Combating Periodontitis through Vaccination: A Review of Emerging Immunological Strategies

Abstract Periodontal disease is a chronic inflammatory condition caused by microbial dysbiosis and host immune response, leading to progressive destruction of the supporting structures of the teeth. Conventional therapies such as mechanical debridement and antimicrobial strategies offer only temporary control and do not prevent recurrence. In recent years, periodontal vaccination has become a promising adjunct for the prevention and management of periodontitis. Several literatures were analyzed, including preclinical and clinical studies focused on vaccine candidates targeting key periodontal pathogens, predominantly Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia. Numerous periodontal vaccines have demonstrated immunogenicity and partial protective effects in animal models, with several strategies showing promise in reducing bacterial colonization and modulating destructive immune responses. However, translation to human application remains limited due to challenges such as antigenic variability, delivery systems, and the complexity of the host microbiome interaction. This review provides a comprehensive overview of current advances in periodontal vaccine development, examining key antigens, vaccine platforms, immunization strategies, and the immunopathology of periodontitis that underpins vaccine design.