La salute di denti e gengive per il benessere generale dell’organismo

Il sanguinamento e l’abbassamento delle gengive, i danni dentali e dell’osso circostante colpiscono in forma moderata il 40% degli adulti, ed il 35% soffre delle forme gravi di malattie parodontali, come la gengivite e la parodontite (1-6).
Prevenire e trattare precocemente questi disturbi, ad iniziare dalla gengivite, è fondamentale per prevenirne le conseguenze e migliorare lo stato di salute generale della popolazione (5). E’ una recente raccomandazione di due istituzioni mediche, come l’European Federation of Periodontology eWONCAEurope (medici di famiglia)  (5).

Secondo recenti studi le malattie parodontali accelerano l’invecchiamento biologico (6). Esistono inoltre strette connessioni con molte malattie croniche (6), ed un’impatto negativo sulla qualità di vita per motivi clinici e di carattere estetico (7).

L’igiene orale, abitudini di vita, appropriate cure odontoiatriche ecc. sono indispensabile per conservare la salute dei denti e della bocca (4, 5, 6).

Crescenti ricerche sottolineano l’importanza di proteggere e migliorare le difese antiossidanti dell’organismo, ridurre lo stress ossidativo, l’infiammazione ed altri dannosi fenomeni, con un’adeguato apporto di antiossidanti presenti negli alimenti ed in specifici integratori (45, 58, 65, 67, 79).

Disturbi parodontali e precoce invecchiamento

Ad aprile 2025 la rivista Periodontal Science ha pubblicato significative prove genetiche che evidenziano il legame tra parodontite ed accelerazione dell’invecchiamento, attraverso l’esame di oltre 28.000 soggetti (6).

Questo fenomeno viene alimentato da: infiammazione cronica, senescenza cellulare, stress ossidativo, disfunzione mitocondriale, alterazioni  del sistema immunitario, disbiosi orale ed intestinale, predisposizione genetica ecc., notoriamente connessi con molte malattie sistemiche (6, 7-22).

I disturbi parodontali infatti possono contribuire ad aumentare il rischio d’insorgenza di molte malattie croniche (23-28), es.:

- neurodegenerative  (9, 28-32);

- cardiometaboliche (9, 28-41), ad iniziare dall’ipertensione arteriosa (42, 43);

- epatiche, come nel caso della steatosi epatica, con aumento del rischio di complicazioni e mortalità  (44);

- renali (45).

All’origine dei danni gengivali e della strutture che sostengono i denti, le ricerche hanno individuato alcuni fattori critici che ne facilitano l’insorgenza, tra quelli di particolare attualità troviamo:

Insufficienti difese antiossidanti

Le malattie parodontali sono caratterizzate dal significativo abbassamento delle capacità antiossidanti totali, rilevabili dalle analisi del sangue e della saliva di persone che ne sono affette (46-49).

Risultano infatti insufficienti i livelli di antiossidanti fisiologici, come glutatione, albumina, vitamine C, E, D ecc. (50-54).

Secondo numerose ricerche l’insufficiente assunzione di antiossidanti / antinfiammatori, incluse le vitamine, derivanti dall’alimentazione aumenta il rischio dei disturbi della bocca (55-62). 

Obesità, disbiosi intestinale ed orale, malattie cutanee e sistemiche, fumo di tabacco, età ecc, aggravano i meccanismi scatenanti  e l’abbassamento delle difese antiossidanti (46-49, 63).

Viceversa, l’introito di adeguate quantità di sostanze che contrastano l’ossido-infiammazione, es.: carotenoidi, vitamina C, D, E, zinco ecc., abbassa il rischio di periodontite e della malattie croniche associate (58).

Un’obiettivo che può essere raggiunto con un’adeguata alimentazione e/o con l’integrazione di antiossidanti, come  suggerito dalla rivista scientifica BMC Oral Healtha a maggio 2025 (58).

Batteri ed alterazioni dei tessuti e degli organi

Alcuni batteri patogeni (Porphyromonas gingivalis) possono aggregarsi ed aderire a gengive e denti (biofilm batterico), ed innescare i fenomeni immunitari (28, 69, 70, 71), infiammatori-ossidativi (28, 72, 73), danni mitocondriali ecc. (9, 47, 64-68).

Questa sequenza viene aggravata dall’eventuale presenza di malattie (9, 74-77) e senza interventi progredisce verso la cronicizzazione (66, 67, 69, 78-81) che, a sua volta, aumenta il rischio d’insorgenza di malattie croniche (66, 67, 69, 78-93).

Altri fattori di rischio

L’iperglicemia facilità i meccanismi patogenetici citati (67, 94), come altre alterazioni metaboliche aggravate da processi infettivi / infiammatori orali, in corso o di vecchia data (64, 95, 96, 97). 

Le alterazioni del metabolismo dell’omociteina sono connesse con la parondotite (98). L’iperomocisteinemia incrementa lo stato infiammatorio sistemico cronico ed è infatti coinvolta anche nella patogenesi odontostomatologica, oltre ad essere un noto fattore di rischio cardiovascolare e neurodegenerativo (98).

Esisterebbe anche un legame tra stress psico-fisico, livelli di cortisolo salivare e parondotite (99, 100, 101).

