Bidirectional Relationship Between Periodontitis and Somatic Pathology: From Systemic Inflammation to Clinical Prognosis

Subject. The subject of the study is the bidirectional relationship between periodontitis and somatic pathology, considered through the lens of chronic systemic inflammation as a common pathophysiological mechanism. Objectives. To systematize current concepts regarding the mechanisms of mutual influence between periodontitis and somatic diseases and to assess their clinical significance for prognosis and planning of dental treatment. Methodology. The work is presented in the form of a literature review, analyzing 52 published sources published between 2018 and 2026. Data on the pathogenesis of periodontitis, systemic effects of chronic inflammation, the role of somatic comorbidity, and the impact of pharmacotherapy on periodontal tissues were evaluated. Results. It was established that periodontitis is not only a local inflammatory disease but also a source of systemic immune-inflammatory activation. Chronic inflammation in periodontal tissues is associated with the entry of microbial factors and inflammatory mediators into the systemic circulation, contributing to endothelial dysfunction and metabolic disturbances. Somatic pathology, including cardiovascular diseases, diabetes mellitus, and metabolic disorders, was shown to enhance inflammatory-destructive processes in periodontal tissues and worsen clinical prognosis. The formation of a closed pathogenic loop was substantiated, in which local and systemic inflammatory reactions mutually potentiate each other. Conclusion. Periodontitis should be considered as a component of systemic inflammatory pathology. The bidirectional nature of its relationship with somatic diseases determines the need for an integrated approach to patient management, taking into account systemic status. Consideration of somatic comorbidity and inflammatory status allows for improved prognostic accuracy and increased effectiveness of dental treatment.