This study assessed whether periodontitis stage and grade are associated with long-term implant survival in periodontally compromised patients. A retrospective analysis was conducted among 362 periodontitis patients who received 1106 implants at the University Clinic Münster, Germany, with a median follow-up of 85.5 months (range: 3.6-236.4). Periodontitis stage and grade were assessed based on clinical and radiographic data at the first clinical visit. Kaplan-Meier curves and Cox regression models were used to analyze implant survival. A total of 85 implants (7.69%) failed, with nearly half of these losses occurring within the first six months (failed osseointegration). Cumulative survival rates were 95.8% at 60 months, 91.1% at 120 months, and 82.6% at 180 months. Grading, but not staging, was significantly associated with implant loss. Patients classified as grade C had a higher risk of implant loss at any given time during follow-up than patients with grade A or B (hazard ratio = 2.78; 95% confidence interval: 1.18-6.54). Our findings demonstrate that periodontitis, particularly in terms of grading as defined by the current classification, is a significant risk factor for implant loss, even in patients undergoing periodontal therapy. Both clinicians and patients should consider these risk factors during treatment planning, as they can substantially impact implant survival. Nevertheless, dental implants remain a reliable and predictable therapeutic option, even for patients with severe periodontitis.

This study evaluates changes in cross-national disparities in the burden of severe periodontitis between 1990 and 2021. All data on severe periodontitis used in this study were derived from the 2021 Global Burden of Disease (GBD) study. Annual years lived with disability (YLDs) and their estimated annual percentage changes (EAPCs) were calculated and stratified by year, age, geographical region, and socio-demographic index (SDI) at global, regional, and national levels. Decomposition analysis assessed the contributions of demographic and epidemiological factors to the evolving burden of severe periodontitis. A frontier analysis identified areas for improvement and disparities among countries based on development levels. Distributional inequalities were measured using the slope index of inequality (SII) and concentration index. The autoregressive integrated moving average model (ARIMA) was used to project the disease burden up to 2036. In 2021, there were 6,903.28 thousand YLDs (95% uncertainty interval [UI]: 2,772.28−14,106.18 thousand) attributed to severe periodontitis globally. Between 1990 and 2021, the global age-standardized rate (ASR) of YLDs showed a stable trend, increasing slightly from 79.62 (95% UI: 31.46–169.62) to 80.89 (95% UI: 32.47–165.37) with an EAPC of 0.08% (95% confidence interval [CI]: −0.03 to 0.18). Population growth accounted for 66.73% of the global increase in YLDs. SII values rose from 12.72 (95% CI: 1.92–23.52) in 1990 to 44.99 (95% CI: 31.14–58.85) in 2021, while the concentration index decreased from 0.05 (95% CI: −0.04 to 0.13) in 1990 to 0.035 (95% CI: −0.06 to 0.13). According to the forecasts, the global ASR of YLDs for severe periodontitis is projected to show a slight decline over the next 15 years. Significant potential exists for reducing the burden of severe periodontitis across countries, irrespective of their development levels. Severe periodontitis remains a significant global health challenge, with substantial cross-country disparities that persist despite overall stable trends in global YLDs. Targeted interventions and policies are urgently needed to address these disparities, focusing on improving oral health outcomes across all countries, regardless of their socio-demographic development levels.

Self-reported periodontitis: A multiethnic community-based validation study.

Chronic kidney disease (CKD) is relatively common in patients with rheumatoid arthritis (RA). Periodontitis and periodontopathic Porphyromonas gingivalis are risk factors for CKD. However, the association of serum immunity to P. gingivalis and its peptidylarginine deiminase (PPAD), as well as periodontitis severity, with CKD in relation to RA has not been elucidated. The present study evaluated whether or not serum immunoglobulin G (IgG) titers against P. gingivalis and PPAD and periodontitis severity are associated with CKD in patients with RA and periodontitis. Demographic, comorbidity, rheumatologic, and periodontal data were collected from 127 patients with RA and periodontitis in a retrospective cohort study. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 and/or proteinuria of ≥ 3 months' duration. Serum IgG titers against P. gingivalis and PPAD were determined using an electrochemiluminescence immunoassay. Twenty patients showed an eGFR < 60 mL/min/1.73 m2, while no patients had proteinuria. The 20 CKD patients were significantly older (p = 0.002), had higher percentages of former smokers (p = 0.01), had more sites with probing depth and clinical attachment level ≥ 4 mm (p = 0.03 and p = 0.02), and had higher levels of serum creatinine and eGFR (p < 0.001 for both) and anti-P. gingivalis IgG titers (p = 0.04) than the 107 non-CKD patients. A significant association was observed between anti-P. gingivalis IgG titers and eGFR (p < 0.001 for both) by bivariate and multivariate analyses and between anti-P. gingivalis IgG titers and CKD (p < 0.001) using a multiple logistic regression analysis after adjusting for age, gender, smoking status, comorbidity, RA condition, and RA-related drugs. These results suggest that serum IgG titers against P. gingivalis, but not against PPAD, are associated with CKD in patients with RA and periodontitis.

