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Advances in Periodontitis and Other Periodontal Diseases

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (20 December 2025) | Viewed by 4893

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Dr. Giovanna Murmura

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Unit of Prosthodontics, Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
Interests: dentistry; oral surgery; periodontology; ozone therapy; periodontal treatment

Special Issue Information

Dear Colleagues,

For decades, periodontitis has been considered a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were each studied separately, and subsequently, relationships were shown. The associations of periodontitis with morbidities, such as cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, and respiratory diseases, have been demonstrated. As most such studies were cross-sectional in nature, questions about causality cannot be univocally answered. Also, periodontitis as an independent risk factor for one systemic disease becomes even more difficult to assess, since recently periodontitis has also been associated with multimorbidity. Periodontitis and many systemic diseases share environmental, lifestyle, and genetic risk factors, and share immunopathology. The purpose of this Special Issue is to highlight recent findings on periodontal disease and new correlations with systemic diseases.

Dr. Giovanna Murmura
Guest Editor

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Keywords

periodontal diseases
gingivitis
periodontitis
systemic disease
classification

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Published Papers (7 papers)

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Research

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14 pages, 829 KB

Open AccessArticle

Topical and Mucoadhesive Administration of Capsaicin in the Burning Mouth Syndrome Treatment

by Jacek Zborowski, Bożena Karolewicz, Arleta Dołowacka-Jóźwiak, Dawid Bursy, Krzysztof Słotwiński and Tomasz Konopka

J. Clin. Med. 2026, 15(2), 780; https://doi.org/10.3390/jcm15020780 - 18 Jan 2026

Viewed by 213

Abstract

Background/Objectives: Burning Mouth Syndrome (BMS) is a common oral condition in older women and is characterized by a multifactorial etiology. To date, no standardized treatment strategy has been established. The aim of this study was to evaluate the effectiveness of topical application of capsaicin (0.025 mg/cm²) in the form of a mucoadhesive bilayer polymer reducing burning sensations in BMS. The study assessed levels of depression, sleep disturbances, and quality of life. Material and Methods: The proof-of-concept study included 29 patients with symptoms of BMS. The peripheral origin of BMS was confirmed by lingual nerve block. Pain intensity was assessed using the Numeric Rating Scale (NRS-11) and the Short-Form McGill Pain Questionnaire (SF-MPQ). Depression, sleep disturbances, and quality of life were evaluated using the Beck Depression Inventory (BDI), Athens Insomnia Scale (AIS), and WHO Quality of Life Questionnaire (WHOQoL). Results: A reduction in pain was observed in over 86% patients. Decrease in burning at treatment sites was recorded immediately after treatment and also at the 3-month follow-up. Gender, taste disturbances, depression, and age were found to have a significant effect on final NRS-11 scores. Conclusions: Significant reduction in pain intensity was achieved in nearly all treated patients, with adverse effects being rare. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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14 pages, 3177 KB

Open AccessArticle

Effects of Subcutaneous Administration of Glucocorticoids by Pellets on a Mouse Model of Ligature-Induced Periodontal Disease

by Rintaro Kato, Takuma Sato, Shunsuke Kako, Masako Tabuchi, Yuki Aoki, Kai Kataoka, Sho Okuni, Yoshihiko Sugita, Hatsuhiko Maeda and Ken Miyazawa

