Nanoceria-mediated redox modulation for periodontal management: Mechanisms, applications, and challenges

Periodontitis is caused by dental plaque that triggers the host immune responses by the dysregulation of reactive oxygen species (ROS), leading to the destruction of local tissues such as gingiva, periodontal ligament, and alveolar bone. With its high prevalence, periodontitis impacts the oral health of billions worldwide. Clinical therapy for periodontitis relies on mechanical debridement and adjunctive antibiotics, strategies that often result in incomplete efficacy and a high recurrence rate. The development of cerium oxide nanoparticles (nanoceria), which exhibits enzyme-like catalytic activity and biocompatibility, enables targeted redox modulation to restore ROS balance, showing promise for clinical treatment. Based on above, this article focuses on the pathogenesis of periodontitis and the regulatory functions of ROS, and summarizes the design principles, functional engineering, and therapeutic mechanisms of nanoceria for periodontal therapy. Furthermore, the review outlines preventive strategies against periodontitis based on nanoceria. It then discusses the associated clinical challenges and future prospects. Overall, this work provides a comprehensive overview of nanoceria as the redox-based strategy for periodontal management. • Nanoceria enables bidirectional ROS regulation aligned with periodontitis progression. • The Ce 3+ /Ce 4+ redox cycling of nanoceria provides enzyme-mimetic activities supporting antibacterial, anti-inflammatory, and regenerative effects. • Functionalization strategies enhance nanoceria’s targeting precision and therapeutic performance through surface modification, composite construction, and biomaterial integration. • Nanoceria-based systems enable early detection of periodontal biomarkers and pathogens for preventive management.