Periodontal Pathogenesis, Host Modulation, and Novel Therapeutic Strategies

This chapter provides an in-depth review of current understanding of the pathogenesis of periodontal diseases, with particular focus on the dysbiotic shift in the subgingival microbiome, the host immune-inflammatory response, and the mechanisms by which systemic conditions bidirectionally interact with periodontal health. It evaluates advances in host modulation therapy, including the use of sub-antimicrobial dose doxycycline, resolvins, and biologics targeting key inflammatory mediators. The chapter also reviews emerging local drug delivery systems, laser-assisted periodontal therapy, and the potential of regenerative approaches — including enamel matrix derivatives and recombinant growth factors — in the surgical management of intrabony and furcation defects.