Periodontal diseases

Nat Rev Dis Primers. 2017 Jun 22:3:17038. doi: 10.1038/nrdp.2017.38.

Abstract

Periodontal diseases comprise a wide range of inflammatory conditions that affect the supporting structures of the teeth (the gingiva, bone and periodontal ligament), which could lead to tooth loss and contribute to systemic inflammation. Chronic periodontitis predominantly affects adults, but aggressive periodontitis may occasionally occur in children. Periodontal disease initiation and propagation is through a dysbiosis of the commensal oral microbiota (dental plaque), which then interacts with the immune defences of the host, leading to inflammation and disease. This pathophysiological situation persists through bouts of activity and quiescence, until the affected tooth is extracted or the microbial biofilm is therapeutically removed and the inflammation subsides. The severity of the periodontal disease depends on environmental and host risk factors, both modifiable (for example, smoking) and non-modifiable (for example, genetic susceptibility). Prevention is achieved with daily self-performed oral hygiene and professional removal of the microbial biofilm on a quarterly or bi-annual basis. New treatment modalities that are actively explored include antimicrobial therapy, host modulation therapy, laser therapy and tissue engineering for tissue repair and regeneration.

Publication types

  • Review

MeSH terms

  • Adult
  • Aggressive Periodontitis / complications
  • Anti-Bacterial Agents / therapeutic use
  • Biofilms / growth & development
  • Dental Plaque / complications
  • Dental Plaque / physiopathology
  • Dental Plaque / prevention & control
  • Female
  • Gingiva / pathology
  • Gingival Diseases / complications*
  • Gingival Diseases / epidemiology
  • Gingival Diseases / physiopathology
  • Humans
  • Inflammation / blood*
  • Inflammation / complications
  • Microbiota / physiology
  • Oral Hygiene / methods
  • Periodontal Diseases / complications*
  • Periodontal Diseases / epidemiology
  • Periodontal Diseases / physiopathology
  • Periodontal Diseases / prevention & control
  • Periodontal Ligament / pathology
  • Periodontitis / complications*
  • Periodontitis / epidemiology
  • Prevalence
  • Risk Factors
  • Tooth Loss / complications
  • Tooth Loss / etiology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents