Intelligent biomaterials for periodontitis and peri-implantitis therapies: stimuli-responsive strategies targeting inflammation and regeneration

Periodontitis and peri-implantitis, driven by dysbiotic biofilms and aberrant host immune responses, lead to pathological inflammation and alveolar bone resorption. Conventional therapies targeting microbial debridement and inflammation control often fail to achieve predictable tissue regeneration. Recent advances in biomaterial science have introduced intelligent biomaterials as transformative tools for precision treatment and functional tissue restoration. These bioengineered scaffolds dynamically interact with the pathological microenvironment through programmable responses to external or endogenous stimuli, enabling spatiotemporal control over immunomodulation, antimicrobial delivery, and osteogenic differentiation. This review aims to comprehensively summarize the progress of intelligent biomaterials in the treatment of periodontitis and peri-implantitis, highlighting their potential for providing targeted and controllable therapy, providing guidance for the development of clinically translatable strategies in future periodontal regenerative medicine, and underscoring multifunctionality, adaptive responsiveness, and enhanced control over efficacy. It systematically reviews the mechanisms, design strategies, advantages and limitations of intelligent biomaterials in addressing the complex pathophysiology of periodontitis and peri-implantitis. By integrating multifunctional responsiveness with clinical applicability, these systems offer unprecedented potential to bridge antimicrobial therapy and regenerative dentistry.