Chronic cannabis use has become increasingly prevalent due to its medicinal and recreational applications, necessitating a comprehensive understanding of its impact on oral and periodontal health. This review explores the multifaceted effects of cannabis consumption, focusing on periodontal health, salivary gland function, oral microbiome alterations, wound healing, and associated risks of oral cancer. Chronic cannabis use is linked to higher prevalence and severity of periodontitis, driven by its influence on inflammatory pathways and immune modulation. Salivary gland dysfunction resulting in xerostomia compromises oral health, increasing the risk of dental caries and mucosal infections. Changes in the oral microbiome, characterized by dysbiosis, contribute to periodontal disease progression and peri-implant complications. Furthermore, while cannabinoids offer therapeutic potential due to their anti-inflammatory and analgesic properties, chronic use poses significant risks, including delayed wound healing and increased oral cancer susceptibility. This review underscores the dual role of cannabis as both a therapeutic agent and a risk factor, emphasizing the need for further research to optimize clinical management strategies for cannabis users and improve oral health outcomes.

Objective: To investigate the correlation between periodontitis staging and plaque stability in patients with carotid artery stenosis (CAS). Methods: Clinical data of patients with CAS combined with periodontitis who underwent carotid endarterectomy in the Department of Vascular Surgery, Nanjing Drum Tower Hospital, from January 2020 to December 2024 were retrospectively collected. All patients underwent preoperative carotid computed tomography angiography (CTA), cone-beam computed tomography (CBCT) of the jaw, and laboratory tests of biochemical indices. Periodontitis staging was assessed according to CBCT findings. Based on pathological examination of carotid plaque specimens, patients were divided into a stable plaque group (n=233) and a vulnerable plaque group (n=175). Multivariable logistic regression analysis was used to examine the association between periodontitis staging and plaque stability. Furthermore, receiver operating characteristic (ROC) curves were drawn to evaluate the efficacy of periodontitis staging and related indicators in predicting plaque stability. Results: A total of 408 patients were enrolled with the age of (67±8) years, including 286 men and 122 women. The stable plaque group aged (67±9) years consisted of 156 men and 77 women, while the vulnerable plaque group aged (69±9) years included 130 men and 45 women. Multivariate analysis revealed that elevated interleukin-6 (IL-6) levels (OR=1.18,95%CI:1.08-1.30), higher C-reactive protein (CRP) levels (OR=1.10,95%CI: 1.03-1.18) and moderate to severe periodontitis stage (moderate periodontitis: OR=1.58, 95%CI: 1.12-2.23; severe periodontitis: OR=2.26, 95%CI: 1.72-3.45), were risk factors for carotid plaque vulnerability. ROC curve analysis demonstrated that when periodontitis severity was moderate or higher, the area under the curve (AUC) of periodontitis stage for predicting plaque stability was 0.75 (95%CI:0.71-0.79,P<0.001), with a sensitivity of 76% and a specificity of 64%. Conclusions: Periodontitis staging is closely associated with plaque stability in patients with CAS. Patients with moderate to severe periodontitis are more likely to have vulnerable carotid plaques.

Non-surgical treatment of peri-implantitis with submarginal erythritol air-polishing in severe periodontitis patients: a randomized controlled trial.

