Harnessing ultrasound-responsive technologies for precision periodontitis therapy: a perspective

Periodontitis disease normally shows oxidative stress, immunological dysregulation, alteration of the periodontal bacterial ecology, and persistent alveolar bone loss. These mechanisms aggravate problems across the body in conjunction with causing tooth loss. The-state-of-the-art therapies using antimicrobial agents and mechanical debridement often fail to regulate immune signaling, clear infection, or repair tissue. Most recently, ultrasound-responsive materials have stood out to show advantages in restoring periodontal balance, which include two types (piezoelectric and sonodynamic materials). For sonodynamic materials, they generate reactive oxygen species (ROS) via acoustic cavitation, which degrades biofilms and disables microorganisms through oxidative damage. For piezoelectric materials, they convert mechanical stress into electrical polarization, resulting in surface charges that drive redox processes, affect immunological responses, and stimulate bone growth. Importantly, we highlight, to improve the periodontitis treatment outcomes, how these materials are incorporated into platforms such as injectable hydrogels, membranes, and scaffolds, which serve as carrier matrices for placing active medicines and improving spatiotemporal control. Also, we point out that integration of piezoelectric and sonodynamic technologies provides a way to combine antibacterial activity with regeneration stimuli. Moreover, challenges such as material stability, activation accuracy, and clinical translation are there and greater mechanistic understanding and rigorous design criteria are required for further development.