The etiology and pathogenesis of periodontitis

Major advances have been made in our basic understanding of periodontal disease during the last decade. Pathways whereby bacteria destroy the periodontal connective tissues and alveolar bone have been elucidated. The manner in which various risk factors alter these pathways to enhance risk and amplify the onset and progression of disease is becoming clearer. Furthermore, a strong link between periodontitis and potentially fatal systemic diseases and conditions has been demonstrated. These advances in knowledge have led to the development of new approaches to treatment that enhance our capacity to prevent and control oral infections and to decrease potential systemic disease consequences.