Scientific Bulletin of the Omsk State Medical UniversityScientific Bulletin of the Omsk State Medical UniversityScientific Bulletin of the Omsk State Medical UniversityScientific Bulletin of the Omsk State Medical UniversityНаучный вестник Омского государственного медицинского университетаScientific Bulletin of the Omsk State Medical University2782-3024Omsk State Medical University70732410.61634/2782-3024-2025-20-12-24Literature reviewsОбзоры литературыReview ArticleMicroelement levels in periodontal diseasesУровень микроэлементов при заболеваниях пародонтаhttps://orcid.org/0000-0002-1597-1876TrukhanDmitry I.ТруханДмитрий Иванович
Russian Federation

д.м.н., доцент, профессор кафедры поликлинической терапии и внутренних болезней

dmitry_trukhan@mail.ruhttps://orcid.org/0009-0004-3249-3425SulimovAnatoly F.СулимовАнатолий Филиппович
Russian Federation

д.м.н., профессор, заведующий кафедрой челюстно-лицевой хирургии

afsulimov@yandex.ruhttps://orcid.org/0000-0002-7695-149XRozhkovaMaria Y.РожковаМария Юрьевна
Russian Federation

к.м.н., доцент кафедры поликлинической терапии и внутренних болезней

marroj@mail.ruhttps://orcid.org/0000-0002-4145-7969IvanovaDaria S.ИвановаДарья Сергеевна
Russian Federation

к.м.н., доцент кафедры поликлинической терапии и внутренних болезней

darja.ordinator@mail.ruhttps://orcid.org/0000-0003-3458-9346МоiseevaMarina V.МоисееваМарина Викторовна
Russian Federation

кандидат медицинских наук, доцент кафедры поликлинической терапии и внутренних болезней

lisnyak80@mail.ruFederal State Budgetary Educational Institution of Higher Education "Omsk State Medical University" of the Ministry of Health of the Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Омский государственный медицинский университет» Министерства здравоохранения Российской Федерации100520265412240905202609052026Copyright ©; 2026, Scientific Bulletin of the Omsk State Medical UniversityCopyright ©; 2026, Scientific Bulletin of the Omsk State Medical UniversityCopyright ©; 2026, Scientific Bulletin of the Omsk State Medical UniversityCopyright ©; 2026, Научный вестник Омского государственного медицинского университетаCopyright ©; 2026, Scientific Bulletin of the Omsk State Medical University2026Scientific Bulletin of the Omsk State Medical UniversityScientific Bulletin of the Omsk State Medical UniversityScientific Bulletin of the Omsk State Medical UniversityНаучный вестник Омского государственного медицинского университетаScientific Bulletin of the Omsk State Medical Universityhttps://creativecommons.org/licenses/by/4.0https://journals.eco-vector.com/2782-3024/article/view/707324

Periodontitis is the sixth most common dental disease worldwide (second only to dental caries) and the leading cause of tooth loss in adults. At the beginning of the 21st century, the concept of "periodontal medicine" emerged, exploring the bidirectional relationship between periodontal pathology and systemic somatic diseases. Nutritional status is now widely recognized as a potential contributing factor to the development of many inflammatory conditions, such as periodontal disease. A search was conducted for publications devoted to the study of trace element levels (magnesium, calcium, copper, selenium, and zinc) and their impact on periodontal physiology and pathology. A search was conducted for publications devoted to the study of the impact of the trace elements magnesium, calcium, selenium, and zinc on periodontal physiology and pathology. The search was conducted in PubMed and Scopus databases, and sources accessed up to February 20, 2024, were included.

The obtained data indicate a deficiency of trace elements (Mg, Ca, Se, Zn) in periodontal diseases, primarily periodontitis. Clinical studies demonstrate the positive impact of trace element replenishment on periodontal health and the course of comorbid diabetes. The use of trace elements (Mg, Ca, Se, Zn) in the comprehensive treatment of periodontal diseases in cases of deficiency will improve the quality and effectiveness of medical care for patients with periodontal disease and comorbid patients with periodontal disease, diabetes mellitus, and other systemic somatic diseases.