Cambiamenti ormonali

Nel peri- e post-menopausa si possono verificare dei cambiamenti di flusso e del pH della salivazione, del gusto, della composizione del microbiota orale, oltre alla riduzione della densità minerale ossea e la sintesi del collagene  (102). 

Tutto questo comporta un aumento del rischio di parodontite e delle sue complicazioni (102-106).

La terapia ormonale sostitutiva contribuirebbe anche alla remissione della parodontite (107, 108). Dopo la menopausa risultano efficaci anche la riduzione del consumo di zucchero e l’adesione ad adeguate abitudini alimentari (77, ).

Nell’uomo adeguati livelli di testosterone libero risulterebbero associati ad un minor rischio di parodontite / perdita di denti (105).

Altri studi hanno individuato l’associazione di bassi livelli di testosterone con alto rischio di parodontite (110, 111).

Inoltre, esisterebbe una correlazione significativa tra malattie parodontali ed alopecia androgenica negli uomini tra i 25 ed i 44 anni, che risulterebbe legata al precoce invecchiamento biologico (112).

Ruolo degli antiossidanti

Per proteggere, riparare e rigenerare i tessuti parondotali,  gli studi clinici confermano i benefici derivanti dall’aumentare le difese antiossidanti e ridurre i fenomeni ossido-infiammatori  (45, 65, 67, 79).

Con questa strategia è possibile prevenire ed alleviare la degenerazione dei tessuti parodontali, oltre alle complicazioni a livello sistemico (45, 65, 67, 79).

Per questo, l’integratore orosolubile Mitofast bit.ly/3VUlGkS, studiato dalla ricerca Mitochon srl https://www.mitochon.it/ per l’antiaging cutaneo e sistemico, ha molti requisiti per proteggere anche la salute della bocca ed attenuarne alcuni disturbi (113, 114).

Per Mitofast si aggiunge il potenziale vantaggio del parziale assorbimento attraverso i tessuti della bocca, essendo orosolubile (113, 114).

Tra gli ingredienti attivi di Mitofast, le continue ricerche mettono in evidenza peculiari vantaggi:

-  coenzima Q10 (61, 62, 97, 115-120) ha dimostrato il miglioramento della salute parodontale (121), anche nelle persone con diabete maggiormente esposte a queste malattie per l’iperglicemia (122).

Ricordiamo il rischio del progressivo declino delle concentrazioni ematiche di coenzima Q10, dovuto all’età, ed altre cause interne ed esterne all’organismo; oltre alla difficoltà di assumerne quantità efficaci dai soli alimenti (113, 114, 115).

- resveratrolo oltre ai noti effetti antiaging risulta particolarmente utile nel peri- e post-menopausa, oltre ai documentati benefici per vari disturbi correlati all’età (100, 101, 116-119, 127, 128-134). L’azione antibatterica e la riduzione di vari meccanismi tipici dell’invecchiamento, contribuiscono a rigenerare i tessuti e promuovere la sintesi ossea (129-134), con significativi risultati anche nelle malattie parodontali (135, 136, 137).

- L’insufficiente assunzione di vitamine del gruppo B, in particolare di folati, espone al rischio di malattie parondontali (55, 138-144).

Il fumo di tabacco e l’eccessivo consumo di alcol possono abbassare ulteriormente i livelli delle vitamine B (79).

Per questo l’adeguata integrazione di acido folico (3) ha un’elevata importanza per ridurre l’ossido-infiammazione, promuovere la sintesi di collagene e rigenerare i tessuti dell’organismo (142).

Inoltre,  folati e/o acido folico permettono di regolare il metabolismo dell’omocisteina e prevenire in modo significativo l’iperomocisteinemia e le sue complicazioni, incluse quelle orali (142).

Per effetto dell’acido folico l’uso di Mitofast abbassa in modo significativo i livelli di omocisteina, - 13% (113).   

Anche i normali livelli ematici di vitamina B12 riducono il rischio di malattie parodontali e, come  l’acido folico,permettonodirallentare l’invecchiamento biologico dell’organismo  (79, 142-146).

La linea Mitochon srl https://www.mitochon.it/  comprende Mitofast B12  bit.ly/4d5ll4P, l’integratore liquido di B12 (cianocobalamina) adatto per integrare questa vitamina spesso soggetta ad un’insufficiente apporto, es.: anziani, vegani, vegetariani (139, 140, 141).

- Vitamina C (acido ascorbico), attraverso le sue molteplici attività, incluse quelle immunoregolatrici e per la sintesi del collagene, la C dimostra benefici per preservare la salute orale e durante i trattamenti clinici delle malattie parodontali (46, 114, 125, 144, 145, 148-153).

- Vitamina E, non è un ingrediente di Mitofast bit.ly/3VUlGkS, ma gli antiossidanti presenti, es.: NAC/glutatione, coenzima Q10, rigenerano in modo fisiologico la vitamina E intracellulare nella forma attiva antiossidante, con un incremento dell’11% (113).

La E appartiene al gruppo di vitamine che in vari studi ha dimostrato benefici anche per la salute orale e l’età biologica (46, 55, 57, 59-63, 97, 125, 145, 152-155).

