The Nexus Between Periodontal Inflammation and Dysbiosis

Abstract

The nexus between periodontal inflammation and the polymicrobial biofilm in the gingival sulcus is critical to understanding the pathobiology of periodontitis. Both play a major role in the etiology and pathogenesis of periodontal diseases and each reinforces the other. However, this nexus is also at the center of a significant conundrum for periodontology. For all mucosal polymicrobial biofilms, the most confounding issue is the paradoxical relationship between inflammation, infection, and disease. Despite significant advances made in both periodontal microbiology and periodontal pathobiology, the issue of which comes first, the inflammatory response or the change to a dysbiotic subgingival microbiota, is still debated. In this paper, we present a model for the pathogenesis of periodontitis based on the central role of inflammation and how this modulates the polymicrobial biofilm within the context of the continuum of health, gingivitis, and periodontitis. We propose a new model termed "Inflammation-Mediated Polymicrobial-Emergence and Dysbiotic-Exacerbation" (IMPEDE), which is designed to integrate into and complement the 2017 World Workshop Classification of Periodontitis.

Prevention of Prosthetic Joint Infection: From Traditional Approaches towards Quality Improvement and Data Mining

“…However, the idea is quite basic in comparison with current knowledge about the complexity of host-bacteria interactions [21]. Other factors that are, to some extent, out of our hands may play a role in the induction of dysbiosis or loss of a tolerance around an implant [13,22].…”

Strong oral plaque microbiome signatures for dental implant diseases identified by strain-resolution metagenomics

“…Similarly to what is known for periodontal diseases, these factors are influenced also by host-specific immune-mediated response and genetics and are partially modulated by lifestyle and environmental factors 23 . Despite significant advances made in both periodontal microbiology and pathobiology, it is still unsettled whether the primary disease trigger is the microbial challenge or the hyperinflammatory state itself 24 . However, differently from the case of bacteria associated with periodontal diseases that have been studied for decades, the only recent emergence of peri-implant diseases limited similar investigations for mucositis and peri-implantitis.…”

High Mobility Group Box 1 Expression in Oral Inflammation and Regeneration

“…Periodontal diseases are dysbiotic conditions in the gingival margin, which are characterized by an imbalance between subgingival microbial communities and the host immune response (26,27). Clinical studies have demonstrated that the levels of TLR2 and TLR4 in periodontitis patients were significantly higher than those in control groups (28,29).…”