DYSBIOSIS-DRIVEN IMMUNE REPROGRAMMING AND OSTEOIMMUNE TISSUE DESTRUCTION IN PERIODONTITIS: SINGLE-CELL INSIGHTS AND PROSPECTS FOR PRECISION HOST MODULATION

Periodontitis is a chronic dysbiosis-associated immunoinflammatory disease characterized by the progressive destruction of gingival connective tissue, periodontal ligament, cementum, and alveolar bone. Contemporary evidence indicates that periodontal tissue damage cannot be explained solely by the direct pathogenic activity of individual bacterial species. Instead, disease development is determined by reciprocal interactions between a dysbiotic subgingival microbial community, impaired epithelial barrier function, dysregulated innate and adaptive immunity, metabolic reprogramming of immune and stromal cells, and failure of inflammation resolution.