Periodontal disease is a highly prevalent chronic inflammatory condition worldwide, significantly impairing patients’ quality of life and imposing a substantial burden on healthcare systems. In recent years, significant progress has been made in the immunopathogenesis of periodontal diseases, highlighting the crucial role of immune regulation in restoring periodontal homeostasis and promoting tissue regeneration. Meanwhile, the rapid development of osteoimmunology in tissue engineering has provided a theoretical framework for elucidating periodontal bone regeneration from the perspective of immune–bone coupling and offered new insights into therapeutic optimization. This review systematically summarizes the osteoimmunological basis of periodontal bone regeneration, focusing on how the physicochemical properties of biomaterials modulate the periodontal osteoimmune microenvironment. Recent progress in osteoimmunomodulatory biomaterials for periodontal bone regeneration is summarized, highlighting strategies involving physical and chemical modifications, bioactive molecule enhancements, as well as cell- and cell-derived product–based modifications. Considering the complexity of the periodontal immune microenvironment, advances in stimuli-responsive biomaterials for immune modulation and their roles in periodontal bone regeneration are further discussed. Finally, key challenges in material design and clinical translation of osteoimmunomodulatory biomaterials are addressed, and future perspectives are proposed to provide theoretical guidance for the rational design and translational development of immunomodulatory biomaterials for periodontal bone regeneration.

Bacterial overproliferation and virulence factors in plaque biofilms can cause inflammation of soft and hard tissues around the implant, resulting in peri-implantitis. If not well controlled, severe peri-implantitis can lead to failure of implant osseointegration and implant loosening and loss. Currently, peri-implantitis can be treated by surgical and non-surgical treatment such as mechanical debridement and chemotherapy, but there remain problems related to the unpredictable therapeutic effect and high recurrence rate. Therefore, gaining a comprehensive understanding of the relationship between plaque biofilm formation and peri-implantitis is crucial for the prevention and treatment of peri-implantitis. In this article, we comprehensively review current research on the specific composition and formation process of biofilms and the influence of implant material characteristics on biofilm formation. The results of the research review indicated that peri-implantitis biofilms are composed of extracellular matrix, with a predominant population of anaerobic Gram-negative bacteria embedded within. The formation process includes the acquisition of an acquired membrane, microbial adhesion, and biofilm detachment and dispersion. Biofilm formation is primarily influenced by the implant surface roughness, surface free energy (SFE), and material properties. Current strategies for biofilm removal around implants mainly involve implant surface coating techniques, mechanical debridement, chemical agents, laser therapy, and photodynamic therapy; however, the therapeutic outcomes remain uncertain. The future research direction will be based on the characteristics of the plaque biofilm around the implant, combined with cutting-edge methods, such as nanotechnology, immunotherapy, and gene therapy, to continuously prevent the formation of plaque biofilm on the surface of the implant to prevent and treat peri-implantitis.