Traditional antimicrobial therapies for periodontitis (PD) have long focused on non-selective and direct approaches that give immediate though short lived clinical improvements. Professional cleaning of the subgingival biofilm by instrumentation of dental root surfaces, known as scaling and root planning (SRP), is the mainstay of periodontal therapy and is indisputably effective. Non-physical approaches, used as adjuncts to SRP, such as chemical and biological agents, will be the focus of this review. We will review traditional antibiotic and antiseptic approaches, but will emphasize immunotherapeutic agents under development that indirectly inhibit microbial colonization/growth and/or bone loss by reducing inflammation. Moreover, those agents that have clear molecular targets and defined mechanisms of action will be stressed. Many of these 'host modulation' agents, have only become possible through decades of research on host-pathogen interactions and the immunopathogenesis of PD. More investment in such approaches is warranted and a goal worth pursuing given the tremendous benefits selective approaches might offer to patients with periodontitis.
This entry is adapted from the peer-reviewed paper 10.3390/ijms22126459