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1 Introduction Periodontitis and peri-implantitis are chronic inflammatory diseases characterized by progressive destruction of the tooth- and implant-supporting tissues, ultimately leading to tooth loss and implant failure ( Periodontitis is among the most prevalent non-communicable diseases globally, affecting over one billion individuals, with severe forms ranking among the leading causes of years lived with disability ( While periodontitis and peri-implantitis share several inflammatory and oxidative stress–related mechanisms, they represent biologically distinct tissue environments

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To ensure that higher scores reflected a better outcome, the raw data for the appearance and symptom scales were scored as follows: “not at all” = 4, “a little” = 3, “quite a bit” = 2, and “very much” = 1