Predisposing Factors in the Etiology of Chronic Inflammatory Periodontal Disease

Reparative Phase Events on Periodontal Disease Progression: Interpretation and Considerations

“…These data demonstrates that susceptibility to periodontal disease differs among diverse individuals and differs in various sites in the same individual, and sometimes differs among surfaces of a tooth [1,5,10,13,15,17,32]. This fact may be due the multifactorial etiology of periodontal disease that requires an association among bacteria and diverse risk factors to induce the development of periodontal disease destructive phase [5,11,14,32]. The risk factor may be an inherent characteristic associated with an increased rate of a subsequently occurring disease, but does not necessarily cause the disease.…”

“…The risk factor may be an inherent characteristic associated with an increased rate of a subsequently occurring disease, but does not necessarily cause the disease. In periodontal disease, the risk factors may be defined as local environmental factors, behavioral factors in nature and systemic factors, which may be responsible in providing an ideal environment for bacterial colonization and/or fragility in a determinate tooth or teeth and adjacent periodontal tissues and/or interference in the inflammatory process [5,11,32,33]. Due to the association with risk factors, the opportunist endogenous bacteria, which are predominant in establishing gingival margin inflammation, also may induce destruction in the initial phase of periodontitis [1,2,8,10,17].…”

“…This fact may be corroborated for the evidence that the research which studied aggressive pathogenic bacteria establishing correlation with periodontitis, have proposed a methodology to harvest the aggressive pathogenic bacteria from recognized periodontally diseased sites. It is improbable that these exogenous anaerobic and facultative aggressive bacteria act intensively as the unique etiological factor, mainly for the onset of periodontitis [3][4][5][6][7][9][10][11][12]14,15,17]. In addition when researchers induce experimental periodontitis, the workers always needs to apply risk factors, such as a ligature around the teeth, to assist bacteria to provoke periodontal disease [4,19,[27][28][29].…”

“…The etiology of periodontal disease is multifactorial, in which bacterial plaque plays an essential role in the development of the disease [1][2][3][4][5][6][7][8][9][10][11][12]. Nevertheless, it has become clear that not all patients with periodontitis harbor the same subgingival microflora, and patients that harbor bacterial species recognized as indicators of periodontal disease may not develop periodontal breakdown all the time [3,6,7,10,[12][13][14][15].…”

“…Nevertheless, it has become clear that not all patients with periodontitis harbor the same subgingival microflora, and patients that harbor bacterial species recognized as indicators of periodontal disease may not develop periodontal breakdown all the time [3,6,7,10,[12][13][14][15]. Periodontal disease onset and progression results from a multifactorial etiology and the etiologic agents must act in association to induce periodic and destructive acute inflammatory responses intercalated by a stable chronic inflammatory process [5,10,11,14,15]. Since bacteria are the essential etiologic agents that cause periodontitis, the principal goal of periodontal treatment is based on control or elimination of bacterial pathogens and theirs derived products [1,3,4].…”