Periodontitis: facts, fallacies and the future

Abstract

This volume of Periodontology 2000 represents the 25th anniversary of the Journal, and uses the occasion to assess important advancements in periodontology over the past quarter-century as well as the hurdles that remain. Periodontitis is defined by pathologic loss of the periodontal ligament and alveolar bone. The disease involves complex dynamic interactions among active herpesviruses, specific bacterial pathogens and destructive immune responses. Periodontal diagnostics is currently based on clinical rather than etiologic criteria, and provides limited therapeutic guidance. Periodontal causative treatment consists of scaling, antiseptic rinses and occasionally systemic antibiotics, and surgical intervention has been de-emphasized, except perhaps for the most advanced types of periodontitis. Plastic surgical therapy includes soft-tissue grafting to cover exposed root surfaces and bone grafting to provide support for implants. Dental implants are used to replace severely diseased or missing teeth, but implant overuse is of concern. The utility of laser treatment for periodontitis remains unresolved. Host modulation and risk-factor modification therapies may benefit select patient groups. Patient self-care is a critical part of periodontal health care, and twice-weekly oral rinsing with 0.10-0.25% sodium hypochlorite constitutes a valuable adjunct to conventional anti-plaque and anti-gingivitis treatments. A link between periodontal herpesviruses and systemic diseases is a strong biological plausibility. In summary, research during the past 25 years has significantly changed our concepts of periodontitis pathobiology and has produced more-effective and less-costly therapeutic options.

Psychometric properties of the Brief Illness Perception Questionnaire (Brief‐IPQ) in periodontal diseases

“…Patients who have an unrealistic or negative perception about PDs may benefit from a brief intervention such as counselling. A multidimensional approach, combining clinical diagnosis with psychosocial and systemic dimensions, is essential to improve global understanding of PDs (Baskaradoss, ; Papapanou & Susin, ; Slots, ).…”

The effect of NLRP inflammasome on the regulation of AGEs‐induced inflammatory response in human periodontal ligament cells

“…Periodontitis is characterized by inflammation of the periodontal ligament and destruction of alveolar bone . Animal experiments and epidemiological researches confirm that severity of periodontitis is highly related to diabetes .…”

Herpesvirus‐bacteria synergistic interaction in periodontitis

“…Effective control of gingivitis restricts herpesviruses imbedded in inflammatory cells from entering the periodontium, and a number of basic periodontal therapies combined with systemic antiviral chemotherapy can resolve established periodontal herpesvirus infections . Maintaining a healthy periodontium depends on proper self‐care, but current methods of oral hygiene require considerable patient commitment, and are often inadequately implemented . Oral rinsing twice‐weekly with 0.25% sodium hypochlorite (dilute household bleach) can markedly improve the subgingival microbiota and the periodontal status, even in unscaled deep pockets, and constitutes a valuable adjunct to traditional patient self‐care …”

“…Maintaining a healthy periodontium depends on proper self‐care, but current methods of oral hygiene require considerable patient commitment, and are often inadequately implemented . Oral rinsing twice‐weekly with 0.25% sodium hypochlorite (dilute household bleach) can markedly improve the subgingival microbiota and the periodontal status, even in unscaled deep pockets, and constitutes a valuable adjunct to traditional patient self‐care …”