Emerging potential of engineered nanozymes in periodontitis treatment: from monotherapy to hierarchical therapy

The unique pathological microenvironment of periodontitis poses significant challenges to conventional therapies and drives the development of advanced treatment strategies. Engineered nanozymes as multifunctional nanomaterials offer promising alternatives for actively modulating disease microenvironments. Compared with traditional nanozymes, engineered nanozymes are rationally designed through elemental doping, heterojunction construction, and surface modification, leading to increased catalytic efficiency, microenvironmental responsiveness, and multifunctional integration. This review systematically discusses three representative engineering strategies for the treatment of periodontitis: antibacterial, anti-inflammatory, and regenerative approaches. Furthermore, we introduce the concept of "hierarchical therapy," which integrates these strategies into a unified framework for achieving more precise and effective therapeutic outcomes. Finally, this review highlights the current challenges faced by engineered nanozymes, including biosafety concerns, catalytic durability, and barriers to clinical translation. Overall, this study aimed to provide a comprehensive overview of the rational design, functional integration, and therapeutic potential of engineered nanozymes in periodontal applications, offering valuable guidance for the development of intelligent nanoplatforms for future precision oral medicine.