Tao Jiawen, Sun Yirong, Wang Guoliang, Sun Jingru, Dong Shujun, Ding Jianxun
The First Outpatient Department, Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, School and Hospital of Stomatology, Jilin University, 6822 Jinhu Road, Changchun, 130021, PR China.
Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022, PR China.
Bioact Mater. 2025 Feb 27;48:474-492. doi: 10.1016/j.bioactmat.2025.02.026. eCollection 2025 Jun.
Periodontitis is a chronic inflammatory disease primarily caused by bacteria, leading to inflamed and bleeding gums, periodontal pocket formation, and bone loss. Affecting 70%-90% of adults over 65, periodontitis is a leading cause of tooth loss and significantly impacts quality of life. Standard treatments, including subgingival scraping and antibiotics, have limitations, and antibiotic resistance among periodontal pathogens is an increasing concern. Biofilms are barriers to drugs and immune responses, contributing to bacterial resistance and reducing antibiotic effectiveness. Due to their adjustable physicochemical properties, bioactive materials potentially eliminate bacterial biofilms, presenting a promising alternative for periodontitis therapy. In this review, the recent innovations in biomaterials for removing mature biofilms in periodontitis are examined, and their broader potential is discussed. Additionally, the compositions of bacterial biofilms, formation pathways, and intrinsic drug resistance mechanisms are discussed. Finally, the strategies for optimizing subgingival biofilm removal in periodontitis are highlighted, such as targeting biofilms-embedded bacteria, disrupting the extracellular polymeric substances, and utilizing combined approaches. A comprehensive understanding of the properties of biomaterials guides the rational design of highly targeted and effective therapies for periodontitis.
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