Genetic Testing in Periodontitis: A Narrative Review on Current Applications, Limitations, and Future Perspectives

Background: Periodontitis is a multifactorial inflammatory disease with a complex interplay\r\nbetween microbial, environmental, and host-related factors. Among host factors, genetic\r\nsusceptibility plays a significant role in influencing both disease onset and progression.\r\nOver the past two decades, a wide range of genetic tests, ranging from single-nucleotide\r\npolymorphism (SNP) analysis to genome-wide association studies (GWAS), have been\r\nexplored to assess individual risk profiles and potential treatment responses. However,\r\ndespite initial enthusiasm, the clinical integration of genetic testing in periodontics remains\r\nlimited. This narrative review aims to critically examine the current landscape of genetic\r\ntesting in periodontitis, including commercially available tests, their scientific validity, and\r\ntheir clinical utility. Methods: Most relevant studies which were published in recent years\r\nwere identified by using the major scientific search engines, including PubMed, Scopus, and\r\nWeb of Science. Articles discussing genetic susceptibility, key gene polymorphisms, and\r\nemerging technologies were included in this narrative review. Results: Polymorphisms in\r\ngenes coding for IL-1, IL-6, TNF-α, and in others involved in immune modulation and bone\r\nmetabolism, are associated with periodontitis. Nevertheless, there are limitations related\r\nto heterogeneity in study design, population stratification, and gene–environment interactions.\r\nMoreover, emerging technologies, including polygenic risk scoring and machine\r\nlearning approaches, may enhance the predictive value of genetic tools in periodontology.\r\nConclusions: A deeper understanding of genetic susceptibility could pave the way for\r\nprecision dentistry and personalized periodontal care, but significant hurdles remain before\r\ngenetic testing can become a routine component of periodontal diagnostics.