Пародонтит является шестым по распространенности заболеванием в мире (среди стоматологической патологии вторым после кариеса) и первой причиной потери зубов у взрослых. В начале XXI века сформировалась концепция «пародонтальной медицины» в рамках которой рассматривается двунаправленная связь патологии пародонта с системными соматическими заболеваниями организма. Пищевой статус в настоящее время широко признан как возможный фактор, способствующий развитию многих воспалительных состояний, таких как заболевания пародонта. Проведен поиск публикаций, посвященных изучению уровня микроэлементов (магния, кальция, меди, селена, цинка) и их влияния на физиологию и патологию пародонта. Проведен поиск публикаций, посвященных изучению влияния микроэлементов магния, кальция, селена и цинка на физиологию и патологию пародонта. Поиск осуществлялся в информационных базах PubMed и Scopus, в него были включены источники до 20.02.2024.

Полученные данные свидетельствуют о дефиците микроэлементов (Mg, Ca, Se, Zn) при заболеваниях пародонта, прежде всего пародонтите. Клинические исследования свидетельствуют о позитивном влиянии восполнения дефицита микроэлементов на состояние пародонта и течение коморбидного сахарного диабета. Использование в комплексном лечении заболеваний пародонта микроэлементов (Mg, Ca, Se, Zn) при их дефиците позволит повысить качество и эффективность медицинской помощи пациентам с заболеваниями пародонта и коморбидным пациентам с заболеваниями пародонта с сопутствующим сахарным диабетом и другими системными соматическими заболеваниями организма.

