Periodontitis is a significant independent risk factor for atherosclerosis. Yet, the exact mechanism of action is still not fully understood. In this study, we investigated the effect of exosomes‐miR‐155‐5p derived from periodontal endothelial cells on atherosclerosis in vitro and in vivo. Higher expression of miR‐155‐5p was detected in the plasma exosomes of patients with chronic periodontitis (CP) and carotid atherosclerosis (CAS) compared to patients with CP. Also, the expression level of miR‐155‐5p was associated with the severity of CP. miR‐155‐5p‐enriched exosomes from HUVECs increased the angiogenesis and permeability of HAECs and promoted the expression of angiogenesis, permeability, and inflammation genes. Along with the overexpression or inhibition of miR‐155‐5p, the biological effect of HUVECs‐derived exosomes on HAECs changed correspondingly. In ApoE−/− mouse models, miR‐155‐5p‐enriched exosomes promoted the occurrence of carotid atherosclerosis by increasing permeable and angiogenic activity. Collectively, these findings highlight a molecular mechanism of periodontitis in CAS, uncovering exosomal miR‐155‐5p derived periodontitis affecting carotid endothelial cells in an ‘exosomecrine’ manner. Exosomal miR‐155‐5p may be used as a biomarker and target for clinical intervention to control this intractable disease in future, and the graphic abstract was shown in Figure .

We investigated how two equal-average-power thulium fiber laser (TFL) regimens differ in vapor-bubble development. Regimens combining measured tip energies of 25 mJ at 100 Hz with a 1000 μs set duration (S1) and 10 mJ at 250 Hz with a 400 μs set duration (S2), both 2.5 W, were compared as whole regimens using 200, 275, 365 and 550 μm fibers. Shadowgraphy at 200,000 frames/s with 0.25 μs exposure captured 192 events from 64 independent recordings. Full-contour measurements with recording-specific calibration characterized area, timing, shape and directional expansion. Recording-level Welch tests and heteroscedastic interaction models used Holm-adjusted families. Maximum-area S2/S1 ratios were 0.917, 0.730, 0.749 and 0.639 (adjusted p < 0.001 at the three larger diameters). S2 reached maximum area earlier with smaller maximum axial extents at every diameter and higher mean-positive transverse extent rates at 200–365 μm over the full measurable event window. Circularity and solidity at maximum area and peak-positive axial extent rate depended on fiber diameter (Holm-adjusted interaction p = 0.0168, 0.0086 and 0.0135). Equal-average-power TFL excitation produced different bubble timing and directional growth—a matched-power description of the vapor source underlying laser-activated irrigation. Because pulse energy, repetition frequency and duration differed together, the findings describe whole-regimen responses, not single-parameter effects.