Oral microbiome and homeostatic regulation of periodontal health: From dysbiosis to precision intervention

Abstract

The oral microbiome is a key component of periodontal health, functioning within a dynamic network involving microbial communities, host immunity, and the local tissue microenvironment. This review summarizes recent advances in the mechanisms underlying periodontal homeostasis, the transition to dysbiosis, and emerging strategies for precision diagnosis and therapy. Periodontal dysbiosis involves not only compositional shifts but also functional remodeling, metabolic remodeling, and dysregulated host‒microbiome interactions, contributing to chronic inflammation, osteoimmune dysregulation, and periodontal tissue destruction. Recent advances in multi‐omics technologies and artificial intelligence have accelerated biomarker discovery, disease risk prediction, and precision diagnostics. Meanwhile, microbiome‐based interventions, including microecological preparations, phage therapy, quorum quenching, oral microbiota transplantation, and nanoparticle‐based targeted drug delivery, are shifting periodontal management from broad‐spectrum antimicrobial approaches toward ecological restoration. Although challenges remain in mechanistic understanding, standardization, and clinical translation, integrating systems biology, multi‐omics, and artificial intelligence is expected to facilitate early diagnosis, personalized intervention, and long‐term maintenance of periodontal health. This review presents an integrated framework linking periodontal homeostasis, dysbiosis, precision diagnostics, and microbiome‐based interventions, providing perspectives for microbiome‐guided precision periodontal medicine.