PurposeThis study investigated the association between periodontitis and oral HPV infection, while exploring the role of oral bacterial microbiota diversity.Methods and MaterialsData from 4,685 adults in the NHANES 2009–2012 cycles were analysed. Periodontitis was defined based on clinical examination, and oral HPV infection was identified using PCR from oral rinse samples. Multivariable logistic regression models were employed to assess the relationship, adjusting for body mass index (BMI), age, sex, ethnicity, education, smoking, alcohol consumption, daily dental flossing, and history of systemic diseases. Subgroup analyses were stratified by age, sex, and education. Mediation analysis was performed to evaluate whether the oral microbiome acts as a mediator in the relationship between periodontitis and oral HPV infection.ResultsNo statistically significant overall association was found between periodontitis and oral HPV infection (P > 0.05). However, females with moderate to severe periodontitis exhibited increased odds of oral HPV infection (P < 0.05). Oral HPV infection was associated with greater microbial diversity (higher operational taxonomic units [OTUs]). No significant mediating effect of the oral microbiome was observed.ConclusionModerate to severe periodontitis appears to be associated with higher odds of oral HPV infection in females. These findings highlight the potential relationship between oral health, microbial diversity, and oral HPV infection.Clinical ImplicationIn the general population, periodontitis does not appear to be a major risk factor for oral HPV; however, female with moderate to severe periodontitis and individuals with higher educati-on showed increased odds of oral HPV infection, suggesting that maintaining periodontal health may be particularly important for HPV related risk management in these subgroups.

BackgroundPeriodontitis is characterized by chronic inflammation and mucosal barrier disruption, which may influence salivary antibody dynamics after systemic vaccination. This study investigated the impact of periodontal disease severity on salivary anti-SARS-CoV-2 antibody responses in vaccinated, non-infected individuals.MethodsSaliva samples were collected from 258 SARS-CoV-2-naïve individuals who had received three vaccine doses. Participants were stratified into three groups based on a standardized oral examination: periodontally healthy controls (n=109), stage I/II periodontitis (n=93), and stage III/IV periodontitis (n=56). Anti-spike IgG, IgA, and sIgA levels were quantified using a validated in-house ELISA.ResultsSalivary anti-spike IgG levels were significantly elevated in both stage I/II (p = 0.0002) and stage III/IV (p < 0.0001) periodontitis groups compared to controls, while IgA and sIgA levels did not differ between groups. IgG levels showed a strong positive correlation with periodontal bleeding scores (r=0.52, p < 0.0001). In contrast, sIgA did not correlate with bleeding (r=0.09, p = 0.12). Analysis of immunoglobulin isotype coordination revealed a strong positive correlation between IgG and IgA in controls (r=0.42, p < 0.0001) and stage I/II periodontitis (r=0.71, p < 0.0001), which was absent in stage III/IV periodontitis (r=0.25, p = 0.06).ConclusionsPeriodontitis was associated with higher salivary anti-spike IgG binding levels, which also showed a strong positive correlation with periodontal bleeding. In contrast, IgA and sIgA binding levels did not differ across periodontal groups. The coordinated relationship between IgG and IgA observed in healthy individuals was disrupted in severe periodontitis. These findings demonstrate distinct alterations in salivary antibody patterns associated with periodontal disease severity following SARS-CoV-2 mRNA vaccination.

Salivary cortisol is widely used to investigate stress–periodontitis interactions, but its measurement is affected by methodological limitations. Cortisone, the predominant salivary glucocorticoid, may offer analytical advantages, yet its role in periodontitis remains unexplored. This study evaluated salivary cortisone in relation to periodontal disease severity and compared its performance with cortisol. Sixty-seven periodontitis patients were classified as Stage I/II (n = 32) or Stage III/IV (n = 35). A comprehensive periodontal examination was performed, including FMPS, FMBS, PPD, CAL, BoP, and the BL/Age ratio. Unstimulated morning saliva samples were analyzed for cortisone and cortisol using liquid chromatography–tandem mass spectrometry, and for IL-1β and IL-6 using ELISA. Both cortisone and cortisol levels were significantly higher in Stage III/IV periodontitis (p = 0.014). Cortisone correlated strongly with cortisol (ρ = 0.523, p < 0.001) and was positively associated with IL-6 (ρ = 0.322, p = 0.008) and multiple clinical indicators of periodontal disease severity. ROC analysis showed comparable discriminatory performance for cortisone and cortisol (AUC = 0.675), with cortisone demonstrating higher specificity (94%) for Stage III/IV periodontitis. Our findings suggest that salivary cortisone performs similarly to cortisol and warrants further investigation as an alternative salivary glucocorticoid marker in periodontal research.

