Dental calculus: the calcified biofilm and its role in disease development
Abstract
Dental calculus represents the first fossilized record of bacterial communities as a testimony of evolutionary biology. The development of dental calculus is a dynamic process that starts with a nonmineralized biofilm which eventually calcifies. Nonmineralized dental biofilm entraps particles from the oral cavity, including large amounts of oral bacteria, human proteins, viruses and food remnants, and preserves their DNA. The process of mineralization involves metabolic activities of the bacterial colonies and strengthens the attachment of nonmineralized biofilms to the tooth surface. From a clinical point of view...
Source: Periodontology 2000 - October 1, 2017 Category: Dentistry Authors: Aliye Akcal ı, Niklaus P. Lang Tags: Review Article Source Type: research
The periodontal pocket
Abstract
Periodontal disease is synonymous with the presence of periodontal pockets, and very often the clinical success of periodontal therapy is based on periodontal pocket depth reduction. Therefore, in the fields of periodontology and implant dentistry, significant research effort has been placed on the etiopathogenesis, diagnosis and treatment of periodontal/peri‐implant disease and as a consequence on pocket pathology. In this volume of Periodontology 2000, the in‐depth reviews include topics ranging from preclinical models, anatomy and structure of tissues, and molecular and bacterial components, to treatments o...
Source: Periodontology 2000 - October 1, 2017 Category: Dentistry Authors: Nikolaos Donos Tags: Review Article Source Type: research
Development of the gingival sulcus at the time of tooth eruption and the influence of genetic factors
Abstract
Tooth eruption is characterized by a concert of mechanisms that result in the emergence of teeth in the oral cavity. Genetic variants seem to regulate this process and the formation of a gingival sulcus around the teeth. Interindividual variability in the response to microbial triggers in the sulcus plays an important role in the onset and progression of periodontal diseases. Host genetic variants can influence this variability, affecting the response of the host to the subgingival biofilm. Genetic factors affecting tooth eruption could potentially influence susceptibility to periodontal diseases and, specifically...
Source: Periodontology 2000 - October 1, 2017 Category: Dentistry Authors: Luigi Nibali Tags: Review Article Source Type: research
Issue Information
(Source: Periodontology 2000)
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Tags: Issue Information Source Type: research
Quo vadis: what is the future of periodontics? How will we get there?
Abstract
Approximately 40 years ago periodontists began systematically developing the evidence to treat predictably and prevent gingivitis and periodontitis. More recently, periodontists have been among a small group of skilled dental‐implant surgeons leading that revolution in dentistry. Today, much of the mild/localized moderate periodontitis is not treated by periodontists, and an increasing number of implants are placed by dentists with limited surgical training. The current field of periodontics includes a broad range of surgical skills and technologies to regenerate predictably destroyed tissues and manage complex...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Kenneth S. Kornman, William V. Giannobile, Gordon W. Duff Tags: Review Article Source Type: research
Failing to meet the goals of periodontal recall programs. What next?
Abstract
Supportive periodontal care is a crucial aspect of the management of chronic periodontitis and peri‐implantitis and is inevitably a long‐term commitment for both the clinician and the patient. The principal goals of supportive care are to achieve a high standard of plaque control, minimize bleeding and maintain pockets at less than 6 mm. Gain of attachment around natural teeth during supportive periodontal care has been reported, although gain of attachment and of bone during supportive care may be a more pragmatic and aspirational aim in the longer term. Furthermore, we occasionally see patients for whom, de...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Giles McCracken, Abisola Asuni, Mark Ritchie, Christopher Vernazza, Peter Heasman Tags: Review Article Source Type: research
Host modulation: controlling the inflammation to control the infection
Abstract
Historically, periodontal disease (gingivitis and periodontitis) has been recognized as being primarily of bacterial origin. However, recent evidence indicates that while bacteria are necessary for disease development they are not sufficient for the clinical manifestation of the many and varied forms of periodontal disease. It is becoming increasingly apparent that it is the host inflammatory response to the subgingival bacteria that is responsible for the tissue damage and, most likely, progression of the disease. We explore the concept that it is the subgingival microenvironment modified by the inflammatory resp...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: P. Mark Bartold, Thomas E. Van Dyke Tags: Review Article Source Type: research
Periodontal plastic surgery of gingival recessions at single and multiple teeth
Abstract
This manuscript aims to review periodontal plastic surgery for root coverage at single and multiple gingival recessions. Techniques are assessed based on biological principles, surgical procedures, prognosticative factors and expected clinical and esthetic outcomes. The use of coronally advanced flap, laterally sliding flap, free gingival graft, the tunnel grafting technique, barrier membranes, enamel matrix derivative, collagen matrix and acellular dermal matrix are evaluated. The clinical scenario and practical implications are analyzed according to a modern evidence‐based approach. (Source: Periodontology 2000)
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Francesco Cairo Tags: Review Article Source Type: research
Lasers and the treatment of periodontitis: the essence and the noise
Abstract
The dental literature contains 25 years of accumulated reports and clinical studies addressing the utility of lasers in the treatment of periodontitis, both as a monotherapy or as an adjunct to surgical and nonsurgical therapy. Yet, the evidence from the 118 human clinical studies cited in this narrative review remains conflicted and insufficient to suggest that integration of a laser in a periodontal treatment protocol will provide antimicrobial and healing outcomes superior to those achieved by traditional therapy. When viewed as a collective body of evidence, it becomes apparent that a majority of the studies ...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Charles M. Cobb Tags: Review Article Source Type: research
Subgingival debridement: end point, methods and how often?
