Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms, periodontal pocketing, clinical attachment loss and alveolar bone destruction. Both periodontal pathogens and the host inflammatory response contribute to tissue destruction.The primary goal of therapy is to arrest disease progression through plaque control, risk-factor management and subgingival instrumentation. However, scaling and root planing may be inadequate in deep pockets, furcations and inaccessible root areas. Local drug delivery provides targeted antimicrobial action, maintains therapeutic drug concentrations at the disease site and minimizes systemic effects.Common agents include tetracycline, minocycline and metronidazole, delivered through gels, fibres, films, microspheres and nanoparticles. Recent advances include injectable hydrogels, biodegradable nanoparticles and host-modulatory systems, offering promising approaches for improved management of periodontitis and peri-implant diseases.
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