periodontal pathologyperiodontitistrace elementsmagnesiumcalciumseleniumzinccopperпатология пародонтапародонтитмикроэлементымагнийкальцийселенцинкмедьWilliams, R.C.; Offenbacher, S. Periodontal medicine: The emergence of a new branch of periodontology. Periodontology 2000 2000, 23, 9–12 https://doi.org/10.1034/j.1600-0757.2000.2230101.x.Pai SI, Matheus HR, Guastaldi FPS. Effects of periodontitis on cancer outcomes in the era of immunotherapy. Lancet Healthy Longev. 2023 Apr;4(4):e166-e175. https://doi.org/10.1016/S2666-7568(23)00021-1.Trukhan D. I. Comorbidity of periodontal diseases and non-alcoholic fatty liver disease. Experimental and Clinical Gastroenterology. 2024;223(3): 14–24. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-223-3-14-24Трухан Д. И. Коморбидность заболеваний пародонта и неалкогольной жировой болезни печени. Экспериментальная и клиническая гастроэнтерология. 2024;223(3): 14–24. https://doi.org/10.31146/1682-8658-ecg-223-3-14-24Trukhan DI, Sulimov AF, Trukhan LYu. Comorbidity of rheumatoid arthritis and periodontal diseases. Meditsinskiy Sovet. 2024;18(5):288–297. (In Russ.) https://doi.org/10.21518/ms2024-079Трухан ДИ, Сулимов АФ, Трухан ЛЮ. Коморбидность ревматоидного артрита и заболеваний пародонта. Медицинский совет. 2024;18(5):288–297. https://doi.org/10.21518/ms2024-079Kaye, E.K. Nutrition, dietary guidelines and optimal periodontal health. Periodontology 2012, 58, 93–111. https://doi.org/10.1111/j.1600-0757.2011.00418.x.Nasri, H.; Baradaran, A.; Shirzad, H.; Rafieian-Kopaei, M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int. J. Prev. Med. 2014, 5, 1487–1499. URL: https://pubmed.ncbi.nlm.nih.gov/25709784/Volpe SL. Magnesium in disease prevention and overall health. Adv Nutr. 2013 May 1;4(3):378S-83S. https://doi.org/10.3945/an.112.003483.Gröber U, Schmidt J, Kisters K. Magnesium in Prevention and Therapy. Nutrients. 2015 Sep 23;7(9):8199-226. https://doi.org/10.3390/nu7095388.Varela-López A, Giampieri F, Bullón P, Battino M, Quiles JL. A Systematic Review on the Implication of Minerals in the Onset, Severity and Treatment of Periodontal Disease. Molecules. 2016 Sep 7;21(9):1183. https://doi.org/10.3390/molecules21091183.Meisel P, Pink C, Nauck M, Jablonowski L, Voelzke H, Kocher T. Magnesium/Calcium Ratio in Serum Predicts Periodontitis and Tooth Loss in a 5-Year Follow-up.JDR Clin Trans Res. 2016 Oct;1(3):266-274. https://doi.org/10.1177/2380084416663458.Li XY, Wen MZ, Liu H, Shen YC, Su LX, Yang XT. Dietary magnesium intake is protective in patients with periodontitis. Front Nutr. 2022 Aug 25;9:976518. https://doi.org/10.3389/fnut.2022.976518.Belluci MM, de Molon RS, Rossa C Jr, Tetradis S, Giro G, Cerri PS, Marcantonio E Jr, Orrico SRP. Severe magnesium deficiency compromises systemic bone mineral density and aggravates inflammatory bone resorption.J Nutr Biochem. 2020 Mar;77:108301. https://doi.org/10.1016/j.jnutbio.2019.108301.Pushparani DS, Anandan SN, Theagarayan P. Serum zinc and magnesium concentrations in type 2 diabetes mellitus with periodontitis.J Indian Soc Periodontol. 2014 Mar;18(2):187-93. https://doi.org/10.4103/0972-124X.131322.Shetty A, Bhandary R, Thomas B, Ramesh A. A Comparative Evaluation of Serum Magnesium in Diabetes Mellitus Type 2 Patients with and without Periodontitis - A Clinico-biochemical Study.J Clin Diagn Res. 2016 Dec;10(12):ZC59-ZC61. https://doi.org/10.7860/JCDR/2016/21063.9078.Meisel P, Schwahn C, Luedemann J, John U, Kroemer HK, Kocher T. Magnesium deficiency is associated with periodontal disease. J Dent Res. 2005 Oct;84(10):937-41. https://doi.org/10.1177/154405910508401012.Watson S, Woodside JV, Winning L, Wright DM, Srinivasan M, McKenna G. Associations between self-reported periodontal disease and nutrient intakes and nutrient-based dietary patterns in the UK Biobank.J Clin Periodontol. 