Substance P-A neuropeptide regulator of periodontal disease pathogenesis and potential novel therapeutic entity: A narrative review

Substance P (SP), a neuropeptide primarily released by neurons, has emerged as a key player in the intricate network of factors governing periodontal inflammation, immune responses, bone metabolism, and tissue regeneration. Due to its multifaceted role, it may be explored for its potential participation in periodontal therapeutic strategies. The databases, PubMed/MEDLINE, and SCOPUS were searched for all published articles on SP, its role in inflammation, and periodontal disease. The following search terms, adapted to the specific database, were used; "substance p AND periodontal *" AND "therapeutics" and records were retrieved. All articles not pertaining to SP in periodontal health and disease were excluded from the study. The full texts of eligible articles were retrieved. Data on SP and its role in inflammation and in periodontal health, disease, and therapy were extracted and have been presented as a narrative review. SP manifests during inflammatory phase of periodontal disease and is one of the causes of bone loss. According to studies, the gingival crevicular fluid from areas with active periodontal disease and bone loss had the greatest levels of SP. These chemicals may linger long enough to trigger neurogenic inflammation and elicit pain in tissues that are vulnerable to it. SP expression during progression of periodontal disease might be a risk factor for individuals with systemic inflammatory diseases, such as chronic arthritis. However, SP may be manipulated to provide avenues for management of periodontal disease and thereby serve as therapeutic target.