Periodontitis is a widespread disease, associated with challenges both in its diagnosis and in selecting from various therapeutic approaches, which do not always yield the expected success. This literature review was conducted to explore diverse therapeutic approaches, especially those focused on nanotechnologies, and their potential contribution to the successful modulation of the host’s response. The effects of the existing microbial diversity and the imbalance of key microbial species in contributing to the progression and worsening of the host’s response in periodontitis are well known. It is essential to understand the role of a well-structured treatment plan for periodontitis, providing opportunities for new research and innovative treatment strategies aimed at reducing the impact of periodontitis on oral and overall systemic health. This will be beneficial for dental professionals, enabling them to effectively prevent and treat periodontitis, ultimately improving the overall health and well-being of patients.

Background: The interdental papilla plays a critical role in maintaining both the esthetic and functional integrity of the periodontium. Although the relationship between the papilla presence and the contact point–bone crest distance is well established, the impact of vertical bone defect morphology—common in periodontitis—remains largely unexplored. Aim: To assess the relationship between the loss of interdental papilla height and three site-specific factors—vertical bone defect morphology, probing depth, and papilla base width—in patients with periodontitis. Materials and Methods: Ten periodontitis patients contributing 28 interdental papillae adjacent to vertical bone defects were included. The recorded parameters included probing depth, papilla base width, and loss of papilla height. Intraoperative measurements of defect depth, mesiodistal width, and buccolingual width were also obtained. Patient-level variables, such as age, sex, oral hygiene, and gingival phenotype, were not controlled or included in the analysis, due to the small number of participants and the study’s focus on defect-level characteristics. Spearman’s rank correlation was used due to non-normal data distribution. Results: A moderate positive association was observed between the probing depth and loss of papilla height (ρ = 0.353), approaching but not reaching statistical significance (p = 0.066). Weak, non-significant associations were found with the remaining parameters (p > 0.05). Conclusions: Although no statistically significant associations were found, observed trends may indicate site-specific influences on the loss of papilla height. These preliminary findings highlight the need for further research with larger, well-characterized cohorts to better understand the factors affecting papilla stability in periodontitis.

Periodontitis is a prevalent chronic inflammatory disease with complex etiopathogenesis involving microbial dysbiosis, host immune response, environmental factors, and genetic susceptibility. Among the cytokines implicated in periodontal immunoregulation, interleukin-35 (IL-35) has emerged as a novel anti-inflammatory mediator with potential diagnostic and therapeutic relevance. This narrative review evaluates the role of IL-35 in periodontal disease by exploring its local and systemic expression, response to non-surgical periodontal therapy (NSPT), and association with clinical disease severity. Additionally, current evidence regarding IL-35 gene polymorphisms and their potential contribution to individual susceptibility and disease progression, as well as their relevance in related systemic conditions, is assessed. A comprehensive review and synthesis of recent clinical and experimental studies were conducted, focusing on IL-35 levels in saliva, serum, and gingival crevicular fluid (GCF) among patients with healthy periodontium, gingivitis, and various stages of periodontitis, both before and after NSPT. Emphasis was placed on longitudinal studies evaluating IL-35 dynamics in correlation with periodontal parameters, as well as genetic association studies investigating IL-12A and EBI3 gene polymorphisms. IL-35 levels were generally found to be higher in healthy individuals and reduced in periodontitis patients, indicating a possible protective role in maintaining periodontal homeostasis. Following NSPT, IL-35 levels significantly increased, corresponding with clinical improvement and reduced inflammatory burden. Genetic studies revealed variable associations between IL-35 polymorphisms and susceptibility to periodontitis and related systemic conditions, although further research is needed for validation. IL-35 appears to function as a modulator of immune resolution in periodontal disease, with potential utility as a non-invasive biomarker for disease activity and therapeutic response. Its upregulation during periodontal healing supports its role in promoting tissue stabilization. The integration of cytokine profiling and genetic screening may enhance personalized risk assessment and targeted interventions in periodontal care.

The regeneration of lost periodontal tissues due to periodontal disease remains a difficult clinical challenge. As clinicians, we look for procedures with improved predictability, beneficial impact on the treatment of periodontal disease, and in the long term – improvement of prognosis of the involved teeth. Various types of grafting materials with substantial research evidence reporting on their efficacy have been introduced in regenerative periodontal therapy based on their ability to facilitate the reconstruction of the lost supporting apparatus. Consequently, the periodontal regeneration of intrabony defects involves not only the experience and skills of the clinicians but also the selection of suitable regenerative material. The type of tissue filling in a periodontal defect after surgical treatment can only be precisely evaluated by histological means, and it is restricted to a few cases due to ethical reasons. Histologic studies have demonstrated regeneration potential for GTR, allografts, xenografts and growth factors. And since the periodontal regeneration includes the regrowth of alveolar bone, by using radiographs, changes of the alveolar crest may be used to monitor periodontal healing. Our case series present the radiographic evaluation of the bone fill of 6 vertical bone defects treated with Cerabone®. The xenograft Cerabone® is a 100% pure bone mineral of bovine origin that has been successfully applied in regenerative dentistry and has been in use for more than 15 years in various medical applications (e.g. craniofacial surgery, oncology and hand and spine surgery).

Aim: Dental implants are a reliable solution for replacing missing teeth and restoring oral health. Despite their high survival rates, complications such as peri-implant mucositis and peri-implantitis remain common challenges. This underscores the importance of assessing implant success not only in terms of stability but also by preserving healthy peri-implant tissues. The review consolidates recent findings on the peri-implant microbiome and examine its relationship with the dental microbiome under both healthy and diseased conditions. Methods: For the present review a search was conducted on PubMed, Google Scholar, and ScienceDirect. Results: Modern microbial identification techniques have uncovered new species previously unknown or not considered in the context of periodontal infection. It is now understood that the peri-implant biofilm, both in health and disease, is not as similar to that on teeth as previously thought. The implant biofilm is directly influenced by the implant material, the implant-abutment connection, the implant surface, as well as the biofilm present in the patient’s mouth. Conclusion: The submucosal microbiota of peri-implantitis lesions has not been extensively studied using culture-independent techniques and our understanding of the microbial profile associated with peri-implantitis remains incomplete.