Modulating the periodontal wound microenvironment through oxygen therapy: a narrative review on the biological basis, clinical applications and future perspectives.

Topical oxygen-releasing formulations have emerged as a potential adjunctive approach to enhance wound healing outcomes in conditions such as gingivitis, periodontitis and peri-implant diseases. Periodontal wound healing is a complex biological process influenced by microbial load, tissue oxygenation, and host inflammatory responses. This narrative review aimed to evaluate the available clinical evidence on the effectiveness of topical oxygen-releasing products in oral soft and hard tissue wound management. Unlike previous broad reviews of topical oxygen therapy, this review specifically synthesizes its role in periodontal wound healing, compares clinical outcomes with conventional therapies, and evaluates emerging opportunities for integration into regenerative periodontal strategies. An organised literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published till 2025. Eligible studies included primarily randomized controlled trials, evaluating clinical outcomes related to periodontal wound healing. A structured search of five electronic databases was undertaken, and eligible studies were narratively synthesized in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA). Included studies, were evaluated qualitatively to compare the efficacy of topical oxygen therapy as an adjunct in periodontal wound healing. The findings suggest that topical oxygen-releasing formulations provide adjunctive benefits in specific contexts, particularly in postoperative healing, periodontal therapy, enhancing soft tissue healing, and improving patient-reported outcomes such as pain and discomfort. However, many outcomes were comparable to conventional therapies such as chlorhexidine. Topical oxygen-releasing formulations appear to be a potential adjunct in periodontal wound repair, particularly in hypoxic or inflammatory conditions.