Related Experiment Video
Updated: Aug 9, 2026
Murine Model of Advanced Periodontitis Induced by Nylon Ligature in the Second Upper Molar
Published on: May 30, 2025
Precision periodontology in clinical practice: bridging omics and clinical decision-making
Simone Sevi1, Stefano Romeggio2, Gilberto Dinatale2
1Department of Medicine and Surgery, University of Insubria, Varese, Italy. simone.sevi@uninsubria.it.
Background:
Precision periodontology integrates molecular diagnostics, genomics, and advanced imaging into clinical decision-making. Despite major advances in microbiome characterisation, host genetics, and inflammatory biomarkers, their translation into routine care remains limited.
Objectives:
To critically appraise current evidence on microbiome-based profiling, genetic and epigenetic markers, host-response biomarkers, and three-dimensional imaging in periodontology, and to propose a conceptual decision-support framework linking diagnostic outputs to potential therapeutic actions and future implementation research.
Materials And Methods:
A narrative review searching PubMed/MEDLINE, Scopus, Embase, and the Cochrane Library (2010-2025) using terms related to precision periodontology, subgingival microbiome, periodontitis genetics and epigenetics, salivary and GCF biomarkers, aMMP-8, CBCT, risk assessment, and artificial intelligence. Priority was given to meta-analyses, systematic reviews, longitudinal studies, and guideline documents.
Results:
Microbiological testing has defined but narrow indications; single-SNP genotyping has not demonstrated clinical utility commensurate with cost; aMMP-8 point-of-care testing is among the most extensively investigated host-response tools and may have adjunctive value in selected monitoring and peri-implant scenarios; however, current evidence remains insufficient to support routine diagnostic implementation. CBCT may directly influence surgical decision-making through defect morphology characterisation. AI-based models show promise but lack prospective clinical validation. These conclusions are consistent with the 20th EFP Workshop Consensus Report.
Conclusions:
Precision periodontology currently operates in addition to, rather than in replacement of, conventional staging and grading. We propose a conceptual decision-threshold framework for the selective consideration of molecular and advanced imaging tools when their additive contribution may meaningfully inform management. This framework should be regarded as a research-oriented decision-support model rather than a validated clinical algorithm.
Clinical Relevance:
Clinicians are provided with a structured, evidence-based framework that identifies specific clinical scenarios where molecular diagnostics, host-response biomarkers, and three-dimensional imaging may meaningfully modify periodontal treatment decisions, supporting the operationalisation of precision approaches in daily practice.