J. Clin. Med. 2025, 14(22), 8251; https://doi.org/10.3390/jcm14228251 - 20 Nov 2025

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Abstract

Background/Objective: Glucocorticoids (GC) have anti-inflammatory effects, but long-term use can suppress bone formation and cause osteoporosis. The impact of inflammatory environments, such as periodontitis, on alveolar bone metabolism remains insufficiently understood. Methods: We used wild-type (C57BL/6J, n = 47) mice to compare glucocorticoid (GC) effects with and without sustained-release GC pellets. Mice were divided into GC-administered (2 weeks: n = 8; 4 weeks: n = 8; 8 weeks: n = 7) and non-GC-administered groups (2 weeks: n = 8; 4 weeks: n = 8; 8 weeks: n = 8). A ligature wire was placed around the left first molar of all mice to induce periodontal disease, while the right first molar served as a control. Femur and alveolar bone changes were assessed at 2, 4, and 8 weeks using μCT, HE staining, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemistry (TNF-α). Anonymized evaluators performed histological analyses, and statistical analyses. One-way ANOVA with the Tukey post hoc test and t tests. Results: GC administration significantly reduced femoral bone mass at 2, 4, and 8 weeks. In mice without ligature, GC administration did not significantly affect alveolar bone mass or osteoblast number at 2 or 4 weeks, but a reduction was noted at 8 weeks post-treatment. No significant differences in osteoclast numbers or TNF-α levels were observed after GC administration. In a periodontal disease mouse model, GC administration led to greater bone loss, fewer osteoblasts, and increased osteoclasts and TNF-α levels. Conclusions: GC use in periodontal disease risks abnormal bone metabolism and progressive alveolar bone resorption. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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11 pages, 991 KB

Open AccessArticle

Effect of Leukocyte- and Platelet-Rich Fibrin on Peri-Implant Mucosal Thickness in Edentulous Patients Treated with Mandibular Implant-Retained Overdentures: A Randomized Controlled Trial

by Ximena Moreno, Patricio Neira, Franz J. Strauss, María Ignacia Mery, Reinhard Gruber and Franco Cavalla

J. Clin. Med. 2025, 14(19), 6917; https://doi.org/10.3390/jcm14196917 - 29 Sep 2025

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Abstract

Background/Objectives: The maintenance of peri-implant soft tissue health is critical for the long-term success of implant therapy, particularly in edentulous patients rehabilitated with mandibular overdentures. Leukocyte- and platelet-rich fibrin (L-PRF) has been proposed as an autologous biomaterial to enhance peri-implant tissue quality. This randomized controlled clinical trial evaluated the effect of L-PRF on peri-implant mucosal thickness in edentulous patients treated with mandibular implant-retained overdentures. Methods: Edentulous patients received two interforaminal implants to retain a mandibular overdenture and were randomly assigned to a test group (L-PRF applied during surgery) or a control group (standard protocol without L-PRF). Clinical measurements of keratinized mucosal thickness and width were recorded at baseline, 12 weeks, and 24 weeks. Volumetric analyses of soft and hard tissue changes were performed using digital superimposition of STL models. The trial was conducted in accordance with the Declaration of Helsinki and approved by the Scientific Ethics Committee of the Aconcagua Health Service. All participants provided written informed consent. Results: A significant increase in keratinized mucosal thickness was observed in the L-PRF group at 12 and 24 weeks compared with baseline (p < 0.01). No significant differences were detected between the groups in soft tissue volume (p = 0.12) or bone volume (p = 0.45). Mucosal width remained stable in both groups throughout follow-up. Conclusions: The application of L-PRF at implant placement resulted in a significant gain in peri-implant mucosal thickness, suggesting a soft tissue modulating effect. Enhancing keratinized mucosal thickness during implant surgery may improve peri-implant tissue quality and support long-term stability of mandibular overdentures. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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14 pages, 1398 KB

Open AccessArticle

Correlation Between Fungal and Bacterial Populations in Periodontitis Through Targeted Sequencing: A Pilot Study

by Jacob Ayers, Jennifer Chinnici, Amarpreet Sabharwal, Pinar Emecen-Huja, Hua-Hong Chien, Shilpi Joshi and Abhiram Maddi

