Differentiated Approaches to the Treatment of Patients with Generalized Periodontitis Associated with Systemic Pathology via the Administration of Magnesium-Based Therapy

Abstract

Background: Periodontal health is intrinsically linked to systemic metabolic balance. Magnesium (Mg) plays a vital role in bone metabolism and inflammatory modulation, yet its differentiated application in patients with comorbid generalized periodontitis and osteoporosis remains underdeveloped. Objective: To evaluate the clinical efficacy of targeted magnesium-based therapy using different organic salts in patients with Stage II generalized periodontitis and systemic bone density loss. Methods: This prospective, randomized study (n = 72) compared standard therapy (Control, n = 18) with standard therapy supplemented for 30 days with: Magnesium Malate (S1), Magnesium Taurate (S2), or Magnesium Lactate (S3). Assessments included clinical indices (PMA, PBI, PPD, and a proprietary Total Periodontal Inflammation Activity Index—TPIAI) and laboratory parameters (serum Mg, DEXA-derived T-scores) at baseline, immediately post-treatment, and at 6 months. Results: All study groups showed superior results compared to the control (p < 0.05). Magnesium taurate (S2) emerged as the most potent anti-inflammatory agent, achieving the lowest TPIAI (26.38 ± 1.6) and PMA indices, likely due to the synergistic antioxidant properties of taurine (OR 4.65, p < 0.01). Magnesium lactate (S3) exhibited the highest osteotropic potential, significantly improving DEXA T-scores from – 2.56 ± 0.09 SD to – 1.13 ± 0.08 SD (p < 0.05), moving patients from the osteoporosis range to osteopenia/normal density. A strong positive correlation (r = 0.64) was found between serum Mg levels and the stabilization of periodontal pocket depth. Conclusion: Magnesium supplementation is essential for achieving stable periodontal remission in comorbid patients. A personalized approach is recommended: magnesium taurate for acute inflammatory resolution and magnesium lactate for stabilizing bone mineral density. To maintain therapeutic effects, a 30-day course (300–400 mg elemental Mg/day) is recommended, with repetition every 6 months for patients with persistent osteoporosis.