Inflammation and Uncoupling as Mechanisms of Periodontal Bone Loss

• Published in: Journal of Dental Research Vol. 90; no. 2; pp. 143 - 153
• Main Authors: Graves, D.T., Li, J., Cochran, D.L.
• Format: Book Review Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.02.2011; International Association for Dental Research
• Subjects: Adaptive Immunity; Alveolar Bone Loss - immunology; Alveolar Bone Loss - metabolism; Alveolar Bone Loss - microbiology; Animals; Biological and medical sciences; Bone Matrix - metabolism; Bone Remodeling - physiology; CD4-Positive T-Lymphocytes - immunology; Cytokines - metabolism; Dental Plaque - microbiology; Dentistry; Diseases of the osteoarticular system; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Gingivitis - immunology; Gingivitis - microbiology; Humans; Inflammation Mediators - metabolism; Medical sciences; Osteoporosis. Osteomalacia. Paget disease; Otorhinolaryngology. Stomatology; Porphyromonas gingivalis - pathogenicity; Reviews; cytokine; RANK ligand; innate immunity; IL-1; bone matrix; osteoblast; osteoclast; TNF; adaptive immunity; Pathogenesis; Diseases of the osteoarticular system; Natural immunity; Osteoclast; Review; Osteoarticular system; Interleukin 1; Osteoblast; Bone matrix; Osteopenia; Human; Acquired immunity; Receptor activator Nfkb ligand; Stomatology; Cytokine; Alveolar bone; Inflammation; Periodontal disease; Tumor necrosis factor; Animal
• ISSN: 0022-0345; 1544-0591; 1544-0591
• DOI: 10.1177/0022034510385236

Periodontal disease is characterized by both inflammation and bone loss. Advances in research in both these areas have led to a new appreciation of not only each field but also the intimate relationship between inflammation and bone loss. This relationship has resulted in a new field of science called osteoimmunology and provides a context for better understanding the pathogenesis of periodontal disease. In this review, we discuss several aspects of the immuno-inflammatory host response that ultimately results in loss of alveolar bone. A proposal is made that periodontal inflammation not only stimulates osteoclastogenesis but also interferes with the uncoupling of bone formation and bone resorption, consistent with a pathologic process. Furthermore, arguments based on experimental animal models suggest a critical role of the spatial and temporal aspects of inflammation in the periodontium. A review of these findings leads to a new paradigm to help explain more fully the impact of inflammation on alveolar bone in periodontal disease so that it includes the effects of inflammation on uncoupling of bone formation from resorption.