Chronic generalized periodontitis (CGP) is a disease of periodontium tissues supporting tooth induced by bacteria, that is characterized by the presence of processes of inflammation with destruction ofbone tissue. The knowledge of molecular mechanisms of CGP pathogenesis facilitates creation of the most effective methods of therapy of this disease. Bacterial infection is a primary factor in periodontitis etiology, however is not sufficient for its start and subsequent development. It is known, that bacterial factors induce a local inflammation reaction and activate the system of innate immunity through activation of Toll-like receptors (TLR), located on the surface of resident cells and leukocytes. Activation of these cells results in production of pro-inflammatory cytokines and recruitment of phagocytes and lymphocytes into the inflammation zone. In review we examined the known data regarding factors of immune protection of periodontium including cell populations and cytokines, as well as mechanisms of tissue destruction, that support the tooth. Perspectives of therapy are also discussed.

The expression of TLR4 and HBD3 in epithelial cells of the oral cavity was studied using polymerase chain reaction in real-time in patients with inflammatory and destructive periodontal lesions before and after surgery using osteoplastic material. Analysis of TLR4 and HBD3 expression in epithelial cells demonstrates the key role of the innate immune factors in the pathogenesis of inflammatory and destructive periodontal lesions. TLR4 gene expression was increased 1.5-7.0 times and HBD3 1.5-5.0 times compared to healthy individuals. Surgical treatment resulted in an effective rehabilitation and normalization of innate immunity.