However, the incidence of progression of the disease to the unaffected teeth was not demonstrated. For this reason, it is important to understand the different molecular and cellular mechanisms of the pathogenesis of periodontal disease, with the purpose of making an opportune diagnosis and appropriate treatment and prognosis. Likewise, activated T and B cells produce both the membrane-bound and soluble RANKL forms. In addition, the periodontal ligament has the capacity to act as a sensory receptor necessary for the proper positioning of the jaws during mastication, and, very importantly, it is a cell reservoir for tissue homeostasis, regeneration, and repair [4]. tactile stimuli. A consideration of currently available data has permitted the formulation of a new concept of the pathogenesis of this disease. Severe periodontitis requires periodontal treatment is required. The main function of the periodontium is to join the tooth to the bone tissue and maintain integrity on the surface of the masticatory mucosa of the oral cavity [6]. It affects nearly 50% of adult population and 60% of aged population globally. It's usually the result of poor oral hygiene. The inflammatory response is mainly characterized by four successive phases: (1) silent phase, where the cells synthesize and release the first proinflammatory mediators; (2) vascular phase, characterized by an increase in vascular permeability and dilatation; (3) cellular phase, characterized by the infiltration of inflammatory cells at the site of injury; and (4) the resolution of the inflammatory response [22]. Consensus Report: Chronic periodontitis. The main etiologic factor of periodontal disease is bacteria which substantially harbor the human oral cavity. Pathogenesis of acute (a,b), chronic (c), and cystic (d,e) apical periodontitis (AP) lesions. PATHOGENESIS OF CHRONIC PERIODONTITIS. By making research easy to access, and puts the academic needs of the researchers before the business interests of publishers. These processes result in the destruction of the tissues that surround and support the teeth, and eventually in the loss of tissues, bones and finally, of the teeth [17]. In addition, they can promote the survival, proliferation, and development of B cells into antibody-secreting plasma cells. Affiliations. Chronic periodontitis (1) 1. Subsequently, the established lesion develops within 2–3 weeks. In the alveolar bone, the RANKL/OPG/RANK system controls the balance of the bone metabolism [43]. Approximately 10% of the global adult population is highly vulnerable to severe periodontitis, and 10–15% appears to be completely resistant to it, while the remainder varies between these two situations [1]. Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In the presence of IL-12, IL-18 induces a Th1 response, whereas, in the absence of IL-12, a Th2 response is promoted . These effector functions of the Th2 lymphocytes negatively regulate the inflammatory and Th1 lymphocyte responses, so that the polarization of a Th2-type immune response in periodontitis may represent a damaged adaptive immune response [18, 49]. Preianò M, Savino R, Villella C, Pelaia C, Terracciano R. Int J Mol Sci. 1111 /j. Pathogenesis of chronic periodontitis The role of host immune system in periodontal pathogenesis involves the following in response to bacterial infection 5 (Fig. The disease serves as a convenient experimental model for analysis of many aspects of chronic inflammation. Our readership spans scientists, professors, researchers, librarians, and students, as well as business professionals. © 2019 The Author(s). The major components of chronic lesions (c) are lymphocytes (Ly), plasma cells (Pc), and macrophages (Ma). It is characterized by a dense infiltrate of lymphocytes and other mononuclear cells, pathologic alteration of fibroblasts, and continuing loss of the connective tissue substance. HeadquartersIntechOpen Limited5 Princes Gate Court,London, SW7 2QJ,UNITED KINGDOM. Pathophysiology. Th2 lymphocytes are the main cellular source of IL-4, which promotes the change of class to the secretion of IgE in B cells and favors the alternative activation of macrophages in an IFN-γ-independent pathway. J Clin Periodontol. Brief introduction to this section that descibes Open Access especially from an IntechOpen perspective, Want to get in touch? Understanding periodontal pathogenesis is key to improving management strategies for this common, complex disease. Periodontal abscesses formation. en C. María Isabel Chávez-Ruvalcaba, and Dra. Inflammation is a physiological response of the innate immune system against several endogenous or exogenous stimuli. PATHOGENESIS Apical periodontitis may be acute (symptomatic) or chronic (asymptomatic). A consideration of currently available data has permitted the formulation of a new concept of the pathogenesis of this disease. Deo V, Bhongade ML. Unlike the bone, the root cementum does not contain blood or lymphatic vessels, lacks innervation, and does not undergo remodeling or physiological resorption, but it is characterized by the fact that continues to be deposited throughout life [6]. A comprehensive search of the literature in English was