J. Clin. Med. 2025, 14(18), 6418; https://doi.org/10.3390/jcm14186418 - 11 Sep 2025

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Abstract

Background and Objective: The oral microbiome plays an important role in oral health and disease, including periodontitis, which affects about 40% of the adult population in the United States. Bacterial pathogens have been well studied and documented in their relationship with periodontitis; however, the role of fungi in periodontitis is still unclear. The purpose of this study is to determine the relationship of specific fungal species with periodontal pathogenic bacteria in healthy, mild periodontitis, and severe periodontitis patients. Methods: In this study, human participants were recruited, and saliva samples were collected. Twelve participants representing periodontal health (n = 2), mild periodontitis (n = 3), and severe periodontitis (n = 7) were included. Salivary samples were sequenced for analysis of their mycobiome (ITS sequencing) and microbiome (16s RNA sequencing). Results: A total of 375 species of bacteria and 39 species of fungi were identified among all samples. Clustering was observed for bacteria in healthy and mild periodontitis, but more variability was observed in the severe periodontal disease group. Variability was observed for fungi among all samples and groups. Red complex bacteria were negatively correlated with Candida species for the disease groups, although the correlation was not statistically significant. A significant correlation was observed between red-complex bacteria in the severe periodontal disease group. Additionally, a significant correlation was observed among Candida species in all groups. Conclusions: This pilot study simultaneously processed saliva samples for microbiome and mycobiome sequencing and found a trend towards negative correlation between Candida species and red complex bacteria. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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13 pages, 2221 KB

Open AccessArticle

Association Between Tobacco and Periodontal Disease in Latin America from 2000 to 2024: Cross-Sectional Analysis of Global Burden of Disease Study

by Brenda Herrera-Serna, Olga López-Soto, Héctor Fuentes-Barría, Raúl Aguilera-Eguía, Lissé Angarita-Davila and Diana Rojas-Gómez

J. Clin. Med. 2025, 14(10), 3549; https://doi.org/10.3390/jcm14103549 - 19 May 2025

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Abstract

Objectives: This study aims to examine the ecological-level association between active and passive tobacco use and periodontal disease in Latin America from 2000 to 2024. Methods: A cross-sectional ecological study was conducted using secondary data from the Global Burden of Disease Study. Data from 20 Latin American countries were analyzed, stratified by country, sex, and age group. Multiple regression models were used to assess the relationship between tobacco consumption and periodontal disease prevalence, adjusted for age and sex. Results: The prevalence of periodontal disease was high in both sexes, particularly among individuals older than 55 years. The countries with the highest age-standardized rates were Colombia, Panama, and Costa Rica, with nearly 35,000 cases per 100,000 population. Regression models indicated that passive tobacco exposure explained 90.4% of the variability in women (R² = 0.9041) and 92.5% in men (R² = 0.9253). Active tobacco use showed weaker associations, with R² values of 0.3721 in women and 0.4601 in men. Passive exposure demonstrated better predictive accuracy, with lower Root MSE values (3192.8 and 3261.7). Conclusions: There is a significant ecological-level association between tobacco use and periodontal disease in Latin America, particularly for passive exposure. These findings highlight the need to strengthen tobacco control policies and preventive strategies targeting environmental exposure. However, due to the ecological nature of the study, these associations do not imply causality at the individual level. Longitudinal studies with individual-level data are needed to explore the underlying biological and contextual factors. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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Review

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17 pages, 839 KB

Open AccessReview

Adjunctive Use of Platelet-Derived Concentrates (Platelet-Rich Plasma, Platelet-Rich Fibrin, Concentrated Growth Factor, Platelet-Poor Plasma) in Non-Surgical Periodontal Therapy: Current Evidence and Comparative Analysis

by Sebastian Gawlak-Socka, Kinga Jeżewska, Natalia Bielecka-Kowalska and Sebastian Kłosek

