ABSTRACT

Periodontology is a rapidly evolving discipline that integrates knowledge from microbiology, immunology, genetics, and clinical dentistry. Despite significant advancements, various aspects of periodontal disease remain controversial, posing challenges in diagnosis, treatment, and interdisciplinary integration. This review aims to analyze the key areas of divergence within periodontics, including the classification of periodontal diseases, the role and significance of attached gingiva, etiological factors such as bacterial dysbiosis and genetic predisposition, and the influence of systemic conditions and psychosomatic stress. It further explores diagnostic dilemmas, debates in instrumentation and surgical versus non-surgical therapy, and the evolving principles of periodontal-restorative and orthodontic interrelationships. The controversies surrounding dental implant therapy and peri-implant diseases are also addressed. By critically examining these contentious areas, the need for continuous research to resolve ambiguities and enhance patient outcomes in periodontal care