performed using the keywords: periodontitis, periodontal disease, combined with the words genes, mutation, or polymorphism. It is generally accepted that periodontitis is initiated by complex and diverse microbial biofilms which form on the teeth, i.e. The inflammatory response consists of four main components: (1) endogenous or exogenous factors, such as molecular patterns associated with pathogens (PAMP) and damage (DAMP), which are derived from bacteria, viruses, fungi, parasites, and cell damage, as well as toxic cellular components or any other harmful condition; (2) cellular receptors that recognize these molecular patterns (PRR), for example, Toll-like receptors (TLR); (3) proinflammatory mediators, such as cytokines, chemokines, the complement system, etc. The existence of periodontal destruction at even one tooth in the mouth increases the risk of further periodontal destruction. Chronic periodontitis (1) 1. According to the Global Oral Health Programme, conducted by the World Health Organization (WHO), around 5-15% of the global population (34-45 years of age) suffer from severe periodontitis Chronic periodontitis, a common disease of microbial origin, is the major cause of tooth loss in adult humans. Pathogenesis of chronic periodontitis The role of host immune system in periodontal pathogenesis involves the following in response to bacterial infection 5 (Fig. It is a complex disease with multifactorial etiology. On the other hand, Th1 lymphocytes have a fundamental role in the establishment and progression of periodontitis, through the increase of IFN-γ levels [18]. It can occur independently vnas lidok microtrauma, chronic pulpitis or after treatment e pulpitis, but often the disease develops after treatment of other chronic forms of periodontitis. Periodontitis is a major public health problem due to its high prevalence, as well as because it may lead to tooth loss and disability, negatively affect chewing function and aesthetics, be a source of social inequality, and impair the quality of life. Periodontitis is a chronic inflammatory condition characterized by destruction of non-mineralized and mineralized connective tissues. Periodontitis can be defined as a chronic inflammatory disease initiated by dental plaque biofilm and perpetuated by a deregulated immune response usually accompanied by an irreversible destruction of the supporting tissues surrounding the tooth, including the alveolar bone that may results in a tooth loss. In the presence of a microbial challenge, the host responds with immediate inflammatory and immune response in order to control the challenge [5]. The alveolar process is the bone of the jaws that contain the sockets (alveoli) of the teeth. The gums will pull back from the teeth and eventually teeth will loosen and fall out. Chronic periodontitis (CP) is an inflammatory disease of the gingiva, accompanied by the loss of supportive connective tissues, including the periodontal ligament and alveolar bone [7]. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. The early injury develops within 4–10 days. Licensee IntechOpen. Periodontal disease sets in when the structure of the junctional epithelium starts to fail, an excellent example of how structure determines function [4]. J Clin Periodontol. The periodontal lesion is initiated as acute inflammation characterized by increased numbers of neutrophils migrating into the gingival crevice through the junctional epithelium, which have the de novo biosynthetic capacity for chemokines and cytokines with proinflammatory, anti-inflammatory, or immunoregulatory properties. dental plaque. Login to your personal dashboard for more detailed statistics on your publications. By José Luis Muñoz-Carrillo, Viridiana Elizabeth Hernández-Reyes, Oscar Eduardo García-Huerta, Francisca Chávez-Ruvalcaba, María Isabel Chávez-Ruvalcaba, Karla Mariana Chávez-Ruvalcaba and Lizbeth Díaz-Alfaro, Submitted: November 23rd 2018Reviewed: April 26th 2019Published: June 6th 2019, Home > Books > Periodontal Disease - Diagnostic and Adjunctive Non-surgical Considerations. Periodontitis can cause teeth to loosen or lead to tooth loss.Periodontitis is common but largely preventable. Periodontitis, we shall Deep, dull, radiating pain during mastication probably caused by irritation of the supporting structures by mobile teeth and impacted food. Several studies have shown that also IL-18 can influence the pathogenesis of chronic periodontitis [46–51]. NLM Aquino-Martinez R, Khosla S, Farr JN, Monroe DG. Periodontitis is defined as a chronic inflammatory disease that affects the tooth-supporting tissues and bacterial deposits play an essential role in the pathogenesis of this condition 18, 22, 25). COVID-19 is an emerging, rapidly evolving situation. Periodontol 2000. The primary cause of chronic periodontitis is poor oral hygiene. It consists of outer cortical plates (buccal, lingual, and palatal) of the compact bone, a central spongiosa, and bone lining the alveolus (alveolar bone) [4]. Is gradually established specific mechanisms involved in the alveolar bone Mohammed Ahmed Yussif, IntechOpen, doi 10.3390/ijms21155270. 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