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Antibiotics
Volume 15
Issue 4
10.3390/antibiotics15040397
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Review

Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics

by
Nada Tawfig Hashim
1,2,*,
Rasha Babiker
3,
Muhammed Mustahsen Rahman
1,
Riham Mohammed
4,
Vivek Padmanabhan
5,
Md Sofiqul Islam
6,
Mariam Elsheikh
7,
Salma Musa Adam Abduljalil
8,
Ghiath Mahmoud
9,
Nallan C. S. K. Chaitanya
10,
Bogahawatte Samarakoon Mudiyanselage Samadarani Siriwardena
11,
Ayman Ahmed
12 and
Bakri Gobara Gismalla
2
1
Department of Periodontics, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
2
Department of Oral Rehabilitation, Faculty of Dentistry, University of Khartoum, Khartoum 11115, Sudan
3
Department of Physiology, RAK College of Medical Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 11172, United Arab Emirates
4
Department of Oral Surgery, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
5
Department of Pediatric and Preventive Dentistry, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
6
Department of Operative Dentistry, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
7
Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, University of Khartoum, Khartoum 11115, Sudan
8
Department of Periodontology, Faculty of Dentistry, National University, Khartoum 11115, Sudan
9
Orthodontics Department, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
10
Department of Oral Medicine and Radiology, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
11
Department of Oral Pathology, RAK College of Dental Sciences, RAK Medical & Health Sciences University, Ras-AlKhaimah 12973, United Arab Emirates
12
Department of Periodontology and Implantology, Nile University, Khartoum 11115, Sudan
 
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*
Author to whom correspondence should be addressed.
Antibiotics 2026, 15(4), 397; https://doi.org/10.3390/antibiotics15040397
Submission received: 12 March 2026 / Revised: 8 April 2026 / Accepted: 10 April 2026 / Published: 14 April 2026
(This article belongs to the Special Issue Strategies to Combat Antibiotic Resistance and Microbial Biofilms)
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Abstract

Periodontitis is a highly prevalent chronic inflammatory disease with significant oral and systemic consequences, including associations with cardiovascular disease, diabetes, and adverse pregnancy outcomes. Although mechanical debridement remains the cornerstone of therapy, adjunctive antibiotic use is increasingly limited by antimicrobial resistance, biofilm-associated tolerance, pharmacokinetic constraints, and disruption of the commensal microbiome, leading to inconsistent outcomes and disease recurrence. This review highlights the mechanistic limitations of conventional antibiotic therapies in periodontitis and critically examines emerging next-generation therapeutic strategies aimed at overcoming these challenges. Specifically, it explores antimicrobial peptides, quorum sensing inhibitors, nanotechnology-based drug delivery systems, host modulation approaches, and microbiome-targeted therapies, with emphasis on their molecular mechanisms, clinical relevance, and translational potential. By integrating microbial, host, and pharmacological perspectives, this review provides a comprehensive framework for advancing precision-guided periodontal therapy and supports the shift toward targeted, sustainable, and personalized treatment strategies.
Keywords: periodontitis; antimicrobial resistance; biofilms; antimicrobial peptides; quorum sensing inhibitors; nanomedicine; host modulation; probiotics; postbiotics; pharmacogenomics periodontitis; antimicrobial resistance; biofilms; antimicrobial peptides; quorum sensing inhibitors; nanomedicine; host modulation; probiotics; postbiotics; pharmacogenomics
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MDPI and ACS Style

Hashim, N.T.; Babiker, R.; Rahman, M.M.; Mohammed, R.; Padmanabhan, V.; Islam, M.S.; Elsheikh, M.; Abduljalil, S.M.A.; Mahmoud, G.; Chaitanya, N.C.S.K.; et al. Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics. Antibiotics 2026, 15, 397. https://doi.org/10.3390/antibiotics15040397

AMA Style

Hashim NT, Babiker R, Rahman MM, Mohammed R, Padmanabhan V, Islam MS, Elsheikh M, Abduljalil SMA, Mahmoud G, Chaitanya NCSK, et al. Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics. Antibiotics. 2026; 15(4):397. https://doi.org/10.3390/antibiotics15040397

Chicago/Turabian Style

Hashim, Nada Tawfig, Rasha Babiker, Muhammed Mustahsen Rahman, Riham Mohammed, Vivek Padmanabhan, Md Sofiqul Islam, Mariam Elsheikh, Salma Musa Adam Abduljalil, Ghiath Mahmoud, Nallan C. S. K. Chaitanya, and et al. 2026. "Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics" Antibiotics 15, no. 4: 397. https://doi.org/10.3390/antibiotics15040397

APA Style

Hashim, N. T., Babiker, R., Rahman, M. M., Mohammed, R., Padmanabhan, V., Islam, M. S., Elsheikh, M., Abduljalil, S. M. A., Mahmoud, G., Chaitanya, N. C. S. K., Siriwardena, B. S. M. S., Ahmed, A., & Gismalla, B. G. (2026). Targeting Bacterial Infections in Periodontal Disease: From Conventional Antibiotics to Next-Generation Therapeutics. Antibiotics, 15(4), 397. https://doi.org/10.3390/antibiotics15040397

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