J. Clin. Med. 2026, 15(2), 554; https://doi.org/10.3390/jcm15020554 - 9 Jan 2026

Viewed by 264

Abstract

Background: Periodontitis is a multifactorial, chronic inflammatory disease that leads to progressive destruction of the periodontal apparatus. Despite the effectiveness of scaling and root planing (SRP), residual inflammation and limited regenerative potential justify the search for adjunctive biologic therapies. Platelet-derived concentrates, including platelet-rich plasma (PRP), platelet-rich fibrin (PRF), concentrated growth factors (CGF), and platelet-poor plasma (PPP), have gained attention as autologous sources of growth factors enhancing periodontal regeneration. Aim: This narrative review provides a comparative analysis of the biological mechanisms, preparation protocols, and clinical outcomes associated with the adjunctive use of platelet-derived concentrates in non-surgical periodontal therapy. Methods: A narrative literature review was conducted using English-language publications retrieved from PubMed and Google Scholar, covering studies published from 2012 onward. The search strategy was based on combinations of keywords related to platelet-derived concentrates and non-surgical periodontal therapy. In vitro, in vivo, and clinical studies, as well as relevant narrative, systematic, and umbrella reviews evaluating the adjunctive use of platelet-derived concentrates (PRP, PRF, CGF, and PPP) were considered. Studies focusing on biological mechanisms, preparation protocols, and clinical periodontal outcomes were included, whereas case reports, studies unrelated to periodontal therapy, and publications lacking relevant clinical or biological outcome data were excluded. Results: Most clinical studies reported improvements in probing depth reduction, clinical attachment level gain, and bleeding indices following adjunctive use of platelet-derived concentrates with SRP. PRF tended to demonstrate more consistent clinical outcomes compared to PRP, potentially related to its simplified preparation and sustained release of bioactive molecules. CGF showed promising osteogenic and angiogenic properties in preclinical and early clinical studies. PPP, although less extensively investigated, exhibited regenerative and antimicrobial potential in preliminary reports. Conclusions: Platelet-derived concentrates may serve as valuable adjuncts in non-surgical periodontal therapy; however, the current evidence is characterized by methodological heterogeneity and variable study quality. While PRF appears to yield more consistent clinical results, definitive conclusions regarding superiority among different platelet concentrates cannot be drawn. Further well-designed randomized controlled trials are required, particularly for CGF and PPP. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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Other

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22 pages, 2195 KB

Open AccessCase Report

Clinical Soft Tissue Adaptation to Biomechanical Modulation with the Bone Protection System (BPS): A Two-Case Report in Thin-Biotype Patients

by Anna Ewa Kuc, Jacek Kotuła, Kamil Sybilski, Grzegorz Hajduk, Joanna Lis, Beata Kawala, Michał Sarul and Magdalena Sulewska

J. Clin. Med. 2026, 15(2), 721; https://doi.org/10.3390/jcm15020721 - 15 Jan 2026

Viewed by 205

Abstract

Background: Patients with a thin gingival phenotype and a narrow buccal alveolar plate are highly susceptible to periodontal complications during orthodontic expansion. Traditional biomechanics often fail to maintain root control in thin alveolar housing. This report presents two clinical cases illustrating soft- and hard-tissue responses to a novel biomechanical approach, the Bone Protection System (BPS), designed to reduce buccal cortical overload during expansion. Case Presentation: Two adult patients with a thin gingival phenotype assessed by a standardized periodontal probe transparency test and narrow alveolar ridges underwent orthodontic expansion. Patient 1 was treated with the full BPS protocol in both arches. Patient 2 received BPS only in the maxilla, while the mandible was treated conventionally, creating an intra-individual control model under identical systemic conditions. Soft-tissue phenotype and cortical plate response were evaluated clinically and radiographically when applicable. Results: In Patient 1 clinically, the vestibular phenotype showed clear thickening and stabilization. In Patient 2, the maxillary arch treated with BPS exhibited progressive thickening of the vestibular phenotype, whereas the mandible treated conventionally presented thinning and increased translucency—features consistent with buccal compression in thin alveolar bone. No soft- or hard-tissue augmentation procedures were performed in either case. Conclusions: The Bone Protection System may contribute to improved periodontal safety during orthodontic expansion in thin-biotype patients by reducing buccal cortical loading and supporting adaptive soft-tissue and bone responses. Preliminary observations suggests that BPS has potential value for possibly expanding the biological limits of safe tooth movement. Further studies on larger cohorts are warranted. Full article

(This article belongs to the Special Issue Advances in Periodontitis and Other Periodontal Diseases)

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