“…Dysbiosis of the gut flora not only damages the intestinal barrier, but also disrupts the oral microbiota and exacerbates bone resorption in periodontitis through Th17/Treg imbalance. Yuan et al found that long-term antibiotic use led to gut ecological dysbiosis, which increased periodontitis-associated pathogens in the oral cavity and decreased oral microbiota probiotics associated with periodontal health, while Th17 cellassociated pro-inflammatory cytokine (IL-17A, IL-6) expression was upregulated and Treg cell-associated cytokine (Foxp3 and IL-10) expression was decreased in periodontal tissues; in contrast, the use of fecal microbiota transplantation (FMT) not only restored the intestinal microbiota of the mice, but even reversed the Th17/Treg imbalance in periodontal tissue and alleviated periodontitis (Yuan et al, 2023). Katarzyna et al found elevated levels of IL-1b, IL-6 and TNF by measuring salivary inflammatory markers in patients with IBD, with elevated levels of TNF-a and IL-6 being strongly associated with the development of periodontitis (Szczeklik et al, 2012); in the Figueredo team's study, inflammation scores in gingival tissue were significantly higher in patients with active IBD (including four cytokines, IL-1b, IL-6, IL-21 and sCD40L) (Figueredo et al, 2017); nevertheless, anti-inflammatory factors such as IL-4 decrease with increasing levels of inflammation, and IL-4 levels were found to be significantly lower in the gingival sulcus of IBD patients with periodontitis (de Mello-Neto et al, 2021).…”