- N-acetilcisteina (NAC), per via orale è la forma più adatta per innalzare le concentrazioni ematiche di glutatione, + 53% come dimostra uno studio con  Mitofast bit.ly/3VUlGkS  (113, 114, 156, 157).

La NAC svolge peculiari azioni sfruttate in vari processi fisiopatologici (mucolitico, antidoto/disintossicante ecc. ) e nell’antiaging  (46, 59-62, 95, 97, 113, 114, 116, 118, 156, 157, 158).

I livelli ematici di glutatione accusano un forte declino nei soggetti con malattie parodontali, come nel caso di altre malattie sistemiche e con l’avanzare dell’età (46, 48, 113, 114, ). Per questo aumentare la biosintesi glutatione contribuisce a ridurre l’ossido-infiammazione anche nei tessuti parodontali, come indicano le prime ricerche (46, 48).  

- N-glucosamina promuove la sintesi intracellulare di acido ialuronico uno dei componente essenziali del derma e delle mucose, oltre a proprietà antinfiammatorie e rigeneratrici sfruttate anche nell’antiaging (159). Una recente revisione della letteratura evidenzia interessanti potenzialità dell’acido ialuronico in supporto ai trattamenti odontoiatrici (160, 161).

Conclusioni

Igiene orale, stile di vita ed appropriate terapie odontoiatriche sono insostituibili per conservare la salute orale.

Mantenere l’efficienza delle difese antiossidanti dell’organismo, attraverso l’alimentazione ed il corretto uso di specifici integratori, è una strategia vincente contro l’invecchiamento e molti disturbi clinici di origine ossido-infiammatoria, incluse le malattie parodontali. 

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46. Liu W and Guo D (2025) Oxidative stress in periodontitis and the application of antioxidants in treatment: a narrative review. Front. Physiol. 16:1485367. doi: 10.3389/fphys.2025.1485367

47. Taha SM Jr, Zardawi FM Sr, Anwar C Sr, Mohammed SA Jr, Mousa H Sr. Assessment of Total Antioxidant Capacity and Malondialdehyde Levels in Obese Patients With Periodontitis. Cureus. 2024 Dec 16;16(12):e75831. doi: 10.7759/cureus.75831.

48. Mohideen K, Chandrasekaran K, Veeraraghavan H, Faizee SH, Dhungel S, Ghosh S. Meta-Analysis of Assessment of Total Oxidative Stress and Total Antioxidant Capacity in Patients with Periodontitis. Dis Markers. 2023 Oct 30;2023:9949047. doi: 10.1155/2023/9949047.

49. Nisha S, Bettahalli Shivamallu A, Prashant A, Shashikumar P, Ganganna A, Das D. Effect of non surgical periodontal therapy and vitamin C supplementation on total antioxidant capacity in patients with chronic generalised periodontitis - A randomised controlled trial. J Oral Biol Craniofac Res. 2023 Jul-Aug;13(4):511-516. doi: 10.1016/j.jobcr.2023.05.003.

50. Zhu B, Song L, Li M, Cheng M, Tang W, Miao L. Comparison of the effects between catalase and superoxide dismutase on regulating macrophage inflammatory response and protecting osteogenic function of periodontal ligament cells. Biochem Biophys Res Commun. 2025 Apr 5;756:151523. doi: 10.1016/j.bbrc.2025.151523. 

51. Viglianisi G, Tartaglia GM, Santonocito S, Amato M, Polizzi A, Mascitti M, Isola G. The Emerging Role of Salivary Oxidative Stress Biomarkers as Prognostic Markers of Periodontitis: New Insights for a Personalized Approach in Dentistry. J Pers Med. 2023 Jan 17;13(2):166. doi: 10.3390/jpm13020166. Erratum in: J Pers Med. 2025 Jun 10;15(6):243. doi: 10.3390/jpm15060243.

52. Mohideen K, Krithika C, Jeyanthikumari T, Vani NV, Dhungel S, Ghosh S. The assessment of glutathione, glutathione peroxidase, glutathione reductase, and oxidized glutathione in patients with periodontitis-A systematic review and meta-analysis. Clin Exp Dent Res. 2024 Jun;10(3):e907. doi: 10.1002/cre2.907. 

53. Yu Z, Yang Y, Yu Z, Yan Z, Gao R. Causal relationship between 14 micronutrients and chronic periodontitis: a Mendelian randomization study. Aust Dent J. 2025 Jun;70(2):124-131. doi: 10.1111/adj.13056.

54. Ziada S, Wishahe A, Mabrouk N, Sahtout S. Vitamin D deficiency and oral health: a systematic review of literature. BMC Oral Health. 2025 Apr 1;25(1):468. doi: 10.1186/s12903-025-05883-w.  

55. Mi N, Zhang M, Ying Z, Lin X, Jin Y. Vitamin intake and periodontal disease: a meta-analysis of observational studies. BMC Oral Health. 2024 Jan 20;24(1):117. doi: 10.1186/s12903-024-03850-5.

56. Hua H, Xu S, Wang Y, Zheng Y, Xiang F. Association between dietary inflammatory index and periodontitis in American adults: exploring the mediating role of biological aging. Front Nutr. 2025 Jun 19;12:1591830. doi: 10.3389/fnut.2025.1591830. 

