Periodontal Disease and Overall Health: A Clinician's Guide

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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.
22 Periodontal Disease and Overall Health: A Clinician's Guide13. Scully C, Laskaris G. Mucocutaneous disorders.Periodontol 2000 1998;18:81–94.14. Page RC, Offenbacher S, Schroeder HE, SeymourGJ, Kornman KS. Advances in the pathogenesisof periodontitis: summary of developments, clinicalimplications and future directions. Periodontol2000 1997;14:216–248.15. Tonetti MS, Mombell A. Early onset periodontitis.Ann Periodontol 1999;4:39–53.16. Kinane DF. Periodontitis modified by systemic factors.Ann Periodontol 1999; 4:54–64.17. Novak MJ. Necrotizing ulcerative periodontitis.Ann Periodontol 1999;4:74–78.18. Meng HX. Periodontal abscess. Ann Periodontol1999;4:79–83.19. Stamm JW. Epidemiology of gingivitis. J ClinPerio dontol 1986;13:360–370.20. Bhat M. Periodontal health of 14- to 17-year-oldUS schoolchildren. J Public Health Dent 1991;51:5–11.21. U.S. Public Health Service, National Center forHealth Statistics. Periodontal Disease in Adults.United States 1960–1962. Washington, DC: Govern -ment Printing Office; 1965.22. Oliver RC, Brown LJ, Löe H. Periodontal diseasesin the United States population. J Periodontol 1998;69:269–278.23. Page RC. Host response tests for diagnosing perio -dontal diseases. J Periodontol 1992;63(Suppl.):356–366.24. Offenbacher S, Collins JG, Yalda B, Haradon G.Role of prostaglandins in high-risk periodontitispatients. In: Genco R, Hamada S, Lehner T,McGhee J. Mergenhagen S, eds. Molecular Pathogenesisof Periodontal Disease. Washington DC:American Society for Microbiology;1994:203–213.25. Burt B. Research, Science and Therapy Committeeof the American Academy of Periodontology. Positionpaper: Epidemiology of periodontal diseases.J Periodontol 2005;76:1406–1419.26. Brown LJ, Löe H. Prevalence, extent, severity andprogression of periodontal disease. Periodontol2000 1993;2:57–71.27. Löe H, Brown LJ. Early onset periodontitis in theUnited States of America. J Periodontol 1991;62:608–616.28. Albandar JM, Brunelle JA, Kingman A. Destructiveperiodontal disease in adults 30 years of age andolder in the United States, 1988–1994. J Perio -dontol 1999;70:13–29.29. Grossi SG, Zambon JJ, Ho AW, Koch G, DunfordRG, Machtei EE, Norderyd OM, Genco RJ. Assessmentof risk for periodontal disease. I. Riskindicators for attachment loss. J Periodontol 1994;65:260–267.30. Grossi SG, Genco RJ, Machtei EE, How AW, KochG, Dunford R, Zambon JJ, Hausmann E. Assessmentof risk for periodontal disease. II. Risk indicatorsfor alveolar bone loss. J Periodontol 1995;66:23–29.31. Genco RJ, Ho AW, Grossi SG, Dunford RG,Tedesco LA. Relationship of stress, distress andinadequate coping behaviors to periodontal disease.J Periodontol 1999;70:711–723.32. Nishida M, Grossi SG, Dunford RG, Ho AW, TrevisanM, Genco RJ. Calcium and the risk for periodontaldisease. J Periodontol 2000;71:1057–1066.33. Nishida M, Grossi SG, Dunford RG, Ho AW, TrevisanM, Genco RJ. Dietary vitamin C and the riskfor periodontal disease. J Periodontol 2000;71:1215–1223.34. Tezal M, Wactawski-Wende J, Grossi SG, Ho AW,Dunford R, Genco RJ. The relationship betweenbone mineral density and periodontitis in postmenopausalwomen. J Periodontol 2000;71:1492–1498.35. Ryan ME. Nonsurgical approaches for the treatmentof periodontal diseases. Dent Clin North Am2005;49:611–636.36. Ryan ME, Preshaw PM. Host modulation. In: NewmanMG, Takei HH, Klokkevold PR, Carranza FA,eds. Carranza’s Clinical Periodontology, 10th Ed.WB Saunders Company; 2006:275–282.37. Page RC, Kornman KS. The pathogenesis of humanperiodontitis: an introduction, Periodontol2000 1997;14:9–11.38. Grossi SG, Zambon J, Machtei EE, Schifferle R,Andreana S, Genco RJ, Cummins D, Harrap G.Effects of smoking and smoking cessation on healingafter mechanical periodontal therapy. J Am DentAssoc 1997;128:599–607.39. Kinane DF, Chestnutt IG. Smoking and periodontaldisease. Crit Rev Oral Biol Med 2000;11:356–365.40. Mealey B. Diabetes and periodontal diseases. JPerio dontol 2000;71:664–678.41. Preshaw PM, Ryan ME, Giannobile WV. Hostmodulation agents. In: Newman MG, Takei HH,Klokkevold PR, Carranza FA, eds. Carranza’s ClinicalPeriodontology, 10 th Ed. WB Saunders Company;2006:813–827.42. Bader HI. Floss or die: implications for dental professionals.Dent Today 1998;17:76–82.43. Cobb CM. Non-surgical pocket therapy: mechanical.Ann Periodontol 1996;1:443–490.44. Greenstein G. Periodontal response to mechanicalnon-surgical therapy: a review. J Periodontol 1992;63:118–130.45. Nesse W, Spijkervet FK, Abbas F, Vissink A. Linksbetween periodontal disease and general health. 1.
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