Periodontal Medicine 2.0: a framework for evidence-calibrated, integrated and patient-centred care.

Periodontal medicine has generated substantial evidence that periodontal and systemic health are biologically, behaviourally, and socially interconnected. Yet a persistent translational gap remains: knowledge of oral-systemic relationships has advanced faster than the systems required to convert this knowledge into coordinated, patient-centred care. Dentistry and medicine continue to operate within fragmented professional structures, limiting opportunities for prevention, early risk identification, and longitudinal disease management. We propose Periodontal Medicine 2.0 (PM2.0), an author derived conceptual hypothesis that reimagines periodontal medicine beyond the study of oral-systemic associations toward evidence-calibrated translation and integrated care. Its proposed contribution lies in the clinically significant interactions amongst the four principal domains centred on the periodontal patient: integrated oral-systemic screening, interprofessional collaborative care, precision periodontal medicine, and population health and policy integration. Digital health and AI, patient engagement, health literacy, equity, ethics and implementation science are positioned as cross-cutting enablers. PM2.0 proposes that these domains should interact according to evidence maturity, clinical relevance and implementation readiness, rather than through uniform integration. The framework distinguishes association from causality, screening from diagnosis, diagnostic performance from clinical utility, and technological capability from demonstrated patient benefit. It proposes a risk based, longitudinal pathway linking periodontal assessment with selective risk identification, coordinated care, individualized management and evaluation. The central hypothesis is that appropriately connected and evidence-calibrated functions may generate greater translational value than fragmented approaches. This proposition is testable through clinical, patient reported, implementation, economic, safety and equity outcomes. PM2.0 is therefore presented not as an established historical stage, clinical guideline or validated model of care, but as a literature-informed hypothesis for the future organization of periodontal medicine- from association to evidence based action, and from action to demonstrable impact.