BackgroundOmadacycline is a tetracycline class aminomethylcycline antibiotic FDA-approved for the treatment of community-acquired bacterial pneumonia and acute bacterial skin and skin structure infections in adults (IV or oral). Omadacycline has broad spectrum antibacterial activity against Gram-positive and -negative bacteria, including aerobic, anaerobic and atypical bacteria, and has demonstrated immunomodulatory properties. The objective of this study was to evaluate omadacycline activity against common periodontal pathogens. Severe periodontal disease, inflammation of tissues around the teeth, is estimated by the World Health Organization to affect more than a billion people worldwide. In certain cases, antibiotics are prescribed as adjunct therapy to minimize infection and decrease inflammation, with the most common being tetracyclines, metronidazole, fluoroquinolones, amoxicillin, and macrolides.MethodsBroth microdilution was performed according to CLSI against aerotolerant streptococci and Actinomyces spp. that were able to grow in 5% CO2 atmosphere. Agar dilution was performed according to CLSI for anaerobes. Omadacycline and comparators tetracycline, meropenem, levofloxacin and metronidazole were evaluated against 63 clinical isolates collected from New York, Indiana, Illinois, and California from 2009 to 2018 and 10 ATCC strains. In total, 73 isolates were evaluated across 8 genera: Streptococcus, Actinomyces, Treponema, Fusobacterium, Parvimonas, Prevotella, Peptostreptococcus, and Aggregatibacter.ResultsOmadacycline MIC values ranged from ≤0.03 to 1 µg/mL with median MIC, MIC50, and MIC90 values of 0.12, 0.12, and 1 µg/mL, respectively, against all isolates tested. The omadacycline median MIC, MIC50, and MIC90 results were identical to those of meropenem and lower than those of tetracycline and levofloxacin. Tables 1 - 3.ConclusionOmadacycline demonstrated potent in vitro activity against a diverse collection of periodontal disease pathogens. These in vitro data, combined with other attributes of omadacycline, including immunomodulatory properties, warrant further investigation of omadacycline targeting periodontitis.DisclosuresDiane M. Anastasiou, BS, Paratek Pharmaceuticals, Inc.: Employee Alisa W. Serio, PhD, Paratek Pharmaceuticals, Inc.: Employee

Periodontitis (PD) as chronic inflammatory disease has been linked with the development of atherosclerotic cardiovascular disease (ASCVD). However, there is a lack of data with regard to the association of PD across the extent of ASCVD and clinical outcomes, which we sought to investigate. Randomly recruited participants from the Hamburg City Health Study were included. The cohort was grouped according to severity of ASCVD at baseline: no ASCVD, monovascular disease (MonoVD), and polyvascular disease (PolyVD). PD was assessed categorically by degree of severity and continuously by clinical attachment loss. Logistic regression models were implemented to investigate the association of PD with prevalent ASCVD subtypes. Kaplan-Meier curves and Cox regression analyses were computed to investigate the associations of clinical attachment loss with major adverse cardiovascular events (composite of all-cause death, myocardial infarction, ischemic stroke, any unplanned coronary revascularization, and new diagnosis of cerebrovascular disease or peripheral arterial disease) across the extent of ASCVD. Across the 6,209 individuals included (n = 3,049, no ASCVD; n = 2,283, MonoVD; n = 877, PolyVD), participants with PolyVD had the highest rates of severe PD. On binary logistic regression analysis, severe PD was independently associated with MonoVD (odds ratio, 1.32; 95% CI, 1.09 to 1.61; P = 0.005) and PolyVD (odds ratio, 1.57; 95% CI, 1.16 to 2.13; P = 0.004). During a median follow-up of 5.5 y (95% CI, 5.3 to 5.6), a trend toward higher major adverse cardiovascular event rates was observed in individuals with ASCVD and the highest clinical attachment loss tertile. However, no independent association of mean clinical attachment loss with adverse events was noted. PD is highly prevalent in patients with more extensive ASCVD, and severe PD is associated with MonoVD and PolyVD. However, no association of PD with major adverse cardiovascular events was noted. These data suggest that PD may be associated with cardiovascular risk in the population.

