Georgios A Kotsakis, D.D.S., M.S.

My research program focuses on delineating the complex interactions between host immune response, oral bacteria and dental biomaterials using human and murine models of oral inflammatory disease phenotypes. Our lab conducts research across the entire spectrum of translational research from basic discovery to human clinical trials and public health implementation. We are currently focusing on the study of the etiology of peri-implant inflammation, which is an inflammatory disease that leads to destruction of jawbone and implant failures. The basis of these investigations is a human-centered model of clinical immunology, which in combination with knock-out animal models, focuses on the effects that implant biomaterial degradation has on immune activation, non-resolving inflammation and cell death. 

Currently, we are investigating caspase activation and downstream effects in immune cells sensitized by dental implant degradation products in an effort to understand why anti-inflammatory and antimicrobial agents that successfully resolve inflammation around teeth fail to resolve inflammatory lesions around dental implants. 

Relevant Diseases: Peri-implantitis, Periodontitis, Inflammation

Research Techniques: Microbiome analyses, bioinformatics, tissue culture 

• Professional Background

  Education

  • 2015 - Residency - Periodontology - University of Minnesota
  • 2015 - MS - Periodontology - University of Minnesota
  • 2008 - DDS - Dentistry (5 year degree) - University Athens

  Appointments

  • 12/2018 - Associate Professor - UT Health San Antonio, Periodontics, San Antonio
  • 1/2015 - Adjunct Assistant Professor - University of Minnesota, Periodontology, Minnesota

• Instruction & Training

  • 1/2018 - Present, Individual Instruction, University of Washington
  • 1/2018 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, PERIO 550, Directed Studies in Periodontics, University of Washington
  • 1/2017 - Present, Seminar on Behavioral Research in Dentistry, University of Washington
  • 1/2017 - Present, Graduate Prosthodontics Literature Review, University of Washington
  • 1/2017 - Present, Ph.D. Dissertations Directed, University of Washington
  • 1/2017 - Present, PSIG Faculty Mentor, University of Washington
  • 1/2017 - Present, AADR Student Research Group, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2017 - Present, Individual Instruction, University of Washington
  • 1/2016 - Present, PERIO 577, Graduate Literature Review
  • 1/2015 - Present, Individual Instruction, University of Washington
  • 1/2015 - Present, Individual Instruction, University of Washington
  • 1/2015 - Present, DENTPC 511, Introduction to Periodontics
  • 1/2015 - Present, PERO 8200, Clinical Seminars
  • 1/2015 - Present, DENTCL 632, Periodontics Clerkship
  • 1/2015 - Present, PERIO 639, Undergraduate Periodontics Clinic
  • 1/2015 - Present, PERIO 660, Graduate Periodontics Clinic
  • 1/2015 - Present, PERIO 600, Independent Research

