An update on periodontal aetiopathogenesis and clinical implications

Periodontal disease is the most commonly occurring yet unusual infection in humans. It is initiated by pathogenic plaque biofilm and characterized by bacteria-induced inflammatory destruction of tooth-supporting structures and alveolar bone. Periodontitis remains the most common cause of tooth loss in adults. Currently, periodontal diseases are also recognized as serious infections with profound effects on general health. In recent years, new concepts and discoveries have been made in further understanding of the nature of periodontal disease and its aetiopathogenesis. These can be well reflected in recognition of dental plaque as a biofilm; identification and characterization of periodontopathogens and their virulence factors; recognition of the importance of host-microbe symbiosis in periodontal health; identification of novel innate host defence molecules in periodontal tissues; further understanding of the molecular mechanisms involved in tissue destruction and alveolar bone resorption; appreciation of the crucial role of host susceptibility in periodontal pathogenesis; and identification of risk factors and incorporation of risk assessment in clinical practice. Committed oral health care professionals should therefore keep abreast of these changing concepts in periodontology and updated strategies for appropriate evidence-based practice. These views are fundamentally important for prevention, diagnosis and treatment of periodontal diseases and peri-implant infections, as well as for long-term maintenance of periodontal health and implant stability. This paper updates the advances in aetiopathogenesis of periodontal disease and highlights the relevant clinical implications and future perspectives.