The omics translational gap: a large language model-augmented landscape analysis of systemic endpoints in periodontal clinical trials (2016–2026)

Substantial evidence has linked the oral microbiome to various systemic diseases, but it remains unclear whether periodontal clinical trials have incorporated omics-level or systemic endpoints. We conducted a dual-modality analysis covering January 2016 to January 2026, including 2,031 Web of Science records and 1,199 interventional periodontal trials from ClinicalTrials.gov. Trial endpoints were classified into three hierarchical tiers using a standardized schema: microbiome/omics, systemic biomarkers, and local clinical parameters. The results showed that although annual publication volume on the oral-systemic axis increased approximately 7-fold, 87.2% of trials still used only local clinical endpoints, only 11.5% included systemic biomarkers, and only 1.3% included microbiome/omics endpoints, with no increase over the decade. Thus, despite substantial research growth, the endpoint structure of periodontal trials has remained largely unchanged, revealing a significant translational gap. Future trials should consider incorporating composite microbial endpoints and biobanking.