2022 May;49(5):428-438. https://doi.org/10.1111/jcpe.13604.Wu Q, Zhang S, Cao R. Association between magnesium depletion score and periodontitis in US adults: results from NHANES 2009-2014.BMC Oral Health. 2024 Oct 24;24(1):1274. https://doi.org/10.1186/s12903-024-05048-1.Cruz-Velasquez T, Rodríguez-Orozco AR. Association Between Magnesium Levels and Periodontal Disease: A Systematic Review.Cureus. 2025 Jul 25;17(7):e88744. https://doi.org/10.7759/cureus.88744.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. https://doi.org/10.7759/cureus.81694.Huang H, Chen S, Cong L, Zeng Y. A cross-sectional study on the relationship between dietary magnesium intake and periodontitis in different body mass index and waist circumference groups: National Health and Nutrition Examination Survey, 2009-2014.J Nutr Sci. 2025 May 8;14:e33. https://doi.org/10.1017/jns.2025.19.Lin J, Xu S, Chu T. Causal effects of serum nutrients and macronutrient intake on periodontitis: A Mendelian randomization study.Medicine (Baltimore). 2025 Oct 17;104(42):e45124. https://doi.org/10.1097/MD.0000000000045124.Matikainen N, Pekkarinen T, Ryhänen EM, Schalin-Jäntti C. Physiology of Calcium Homeostasis: An Overview.Endocrinol Metab Clin North Am. 2021 Dec;50(4):575-590. https://doi.org/ 10.1016/j.ecl.2021.07.005.Jomova K, Makova M, Alomar SY, Alwasel SH, Nepovimova E, Kuca K, Rhodes CJ, Valko M. Essential metals in health and disease.Chem Biol Interact. 2022 Nov 1;367:110173. https://doi.org/10.1016/j.cbi.2022.110173.Hildebolt CF. Effect of vitamin D and calcium on periodontitis. J Periodontol. 2005 Sep;76(9):1576-87. https://doi.org/10.1902/jop.2005.76.9.1576.O'Connor JP, Milledge KL, O'Leary F, Cumming R, Eberhard J, Hirani V. Poor dietary intake of nutrients and food groups are associated with increased risk of periodontal disease among community-dwelling older adults: a systematic literature review. Nutr Rev. 2020 Feb 1;78(2):175-188. https://doi.org/10.1093/nutrit/nuz035.Nishida M, Grossi SG, Dunford RG, Ho AW, Trevisan M, Genco RJ. Calcium and the risk for periodontal disease. J Periodontol. 2000 Jul;71(7):1057-66. https://doi.org/10.1902/jop.2000.71.7.1057.Ramesh A, Mahajan K, Thomas B, Shenoy N, Bhandary R. Alveolar bone mass in pre- and postmenopausal women with serum calcium as a marker: a comparative study. Indian J Dent Res. 2011 Nov-Dec;22(6):878. https://doi.org/10.4103/0970-9290.94667.Agrawal AA, Kolte AP, Kolte RA, Chari S, Gupta M, Pakhmode R. Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy, chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus - a cross-sectional study. Acta Odontol Scand. 2019 Nov;77(8):592-599. https://doi.org/10.1080/00016357.2019.1623910.Nascimento GG, Leite FRM, Gonzalez-Chica DA, Peres KG, Peres MA. Dietary vitamin D and calcium and periodontitis: A population-based study. Front Nutr. 2022 Dec 22;9:1016763. https://doi.org/ 10.3389/fnut.2022.1016763.Garcia MN, Hildebolt CF, Miley DD, Dixon DA, Couture RA, Spearie CL, Langenwalter EM, Shannon WD, Deych E, Mueller C, Civitelli R. One-year effects of vitamin D and calcium supplementation on chronic periodontitis.J Periodontol. 2011 Jan;82(1):25-32. https://doi.org/10.1902/jop.2010.100207.Barceloux DG. Copper.J Toxicol Clin Toxicol. 1999;37(2):217-30. https://doi.org/10.1081/clt-100102421.Scheiber I, Dringen R, Mercer JF. Copper: effects of deficiency and overload. Met Ions Life Sci. 2013;13:359-87. https://doi.org/10.1007/978-94-007-7500-8_11.Zhou L, Mao H, Wen Y, Chen Z, Zhang L. Cuproptosis promotes inflammatory osteolysis via GYS1-mediated glycogen metabolism. Int J Oral Sci. 2026 Feb 3;18(1):13. https://doi.org/10.1038/s41368-025-00408-1.Gutiérrez-Guerra MA, Puerto-Parejo LM, Pastor-Ramón E, Pedrera-Canal M, Vera V, Pedrera-Zamorano JD, Lavado-García JM, López-Espuela F, Roncero-Martín R, Fabregat-Fernández J, Morán JM. Dietary Copper Intake and Bone Health: A Systematic Review and Meta-Analysis of Observational Studies.Calcif Tissue Int. 2025 Dec 9;116(1):149. https://doi.org/10.1007/s00223-025-01463-w.