• Research & Grants

  Grants

  https://clinicaltrials.gov/ct2/show/NCT03384446 Funding Agency Royalty Research Fund, University of Washington Title Dental Hygiene Procedures Disrupt Healthy Homeostasis in Tissues Surrounding Dental Implants Status Active Period 11/2017 - 11/2018 Role Principal Investigator Grant Detail This is an ancillary study to our funded RCT entitled "Dental Hygiene Procedures Disrupt Healthy Homeostasis in Tissues Surrounding Dental Implants" aiming to assess whether a hyper-responsive monocyte phenotype determines individual susceptibility to peri-implant inflammation. Funding Agency Hack Fund, University of Washington Title Mucosal immunity in peri-implantitis Status Complete Period 9/2016 - 9/2018 Role Principal Investigator Grant Detail Based on existing information, peri-implantitis is associated with a primarily gram-negative microbiota that is dissimilar to that of periodontitis. TLR4 and to a limited extent TLR2, are the main pattern recognition receptors responsible for recognizing components derived from gram-negative bacteria. In this project, we aim to characterize, for the first time, pathogen recognition and TLR activation in peri-implantitis. Funding Agency Waterpik Inc. Title Application of water jet in the treatment of peri-implantitis Status Complete Period 6/2016 - 6/2018 Role Principal Investigator Grant Detail The goal of this project is to determine whether pressurized irrigation of biofilm coated titanium surfaces augments biofilm removal as compared to saline immersion while maintaining titanium surface properties. Funding Agency SunStar Americas Preventive Dentistry Award Seminario AL Title Integrating oral health into the pediatric HIV care continuum: Baseline data of oral and systemic inflammation Status Complete Period 4/2017 - 4/2018 Role Co-Investigator Grant Detail This work aims to assess the impact of an integrated oral health intervention on markers of oral and systemic inflammation in an established cohort of HIV+ children in Kenya. Funding Agency NIDCR/NIH Title Aiding Effective Decision Making in Dental Research Using Network Meta-analysis Status Complete Period 6/2015 - 5/2017 Role Co-Investigator Grant Detail The overall goal of this proposal is to develop cutting-edge statistical methods in dental research. Specifically, we will develop multivariate Bayesian hierarchical models for multiple mixed outcomes to aid decision-making in Dental research. Funding Agency Dr. Douglass L. Morell Dentistry Research Fund, University of Washington Title Application of machine learning algorithms for periodontal disease classification Status Complete Period 7/2016 - 12/2016 Role Principal Investigator Grant Detail The aim of this inter-disciplinary project was to combine advanced feature selection and classification algorithms to enhance the accuracy of partial mouth protocols for classification of periodontal disease. Periodontal examination of selected intraoral sites and disease classification via machine learning algorithms has the potential to reduce the cost and effort associated with population-level disease surveillance and can facilitate appropriately powered epidemiologic studies.

• Publications

  Book Chapter

  Hinrichs JE, Kotsakis GA. Classification of Diseases and Conditions Affecting the Periodontium. In: Newman M, Takei H, Klokkevold P, Carranza F. Clinical Periodontology, Chapter 5, 13th Edition. 2018. Babbush C, Hinrichs JE, Kotsakis GA. The evolution of implant dentistry from a patient-oriented perspective. In: Agliardi E, Romeo D, eds. Tilted Implants - Implants prosthetic rehabilitation of the atrophic patient, Chapter 2. 2018. Hujoel P, Kotsakis GA. Fundamentals in the Methods of Periodontal Disease. In: Newman M, Takei H, Klokkevold P, Carranza F. Clinical Periodontology, Chapter 6, 13th Edition. 2018. Javed F, Boutros S, Kotsakis GA. Management of complications associated with soft tissue grafting in implant dentistry. In: Tolstunov L ed. Vertical Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual. 2016. Kotsakis GA, Boutros S, Ioannou A. Soft Tissue Grafting for Implant Site Development: Diagnosis and Treatment Planning. In: Tolstunov L ed. Vertical Alveolar Ridge Augmentation in Implant Dentistry: A Surgical Manual. 2016. Boutros S, Kotsakis GA. Techniques of Soft Tissue Grafting in Implant Dentistry. In: Tolstunov L ed. Vertical Alveolar Ridge Augmentation in Implant Dentistry. 2016. Hinrichs JE, Kotsakis GA, Lareau D. Soft Tissue Augmentation Surgery for Dental Implants. In: Kademami D, Tiwana P eds. Atlas of Oral and Maxillofacial Surgery, Chapter 27, 1st Edition. 2015. Hinrichs JE, Kotsakis GA. Classification of Diseases and Conditions Affecting the Periodontium. In: Newman M, Takei H, Klokkevold P, Carranza F. Clinical Periodontology, Chapter 3, 12th Edition. 2014.

  Editorial

  Kotsakis GA. Mandatory trial registration in oral health research: Long overdue? (Impact factor: 1.8; invited editorial) J Am Dent Assoc (JADA) 2017 Jun;148(6):353-356.

