Piezocatalytic Therapy for Periodontitis: From Biofilm Disruption to Immunomodulatory Tissue Regeneration

Abstract

Periodontitis is a chronic inflammatory disease characterized by an interplay between microbial dysbiosis and dysregulated host immune responses. Traditional therapies, including scaling and root planing combined with localized antimicrobial administration, often struggle with the drug resistance of structured biofilms and persistent inflammation. Piezocatalysis is an emerging on-demand intervention that, in situ, transforms mechanical energy from both endogenous and exogenous sources into therapeutic reactive oxygen species (ROS) and bioelectric signals. Unlike conventional antibiotics, these locally generated ROS can degrade the biofilm matrix to eradicate resistant pathogens, while the concurrent bioelectric cues resolve persistent inflammation, offering a promising solution for periodontitis treatment. This review delineates the evolution of piezoelectric biomaterials and analyzes activation strategies tailored for the oral microenvironment. Key clinical translation bottlenecks, including the protein corona effect and biofilm penetration barriers, are critically addressed. Furthermore, synergistic methods that integrate nanocatalytic therapy and immune engineering strategies are highlighted to modulate the periodontal immune microenvironment. By leveraging stimuli-responsive elements and biomimetic materials, piezocatalytic platforms are evolving from passive bactericidal agents into bioactive modulators capable of simultaneously eradicating pathogens and guiding tissue healing. This shift marks a transition from disease control toward the precise reconstruction of periodontal homeostasis and functional tissue regeneration.