The Pathogenesis of Periodontal Diseases: Periodontist Houston, TX

Article by Rozar Platini

For periodontist in Houston, TX successful intervention in a illness process requires that the practitioner recognize the disease process fully. An example of this is our new understanding of duodenal ulcer pathogenesis, which has led to a paradigm shift in treatment of ulcers away from medications affecting acid production to treatment with antibiotics. With out an understanding of the role of Heliobacter pylorii in the pathogenesis, a rationale for treatment with antibiotics was non-existent.

Our understanding of periodontal diseases has developed slowly. In a series of papers, Low established the role of oral hygiene in the prevention of gingivitis and implicated bacteria in the development of gingivitis (I). This obtaining provided support for several approaches to treatment. First, it supported the idea that removal of bacteria from the root surface was a crucial step in controlling periodontal disease, thus leading the way for scaling and root planning as a cornerstone of periodontal illness treatment. Second, it supported the role for 'treating periodontal illness with antibiotics. We have given that found that both of these approaches have limitations. To a degree, these limitations are defined by our incomplete understanding of the disease method.

Currently, our model explaining the pathogenesis of periodontal disease is substantially distinct from what it was five years ago(2l. We now believe that wellness exists as a homeostatic condition between oral bacteria and host defenses. Alterations in host defenses can lead to establishment of an "eco-system" of bacteria capable of supporting periodontal pathogens. Subsequently, these bacteria stimulate the host immune system. To a excellent extent, this response of the immune program determines the level of tissue destruction that occurs in periodontal diseases.

The purpose of this paper is to present the existing theories of periodontal illness pathogenesis. This discussion will offer the groundwork for understanding the relationship between systemic diseases and periodontal diseases. In addition, understanding these new concepts of the disease procedure will clarify the limitations of currently employed treatment modalities and provide a basis for future treatment protocols.

Bacteria in the periodontal pocket exist in a biofilm.

Most bacteria implicated in the pathogenesis of periodontal illness are anaerobic(2-four). At present, Porphyromonas gingival is, Bacteriodes forsythus, and Actinobacillus actinomycetemcomitans are thought to cause the majority of periodontal diseases (four). Exxposure to oxygen leads to the death of most of these microorganisms. This characteristic was the basis for the Keyes method using sodium bicarbonate (baking soda) and hydrogen peroxide. Even though the method was effective at controlling superficial bacteria, its application to patients with moderate to advanced periodontal illness had small effect. This limitation was possibly due to failure of the agents to reach the bacteria, primarily simply because the bacteria are at too deep a sulcular depth in much more advanced illness and secondly because the bacteria exist in a biofilm which limited exposure to chemicals in the periodontal pocket.

The term biofilm refers to a glycoprotein matrix containing bacterial4J• Typically, many strains of bacteria exist in the biofilm in a symbiotic relation. Thus, species A of bacteria may possibly call for an element or metabolite for its growth, that is deleterious to species B. By utilizing all of the obtainable element/metabolite, species A promotes the growth of B. In other instances, a waste item of species A may possibly be essential for the growth of species B. This symbiotic interaction is a hallmark of biofilms. The glycoprotein matrix serves an essential function by limiting diffusion and aiding in the establishment of concentration gradients.

In addition to aiding the development of concentration gradients for periodontist in Houston, TX, the biofilm gives a protective barrier for bacteria from host defenses. The biofilm limits the exposure of bacteria to crevicular fluid. Thus, bacteria in a biofilm have a significantly limited exposure to serum factors such as antibodies as well as antibiotics. A excellent example of this characteristic is to picture Jello gelatin as the biofilm. Water poured onto the jello will not penetrate into the jello due to limited diffusion. Penetration of antibiotics into the biofilm can be thought to have diffusion characteristics comparable to that of water. Therefore, the majority of bacteria in the biofilm would not be exposed to the antibiotic. This model offers a greater understanding of our failure to treat periodontal diseases with antibiotics alone.

One more function of the biofilm is to limit access of the host defense cells to the bacteria. In a patient with severe gingivitis, as a lot of as 10 million neutrophils (PMNs) traverse the gingival sulculus each and every minute. Even though these cells may possibly recognize and respond to bacteria on the surface of the biofilm, bacteria deeper in the biofilm will not be recognized. Thus, if these cells are supplied the nutrients required for their growth, survival of the species is ensured and continued exposure of the host to bacterial challenge occurs. Together, this info will prove to be essential in predicting patient outcomes, and genetic tests will turn out to be essential tools in treatment planning for periodontist Houston, TX.

About the Author

Rozar Platini well identified for dental articles.His articles are focused on periodontist Houston,TX.In his other articles find details aboutperiodontal treatment Houston.