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Current concepts in periodontal pathogenesis.

Philip M Preshaw1, Robin A Seymour, Peter A Heasman

  • 1School of Dental Sciences, University of Newcastle upon Tyne, UK.

Dental Update
|January 20, 2005
PubMed
Summary

Severe periodontitis affects 10-15% of people, while gingivitis and mild periodontitis are common. Understanding periodontal disease involves studying its epidemiology, microbiology, and pathogenesis.

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Area of Science:

  • Periodontology
  • Oral Microbiology
  • Immunology

Background:

  • Severe periodontitis impacts 10-15% of the population, with milder forms affecting the majority.
  • Plaque bacteria form protective biofilms, necessitating mechanical disruption for treatment.
  • Periodontal disease results from bacterial presence in a susceptible host, modulated by immune responses.

Purpose of the Study:

  • To review current understanding in periodontics.
  • Focus on periodontal epidemiology, microbiology, and pathogenesis.
  • Highlight the role of host-pathogen interactions and immune responses.

Main Methods:

  • Review of existing periodontal research over 40 years.
  • Analysis of epidemiological data on periodontitis prevalence.
  • Examination of microbiological findings on key pathogens and biofilms.
  • Discussion of host immune-inflammatory responses and influencing factors.

Main Results:

  • Identification of key bacterial pathogens in periodontal disease.
  • Understanding of biofilm formation and its protective role.
  • Recognition of the susceptible host's role in disease progression.
  • Elucidation of genetic and environmental factors influencing the host response.

Conclusions:

  • Root surface instrumentation (RSI) is crucial for mechanical biofilm disruption.
  • Host immune-inflammatory responses, influenced by genetics and environment, are central to tissue destruction.
  • Both hypo- and hyper-responsiveness of the host immune system can exacerbate periodontal damage.

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