Current understanding of periodontal disease pathogenesis and targets for host‐modulation therapy

Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbio...

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Bibliographic Details
Published in:Periodontology 2000 2020-10, Vol.84 (1), p.14-34
Main Authors: Hajishengallis, George, Chavakis, Triantafyllos, Lambris, John D.
Format: Article
Language:English
Subjects:
complement
cytokines
Dentistry
dysbiosis
host modulation
inflammation
inhibitors
periodontitis
resolution
therapeutics
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Summary:Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self‐sustained feed‐forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host‐modulation therapies for the treatment of periodontitis. Such host‐modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application.
ISSN:0906-6713
1600-0757
DOI:10.1111/prd.12331