Periodontitis and cardiovascular disease share inflammatory, immune, endothelial, oxidative, and lipid-related pathways. Although sex-related differences are well established for many cardiovascular biomarkers, it remains unclear whether sex modifies biomarker patterns at the intersection of periodontal and cardiovascular disease. PubMed, Scopus, and Web of Science were searched in accordance with PRISMA 2020. Eligible adult human studies evaluated periodontitis or periodontal inflammation together with atherosclerotic or related cardiovascular phenotypes and reported candidate biomarkers in blood or, as supportive evidence, oral fluids. High-throughput omics studies were eligible when available. Data on study design, periodontal and cardiovascular assessment, biological matrix, biomarker findings, sex-stratified analyses, and menopausal status were extracted. Twelve studies were included. Most assessed single biomarkers or small predefined panels rather than discovery-scale omics. Reported markers involved inflammation and immunity (CRP, hs-CRP, IL-6, LPS, and periodontal antibodies), endothelial or vascular injury, lipid and autoimmune pathways (PCSK9 and anti-ApoA-1 IgG), innate-immune and metabolic regulation (MBL and SIRT1), cardiac stress, and oxidative stress. Findings were heterogeneous across cardiovascular phenotypes, and several key associations were null or imprecise. Only two studies performed direct male–female comparisons: one enrolled women only, and none stratified women by menopausal status. No study derived and validated a sex-specific omics signature. The literature identifies overlapping candidate-biomarker pathways but does not establish a causal, clinically validated, sex-specific, or menopause-specific signature of periodontitis-associated cardiovascular disease. The current evidence should be considered hypothesis-generating.

Background: Rapid maxillary expansion requires substantial caregiver participation in screw activation, oral hygiene and early recognition of appliance-related problems. Structured education and remote photographic monitoring may support families during the active expansion phase. Methods: This single-center, prospective, preference-based comparative cohort study included 100 children aged 7–11 years requiring rapid maxillary expansion. After receiving standardized information, caregivers independently selected conventional weekly in-office follow-up or an educational telemonitoring pathway comprising illustrated materials, standardized weekly caregiver-taken intraoral photographs acquired at home, clinician-led remote review and feedback and an in-office examination at completion of active expansion or earlier when clinically indicated. Quota-based consecutive recruitment continued until 50 participants were included in each cohort. The primary outcome was the proportion of participants with at least one recorded biological or technical complication during active expansion. All participants underwent the same standardized final in-office clinical examination. Results: All participants completed follow-up. In the telemonitoring cohort, 188 of 200 scheduled photographic sets were submitted, of which 174 (92.6%) were adequate for remote assessment. At least one recorded complication occurred in 12 of 50 participants (24.0%) in the telemonitoring cohort and 23 of 50 (46.0%) in the conventional cohort [unadjusted risk ratio [RR], 0.52; 95% confidence interval [CI], 0.29–0.93; p = 0.021]. Recorded biological complications occurred in 16.0% and 36.0% of participants, respectively (RR, 0.44; 95% CI, 0.21–0.93; p = 0.023), and recorded technical complications in 12.0% and 30.0%, respectively (RR, 0.40; 95% CI, 0.17–0.95; p = 0.027). Mean activation adherence was higher in the telemonitoring cohort (94.8 ± 6.1% vs. 89.3 ± 9.7%; mean difference, 5.5 percentage points; 95% CI, 2.3–8.7; p = 0.001). Child- and caregiver-reported treatment acceptance scores were also higher. Unscheduled in-office visits did not differ significantly between cohorts, and no delayed detection of clinically relevant complications occurred Conclusions: The educational telemonitoring pathway was feasible and associated with fewer recorded complications, higher activation adherence, and greater treatment acceptance. However, because caregivers selected the follow-up pathway, estimates were unadjusted, and interim assessment modalities differed between cohorts, the findings should be considered exploratory and not interpreted as evidence of a causal treatment effect.

Periodontitis is a chronic immune-mediated inflammatory disease of the oral cavity, frequently linked to systemic conditions through complex immunological pathways. Regulatory T lymphocytes (Tregs) are pivotal in maintaining immune homeostasis by producing anti-inflammatory mediators and enforcing self-tolerance. Recent research has highlighted their role in inflammatory, immune-mediated, and neoplastic diseases. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, exploring the role of Tregs in periodontitis, including patients with comorbidities such as type 2 diabetes mellitus, rheumatoid arthritis, atherosclerosis, and cancer, with a focus on cytokine profile alterations and therapeutic implications of Treg modulation. A systematic search of PubMed, Scopus, Web of Science, and Cochrane from January 2015 to August 2025 using “periodontitis” and “Tregs” or “regulatory T cells” yielded 20 studies. Available evidence suggests alterations in the balance between immunomodulatory Tregs and pro-inflammatory Th17 lymphocytes, together with changes in related cytokine profiles compared with healthy controls. Changes in Treg-related immune markers have also been reported following periodontal interventions; however, these findings do not establish a causal role for Treg modulation or support Treg-targeted therapies in current clinical practice. Well-designed prospective studies and, where appropriate, randomized controlled trials are required to strengthen causal and therapeutic inference.