Periodontal Disease and Overall Health: A Clinician's Guide

CHAPTER 2 Overview of Periodontal Disease:CHAPTER 2 Causes, Pathogenesis, and Characteristics 21regenerative procedures approved recentlyby the FDA, as well as recombinant humanbone morphogenetic protein-2 (rhBMP-2)contained within an absorbable collagensponge to assist with ridge and sinus augmentation.The technology behind GEM 21Shas already been marketed for use in woundhealing, particularly in people with diabetes,and rhBMP-2 has been used for quite sometime by the orthopedic community for thehealing of fractures.The findings discussed with regard to theuse of host-modulation therapy to better managechronic periodontal disease may have applicationsto other chronic systemic diseasessuch as arthritis, diabetes, osteoporosis, andcardiovascular disease. In addition, studiesutilizing locally delivered antimicrobials aspart of an intensive periodontal therapy regimenhave shown very promising results.Future studies may demonstrate that in additionto our current standard therapies, intensiveperiodontal therapy with adjunctiveantibiotics and/or host modulation for themanagement of periodontal disease mayhave profound positive effects on the overallhealth status of high-risk patients. Theproper management of local infection andinflammation (periodontitis) will have a significantimpact on general overall health ofthe population.AcknowledgmentsThe authors would like to acknowledge Dr.Hsi-ming Lee, René Martin, and LauraBertolotti for their assistance in the organizationof this manuscript.Supplemental ReadingsWilliams RC. Periodontal disease. N Engl J Med 1990;322:373-382.Page RC, Offenbacher S, Schroeder HE, Seymour GJ,Kornman KS. Advances in the pathogenesis of perio -dontitis: summary of developments, clinical implicationsand future directions. Periodontol 2000 1997;14:216-248.Brown LJ, Löe H. Prevalence, extent, severity and progressionof periodontal disease. Periodontol 2000 1993;2:57-71.Burt B. Research, Science and Therapy Committee of theAmerican Academy of Periodontology. Position paper:Epidemiology of periodontal diseases. J Periodontol2005;76:1406-1419.Ryan EM. Nonsurgical approaches for the treatment ofperiodontal diseases. Dent Clin North Am 2005;49:611–636.Ryan ME, Preshaw PM. Host modulation. In: NewmanMG, Takei HH, Klokkevold PR, Carranza FA, eds.Carranza’s Clinical Periodontology, Edition 10. WBSaunders Co. 2006; pp. 275-282.Preshaw PM, Ryan ME, Giannobile WV. Host modulationagents. In: Newman MG, Takei HH, KlokkevoldPR, Carranza FA, eds. Carranza’s Clinical Periodontology,Edition 10. WB Saunders Co. 2006; pp. 813-827.REFERENCES1. Mariotti A. Dental plaque-induced gingival diseases.Ann Periodontol 1999;4:7–19.2. Van Dyke TE. The management of inflammation inperiodontal disease. J Periodontol 2008;79(8 Suppl):1601–1608.3. Armitage GC. Development of a classification systemfor periodontal diseases and conditions. AnnPeriodontol 1999;4:1–6.4. Novak MJ. Classification of diseases and conditionsaffecting the periodontium. In: Newman MG,Takei HH, Carranza FA, eds. Carranza’s ClinicalPeriodontology, 9th Ed. WB Saunders Company;2002:64–73.5. Flemmig TF. Periodontitis. Ann Periodontol 1999;4:32–38.6. Armitage GC. Periodontal diseases: diagnosis. AnnPeriodontol 1996;1:37–215.7. Kinane DF. Blood and lymphoreticular disorders.Periodontol 2000 1999;21:84–93.8. Rees TD. Drugs and oral disorders. Periodontol2000 1998;18:21–36.9. Scully C, Monteil R, Sposto MR. Infectious andtropical diseases affecting the human mouth. Periodontol2000 1998;18:47–70.10. Holmstrup P. Non-plaque induced gingival lesions.Ann Periodontol 1999;4:20–31.11. Stanford TW, Rivera-Hidalgo F. Oral mucosal lesionscaused by infective microorganisms II. Fungi& parasites. Periodontol 2000 1999;21:125–144.12. Aldred MJ, Bartold PM. Genetic disorders of thegingivae and periodontium. Periodontol 2000 1998;18:7–20.