Phyto-Immunological Interface in Periodontics: A Synergistic Review of Ayurvedic Molecular Therapeutics and Contemporary Clinical Standards

Abstract

Periodontal disease is a complex inflammatory disorder involving a dysbiotic microbiome and an aberrant host-immune response. While Scaling and Root Planing (SRP) remains the clinical gold standard, the persistent nature of pro-inflammatory cytokines often leads to recurrence. Objective: This review provides a comprehensive molecular exploration of Ayurvedic bioactives and their potential to modulate the periodontal inflammatory cascade, specifically targeting Matrix Metalloproteinases (MMPs) and the NF-κB pathway. Methods: A systematic multi-database search (PubMed, Scopus, DHARA, and Web of Science) was conducted for literature published between 2015 and 2025. The review correlates ancient 'Dantamoola' concepts with modern immunomodulatory findings. Results: Molecular analysis reveals a synergistic multi-target effect of Ayurvedic phytochemicals. While Curcumin (from Haridra) and chebulinic acid (from Triphala) act as potent inhibitors of TNF-α, IL-1β, and MMP-9, other bioactives like azadirachtin (from Neem) and Glycyrrhizin (from Yashtimadhu) provide critical anti-adhesion and immunomodulatory support. Clinical data suggests that integrative protocols, such as Gandusha (oil pulling), provide anti-biofilm properties comparable to 0.2% chlorhexidine without associated cytotoxicity. Furthermore, the emergence of 'Nano-Ayurveda' offers a novel sustained-release drug delivery model for localized periodontal therapy. Conclusion: An integrative "Bio-Ayurvedic" approach offers a superior, biocompatible, and sustainable therapeutic model. It addresses both the microbial etiology and host susceptibility, bridging the gap between traditional wisdom and modern "Green Periodontics.".