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. https://doi.org/10.3389/fimmu.2025.1526961.Lynch RJM, Duckworth RM. Chapter 4: Microelements: Part I: Zn, Sn, Cu, Fe and I.Monogr Oral Sci. 2020;28:32-47. https://doi.org/10.1159/000499007.Li W, Shang Q, Yang D, Peng J, Zhao H, Xu H, Chen Q. Abnormal Micronutrient Intake Is Associated with the Risk of Periodontitis: A Dose-response Association Study Based on NHANES 2009-2014. Nutrients. 2022 Jun 14;14(12):2466. https://doi.org/10.3390/nu14122466.Baima G, Iaderosa G, Corana M, Romano F, Citterio F, Giacomino A, Berta GN, Aimetti M. Macro and trace elements signature of periodontitis in saliva: A systematic review with quality assessment of ionomics studies. J Periodontal Res. 2022 Jan;57(1):30-40. https://doi.org/10.1111/jre.12956.Thomas B, Kumari S, Ramitha K, Ashwini Kumari MB. Comparative evaluation of micronutrient status in the serum of diabetes mellitus patients and healthy individuals with periodontitis. J Indian Soc Periodontol. 2010 Jan;14(1):46-9. https://doi.org/10.4103/0972-124X.65439.Sundaram G, Ramakrishnan T, Parthasarathy H, Moses J, Lalitha T. Evaluation of Micronutrient (Zinc, Magnesium, and Copper) Levels in Serum and Glycemic Status after Nonsurgical Periodontal Therapy in Type 2 Diabetic Patients with Chronic Periodontitis. Contemp Clin Dent. 2017 Jan-Mar;8(1):26-32. https://doi.org/10.4103/0976-237X.205036.Ogunleye BA, Nwhator SO, Adedeji TA, Onabanjo OA, Ogundiran T, Adewole OM. Effect of Non-surgical Periodontal Therapy on the Serum and Salivary Levels of Selenium, Zinc, Copper and Iron in Patients with Periodontitis at a Tertiary Institution in Nigeria. Niger Postgrad Med J. 2025 Oct 1;32(4):332-338. https://doi.org/10.4103/npmj.npmj_227_25.Trukhan D.I., Sulimov A.F., Trukhan L.Yu. Possibilities of vitamin-mineral complexes in adjuvant therapy of comorbid patients with periodontal diseases, diabetes and other systemic diseases of the body. Clinical review for general practice. 2024; 5 (5): 91–100 (In Russ.). https://doi.org/10.47407/kr2024.5.5.00411Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю. Возможности витаминно-минеральных комплексов в адъювантной терапии коморбидных пациентов с заболеваниями пародонта, сахарным диабетом и другими системными заболеваниями организма. Клинический разбор в общей медицине. 2024; 5 (5): 91–100. https://doi.org/10.47407/kr2024.5.5.00411Huang H, Yao J, Yang N, Yang L, Tao L, Yu J, Gao Y, Liu Z. Association between levels of blood trace minerals and periodontitis among United States adults. Front Nutr. 2022 Sep 7;9:999836. https://doi.org/10.3389/fnut.2022.999836.Inonu E, Hakki SS, Kayis SA, Nielsen FH. The Association Between Some Macro and Trace Elements in Saliva and Periodontal Status.Biol Trace Elem Res. 2020 Sep;197(1):35-42. https://doi.org/10.1007/s12011-019-01977-z.Uytun M, Orbak R, Kızıltunç A. Potential Relationship Between Decreased Serum Selenium Levels and Oxidative Stress in Periodontitis Stage III-IV.Biol Trace Elem Res. 2025 Dec;203(12):6415-6425. https://doi.org/10.1007/s12011-025-04649-3.Thomas B, Ramesh A, Suresh S, Prasad BR. A comparative evaluation of antioxidant enzymes and selenium in the serum of periodontitis patients with diabetes mellitus type 2. Contemp Clin Dent. 2013 Apr;4(2):176-80. https://doi.org/10.4103/0976-237X.114867.Thomas B, Prasad BR, Kumari NS, Radhakrishna V, Ramesh A. A comparative evaluation of the micronutrient profile in the serum of diabetes mellitus Type II patients and healthy individuals with periodontitis.J Indian Soc Periodontol. 