  Journal Article

  Siormpas KD, Mitsias ME, Kotsakis GA, Tawil I, Pikos MA, Mangano FG. The Root Membrane Technique: A Retrospective Clinical Study with Up to 10 Years of Follow-Up Implant Dent 2018 Oct;27(5):564-574. Daubert D, Pozhitkov A, McLean J, Kotsakis G. Titanium as a modifier of the pari-implant microbiome structure Clin Implant Dent Relat Res 2018 Sep;. Global Burden of Disease 2016 Greece Collaborators *Kotsakis, GA (*corresponding author in this paper). The burden of disease in Greece, health loss, risk factors, and health financing,2000-16: an analysis of the Global Burden of Disease Study 2016 Lancet Public Health 2018 Aug;3(8):e395-e406. Kotsakis GA, Lian Q, Ioannou AL, Michalowicz BS, John M, Chu H. A network meta-analysis of interproximal oral hygiene methods in the reduction of clinical indices of inflammation. (Epub ahead of print) J Periodontol 2018 Feb;. Karoussis IK, Kyriakidou K, Papaparaskevas J, Vrotsos IA, Simopoulou M, Kotsakis GA. Osteostimulative calcium phosphosilicate biomaterials partially restore the dytocompatibility of decontaminated titanium surfaces in a peri-implantitis model (Epub ahead of print) J Biomed Mater Res B Appl Biomater 2018 Feb;. Hujoel PP, Hujoel ML, Kotsakis GA. Personal oral hygiene and dental caries: A systematic review of randomized controlled trials [Ebub ahead of print) Gerodontology 2018 Jan;. GBD 2016 Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 Lancet 2017 Sep;390(10100):1260-1344. Abduljabbar T, Kellesarian SV, Vohra F, Akram Z, Kotsakis GA, Yunker M, Romanos GE, Javed F. Effect of Growth Hormone Supplementation on Osseointegration: A Systematic Review and Meta-Analyses Implant Dent 2017 Aug;26(4):613-620. Tyrovolas S, Koyanagi A, Kotsakis GA, Panagiotakos D, Shivappa N, Wirth MD, Hebert JR, Haro JM. Dietary inflammatory potential is linked to cardiovascular disease risk burden in the US adult population Int J Cardiol 2017 Aug;1(240):409-413. Safioti LM, Kotsakis GA, Pozhitkov AE, Chung WO, Daubert DM. Increased Levels of Dissolved Titanium are Associated with Peri-Implantitis J Periodontol 2017 May;88(5):436-442. Koutouzis T, Gholami F, Reynolds J, Lundgren T, Kotsakis GA. Abutment Disconnection/Reconnection Affects Peri-implant Marginal Bone Levels: A Meta-Analysis Int J Oral Maxillofac Implants 2017 May;32(3):575-581. GBD Collaborators. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015 Lancet 2017 May;389(10082):1885-1906. Pitcher B, Alaqla A, Noujeim M, Wealleans JA, Kotsakis GA, Chrepa V. Binary Decision Trees for Preoperative Periapical Cyst Screening Using Cone-beam Compound Tomography J Endod 2017 Mar;43(3):383-388. Mitsias ME, Siormpas KD, Kotsakis GA, Ganz SD, Mangano C, Iezzi G. The Root Membrane Technique: Human Histologic Evidence after Five Years of Function 2017:7269467 Biomed Res Int 2017 Jan;. John MT, Michalowicz BS, Kotsakis GA, Chu H. Network Meta-Analysis of Studies Included in the Clinical Practice Guideline on the Nonsurgical Treatment of Chronic Periodontitis J Clin Periodontol 2017 Jan;44(6):603-611. GBD collaborators. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis from the Global Burden of Diseases, Injuries, and Risk Factors (Impact factor: 4.6; Citations J Dent Res 2017 Jan;96(4):380-387. Lareau DE, Hinrichs JE, Kotsakis GA . Enhancing Root Eminence and Papilla Contour Using Single, Contoured, Subepithelial Connective Tissue Autografts for Recession Coverage Int J Periodontics Restorative Dent 2017 Jan;37(5):751-757. Kotsakis GA, Chrepa V, Shivappa N, Wirth M, Hebert J, Koyanagi A, Tyrovolas S . Diet-borne systemic inflammation is associated with prevalent tooth loss. pii: S0261-5614(17)30209-1 (Epub ahead of print) Clinical Nutrition 2017 Jan;. Hujoel