Resolution of Inflammation in Periodontitis: Role of Treg Cells, Lipid Mediators and Emerging Therapeutics

Abstract Periodontitis is a chronic inflammatory disease characterized by progressive destruction of the tooth-supporting structures due to microbial biofilm and a dysregulated host immune response. While conventional therapies focus on mechanical debridement, emerging evidence highlights the importance of actively resolving inflammation to restore periodontal health. Regulatory T cells (Tregs) and lipid-derived pro-resolution mediators such as lipoxins, resolvins, protectins and maresins play pivotal roles in modulating immune responses, promoting tissue regeneration, and preventing chronic inflammation. This review explores the cellular and molecular mechanisms of inflammation resolution in periodontitis, the therapeutic potential of Treg cells and lipid mediators, and novel strategies including nano-medicine, dietary interventions, and cytokine modulation. Understanding these pathways offers a paradigm shift in periodontal therapy from infection control to immune regulation and tissue healing.