Pathogenesis of Periodontal Disease

Periodontal diseases are inflammatory diseases in which microbial etiologic factors induce a series of host responses that mediate inflammatory events. In susceptible individuals, dysregulation of inflammatory and immune pathways leads to chronic inflammation, tissue destruction and disease. Physiologic inflammation is a well orchestrated network of cells, mediators and tissues. It is very important to consider the inflammatory / immune response as a whole, rather than many different modules working separately. As disease appears to be the result of loss of regulation and a failure to return to homeostasis, it is important to achieve a more complete understanding of the molecular and cellular events in this complex system. The paradigm shift in our understanding of inflammatory disease, such as periodontitis, is that resolution of inflammation is an active, rather than a passive, process that activates specific biochemical programs of resolution. It is increasingly evident that future care of periodontal infections and periodontal surgical patients will rely on clinicians having a detailed map and molecular appreciation of the resolution programs for inflammation and tissue injury.