Periodontal disease, a chronic inflammatory condition affecting the supporting tissues of the teeth, has shown significant links with various systemic diseases. This study aimed to analyze the relationship between the severity of periodontitis and the presence of systemic conditions in patients treated at the dental clinics of Universidad San Gregorio de Portoviejo, Ecuador. A cross-sectional observational study was conducted with a sample of 301 patients. Clinical and systemic health data were collected, and the clinical attachment level (CAL) was used as an indicator of periodontal severity. Statistical analysis included non-parametric tests, such as the Chi-square test and the Mann-Whitney test with Bonferroni correction. The results showed a significant association between the presence of systemic diseases and increased periodontal severity (p &lt; 0.001). Specifically, patients with hypertension presented greater clinical attachment loss compared to those without systemic conditions (adjusted p = 0.00063). Although patients with comorbid diabetes and hypertension also exhibited more severe periodontal involvement, this difference was not statistically significant after correction (adjusted p = 0.072). It is concluded that arterial hypertension may act as an aggravating factor in the progression of periodontitis. However, cross-sectional design limits causal inference; therefore, longitudinal studies are recommended to further investigate the pathophysiological mechanisms underlying this association.

Cigarette smoking is a major modifiable risk factor for periodontitis, and its dose–response effect on disease severity warrants focused investigation to guide public health interventions. This cross-sectional study examined the prevalence and dose–response relationship between cigarette smoking and periodontitis severity in 210 male smokers in Benghazi, Libya. Data were collected through clinical examination and a structured questionnaire and analyzed using SPSS version 23. Periodontitis was highly prevalent (87.6%), with 95.65% of cases classified as Grade C. Inferential analysis revealed a signific association between smoking dose and overall disease status (p = 0.005). A strong positive dose–response correlation was observed, whereby periodontitis severity (Stages I–IV) increased with both mean age and mean smoking duration. Additionally, 90.9% of Stage IV patients reported never brushing. These findings highlight the dose-dependent and compounding detrimental effects of smoking on periodontal health.

Periodontitis and smoking are major contributors to oral and systemic health deterioration in aging adults. This study investigated the combined effects of smoking status and periodontitis severity on the subgingival microbiome in 1107 individuals aged 69-72 using shotgun metagenomic sequencing. Smoking was linked to reduced microbial diversity, enrichment of periodontal pathogens, and depletion of health-associated commensals, while increasing periodontitis severity was associated with broader dysbiotic shifts, including enrichment of canonical pathogens. The presence of overlapping taxa suggests shared dysbiotic pathways that may accelerate disease progression in older adults. Notably, the combination of smoking and severe periodontitis was characterized by enrichment of key pathogens, such as Tannerella forsythia, Fusobacterium nucleatum, Actinomyces israelii, and Mogibacterium timidum. Although former smokers showed fewer opportunistic pathogens than current smokers, their microbiomes remained altered compared to never smokers, suggesting persistent differences potentially related to past smoking. Functional profiling revealed largely additive effects of smoking and periodontitis, with enrichment of lipopolysaccharide biosynthesis, proteolysis, and sulfur metabolism, alongside depletion of commensal biosynthetic functions. Overall, the findings highlight the persistent and additive impacts of smoking and periodontitis on the subgingival microbiome, underscoring the importance of addressing both exposures jointly in long-term oral health strategies for older adults.

