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Periodontal diseases

Nature Reviews Disease Primers volume 3, Article number: 17038 (2017) | Download Citation

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.

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Acknowledgements

The authors thank M. Benakanakere for assistance in developing Figure 3.

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Affiliations

  1. University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, Pennsylvania 19104, USA.

    • Denis F. Kinane
    •  & Panagiota G. Stathopoulou
  2. Columbia University College of Dental Medicine, New York, New York, USA.

    • Panos N. Papapanou

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  3. Search for Panos N. Papapanou in:

Contributions

Introduction (D.F.K.); Epidemiology (P.N.P.); Mechanisms/pathophysiology (D.F.K.); Diagnosis, screening and prevention (D.F.K. and P.G.S.); Management (P.G.S.); Quality of life (D.F.K.); Outlook (D.F.K.); Overview of Primer (D.F.K.).

Competing interests

The authors declare no competing interests.

Corresponding author

Correspondence to Denis F. Kinane.

About this article

Publication history

Published

DOI

https://doi.org/10.1038/nrdp.2017.38

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