Periodontal diseases

• Published in: Nature reviews. Disease primers Vol. 3; no. 1; p. 17038
• Main Authors: Kinane, Denis F., Stathopoulou, Panagiota G., Papapanou, Panos N.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 22.06.2017; Nature Publishing Group
• Subjects: 631/250/256/2515; 631/326/41; 692/699/3020/3029; 692/700/3032/3149/3028; Adult; Aggressive Periodontitis - complications; Anti-Bacterial Agents - therapeutic use; Biofilms; Biofilms - growth & development; Cancer Research; Dental Plaque - complications; Dental Plaque - physiopathology; Dental Plaque - prevention & control; Disease; Epidemiology; Female; Gingiva - pathology; Gingival Diseases - complications; Gingival Diseases - epidemiology; Gingival Diseases - physiopathology; Gum disease; Humans; Inflammation; Inflammation - blood; Inflammation - complications; Internal Medicine; Medical Microbiology; Medicine; Medicine & Public Health; 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; primer; Quality of Life Research; Risk Factors; Tissue engineering; Tooth Loss - complications; Tooth Loss - etiology; Treatment Outcome
• ISSN: 2056-676X; 2056-676X
• DOI: 10.1038/nrdp.2017.38

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. Periodontal diseases are characterized by inflammation and loss of the tissues supporting the teeth, which could lead to eating and speaking problems. Although some risk factors are non-modifiable (for example, genetic susceptibility), others, such as smoking, can be effectively managed.