57. Nguyen LM, Tran AV, Kincheloe JP, Ebersole JE. Serum Nutrients, Periodontitis and Biological Ageing. J Clin Periodontol. 2025 Jun;52(6):868-876. doi: 10.1111/jcpe.14125. 

58. Chen X, Han R, Liu X, Xu J. Association between composite dietary antioxidant index and the prevalence of periodontitis: results from NHANES 2009-2014. BMC Oral Health. 2025 May 24;25(1):779. doi: 10.1186/s12903-025-06151-7.

59. Mini-Review Infiammazione Cronica - Antiossidanti https://www.mitochon.it/infiammazione-cronica-attualita-sul-ruolo-di-specifici-antiossidanti-per-combatterla-a-livello-cutaneo-e-sistemico/

60. Mini-Review Pelle - Infiammazione cronica 2025 https://www.mitochon.it/la-pelle-come-scudo-contro-linfiammazione-cronica-dellorganismo/?v=0d149b90e739

61. Mini - Review Benessere e salute mitocodriale https://www.mitochon.it/obiettivo-benessere-partendo-dalla-salute-dei-mitocondri/

62. Mini-Review AGEs - invecchiamento cutaneo 2025 https://www.mitochon.it/invecchiamento-cutaneo-e-prodotti-della-glicazione-avanzata-ages-4-possibili-strategie-per-combatterli/?v=0d149b90e739

63. Mini-Review Sovrappenso / Obesità - Resveratrolo - Antiossidanti 2025 https://www.mitochon.it/sovrappeso-obesita-quale-contributo-dal-resveratrolo-ed-altri-antiossidanti/?v=0d149b90e739

64. Morandini AC, Ramos-Junior ES. Mitochondrial function in oral health and disease. J Immunol Methods. 2024 Sep;532:113729. doi: 10.1016/j.jim.2024.113729. 

65. Zhou, H.; Qi, Y.-X.; Cao, R.-Y.; Zhang, X.-X.; Li, A.; Pei, D.-D. Causal Relationship between Mitochondrial Biological Function and Periodontitis: Evidence from a Mendelian Randomization Study. Int. J. Mol. Sci. 2024, 25, 7955. https://doi.org/10.3390/ijms25147955

66. Deng, Y.; Xiao, J.; Ma, L.; Wang, C.; Wang, X.; Huang, X.; Cao, Z. Mitochondrial Dysfunction in Periodontitis and Associated Systemic Diseases: Implications for Pathomechanisms and Therapeutic Strategies. Int. J. Mol. Sci. 2024, 25, 1024. https://doi.org/10.3390/ijms25021024

67. Meng L, Wen W. Mitochondrial Dysfunction in Diabetic Periodontitis: Mechanisms and Therapeutic Potential. J Inflamm Res. 2025 Jan 10;18:115-126. doi: 10.2147/JIR.S492041.

68. Luo S, Xu T, Zheng Q, Jiang A, Zhao J, Ying Y, Liu N, Pan Y, Zhang D. Mitochondria: An Emerging Unavoidable Link in the Pathogenesis of Periodontitis Caused by Porphyromonas gingivalis. Int J Mol Sci. 2024 Jan 6;25(2):737. doi: 10.3390/ijms25020737.

69. Lin XJ, Yuan Q, Zhou J, Dong YL, Sunchuri D, Guo ZL. Cellular senescence: A new perspective on the suppression of periodontitis (Review). Mol Med Rep. 2024 Dec;30(6):238. doi: 10.3892/mmr.2024.13362.

70. Komori T, Kram V, Perry S, Pham HT, Jani P, Kilts TM, Watanabe K, Kim DG, Martin D, Young MF. Type VI Collagen Deficiency Causes Enhanced Periodontal Tissue Destruction. J Dent Res. 2024 Aug;103(9):878-888. doi: 10.1177/00220345241256306.

71. Rajasekaran JJ, Krishnamurthy HK, Bosco J, Jayaraman V, Krishna K, Wang T, Bei K. Oral Microbiome: A Review of Its Impact on Oral and Systemic Health. Microorganisms. 2024 Aug 29;12(9):1797. doi: 10.3390/microorganisms12091797. 

72. Chen WA, Dou Y, Fletcher HM, Boskovic DS. Local and Systemic Effects of Porphyromonas gingivalis Infection. Microorganisms. 2023 Feb 13;11(2):470. doi: 10.3390/microorganisms11020470.

73. Murugaiyan, V., Utreja, S., Hovey, K.M. et al. Defining Porphyromonas gingivalis strains associated with periodontal disease. Sci Rep 14, 6222 (2024). https://doi.org/10.1038/s41598-024-56849-x

74. Dhamija R, Tewari S, Gill PS, Monga N, Mittal S, Duhan J. Association of Apical Periodontitis with Glycated Hemoglobin Levels and Systemic Inflammatory Markers in Patients with Type 2 Diabetes: A Cross-Sectional Study. J Endod. 2025 Feb;51(2):124-131. doi: 10.1016/j.joen.2024.11.008.

75. Yang J, Gong L, Zhu X, Wang Y, Li C. Mediation of Systemic Inflammation Response Index in the Association of Healthy Eating Index-2020 in Patientis with Periodontitis. Oral Health Prev Dent. 2025 Apr 15;23:225-232. doi: 10.3290/j.ohpd.c_1946.

