Pathogenetic OptimizationOf InflammatoryPeriodontal DiseaseManagement In PatientsWith Gastrointestinal TractPathology: A Clinical,Immunological, AndMicrobiological Study
European Journal of Prosthodontics and Restorative Dentistry (2026) 34(2s),111–122
Keywordsperiodontitis; gastrointestinal disease; Helicobacter pylori; oral-gut axis; vacuumlaser therapy; Nigella sativa; black seed oil; IL-1β; TNF-α; oral microbiome; periodontal pathogens; immunology
AuthorsAbstractBackground: Inflammatory periodontal diseases represent a global health burden, with growing evidence implicating bidirectional pathogenetic links with gastrointestinal tract (GIT) pathology. The shared microbial and inflammatory mechanisms connecting the oral cavity and digestive system remain incompletely characterized, and targeted therapeutic protocols for patients with concurrent periodontitis and GIT disease are lacking. Objective: To investigate the clinical, immunological, microbiological, and biochemical characteristics of inflammatory periodontal disease in patients with concurrent GIT pathology and to evaluate the efficacy of a novel integrated treatment protocol incorporating vacuum-laser therapy and cold-pressed black seed oil (Nigella sativa) as adjuncts to standard periodontal therapy. Methods: A prospective controlled clinical trial enrolled 182 participants aged 25–80 years, divided into a study group (n=89, periodontitis with GIT comorbidity receiving integrated treatment), a comparison group (n=63, periodontitis without GIT pathology receiving standard treatment), and a healthy control group (n=30). Clinical periodontal indices (GBI, BOP, PPD, CAL, PI, OHI-S), immunological markers (IL-1β, TNF-α, IL-6, salivary sIgA), biochemical parameters (total salivary protein, α-amylase),and microbiological profiles (PCR detection of P. gingivalis, T. forsythia, T. denticola, F. nucleatum, P. intermedia, H. pylori) were assessed at baseline, 7–10 days, 1 month, and 3 months. Results: Patients with concurrent GIT pathology demonstrated significantly elevated inflammatory markers (IL-1β: 142.3±28.4 vs.138.6±26.9 pg/mL; TNF-α: 89.2±18.6 vs. 86.8±17.3 pg/mL) and higher periodontal pathogen detection rates compared to isolated periodontitis. The severity of periodontal inflammation correlated positively with GIT disease severity (r=0.64, p<0.001). After 3 months, the integrated treatment protocol produced significantly greater improvements across all clinical indices (GBI reduction: 72.8% vs. 40.2%), immunological parameters (IL1β reduction: 66.1% vs. 39.2%), and microbiological outcomes compared to standard therapy (p<0.001). Conclusion: Concurrent GIT pathology substantially modifies the clinical and immunological course of periodontal disease. The combination of vacuum-laser therapy and cold-pressed black seed oil as adjuncts to standard periodontal treatment significantly improves clinical, immunological, and microbiological outcomes in this comorbid population. •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.
EJPRD
Copyright © 2026 by Riset Publishing Services LLC