The Precision Paradigm in Periodontology: A Multilevel Framework for Tailored Diagnosis, Treatment, and Prevention.

Abstract

Background: Precision medicine in periodontology seeks to individualize prevention, diagnosis, and treatment based on biological, genetic, behavioral, and environmental factors. This approach addresses the limitations of standardized protocols, which often fail to consider patient-specific variability in disease susceptibility and progression. Materials and Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (ID: CRD42024593760). Searches were performed in PubMed, Scopus, and Web of Science (2014-2025) using terms related to precision and personalized medicine in periodontology. Studies were screened based on predefined inclusion criteria, and risk of bias was assessed using the ROBINS tool. Results: Sixteen studies met the inclusion criteria. Diagnostic tools integrating biomarkers (e.g., IL-1β, salivary and GCF proteomics) and digital platforms (e.g., flowcharts and decision support systems) showed improved accuracy and early disease detection. Personalized treatments, including host-modulating therapies and customized antibiotics, improved clinical outcomes. Tailored preventive strategies based on genetic, systemic, and behavioral risk profiling reduced tooth loss and optimized care frequency. Conclusions: Precision periodontology enhances patient-centered care by integrating omics technologies, real-time diagnostics, and behavioral insights. This paradigm improves diagnostic precision, therapeutic outcomes, and long-term prevention, supporting its broader implementation in clinical practice.