76. Zhao J, Zheng Q, Ying Y, Luo S, Liu N, Wang L, Xu T, Jiang A, Pan Y, Zhang D. Association between high-density lipoprotein-related inflammation index and periodontitis: insights from NHANES 2009-2014. Lipids Health Dis. 2024 Sep 28;23(1):321. doi: 10.1186/s12944-024-02312-9.

77. Marruganti C, Luthra S, Hussain SB, Suvan J, D'Aiuto F. Healthy lifestyles and better periodontal health: Results from two large population-based surveys. J Periodontal Res. 2025 Feb;60(2):144-153. doi: 10.1111/jre.13320.

78. Abulaiti G, Qin X, Chen L, Zhu G. Mitophagy and Its Significance in Periodontal Disease. Oral Dis. 2025 Feb 10. doi: 10.1111/odi.15279. 

79. Pawlowska, E.; Szczepanska, J.; Derwich, M.; Sobczuk, P.; Düzgüneş, N.; Blasiak, J. DNA Methylation in Periodontal Disease: A Focus on Folate, Folic Acid, Mitochondria, and Dietary Intervention. Int. J. Mol. Sci. 2025, 26, 3225. https://doi.org/10.3390/ijms26073225

80. Kannan B, Arumugam P. The implication of mitochondrial DNA mutation and dysfunction in periodontal diseases. J Indian Soc Periodontol. 2023 Mar-Apr;27(2):126-130. doi: 10.4103/jisp.jisp_678_21.

81. Larsson L, Giraldo-Osorno PM, Garaicoa-Pazmino C, Giannobile WV, Asa'ad F. DNA and RNA Methylation in Periodontal and Peri-implant Diseases. J Dent Res. 2025 Feb;104(2):131-139. doi: 10.1177/00220345241291533. 

82. Huang D, Wang YY, Li BH, Wu L, Xie WZ, Zhou X, Ma B. Association between periodontal disease and systemic diseases: a cross-sectional analysis of current evidence. Mil Med Res. 2024 Dec 4;11(1):74. doi: 10.1186/s40779-024-00583-y. 

83. Kanimozhi, Aishwarya K, Yadav S, Chandy AA, Muralikrishna R, Shinkre R. Exploring the Link between Periodontal Disease and Systemic Conditions: Implications for Alzheimer's, Parkinson's, and Rheumatoid Arthritis. J Pharm Bioallied Sci. 2024 Dec;16(Suppl 4):S3775-S3777. doi: 10.4103/jpbs.jpbs_975_24.

84. Arbildo-Vega HI, Cruzado-Oliva FH, Coronel-Zubiate FT, Meza-Málaga JM, Luján-Valencia SA, Luján-Urviola E, Echevarria-Goche A, Farje-Gallardo CA, Castillo-Cornock TB, Serquen-Olano K, Padilla-Cáceres T, Caballero-Apaza L, Aguirre-Ipenza R. Periodontal disease and cardiovascular disease: umbrella review. BMC Oral Health. 2024 Oct 28;24(1):1308. doi: 10.1186/s12903-024-04907-1.

85. Isola G, Polizzi A, Serra S, Boato M, Sculean A. Relationship between periodontitis and systemic diseases: A bibliometric and visual study. Periodontol 2000. 2025 Jan 8. doi: 10.1111/prd.12621. 

86. Villoria GEM, Fischer RG, Tinoco EMB, Meyle J, Loos BG. Periodontal disease: A systemic condition. Periodontol 2000. 2024 Oct;96(1):7-19. doi: 10.1111/prd.12616.

87. Wang YT, Zheng SY, Luo Y, Xiao WF, Huang C, Li YS. Osteoimmunology and aging: Mechanisms, implications, and therapeutic perspectives. Ageing Res Rev. 2025 Jul 1;111:102822. doi: 10.1016/j.arr.2025.102822.

88. Zhao Y, Shao W, Zhu Q, Zhang R, Sun T, Wang B, Hu X. Association between systemic immune-inflammation index and metabolic syndrome and its components: results from the National Health and Nutrition Examination Survey 2011-2016. J Transl Med. 2023 Oct 4;21(1):691. doi: 10.1186/s12967-023-04491-y. 

89. Haishan Wei, Dan Xu, Jiying Chen, Haiyan Yu, Xiaodong Zhang, Zhiyun Liu, Chen Liu, Yuan Guo, Age Difference in the Connection Between Systemic Inflammatory Response and Metabolic Syndrome, The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 3, March 2025, Pages 634–648, https://doi.org/10.1210/clinem/dgae669

90. Ramezankhani A, Tohidi M, Hadaegh F. Association between the systemic immune-inflammation index and metabolic syndrome and its components: results from the multi-ethnic study of atherosclerosis (MESA). Cardiovasc Diabetol. 2025 Feb 15;24(1):78. doi: 10.1186/s12933-025-02629-4.

91. Guerrero-Sabater M, Cosín-Villanueva M, Almiñana-Pastor P, López-Roldán A. Expression of miRNAs in the Relationship Between Periodontitis and Cardiovascular Diseases: A Systematic Review. Noncoding RNA. 2025 May 6;11(3):37. doi: 10.3390/ncrna11030037. 