Generalised periodontitis is a chronic inflammatory disease with a multifactorial pathogenesis, the progression of which is substantially modulated by systemic comorbidities, including atherosclerosis, with which it exhibits shared pathobiological pathways, including chronic systemic inflammation, endothelial dysfunction, and alterations in bone remodelling. Consequently, there is growing interest in investigating genetic factors that may influence the individual severity of periodontitis, particularly in patients with concomitant vascular diseases. Aim: To determine the distribution of of polymorphisms in VDR (BsmI), CASR (A986S), PTH (rs6256), CALCR (C/T), MTHFR (C677T), and OPN (C/T) in patients presenting with generalized periodontitis and concomitant atherosclerosis, and to assess association of these variants with clinical severity of periodontal disease. Materials and Methods. A total of fifteen patients diagnosed with generalized periodontitis and confirmed atherosclerosis were included. Participants were classified according to clinical severity into stages I-II (n = 9) and stages II, II-III (n = 6) periodontitis subgroups. Genotyping of VDR (BsmI), CASR (A986S), PTH (rs6256), CALCR (C/T), MTHFR (C677T), and OPN (C/T) was performed by means of allele-specific triprimer polymerase chain reaction with agarose gel electrophoresis. Genotype frequencies were compared between the two clinical subgroups. This study has a pilot character. The study was conducted in compliance with the principles of the World Medical Association's Ethical Code (Declaration of Helsinki), as confirmed by the conclusion of the Bioethics Committee of the State Institution «Institute of Stomatology and Maxillofacial Surgery of the NAMS» (Protocol No. 1011 dated 14 April 2022). The study forms part of the research project entitled «Correction of Impairments in Osteogenesis Processes in the Treatment and Prevention of Complications of Dental Diseases During Wartime», State Registration No. 0123U103247. Results. A statistically significant association with disease severity was observed exclusively for the CALCR (C/T) polymorphism. The TT genotype was detected in 83.3% of individuals with severe periodontitis, whereas the CT genotype predominated in the I-II stage subgroup. The polymorphisms VDR (BsmI), CASR (A986S), MTHFR (C677T), and OPN (C/T) did not demonstrate a significant association with clinical manifestations. The PTH rs6256 (G&gt;A) polymorphism exhibited a trend towards a higher frequency of the AA genotype in patients with milder forms of periodontitis, which may indicate a potential modulatory effect of the A allele. The universal presence of atherosclerosis across the cohort may have exerted a systemic inflammatory influence capable of modifying the phenotypic expression of genetic variants. Conclusions. The CALCR (C/T) polymorphism may serve as a potential genetic marker predictive of severe generalized periodontitis in patients with concomitant atherosclerosis. No clinically meaningful associations were demonstrated for polymorphisms in VDR, CASR, MTHFR, or OPN. The PTH rs6256 polymorphism demonstrated a trend towards a protective effect of the A allele. The genetic influence on the course of periodontitis may be modified by systemic inflammation associated with atherosclerosis; further studies with larger sample sizes are required.

Periodontal surgery is the core treatment for moderate to severe periodontitis, aiming to control infection, eliminate periodontal pockets, and restore periodontal tissue function. Over the past decade, driven by the integration of digital medicine, tissue engineering, and minimally invasive technology, periodontal surgery has achieved a paradigm shift from "disease control" to "functional regeneration". This systematic review summarizes the latest progress in periodontal surgery, focusing on digital diagnosis and navigation, minimally invasive debridement techniques, periodontal regenerative therapy, and aesthetic periodontal surgery. We also analyze current clinical challenges and future development directions to provide evidence-based support for periodontal clinical practice. A comprehensive literature search was conducted in PubMed, Embase, and Cochrane Library using keywords including "periodontal surgery", "minimally invasive periodontal therapy", "periodontal regeneration", and "digital periodontology". Relevant studies published between 2018 and 2025 were included, and the final analysis covered 40 high-quality articles (randomized controlled trials, systematic reviews, and prospective cohort studies).

Inflammatory periodontal diseases are among the most common dental pathologies and remain one of the leading problems in practical medicine. The high frequency of severe periodontitis, accompanied by pronounced clinical manifestations and systemic disorders, emphasizes the need to study pathogenesis and search for pathogenetically justified therapeutic approaches. The aim of the study was to evaluate the dynamics of clinical indicators, microbiological status, and cytokine profile during the treatment of severe periodontitis in patients from Primorsky Krai. The study included 27 patients (11 men and 16 women) aged 39 to 47 years with a confirmed diagnosis of generalized severe periodontitis. All patients were evaluated twice (before treatment and after 7 days) for clinical indicators of periodontal tissue condition such as simplified oral hygiene index (OHI-s), papillary bleeding index (PBI), papillary-marginal-alveolar index (PMA), approximal plaque index (API), tooth mobility index, and periodontal pocket depth. Bacterial composition was studied using PCR method. Cytokine profile was studied in periodontal pocket exudate using solid-phase ELISA. Statistical data processing was performed using StatTech v. 4.8.11 software. Results showed that the main group of microorganisms in periodontal pocket contents consists of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. After the therapy, a statistically significant increase in the levels of anti-inflammatory cytokines IL-4 (2.5-fold) and IL-10 (2-fold) was noted (p &lt;0.001), reflecting the restoration of regulatory mechanisms of local immune response. Important is the identified correlation between periodontal pocket depth and IL-10 level (ρ=0.397; p=0.04), which allows considering this cytokine as a possible prognostic marker of treatment effectiveness. The obtained results are important not only for clarifying the mechanisms of this pathology development, but also for developing pathogenetically justified approaches to the therapy of generalized severe periodontitis

