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Evolving Paradigms in the Pathogenesis and Management of Periodontitis

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Emerging Therapies in Periodontics

Abstract

The premise for periodontal therapy is to control deregulated immune response and dysbiotic microbiome to sustain a balanced tissue homeostasis and achieve regeneration of the lost tissues. Over the years, our understanding of the pathogenesis of periodontitis changed from one being an infectious disease of solely bacterial origin to the one being a non-resolving inflammatory process to a diverse group of dysbiotic microbial species which is driven by genetic, environmental, local, and systemic factors. This paradigm shift from infectious to inflammatory diseases combined with rising concerns for antibiotic resistance worldwide changed the philosophy of periodontal patient management from one treatment for all approach and fostered research to identify more individualized strategies to control the inflammatory component of the disease either through targeting host immune response and/or modulating microbiome. Similarly, considerable progress has been made in periodontal regenerative medicine through promising research on protein and cell-based therapies, 3D printing, and laser therapy. Clinicians and researchers are now facing a new challenge as the increased lifespan and the growing number of implant-supported restorations change the clinical landscape which demands more investigations toward understanding the physiology of aging and defining the pathogenesis and risk for implant diseases. The era of “precision periodontics” will include personalized strategies for the prevention of periodontal and peri-implant diseases and tailored therapies toward individuals’ unique biology and risk profiles, which will take into consideration many elements in clinical decision making including changes in microbiome, genetic and epigenetic factors, environmental and systemic perturbations, and lifestyle preferences.

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Acknowledgement

Dr. Sahingur is supported by the grants from the U.S. National Institutes of Health DE025037 and DE027374. Dr. Yajie Li and Ms. Erin Mooney assisted with the preparation of Fig. 1.1. There are no conflicts of financial interest.

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  1. School of Dental Medicine, Department of Periodontics, University of Pennsylvania, Philadelphia, PA, USA

    Sinem Esra Sahingur

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Correspondence to Sinem Esra Sahingur .

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  1. School of Dental Medicine, Department of Periodontics, University of Pennsylvania, Philadelphia, PA, USA

    Sinem Esra Sahingur

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Sahingur, S.E. (2020). Evolving Paradigms in the Pathogenesis and Management of Periodontitis. In: Sahingur, S. (eds) Emerging Therapies in Periodontics. Springer, Cham. https://doi.org/10.1007/978-3-030-42990-4_1

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  • DOI: https://doi.org/10.1007/978-3-030-42990-4_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42989-8

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