Exploring innovative approaches and genetic roles in periodontal health care: a narrative review

Periodontitis is a common inflammatory disorder that causes irreversible damage to the periodontium, resulting in tooth mobility and loss, negatively affecting quality of life. It is also linked to systemic diseases like cardiovascular problems, diabetes, and rheumatoid arthritis due to common inflammatory pathways. The disease develops from a complex interplay between microbial, genetic, host, and environmental factors. Bacteria such as Porphyromonas gingivalis and Treponema denticola disrupt the immune response, promoting tissue destruction. Traditional treatments like scaling and root planing (SRP) and surgical methods reduce microbial burden but fail to address host-microbe interactions completely. New advancements in microbiome research and personalized medicine offer hope for more precise therapies targeting individual risk factors. This review explores the pathogenesis of periodontitis, current treatment strategies, and the genetic aspects influencing the disease. It highlights the role of microbial imbalance, with harmful bacteria exacerbating inflammation and tissue damage. Non-surgical treatments such as SRP are foundational, while adjunct therapies like antibiotics, probiotics, and regenerative approaches, including bone grafting, offer additional benefits. The review also emphasizes the potential of personalized treatments based on genetic and microbial profiling, offering the possibility of more effective, targeted therapies for improved long-term patient outcomes.