PP, Kotsakis GA, Hujoel IA. Dental Morbidities, Smoking, Oral Hygiene, and Inflammatory Bowel Diseases Clin Gastroenterol Hepatol 2016 Dec;14(12):1840-1841. Tyrovolas S, Koyanagi A, Panagiotakos D, Haro JM, Kassebaum NJ, Chrepa V, Kotsakis GA. Population prevalence of edentulism and its association with depression and self-rated health. doi: 10.1038/srep37083 (Impact factor: 5.23; Citations: 7) Sci. Rep 2016 Nov;6(37083). Chatzopoulos GS, Tsalikis L, Konstantinidis A, Kotsakis GA. A two-domain self-report measure of periodontal disease has good accuracy for periodontitis screening in dental school outpatients J Periodontol 2016 Oct;87(10):1165-1173. GBD Collaborators. Measuring the health-related Sustainable Development Goals in 188 countries: A baseline analysis from the global Burden of Disease Study 2015 Lancet 2016 Oct;388(10053):1813-1850. GBD Collaborators. Global, regional, and national incidence, and YLDs for 310 acute and chronic diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. (Impact factor: 44; Citations: 340; an editorial was published to highlight Lancet 2016 Oct;388(10053):1545-1602. Konstantinidis IK, Siormpas KD, Kontsiotou-Siormpa E, Mitsias ME, Kotsakis GA. Long-Term Esthetic Evaluation of the roll Flap Technique in the Implant Rehabilitation of Patients with Agenesis of Maxillary Lateral Incisors: 10-Year Follow-Up Int J Oral Maxillofac Implants 2016 Jul;31(4):820-826. Kotsakis GA, Lan C, Barbosa J, Lill K, Chen R, Rudney J, Aparicio C . Antimicrobial agents used in the treatment of peri-implantitis alter the physicochemistry and cytocompatibility of titanium surfaces (Impact factor: 2.7; Citations: 9) J Periodontol 2016 Jul;87(7). Babbush C, Kanawati A, Kotsakis GA . Marginal Bone Stability Around tapered, Platform-Shifted Implants Placed with an Immediately Loaded Four-Implant-Supported Fixed Prosthetic Concept: A Cohort Study Int J Oral Maxillofac Implants 2016 May;31(3):643-650. Kotsakis GA, Boufidou F, Hinrichs JE, Prasad HS, Rohrer M, Tosios KI . Extraction Socket Management Utilizing Platelet Rich Fibrin: A Proof-of-Principle Study of the "Accelerated-Early Implant Placement" Concept J Oral Implantol 2016 Apr;42(2):164-168. Kotsakis GA, Zhang L, Gaillard P, Walter MH, Raedel M, Konstantinides J . Investigation of the association between cement-retention and prevalent peri-implant diseases: a cross-sectional study J Periodontol 2016 Mar;87(3):212-220. Ioannou AL, Koidou VP, Kamintzi GI, Hinrichs JE, Kotsakis GA, Romanos GE. Risk Indicators of Papillary Recession in the Anterior Maxilla J Esthet Restor Dent 2015 Nov;27(6):367-373. Mitsias ME, Siormpas KD, Kontsiotou-Siormpa E, Prasad H, Garber D, Kotsakis GA. A Step-by-Step Description of PDL-Mediated Ridge Preservation for Immediate Implant Rehabilitation in the Esthetic Region Int J Periodontics Restorative Dent 2015 Nov;35(6):835-841. Kotsakis GA, Ioannou A, Hinrichs JE, Romanos G . A systematic review of observational studies evaluating implant placement in the maxillary jaws of medically compromised patients Clin Imp Dent Rel Res 2015 Jun;17(3):598-609. Mahesh L, Venkataraman N, Shukla S, Prasad H, Kotsakis GA . Ridge preservation with the socket-plug technique utilizing an alloplastic putty bone substitute or a particulate xenograft: a histological pilot study J Oral Implantol 2015 Apr;41(2):178-183. Kotsakis GA, Thai A, Ioannou A, Demmer R, Michalowicz BS . Association between Low-Dose Aspirin and Periodontal Disease: Results from the Continuous National Health and Nutrition Examination Survey (NHANES) 2011-2012 J Clin Periodontol 2015 Apr;42(4):333-341. Ioannou AL, Kotsakis GA, Kumar T, Hinrichs JE, Romanos G . Evaluation of the bone regeneration potential of bioactive