2019 Jan-Feb;23(1):12-20. https://doi.org/10.4103/jisp.jisp_398_18.Berg Y, Gabay E, Božić D, Shibli JA, Ginesin O, Asbi T, Takakura L, Mayer Y. The Impact of Nutritional Components on Periodontal Health: A Literature Review.Nutrients. 2024 Nov 15;16(22):3901. https://doi.org/10.3390/nu16223901.Livingstone C. Zinc: physiology, deficiency, and parenteral nutrition. Nutr Clin Pract. 2015 Jun;30(3):371-82. https://doi.org/10.1177/0884533615570376.Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection Am J Clin Nutr 1998 Aug;68(2 Suppl):447S-463S. https://doi.org/10.1093/ajcn/68.2.447S.Overbeck S, Rink L, Haase H. Modulating the immune response by oral zinc supplementation: a single approach for multiple diseases. Arch Immunol Ther Exp (Warsz). 2008 Jan-Feb;56(1):15-30. https://doi.org/10.1007/s00005-008-0003-8.Jarosz M, Olbert M, Wyszogrodzka G, Młyniec K, Librowski T. Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-kappaB signaling. Inflammopharmacology. 2017 Feb; 25(1):11-24. https://doi.org/10.1007/s10787-017-0309-4.Skalny AV, Rink L, Ajsuvakova OP, Aschner M, Gritsenko VA, Alekseenko SI, Svistunov AA, Petrakis D, Spandidos DA, Aaseth J, Tsatsakis A, Tinkov AA. Zinc and respiratory tract infections: Perspectives for COVID-19 (Review). Int J Mol Med. 2020 Jul;46(1):17-26. https://doi.org/10.3892/ijmm.2020.4575.Uwitonze AM, Ojeh N, Murererehe J, Atfi A, Razzaque MS. Zinc Adequacy Is Essential for the Maintenance of Optimal Oral Health.Nutrients. 2020 Mar 30;12(4):949. https://doi.org/10.3390/nu12040949.Liu Y, Li X, Liu S, Du J, Xu J, Liu Y, Guo L. The changes and potential effects of zinc homeostasis in periodontitis microenvironment. Oral Dis. 2023 Nov;29(8):3063-3077. https://doi.org/10.1111/odi.14354.Caruso S, Valenti C, Marinucci L, Di Pasquale F, Truppa C, Di Benedetto G, Caruso S, Pagano S. Systematic Review of Zinc's Benefits and Biological Effects on Oral Health.Materials (Basel). 2024 Feb 7;17(4):800. https://doi.org/10.3390/ma17040800.Trukhan DI, Konshu NV, Mogilina PО, Моiseeva МV. Levels of antioxidant vitamins (A, E, C) and zinc in patients with diabetes mellitus and the possibility of their use as adjuvant therapy. Meditsinskiy Sovet. 2025;19(13):313–322. (In Russ.) https://doi.org/10.21518/ms2025-332.Трухан ДИ, Коншу НВ, Могилина ПО, Моисеева МВ. Уровни витаминов антиоксидантов (А, Е, С) и цинка у пациентов с сахарным диабетом и возможности их применения в качестве адъювантной терапии. Медицинский совет. 2025;19(13):313–322. https://doi.org/10.21518/ms2025-332.Rai J, Kilari AN, Sachdev H, Quazi WA, Bhattu BK, Pattnaik N, Mehta M, Late L. Study on the Antimicrobial Properties of Surface-Modified Dental Implants.J Pharm Bioallied Sci. 2025 Jun;17(Suppl 2):S1544-S1546. https://doi.org/10.4103/jpbs.jpbs_105_25.Emram R, Sionov RV, Gutkin V, Wilensky A, Steinberg D, Assad R. Mechanism of Action of Zinc Oxide Nanoparticles as an Antibacterial Agent Against Streptococcus mutans. Biomolecules. 2025 Nov 27;15(12):1660. https://doi.org/10.3390/biom15121660.Alkaya B, Kayhan HG, Demirbilek F, Sahin M, Totik N, Ozcan M, Teughels W. Clinical Effects of Zinc-containing Stents on Gingivitis: A Randomised Controlled Trial.Oral Health Prev Dent. 2025 Sep 26;23:577-584. https://doi.org/10.3290/j.ohpd.c_2275.Aziz J, Rahman MT, Vaithilingam RD. Dysregulation of metallothionein and zinc aggravates periodontal diseases. J Trace Elem Med Biol. 2021 Jul;66:126754. https://doi.org/10.1016/j.jtemb.2021.126754.Kim J, Kim S, Jeon S, Hui Z, Kim Y, Im Y, Lim W, Kim C, Choi H, Kim O. Anti-inflammatory effects of zinc in PMA-treated human gingival fibroblast cells.Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20(2):e180-7. https://doi.org/10.4317/medoral.19896.Poleník P. Zinc in etiology of periodontal disease. Med Hypotheses. 