The objective of this review was to describe the end point of this therapy, the different methods used and how often it should be carried out. The literature shows that several methods are currently available for subgingival debridement, namely hand instrumentation, (ultra)sonic instrumentation, laser, photodynamic therapy and air‐polishing. None of these methods seems superior to any other regarding clinical benefits or microbiological differences. However, less treatment discomfort is reported using laser, photodynamic therapy or air‐polishing compared with hand‐ and/or (ultra)sonic instrumentation. Subgingival deb...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Isabelle Laleman, Simone Cortellini, Senne De Winter, Esteban Rodriguez Herrero, Christel Dekeyser, Marc Quirynen, Wim Teughels Tags: Review Article Source Type: research
Nonsurgical and surgical treatment of periodontitis: how many options for one disease?
Abstract
Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral‐hygiene instructions; a smoking‐cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment opt...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Filippo Graziani, Dimitra Karapetsa, Bettina Alonso, David Herrera Tags: Review Article Source Type: research
Revisiting the Page & Schroeder model: the good, the bad and the unknowns in the periodontal host response 40 years later
Abstract
In their classic 1976 paper, Page & Schroeder described the histopathologic events and the types of myeloid cells and lymphocytes involved in the initiation and progression of inflammatory periodontal disease. The staging of periodontal disease pathogenesis as ‘initial’, ‘early’, ‘established’ and ‘advanced’ lesions productively guided subsequent research in the field and remains fundamentally valid. However, major advances regarding the cellular and molecular mechanisms underlying the induction, regulation and effector functions of immune and inflammatory responses necessitate a reassessment o...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: George Hajishengallis, Jonathan M. Korostoff Tags: Review Article Source Type: research
The periodontal war: microbes and immunity
Abstract
Maintenance of periodontal health or transition to a periodontal lesion reflects the continuous and ongoing battle between the vast microbial ecology in the oral cavity and the array of resident and emigrating inflammatory/immune cells in the periodontium. This war clearly signifies many ‘battlefronts’ representing the interface of the mucosal‐surface cells with the dynamic biofilms composed of commensal and potential pathogenic species, as well as more recent knowledge demonstrating active invasion of cells and tissues of the periodontium leading to skirmishes in connective tissue, the locality of bone and ...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Jeffrey L. Ebersole, Dolph Dawson, Pinar Emecen ‐Huja, Radhakrishnan Nagarajan, Katherine Howard, Martha E. Grady, Katherine Thompson, Rebecca Peyyala, Ahmad Al‐Attar, Kathryn Lethbridge, Sreenatha Kirakodu, Octavio A. Gonzalez Tags: Review Article Source Type: research
Periodontitis epidemiology: is periodontitis under ‐recognized, over‐diagnosed, or both?
Abstract
Currently, two principal forms of destructive periodontal disease are recognized – chronic periodontitis and aggressive periodontitis – but their distinction in epidemiologic studies has been rather problematic because of substantial overlap of their primary features. This review critically appraises some key features relevant to the epidemiology of human periodontitis that underlie its core ‘identity’ as a bacterial biofilm‐induced, inflammatory disease and discusses its impact within the larger context of aging populations. The currently adopted epidemiologic methodologies/definitions that result in th...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Panos N. Papapanou, Cristiano Susin Tags: Review Article Source Type: research
What exactly distinguishes aggressive from chronic periodontitis: is it mainly a difference in the degree of bacterial invasiveness?
Abstract
At the International Workshop for Classification of Periodontal Diseases and Conditions in 1999, the classification of aggressive and chronic periodontitis that is presently used was introduced. A literature review of papers published in 2015 and having aggressive periodontitis in the title revealed that most studies use this terminology but it is questionable whether all established criteria were really applied correctly. Review of the literature showed no qualitative differences between aggressive and chronic periodontitis regarding bacterial and viral aspects. It is also unlikely that that there are major immun...
Source: Periodontology 2000 - July 31, 2017 Category: Dentistry Authors: Ubele Van der Velden Tags: Review Article Source Type: research
