Prevalence of Periodontal Disease Determined by the Presence of Periodontal Pockets Alone

Reparative Phase Events on Periodontal Disease Progression: Interpretation and Considerations

“…However, gingivitis susceptibility varied considerably among the various individuals who harbored the similar bacterial complex. 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].…”

“…Furthermore, is impossible to identify in relevant publications, any consistent evidence confirming that pathogens considered as periodontopathogenic bacteria, could induce experimental periodontitis without association with an additional risk factor. Bacteria may not establish preference to colonize only one tooth or group of teeth [1,5,10,[13][14][15]32]. However the vast majority of periodontal disease induce localized destruction in a dental region, around a single tooth, in an interproximal space, or on the side of a single tooth, fundamentally due association among opportunist bacteria and the diverse local risk factors, which may establish a favorable environment for bacteria colonization and development or/and may provoke fragility in periodontal tissues around a tooth facilitating bacterial action [5,13,32,33,41].…”

“…Bacteria may not establish preference to colonize only one tooth or group of teeth [1,5,10,[13][14][15]32]. However the vast majority of periodontal disease induce localized destruction in a dental region, around a single tooth, in an interproximal space, or on the side of a single tooth, fundamentally due association among opportunist bacteria and the diverse local risk factors, which may establish a favorable environment for bacteria colonization and development or/and may provoke fragility in periodontal tissues around a tooth facilitating bacterial action [5,13,32,33,41]. When periodontal destruction is generalized, probably opportunist bacteria are associated with systemic risk factors, which affect inflammatory process inducting altered defense response against opportunist bacteria and consequently, generalized periodontal destruction [5,11,32,43].…”

“…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].…”

“…The active acute phase of periodontal disease, which causes periodontal tissue destruction, is not persistent and does not produce the same pattern of destruction in the periodontal tissues around the teeth [10,[13][14][15]17,18]. Instead, the active acute phase is brief, periodic, and may occur in various locations in different teeth or only in a single tooth, always intercalated by a stable chronic phase [13,15]. Due the absence of a predictive trustful test to identify earlier the destructive acute phase of periodontal disease, the majority of periodontal treatments are performed when the disease presents a stable and reparative chronic phase.…”