Adjunctive Therapies in Periodontitis: Current Concepts and the Future.

Area of Science:

• Periodontal Medicine
• Translational Research
• Therapeutic Innovation

Background:

• Periodontitis involves chronic inflammation and bone loss, necessitating adjunctive therapies beyond mechanical biofilm control.
• Translating preclinical discoveries into effective clinical treatments for periodontitis remains a significant challenge.
• Current research highlights the need for improved translational methodologies and innovative adjunctive strategies.

Purpose of the Study:

• To critically review translational research methodology and adjunctive therapeutic innovation in periodontitis management.
• To examine how preclinical findings can be more effectively bridged to clinical practice.
• To identify promising adjunctive modalities and emerging translational tools.

Main Methods:

• Narrative review synthesizing evidence from experimental, translational, and clinical studies up to September 2025.
• Emphasis on mechanistic insights, model validity, and translational feasibility of various adjuncts.
• Analysis of limitations in current animal models and their impact on human extrapolation.

Main Results:

• Animal models offer mechanistic insights but have limitations (interspecies differences, kinetics, endpoints) affecting translational predictability.
• Promising adjunctive therapies include specialized pro-resolving mediators, probiotics, natural compounds (curcumin, resveratrol), and antimicrobial photodynamic therapy.
• Emerging tools like bioresponsive delivery systems, nanocarriers, 3D scaffolds, and AI-driven precision periodontics show potential.

Conclusions:

• Harmonized translational models, bioresponsive delivery platforms, and precision diagnostics are crucial for advancing adjunctive periodontal therapy.
• Aligning methodological rigor with therapeutic innovation can accelerate the clinical integration of novel treatments.
• Improved translational research is key to bridging preclinical efficacy with real-world outcomes for periodontitis management.