PERIODONTAL DISEASE

Dysbiosis

Host response

Pathogenesis

1. Early bacterial accumulation phase

2. Early gingivitis - plaque overgrowth phase

3. Established gingivitis - subgingival plaque phase

4. periodontitis - tissue destruction phase

The presence of periodontal pathogens does not necessarily mean that an individual will experience periodontitis.

bacteria

microbiome

Biochemical mediators of the immune system

Cytokines

- Recruit PMNs and macrophages to the infection site.
- Initiate tissue destruction and bone

Prostaglandins

- Increase vascular permeability allowing inmune cells and complement to move to the infection site
- PGE2 Alveolar bone destruction

MMPs

- Facilitate normal turnover of the connective tissue matrix
- Collagen destruction

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