References

Mitsis FJ. Hippocrates in the golden age: his life, his work and his contributions to dentistry. J Am Coll Dent. 1991; 58:26-30
Kassebaum NJ, Bernabe E, Dahiya M Global burden of severe periodontitis in 1990–2010: a systematic review and meta-regression. J Dent Res. 2014; 93:1045-1053 https://doi.org/10.1177/0022034514552491
Loe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age. J Clin Periodontol. 1986; 13:431-445 https://doi.org/10.1111/j.1600-051x.1986.tb01487.x
Zhuang LF, Watt RM, Steiner S Subgingival microbiota of Sri Lankan tea labourers naive to oral hygiene measures. J Clin Periodontol. 2014; 41:433-441 https://doi.org/10.1111/jcpe.12230
Norderyd O, Hugoson A, Grusovin G. Risk of severe periodontal disease in a Swedish adult population. A longitudinal study. J Clin Periodontol. 1999; 26:608-615 https://doi.org/10.1034/j.1600-051x.1999.260908.x
Brinig MM, Lepp PW, Ouverney CC Prevalence of bacteria of division TM7 in human subgingival plaque and their association with disease. Appl Environ Microbiol. 2003; 69:1687-1694 https://doi.org/10.1128/AEM.69.3.1687-1694.2003
Ximenez-Fyvie LA, Haffajee AD, Socransky SS. Comparison of the microbiota of supra- and subgingival plaque in health and periodontitis. J Clin Periodontol. 2000; 27:648-657 https://doi.org/10.1034/j.1600-051x.2000.027009648.x
Kumar PS, Mason MR, Brooker MR, O'Brien K. Pyrosequencing reveals unique microbial signatures associated with healthy and failing dental implants. J Clin Periodontol. 2012; 39:425-433 https://doi.org/10.1111/j.1600-051X.2012.01856.x
Kistler JO, Booth V, Bradshaw DJ, Wade WG. Bacterial community development in experimental gingivitis. PLoS One. 2013; 8 https://doi.org/10.1371/journal.pone.0071227
Pelekos G, Ho SN, Acharya A A double-blind, paralleled-arm, placebo-controlled and randomized clinical trial of the effectiveness of probiotics as an adjunct in periodontal care. J Clin Periodontol. 2019; 46:1217-1227 https://doi.org/10.1111/jcpe.13191
Zheng H, Xu L, Wang Z Subgingival microbiome in patients with healthy and ailing dental implants. Sci Rep. 2015; 5 https://doi.org/10.1038/srep10948
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Van Dyke TE, Bartold PM, Reynolds EC. The nexus between periodontal inflammation and dysbiosis. Front Immunol. 2020; 11 https://doi.org/10.3389/fimmu.2020.00511
Lafaurie GI, Sabogal MA, Castillo DM Microbiome and microbial biofilm profiles of peri-implantitis: a systematic review. J Periodontol. 2017; 88:1066-1089 https://doi.org/10.1902/jop.2017.170123

New Insights into the Pathogenesis of Periodontal Diseases

From Volume 49, Issue 4, April 2022 | Pages 314-317

Authors

Svetislav Zaric

BDS, MSc, PhD, FHEA

NIHR Academic Clinical Lecturer, Specialty Registrar in Periodontology

Articles by Svetislav Zaric

Email Svetislav Zaric

Mark Ide

BDS, MSc, PhD, FDS(RestDent), FDSRCS(Eng), FHEA, BDS, MSc, PhD, FDS (RestDent), FDSRCS (Eng)

Professor/Honorary Consultant in Periodontology

Articles by Mark Ide

Luigi Nibali

Professor/Honorary Consultant in Periodontology; Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London

Articles by Luigi Nibali

Abstract

Throughout our lives, we continuously encounter micro-organisms that range from those essential for health, to those causing diseases. The oral cavity is permanently colonized by micro-organisms and our immune system has a challenging role in maintaining oral homeostasis by balancing its responses to this unique microbiota, while preserving the structural integrity of oral tissues. This article discusses relationships between oral microbial community structure and activity, specifically addressing the role of low-abundance microbial species and their interplay with the host immune system, in view of the pathogenesis of dental plaque-induced periodontal conditions.

CPD/Clinical Relevance: The knowledge of periodontal disease pathogenesis is critical for understanding periodontal risk assessment and designing effective, patient-centred treatment options.

Article

Unlike dental caries, which historically developed as a result of emerging civilizations, periodontal diseases are as old as humanity. They also affect wild and domesticated animals and continue to be one of the most prevalent diseases affecting humankind. Ancient Egyptians and the Chinese characterized periodontal diseases as inflammatory conditions, and Hippocrates discussed the aetiology, pathogenesis and treatment options for different forms of gum problems.1 Nowadays, severe periodontitis is the sixth-most prevalent condition worldwide, with an overall prevalence of 10.8% and around 743 million people affected.2 This figure corresponds surprisingly well with the seminal work of Loe et al. in Sri Lankan tea workers, who despite the fact of having high levels of plaque, calculus and gingival inflammation, showed rapid progression of periodontal disease in 8% of cases, while 11% of the examined population were largely free of alveolar bone loss.3 Modern, culture-independent methods have recently been used to characterize the subgingival microbiota of this ‘classical’ cohort of Sri Lankan tea workers, naïve to oral hygiene practices.4 Although significant differences in the overall subgingival microbial compositions were identified between shallow and deep periodontal sites, there was no obvious microbial clustering of the subjects according to their respective clinical progression groups, confirming the important role of the individual host response in the progression of the disease. Interestingly, improvements in plaque control and consequent reduction in mild disease in other cohort studies, did not necessarily result in similar reductions in the prevalence of severe periodontitis.5

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