92. Liu S, Butler CA, Ayton S, Reynolds EC, Dashper SG. Porphyromonas gingivalis and the pathogenesis of Alzheimer's disease. Crit Rev Microbiol. 2024 Mar;50(2):127-137. doi: 10.1080/1040841X.2022.2163613.

93. Jiang Y, Xu L, Zhao X, Shen H, Qiu C, He Z, Song Z, Zhou W. Porphyromonas gingivalis-induced periodontitis promotes neuroinflammation and neuronal loss associated with dysfunction of the brain barrier. Front Cell Infect Microbiol. 2025 Jun 9;15:1559182. doi: 10.3389/fcimb.2025.1559182.

94. Wadan AS, Moshref AS, Emam AM, Bakry YG, Khalil BO, Chaurasia A, Ibrahim RAH, Badawy T, Mehanny SS. Mitochondrial dysfunction as a key player in aggravating periodontitis among diabetic patients: review of the current scope of knowledge. Naunyn Schmiedebergs Arch Pharmacol. 2025 Apr 24. doi: 10.1007/s00210-025-04025-x.

95. Zheng T, Lu F, Wu P, Chen Y, Zhang R, Li X. Ferroptosis and cuproptosis in periodontitis: recent biological insights and therapeutic advances. Front Immunol. 2025 Feb 24;16:1526961. doi: 10.3389/fimmu.2025.1526961.

96. Chen J, Ou L, Liu W, Gao F. Exploring the molecular mechanisms of ferroptosis-related genes in periodontitis: a multi-dataset analysis. BMC Oral Health. 2024 May 27;24(1):611. doi: 10.1186/s12903-024-04342-2.

97. Mini-Review Antiaging cardiovascolare 2025 https://www.mitochon.it/antiaging-cardiovascolare/?v=0d149b90e739

98. Yang K, Yang Y, Long T, Wang X, Chen Y, He C, Li L, Yang X, Jiang M, Hu Y, Dai F, Song L. Hyperhomocysteinaemia aggravates periodontitis by suppressing the Nrf2/HO-1 signalling pathway. Redox Rep. 2025 Dec;30(1):2475691. doi: 10.1080/13510002.2025.2475691.

99. Hingorjo MR, Owais M, Siddiqui SU, Nazar S, Ali YS. The impact of psychological stress on salivary cortisol levels in periodontitis patients: a case-control study. BMC Oral Health. 2025 Feb 21;25(1):276. doi: 10.1186/s12903-024-05017-8. 

100. Mini-Review Stress psicofisico - Antiossidanti / Neuroprotettori 2025 https://www.mitochon.it/stress-psicofisico-attualita-sulluso-appropriato-di-antiossidanti-neuroprotettivi/?v=0d149b90e739

101. Mini-review Pelle / Stress psicologico 2025 https://www.mitochon.it/linvecchiamento-della-pelle-causato-dallo-stress-psicologico/?v=0d149b90e739

102. Jawed STM, Tul Kubra Jawed K. Understanding the Link Between Hormonal Changes and Gingival Health in Women: A Review. Cureus. 2025 Jun 3;17(6):e85270. doi: 10.7759/cureus.85270. 

103. Yakar N, Yilmaz B, Emingil G, Chen T, Ozdemir G, Kantarci A. Subgingival microbial profiles in pre- and postmenopausal women: Associations with serum estradiol levels. J Periodontol. 2025 Jan;96(1):97-108. doi: 10.1002/JPER.24-0267.

104. Labunet A, Objelean A, Kui A, Rusu L, Vigu A, Sava S. Oral Manifestations in Menopause-A Scoping Review. Medicina (Kaunas). 2025 May 1;61(5):837. doi: 10.3390/medicina61050837.

105. Doughan M, Chehab O, Doughan B, Lima JAC, Michos ED. Association of endogenous sex hormone levels with tooth loss due to periodontitis in men and post-menopausal women: The multi-ethnic study of atherosclerosis. J Periodontal Res. 2025 Feb;60(2):166-176. doi: 10.1111/jre.13312.

106. Reeves J. The Impact of Female Hormones on the Periodontium-A Narrative Review. Int J Dent Hyg. 2025 Mar 14. doi: 10.1111/idh.12908.

107. Man Y, Qin J, Qiu H, Wang Y, Zhang X, Yan S. Hormone Replacement Therapy Relieves Periodontitis by Inhibiting Alveolar Bone Loss and Inflammation. Oral Dis. 2025 Apr;31(4):1307-1316. doi: 10.1111/odi.15192.

108. Man Y, Li X, Cui L, Song J, Cheng C, Zhang X, Niu F. Dydrogesterone alleviates periodontitis in perimenopausal women undergoing periodontal therapy by decreasing inflammation and mediating oral microbiota. Microb Pathog. 2025 Apr;201:107380. doi: 10.1016/j.micpath.2025.107380.

109. Yue Y, Hovey KM, Wactawski-Wende J, LaMonte MJ, Andrews CA, Diaz PI, McSkimming DI, Buck M, Sun Y, Millen AE. Association Between Healthy Eating Index-2020 and Oral Microbiome Among Postmenopausal Women. J Nutr. 2025 Jan;155(1):66-77. doi: 10.1016/j.tjnut.2024.08.023.