1993 Mar;40(3):182-5. https://doi.org/10.1016/0306-9877(93)90208-8.Zaĭchk VE, Bagirov ShT. The chemical element content of mixed unstimulated saliva in periodontal diseases.Stomatologiia (Mosk). 1994 Jan-Mar;73(1):8-11. URL https://pubmed.ncbi.nlm.nih.gov/8191535/Aziz J, Vaithilingam RD, Radzi Z, Rahman MT. Inflammatory Responses in Periodontitis with or Without Rheumatoid Arthritis Alter Salivary Metallothionein and Zinc. Biol Trace Elem Res. 2023 Jul;201(7):3162-3174. https://doi.org/10.1007/s12011-022-03416-yCosta PD, Canaan JCR, Midori Castelo P, Campideli Fonseca D, Márcia Pereira-Dourado S, Mendonça Murata R, Pardi V, Pereira LJ. Influence of Micronutrient Intake, Sociodemographic, and Behavioral Factors on Periodontal Status of Adults Assisted by a Public Health Care System in Brazil: A Cross-Sectional Multivariate Analysis.Nutrients. 2021 Mar 17;13(3):973. https://doi.org/10.3390/nu13030973.Thomas B, Gautam A, Prasad BR, Kumari S. Evaluation of micronutrient (zinc, copper and iron) levels in periodontitis patients with and without diabetes mellitus type 2: a biochemical study.Indian J Dent Res. 2013 Jul-Aug;24(4):468-73. https://doi.org/10.4103/0970-9290.118400.Pushparani DS. Serum Zinc and β D Glucuronidase Enzyme Level in Type 2 Diabetes Mellitus with Periodontitis.Curr Diabetes Rev. 2016;12(4):449-453. https://doi.org/10.2174/1573399811666150724094525.Willershausen B, Ross A, Försch M, Willershausen I, Mohaupt P, Callaway A. The influence of micronutrients on oral and general health.Eur J Med Res. 2011 Nov 10;16(11):514-8. https://doi.org/10.1186/2047-783x-16-11-514Kim J, Kim S, Jeon S, Hui Z, Kim Y, Im Y, Lim W, Kim C, Choi H, Kim O. Anti-inflammatory effects of zinc in PMA-treated human gingival fibroblast cells.Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20(2):e180-7. https://doi.org/10.4317/medoral.19896.Alarcón-Moreno JC, Flores-Muñoz M, Blázquez-Morales MSL, García-Rivera ME, Rodríguez-Alba JC, Castro-López CR, Nachón-García FJ, Muñoz-Muñoz VH, Nachón-García MG. "The effects of non-surgical periodontal treatment plus zinc and magnesium supplementation on oxidative stress and antioxidants enzymes in type 2 diabetes patients: a quasi-experimental study".BMC Oral Health. 2024 Aug 4;24(1):892. https://doi.org/10.1186/s12903-024-04688-7.Fiorino S, Gallo C, Zippi M,et.al. Cytokine storm in aged people with CoV-2: possible role of vitamins as therapy or preventive strategy. Aging Clin Exp Res. 2020 Oct;32(10):2115-2131. https://doi.org/10.1007/s40520-020-01669-y.Trukhan D.I., Sulimov A.F., Trukhan L.Yu. Association of arterial hypertension and periodontal disease: a review of new data. Farmateka. 2023;30(9-10):40-51. (In Russ.). https://doi.org/10.18565/pharmateca.2023.9-10.40-51Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю. Ассоциация артериальной гипертензии и патологии пародонта: обзор новых данных. Фарматека. 2023;30(9-10):40-51. https://doi.org/10.18565/pharmateca.2023.9-10.40-51Trukhan D.I., Sulimov A.F., Trukhan L. Yu. Comorbidity of arterial hypertension and periodontitis: dental hypertension. Clinical review for general practice. 2023; 4 (6): 62–68 (In Russ.). https://doi.org/10.47407/kr2023.4.5.00273Трухан Д.И., Сулимов А.Ф., Трухан Л.Ю. Коморбидность артериальной гипертензии и пародонтита: стоматологическая гипертензия. Клинический разбор в общей медицине. 2023; 4 (6): 62–68. https://doi.org/10.47407/kr2023.4.5.00273Zhang Y, Zhao Y, Zhong Y, Zeng R, Ye D, Guo D, Li W. Dietary zinc intake is inversely associated with the risk of hypertension in the periodontitis population.Front Nutr. 2025 Jul 15;12:1616989. https://doi.org/10.3389/fnut.2025.1616989.Duntas LH, Benvenga S. Selenium: an element for life. Endocrine. 2015 Apr;48(3):756-75. https://doi.org/10.1007/s12020-014-0477-6.