Plaque and chronic inflammatory Periodontal disease A question of ecology

Abstract

The nature of the relationship between dental plaque and chronic inflammatory periodontal disease (CIPD) remains unclear, although there is no doubt that plaque is the direct cause. Non-specific, specific and exogenous hypotheses have been proposed to explain plaque-host relationships. Current evidence indicates that plaque is part of the natural human microflora, one of many such in nature, and that disruption of oral microbial ecology, due primarily to diet texture changes, leads to gingivitis and periodontitis. These result in increased plaque accumulation, and particularly in increased interdental effective plaque thickness. The latter leads to alterations in plaque ecology, particularly increasing anaerobiosis, with resultant shifts in proportions of its constituent species. These shifts are responsible for the increased counts of, for example, Bacteroides gingivalis, Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Wolinella recta, spirochaetes and others, associated with chronic periodontitis in its various forms. Measures to prevent or control chronic periodontitis should aim, not to eliminate plaque, which ignores ecology and would compromise host defence, but to restore the species distribution in plaque to that compatible with health.

The Buccale Puzzle: The Symbiotic Nature of Endogenous Infections of the Oral Cavity

“…Stagnation of GCF and the retention of anaerobic microbial communities appear to be significant determinants in the pathogenesis of periodontal diseases. The accumulation of dental plaque biofilm as the result of soft diets, poor oral hygiene, orthodontic bands, restorations with overhanging margins, calculus or foreign objects lodged in the gingival sulcus may lead to an enhanced inflammatory response due to allogenic change (5,46). The selection and propagation of proteolytic anaerobes are key events in the cascading reduction of heterotropic compounds that leads to anaerobiosis, and is driven by microbial syntrophy.…”

Factors associated with adult periodontitis in a dental teaching clinic population

“…Although use of cyclosporin has been associated with gingival overgrowth and a dose-response relationship observed (Seymour and Heasman 1988), increased dosage of cyclosporin has not been associated with increased prevalence/severity of gingival overgrowth in another crosssectional study (Thomason et al 19g3). There is conflicting evidence as to a dose-response relationship between phenytoin and gingival overgrowth (Seymour and Heasman 1988 (Suzuki 1988 (Newman 1990 ( Löe et aI 1965;Page 1986 …”

Prevalencia, Severidad Y Necesidad De Tratamiento De La Enfermedad Periodontal en Personal Del Batallón De Artillería De Defensa Aérea No. 2 Nueva Granada

“…Tal como lo revela en su revisión, Newman dice: "La naturaleza de la relación entre la placa dental y la enfermedad periodontal sigue siendo poco clara, aunque no hay duda de que la placa es la causa directa". 18 Gonzáles y colaboradores demostraron una dependencia altamente significativa con una relación inversamente proporcional entre la higiene bucal, y la prevalencia y gravedad de la enfermedad periodontal. 19 Estos resultados sugieren que la placa bacteriana sigue siendo un factor de riesgo para el desarrollo de la enfermedad periodontal, es necesaria la presencia de ciertas bacterias para que ocurra la periodontitis aunque no es causa suficiente pues depende de la respuesta del huésped, esto explica porque muchos individuos pueden albergar los microorganismos y no desarrollar la enfermedad.…”