The extracellular matrix (ECM) is a complex, dynamic network composed of proteins, glycosaminoglycans, proteoglycans, minerals, and water, providing structural support and biochemical functions for cells. Matrix metalloproteinases (MMPs) are key proteolytic enzymes that degrade all ECM components, playing crucial roles in physiological and pathological processes such as embryogenesis, wound healing, and tissue remodeling. However, their activity is also associated with chronic inflammation, tissue breakdown, fibrosis, and cancer invasion and metastasis. Periodontitis, a chronic inflammation affecting the periodontium, is characterized by increased MMP activity, leading to irreversible loss of periodontal tissues. The ECM in the periodontium, composed of connective tissues, is highly dynamic and constantly remodeled. MMPs are involved in the development and diseases of the oral cavity, including dental erosion, caries, pulpitis, periapical periodontitis, and oral cancer. In periodontitis, the balance between host response and bacterial virulence is disrupted, leading to the degradation of the ECM by MMPs, resulting in tissue destruction. The periodontium, including the gingiva, periodontal ligament, cementum, and alveolar bone, is a complex structure with specific ECM components. MMPs play a significant role in the turnover and remodeling of these tissues, but their activity is tightly regulated by tissue inhibitors of MMPs (TIMPs) and other factors. Excessive MMP activity, as seen in periodontitis, leads to uncontrolled tissue destruction and subsequent tooth loss, affecting overall health and well-being. This review provides a comprehensive insight into the molecular aspects of periodontal anatomy and the role of MMPs in both physiological and pathological processes, highlighting the importance of understanding MMP activity in the context of periodontal diseases.The extracellular matrix (ECM) is a complex, dynamic network composed of proteins, glycosaminoglycans, proteoglycans, minerals, and water, providing structural support and biochemical functions for cells. Matrix metalloproteinases (MMPs) are key proteolytic enzymes that degrade all ECM components, playing crucial roles in physiological and pathological processes such as embryogenesis, wound healing, and tissue remodeling. However, their activity is also associated with chronic inflammation, tissue breakdown, fibrosis, and cancer invasion and metastasis. Periodontitis, a chronic inflammation affecting the periodontium, is characterized by increased MMP activity, leading to irreversible loss of periodontal tissues. The ECM in the periodontium, composed of connective tissues, is highly dynamic and constantly remodeled. MMPs are involved in the development and diseases of the oral cavity, including dental erosion, caries, pulpitis, periapical periodontitis, and oral cancer. In periodontitis, the balance between host response and bacterial virulence is disrupted, leading to the degradation of the ECM by MMPs, resulting in tissue destruction. The periodontium, including the gingiva, periodontal ligament, cementum, and alveolar bone, is a complex structure with specific ECM components. MMPs play a significant role in the turnover and remodeling of these tissues, but their activity is tightly regulated by tissue inhibitors of MMPs (TIMPs) and other factors. Excessive MMP activity, as seen in periodontitis, leads to uncontrolled tissue destruction and subsequent tooth loss, affecting overall health and well-being. This review provides a comprehensive insight into the molecular aspects of periodontal anatomy and the role of MMPs in both physiological and pathological processes, highlighting the importance of understanding MMP activity in the context of periodontal diseases.