The aim of this study was to explore the association of severe periodontitis (SP) in middle-aged patients with cognitive dysfunction. Patients with periodontitis were referred to a periodontal examination and underwent neuropsychological testing. We evaluated plaque index (PI), bleeding on probing (BoP), periodontal probing depth (PPD), gingival recession (GR), clinical attachment level (CAL), dental hard tissues, basic medical history data and oral hygiene habits and oral health-related quality of life. A neuropsychological assessment was performed using a battery of 6 tests-Five Words Test (WORDS), Trail Making Test A and B (TMT A and B), Digit Span and Reverse (SPAN and REV), Attention Matrices Test (ATT), Symbol Digit Modalities Test (SDMT) to estimate short-term, long-term and working memory, visual-spatial orientation, mental flexibility, and psychomotor speed. In total, we included 102 participants, 71 with SP and 31 with mild and moderate periodontitis (MP). Increased age, male sex, lower number of teeth and higher Decayed, Missing and Filled permanent Teeth index (DMFT) were more prevalent among SP than MP group. Logistic regression analysis revealed that lower cognitive performance (lower Symbol Digit Modalities Test score) was associated with greater odds of SP (odds ratio [OR]=0.77, confidence interval [CI]=0.64-0.93, p=0.005) indicating the risk for mild cognitive impairment (MCI). In other words, the odds for MCI among patients with SP were 1.29-fold compared to those with MP. Within the study's limitations, our findings indicate that although MCI was not diagnosed, the risk for MCI was associated with SP in middle-aged patients. This study looked at whether middle-aged people with severe gum disease (periodontitis) are more likely to have problems with thinking and memory. Researchers worked with 102 patients, some with severe gum disease and others with milder forms. Each participant had their teeth and gums examined and completed tests that measured memory, attention span, and how quickly they could think and react. The results showed that those with more severe gum disease tended to have worse results on a key test, suggesting a link between gum health and brain function. In fact, people with severe gum disease had a higher chance of displaying symptoms of mild cognitive impairment, a condition that can lead to memory loss and dementia over time. These findings suggest that keeping gums healthy may be important not just for oral health, but also for protecting brain health as we age.

Severe periodontitis is a major cause of tooth loss, and the management of hopeless teeth remains a clinical challenge. Intentional reimplantation has been proposed as a conservative alternative to extraction and prosthetic replacement, but its clinical value in periodontitis-affected teeth has not been fully established. In this study, sixty patients with severe periodontitis, each contributing a single tooth, underwent intentional reimplantation and were followed for 18 months. Clinical examinations and radiographic assessments were performed at 3, 6, 9, 12, and 18 months after surgery. At the final follow-up, 53 teeth were successfully retained, corresponding to a survival rate of 88.3%, with cumulative survival rates of 100%, 96.7%, 95.0%, and 91.7% at 3, 6, 9, and 12 months, respectively. Among the retained teeth, 45 (85.0%) developed ankylosis, and the overall improvement rate in mobility reached 83.3%. Periodontal parameters, including probing depth and adjacent bone loss, were significantly improved compared with baseline values (P < .05). These findings indicate that intentional reimplantation is an effective approach for selected teeth with severe periodontitis, allowing for preservation of natural dentition and restoration of function. Although ankylosis frequently represents the predominant healing modality, the procedure remains clinically valuable and may serve as an alternative treatment when conventional periodontal therapy is inadequate.