Reframing Periodontitis: A Concise Review of Shifting Paradigms and Contemporary Clinical Practice

Document Type

Review

Publication Date

8-1-2026

Abstract

Introduction and aims Periodontitis is a highly prevalent, chronic inflammatory disease that progressively destroys tooth-supporting structures, significantly impacting systemic health and patient quality of life. Given its global public health implications, a current, evidence-based understanding of periodontitis management is essential, particularly as therapeutic strategies have evolved rapidly. This paper critically traces the evolution of periodontitis management from historical paradigms to modern, evidence-based practices, highlighting how shifting conceptual frameworks have reshaped clinical decision-making and patient care. Methods A structured narrative literature review was conducted, analysing recent clinical studies, systematic reviews, updated classification systems, and internationally recognised treatment guidelines. Results This review highlights emerging paradigm shifts in the aetiopathogenesis, risk factors, and treatment of periodontitis. Advances in diagnostic tools and classification systems now enable refined, risk-informed, and personalised care pathways. Despite these improvements, the global prevalence of periodontitis remains high. Given that periodontitis is largely preventable, this work aims to re-engineer current therapeutic strategies to prioritise robust preventive measures. This approach is combined with updated, validated clinical protocols for curative treatment, aiming to drastically reduce the global burden of disease and its systemic impact. Conclusion with clinical relevance Current evidence-based guidelines underscore a shift toward personalised periodontal care, emphasising tailored, patient-specific management over 'one-size-fits-all' protocols. Future research must prioritise refining diagnostic precision and validating innovative, preventive strategies to bridge the gap between scientific advancements and everyday clinical practice.

Keywords

Adjuncts, Antibiotics, Biofilm, Clinical practice guidelines, Microbial, Periodontitis, Risk factors

Publication Title

International Dental Journal

ISSN

0020-6539

DOI

10.1016/j.identj.2026.109598

Volume

76

Issue

4

Publisher

Elsevier

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