Recent Advances in Host Modulation Therapy: Emerging Strategies for Modifying the Periodontal Host Response

Periodontitis is a chronic inflammatory disease characterized by the destruction of tooth-supporting tissues, primarily driven by an exaggerated host immune-inflammatory response to microbial biofilm. Conventional periodontal therapy focuses mainly on mechanical plaque control; however, it does not directly address the underlying host-mediated tissue breakdown. This limitation has led to the emergence of Host Modulation Therapy (HMT) as an adjunctive approach in periodontal management. Host modulation therapy aims to alter or down-regulate destructive inflammatory pathways while enhancing protective and regenerative mechanisms, thereby restoring the balance between host defense and tissue destruction. Recent advances in this field have expanded beyond the use of sub-antimicrobial dose doxycycline to include non-steroidal anti-inflammatory drugs, bisphosphonates, statins, omega-3 fatty acids with specialized pro-resolving mediators probiotics, antioxidants, and biologic agents targeting specific cytokines and enzymes involved in periodontal inflammation and bone resorption.