Phytochemicals in Treatment of Periodontal Disease: A Review of Mechanisms and Roles.

Periodontitis, a chronic inflammatory oral disease affecting over 10% of the global population, causes periodontal tissue destruction and tooth loss. Conventional treatments are hindered by antibiotic resistance and limited tissue regeneration. Phytochemicals offer promising alternatives due to their antimicrobial, anti-inflammatory, and regenerative properties. This review evaluates their therapeutic potential in periodontitis management. Phytochemicals effectively combat key periodontal pathogens by disrupting bacterial membranes, inhibiting metabolism, and preventing biofilm formation. They also mitigate inflammation by targeting pathways such as NF-kappaB, MAPK, JAK/STAT, Wnt, PI3K/Akt, and Nrf2/HO1, reducing tissue damage. Additionally, phytochemicals promote periodontal regeneration by enhancing stem cell osteogenic differentiation, optimizing the osteogenic microenvironment, and accelerating soft-tissue repair. Several clinical studies show significant reductions in bone loss and improved clinical outcomes. However, the active components and long-term efficacy of phytochemicals require further investigation. Future research should prioritize in-depth in vivo studies and clinical trials to confirm the safety and effectiveness of phytochemicals for periodontitis prevention and treatment. In summary, phytochemicals offer a multifaceted approach to managing periodontitis, with significant potential to transform clinical practice pending further validation.