110. Su X, Jin K, Zhou X, Zhang Z, Zhang C, Li Y, Yang M, Huang X, Xu S, Wei Q, Cheng X, Yang L, Qiu S. The association between sex hormones and periodontitis among American adults: A cross-sectional study. Front Endocrinol (Lausanne). 2023 Feb 14;14:1125819. doi: 10.3389/fendo.2023.1125819.

111. Yan L, Liu Z, Xie B, Huang Y, Wu Y, He B, Li Y, Luo L, Yan F, Chen F. Risk Factors of Periodontitis: Evidence From Two-Sample Mendelian Randomization and Meta-Analysis. J Periodontal Res. 2025 Jul 10. doi: 10.1111/jre.70001.

112. Karasu YÖ, Orbak R, Kaşalı K, Berker E, Kantarci A. Association between androgenetic alopecia and periodontitis. J Periodontal Res. 2023 Oct;58(5):1105-1111. doi: 10.1111/jre.13175.

113. Mini-Review studio pilota Mitofast https://www.mitochon.it/mitofast-nuovi-ed-importanti-risultati-da-uno-studio-clinico-preliminare/

114. Mini-Review Motivi per l’Integrazione Mirata https://www.mitochon.it/4-motivi-1-per-utilizzare-lintegrazione-mirata-contro-linvecchiamento-cutaneo-e-sistemico/

115. Mini-Review Coenzima Q10 2025 https://www.mitochon.it/il-coenzima-q10-novita-per-luso-mirato-nellantiaging-cutaneo-e-per-gli-effetti-sistemici/?v=0d149b90e739

116. Mini-Review Antiaging cognitivo 2025 https://www.mitochon.it/antiaging-cognitivo/?v=0d149b90e739

117. Mini-Review Antiaging muscolare 2025 https://www.mitochon.it/antiaging-muscolare/?v=0d149b90e739

118. Mini-Review Osteoporosi - Resveratrolo 2025 https://www.mitochon.it/osteoporosi-nel-post-menopausa-attualita-sul-ruolo-del-resveratrolo-altri-antiossidanti-e-vitamine/?v=0d149b90e739

119. Mini-Review Sovrappenso / Obesità - Resveratrolo - Antiossidanti 2025 https://www.mitochon.it/sovrappeso-obesita-quale-contributo-dal-resveratrolo-ed-altri-antiossidanti/?v=0d149b90e739

120. DiNicolantonio JJ, McCarty MF, O'Keefe JH. Coenzyme Q10 deficiency can be expected to compromise Sirt1 activity. Open Heart. 2022 Mar;9(1):e001927. doi: 10.1136/openhrt-2021-001927.

121. Fernandez MDS, Martins TM, Meza-Mauricio J, Ribeiro MC, Silva FH, Casarin M, Muniz FWMG. Clinical efficacy of adjunctive use of coenzyme Q10 in non-surgical periodontal treatment: A systematic review. Eur J Oral Sci. 2025 Apr;133(2):e70002. doi: 10.1111/eos.

122. Ghasemi S, Torab Z, Shirmohammadi A, Babaloo A, Johari R, Farhadi F, Mobasseri M, Mohammadi H. Evaluation of the effect of coenzyme Q10 supplementation along with scaling and root planing (SRP) on periodontal and gingival indices in controlled diabetic patients. J Adv Periodontol Implant Dent. 2022 Mar 13;14(1):32-37. doi: 10.34172/japid.2022.003. 

123. McSorley R. Multi-nutrients and periodontal disease - a new adjunct to improving treatment outcomes? A randomised placebo-control clinical trial. Evid Based Dent. 2024 Jun;25(2):81-82. doi: 10.1038/s41432-024-01010-w.

124. Laky B, Bruckmann C, Blumenschein J, Durstberger G, Haririan H. Effect of a multinutrient supplement as an adjunct to nonsurgical treatment of periodontitis: A randomized placebo-controlled clinical trial. J Periodontol. 2024 Feb;95(2):101-113. doi: 10.1002/JPER.23-0115.

125. Barnawi BM, Alrashidi NS, Albalawi AM, Alakeel NS, Hamed JT, Barashid AA, Alduraibi MS, Alhussain GS, Alghadeer JY, Alarifi NA, Altalhi AM. Nutritional Modulation of Periodontal Diseases: A Narrative Review of Recent Evidence. Cureus. 2023 Dec 8;15(12):e50200. doi: 10.7759/cureus.50200.

126. Dahiya P, Malhotra A, Pajnoo A, Gupta R, Kamal R. Comparative evaluation of efficacy of topical and intra-sulcular application of Co-enzyme Q10 in the non-surgical treatment of periodontal diseases. J Indian Soc Periodontol. 2022 Nov-Dec;26(6):533-538. doi: 10.4103/jisp.jisp_542_21.