glass in implant site development surgeries: a systematic review of the literature Clin Oral Investig 2015 Mar;19(2):181-191. Konstantinides J, Kumar T, Kher U, Stanitsas P, Hinrichs JE, Kotsakis GA . Clinical results of implant placement in resorbed ridges using simultaneous guided bone regeneration: A multi-center case series Clin Oral Investig 2015 Mar;19(2):553-559. Kotsakis GA, Maxor Z . A simplified approach to the minimally invasive antral membrane elevation technique utilizing a viscoelastic medium for hydraulic sinus floor elevation Oral Maxillofac Surg 2015 Mar;19(1):97-101. Kotsakis GA, Javed F, Hinrichs J, Karoussis I, Romanos G . A systematic review and meta-analysis of the impact of cigarette smoking on clinical outcomes following periodontal flap surgical procedures J Periodontol 2015 Jan;86(2):254-263. Ioannou A, Kotsakis GA, McHale M, Lareau DE, Hinrichs JE, Romanos GE. Soft tissue surgical procedures for optimizing anterior implant esthetics. 2015:740764 Int J Dent 2015 Jan;. Konstantinides J, Kotsakis GA, Gerdes S, Walter MH. A Cross-Sectional Study on the Prevalence and risk Indicators of Peri-Implant Diseases Eur J Oral Imp 2015 Jan;8(1):75-88. Ioannou AL, Kotsakis GA. Prognostic factors in periodontal therapy and their association with treatment outcomes World J Clin Cases 2014 Dec;16(2):822-827. Kher U, Ioannou A, Kumar T, Siormpas K, Mitsias ME, Mazor Z, Kotsakis GA. A clinical and radiographic case series of implants placed with the Simplified Minimally Invasive Antral Membrane elevation technique in the posterior maxilla J Craniomaxillofac Surg 2014 Dec;42(8):1942-1947. Kotsakis GA, Chrepa V, Marcou N, Prasad H, Hinrichs J. Flapless alveolar ridge preservation utilizing the "socket-plug" technique: clinical technique and review of the literature J Oral Implantol 2014 Dec;40(6):690-698. Siormpas K, Mitsias M, Kontsiotou-Siormpa E, Garber D, Kotsakis GA. Immediate implant placement in the esthetic zone utilizing the "root-membrane" technique: clinical results up to 5 years post-loading Int J Oral Maxillofac Implants 2014 Nov;29(6):1397-1405. Kotsakis GA, Konstantinides J, Karoussis I, Ma X, Chu H. A systematic review and meta-analysis of the effect of laser therapy in the treatment of peri-implantitis J Periodontol 2014 Sep;85(9):1203-1213. Chrepa V, Kotsakis GA, Pagonis TC, Hargreaves KM. The effect of photodynamic therapy in root canal disinfection: a systematic review J Endodontics 2014 Jul;40(7):891-898. Babbush C, Kanawati A, Kotsakis GA, Hinrichs JE. Patient-related and financial outcomes analysis of conventional full-arch rehabilitation versus the All-on-4 concept: a cohort study Implant Dent 2014 Apr;23(2):218-224. Kotsakis GA, Joachim F, Saroff SA, Mahesh L, Prasad H, Rohrer M. Histomorphometric Evaluation of a Calcium-Phosphosilicate Bone Substitute in Extraction Sockets Int J Periodontics Restorative Dent 2014 Mar;34(2):233-239. Kotsakis GA, Maragou T, Ioannou AL, Romanos G, Hinrichs JE. Prevalence of maxillary midline papillae recession and association with interdental smile line: a cross-sectional study (suppl):s81-s87 Int J Periodontics Restorative Dent 2014 Feb;34. Kher U, Mazor Z, Stanitsas P, Kotsakis GA. Implants placed simultaneously with lateral window sinus augmentation utilizing a calcium phosphosilicate putty alloplastic bone substitute for increased primary implant stability: A retrospective study Implant Dent 2014 Jan;23(4):496-501. Kotsakis GA, Salama M, Chrepa V, Hinrichs J, Gaillard P. A randomized, blinded, controlled clinical study of particulate Anorganic Bovine Bone Mineral and Calcium Phosphosilicate Putty bone substitutes for alveolar ridge preservation Int J Oral Maxillofac Implants 2014 Jan;29(1):141-151.