Host Modulation in Periodontology: Redefining Therapy Beyond Scaling and Root Planing

The management of periodontal diseases has traditionally centered on mechanical debridement through scaling and root planing, a cornerstone of periodontal therapy. While effective in reducing bacterial load and disrupting biofilm, this approach alone does not fully address the complex host-mediated inflammatory pathways that drive disease progression and tissue destruction. Advances in molecular biology and immunology have revealed the critical role of host response modulation in periodontal pathogenesis, leading to the development of adjunctive therapeutic strategies that go beyond mechanical intervention. Emerging agents, such as subantimicrobial dose doxycycline, non-steroidal anti-inflammatory drugs, pro-resolving lipid mediators, and host-targeted biologics, demonstrate potential in attenuating destructive inflammation while promoting resolution and regeneration. This editorial explores the evolving concept of host modulation in periodontology, emphasizing its role in redefining therapeutic goals, improving long-term outcomes, and personalizing care for patients with periodontitis. By integrating host-modulatory approaches into routine practice, periodontology is poised to transition from a solely pathogen-centered model to a comprehensive, host-focused paradigm.