 1
Fig. 2

Data availability

Data will be made available upon reasonable request to the corresponding author.



Body mass index


Community Periodontal Index


Decayed, missed, and filled teeth


Operational taxonomic units


Analysis of variance


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This work was supported by the State of São Paulo Research Foundation (FAPESP, SP, Brazil, grants number 2016/10940-9, 2017/26400-6 and 2020/16020-4) and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES/financial code 001 - scholarship). The funding sources were not involved in the data collection, analysis, and interpretation; neither in the manuscript writing and in the decision to submit it for publication.

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Authors and Affiliations



Aianne Souto Pizzolato Ribeiro: design of methodology, formal analysis, investigation, data curation, writing—original draft preparation;

Maria Carolina Salomé Marquezin: conceptualization, design of methodology, investigation, data curation, project administration, writing—review and editing;

Elisane Rossin Pessotti Pacheco: investigation, resources, data curation, visualization, project administration, writing—review and editing;

Irineu Rasera Jr: investigation, resources, visualization, project administration, writing—review and editing;

Marlise Inês Klein: conceptualization, design of methodology, formal analysis, visualization, writing—review and editing;

Suzan Pantaroto de Vasconcellos: conceptualization, design of methodology, formal analysis, writing—original draft preparation, visualization, writing—review and editing;

Richardt Gama Landgraf: Investigation, resources, data curation, writing—review and editing;

Debora Okamoto: design of methodology, investigation, data curation, visualization, writing—review and editing;

Leandro Augusto Calixto: design of methodology, investigation, data curation, visualization, writing—review and editing;

Paula Midori Castelo: conceptualization, formal analysis, resources, writing—original draft preparation, supervision, funding acquisition.

Corresponding author

Correspondence to Paula Midori Castelo.

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Ethical approval

This study was approved by the Research Ethics Committee of the Universidade Federal de São Paulo (CAAE 78018517.1.0000.5505). All procedures performed were in accordance with the ethical standards of the institutional and national research committees and with the latest version of the Helsinki Declaration.

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Written free and informed consent was obtained from all participants included in the study.

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Ribeiro, A.S.P., Marquezin, M.C.S., Pacheco, E.R.P. et al. Bypass gastroplasty impacts oral health, salivary inflammatory biomarkers, and microbiota: a controlled study. Clin Oral Invest 27, 4735–4746 (2023).

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