[Imbalance and reconstruction of periodontal homeostasis: new perspectives on the pathogenesis, prevention and treatment of periodontitis].

Periodontal homeostasis is a dynamic equilibrium based on healthy periodontal structures, a relatively stable oral microbiome, appropriately regulated host immunity, coordinated cellular metabolism, and a functional dentition with normal occlusion. This review aims to systematically elucidate the key mechanisms underlying the maintenance and disruption of periodontal homeostasis. The dysregulation of microbiota and excessive immune activation mutually reinforce each other, serving as the core driving forces for the occurrence and progression of periodontitis. On this basis, a treatment approach oriented toward "re-establishing periodontal homeostasis" is proposed. Based on microbiota remodeling and structural reconstruction, combined with host immune regulation and immunometabolic intervention, emphasizing systemic risk factor management and functional dentition reconstruction, we aim to establish a personalized, precise, and sustainable new model for periodontal prevention and treatment.