127. Mini-Review Resveratrolo Peri- Post-Menopausa https://www.mitochon.it/peri-e-post-menopausa-novita-sui-vantaggi-dellintegrazionealimentare-mirata/

128. Mini-Review Resveratrolo effetti neuroprotettivi https://www.mitochon.it/cervello-e-cognitivita-effetti-neuroprotettivi-del-resveratrolo/

129. Hashim, N.T.; Babiker, R.; Chaitanya, N.C.S.K.; Mohammed, R.; Priya, S.P.; Padmanabhan, V.; Ahmed, A.; Dasnadi, S.P.; Islam, M.S.; Gismalla, B.G.; et al. New Insights in Natural Bioactive Compounds for Periodontal Disease: Advanced Molecular Mechanisms and Therapeutic Potential. Molecules 2025, 30, 807.

130. Conte R, Valentino A, Sepe F, Gianfreda F, Condò R, Cerroni L, Calarco A, Peluso G. Resveratrol-Loaded Solid Lipid Nanoparticles Reinforced Hyaluronic Hydrogel: Multitarget Strategy for the Treatment of Diabetes-Related Periodontitis. Biomedicines. 2025 Apr 27;13(5):1059. doi: 10.3390/biomedicines13051059.

131. Zhang C, Jiao B, Qian D. Protective Effect of Resveratrol Against Peri-Implant Inflammation and Oxidative Stress: An in vivo Study. Discov Med. 2025 May;37(196):862-870. doi: 10.24976/Discov.Med.202537196.76.

132. Li Y, Huang Z, Pan S, Feng Y, He H, Cheng S, Wang L, Wang L, Pathak JL. Resveratrol Alleviates Diabetic Periodontitis-Induced Alveolar Osteocyte Ferroptosis Possibly via Regulation of SLC7A11/GPX4. Nutrients. 2023 Apr 28;15(9):2115. doi: 10.3390/nu15092115. 

133. Huang CY, Chen SH, Lin T, Liao YW, Chang YC, Chen CC, Yu CC, Chen CJ. Resveratrol attenuates advanced glycation end product-induced senescence and inflammation in human gingival fibroblasts. J Dent Sci. 2024 Jan;19(1):580-586. doi: 10.1016/j.jds.2023.10.016. 

134. Farhad SZ, Karbalaeihasanesfahani A, Dadgar E, Nasiri K, Hosseini NM, Valian N, Esfahaniani M, Nabi Afjadi M. Promising potential effects of resveratrol on oral and dental health maintenance: a comprehensive review. Naunyn Schmiedebergs Arch Pharmacol. 2025 Feb;398(2):1367-1389. doi: 10.1007/s00210-024-03457-1.

135. Nikniaz S, Vaziri F, Mansouri R. Impact of resveratrol supplementation on clinical parameters and inflammatory markers in patients with chronic periodontitis: a randomized clinical trail. BMC Oral Health. 2023 Mar 27;23(1):177. doi: 10.1186/s12903-023-02877-4.

136. Zhang Q, Xu S, Xu W, Zhou Y, Luan H, Wang D. Resveratrol decreases local inflammatory markers and systemic endotoxin in patients with aggressive periodontitis. Medicine (Baltimore). 2022 Jun 24;101(25):e29393. doi: 10.1097/MD.0000000000029393.

137. Mohammed SA, Akram HM. Evaluating the Efficacy of Resveratrol-Containing Mouthwash as an Adjunct Treatment for Periodontitis: A Randomized Clinical Trial. Eur J Dent. 2025 May;19(2):354-365. doi: 10.1055/s-0044-1788686.  

138. Mini-Review Vitamine complesso B - microbiota https://www.mitochon.it/le-vitamine-del-gruppo-b-cosa-ce-di-nuovo-parte-2/

139. Mini-Review Vitamina B12 - Acido Folico https://www.mitochon.it/vitamina-b12-e-acido-folico-cosa-ce-di-nuovo-parte-1/

140. Mini-Review Vitamina B12 https://www.mitochon.it/vitamina-b12-nelle-strategie-antiaging/

141. Mini-Review Acido Folico https://www.mitochon.it/acido-folico-dalla-clinica-allantiaging-attualita-2024/

142. Buzatu R, Luca MM, Bumbu BA. The Role of Vitamin B Complex in Periodontal Disease: A Systematic Review Examining Supplementation Outcomes, Age Differences in Children and Adults, and Aesthetic Changes. Nutrients. 2025 Mar 27;17(7):1166. doi: 10.3390/nu17071166.

143. Zhao LX, Hu CY, Li ZH, Shao MC, Liu JJ, Yan XR, Li J, Xu WH, Zhang XJ. Low folate biomarker concentrations are associated with increase the risk and severity of periodontitis in adults: A cross-sectional study based on the National Health and Nutrition Examination Survey 2009-2014. Nutr Res. 2025 Feb;134:73-87. doi: 10.1016/j.nutres.2024.12.003.

144. Doshi D, Kumar S, Patel B, Chaudhari D, Patel S, Hirani T, Patadiya HH, Bhingradia IR, Haque M. Micronutrients and the Periodontium: A Narrative Review. Cureus. 2025 Apr 4;17(4):e81694. doi: 10.7759/cureus.81694.

145. Steigmann L, Kačarević ŽP, Khoury J, Nagy K, Feres M. Integration of precision medicine into the dental care setting. Front Dent Med. 2024 Aug 21;5:1398897. doi: 10.3389/fdmed.2024.1398897.

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