Category: Basic Periodontology

Introduction to the genetic aspect of periodontal diseases Periodontitis may have a slow (Grade A), moderate (Grade B) or rapid (Grade C) rate of progression (see “Classification of periodontal and peri-implant diseases and conditions”). Grade A/B periodontitis has a slow rate of disease progression which is consistent with the presence of local factors; whereas, Grade…

Introduction to risk factors for periodontal diseases There is strong evidence available today suggesting a multifactorial etiology of periodontal diseases. It has been demonstrated that the susceptibility of different individuals to periodontitis for the same amount of local factors is variable. Some individuals demonstrate less periodontal breakdown, whereas other demonstrate significantly more, for a similar…

Introduction to host-modulation therapeutics As already discussed in the previous chapters, the primary etiology of periodontal diseases is bacterial infection 1. In addition to bacterial etiology, the progression of periodontal diseases is adversely influenced by a number of risk factors and risk indicators like diabetes, gender, age, hereditary factors and smoking 2. Traditional treatments focused…

Introduction to host modulation As discussed in previous chapters, periodontal disease progression is associated with subgingival bacterial colonization and biofilm formation. This microbial biofilm elicits a host response, with resultant osseous and soft tissue destruction. In response to endotoxins derived from periodontal pathogens, various inflammatory chemical mediators are released by the host cells. The immunoinflammatory…

Introduction Various defense mechanisms active in the oral cavity include saliva, gingival sulcular/crevicular fluid, intact epithelial barrier (junctional epithelium), the presence of beneficial flora, migrating polymorphonuclear cells and other leukocytes, and local antibody production. The gingival crevicular fluid (GCF) and saliva play an important role in the defense mechanism of the oral cavity. Both GCF…

Introduction to osteoimmunology Periodontal arena harbors a very complex biofilm which consists of numerous bacterial species 1, 2. As this biofilm matures, there is an increased accumulation of facultative anaerobic, Gram-negative microorganisms 3, which result in early vascular changes in the periodontium, with exudation and migration of phagocytic cells, including neutrophils and monocytes/ macrophages, into…

Introduction to matrix metalloproteinases The matrix metalloproteinases (MMPs) are a family of structurally and functionally related endoproteinases that are collectively capable of degrading most of the components of the extracellular matrix (ECM) 1, 2. They are calcium-dependent, zinc-containing endopeptidases, which are involved in tissue remodeling and degradation of the ECM, including collagens, elastins, gelatin, matrix…

Introduction to cytokines Cytokines (in Greek ”Cyto-”, cell; and ”-Kinos”, movement) are the substances that are secreted by specific cells of the immune system which carry signals locally between the cells, and thus have an effect on other cells. A special subset of cytokines is the interleukins (ILs), of which 23 different types have been…

Introduction to neutrophils Neutrophilic polymorphonuclear leukocytes or poly-morphonuclear neutrophils (PMNs) play a crucial role in host defense by phagocytosing and killing the invading microorganisms, and in the pathogenesis of inflammatory diseases 1, 2. Neutrophils accumulate at the site of inflammation and can promote vascular injury through the secretion of granule constituents, reactive oxygen metabolites, and…

Introduction Tannerella forsythia, Treponema denticola, Prevotella intermedia, Fusobacterium nucleatum, and Capnocytophaga species are major periodontal pathogens. These bacteria have been found in increased numbers in areas with active periodontal destruction. There are many other microorganisms also which are actively involved in periodontal disease progression but have not been well investigated. In the present discussion, we…