Abstract
Periodontitis, being a multifactorial disorder is found to be the most common oral disease denoted by the inflammation of gingiva and resorption of tooth supporting alveolar bone. The disease being closely linked with fast life style and determined by unhygienic behavioural factors, the internal milieu of oral cavity and formation of plaque biofilm on the dental and gingival surfaces. Porphyromonas gingivalis, being the major keystone pathogen of the periodontal biofilm evokes host immune responses that causes damage of gingival tissues and resorption of bones. The biofilm associated microbial community progressively aggravates the condition resulting in chronic inflammation and finally tooth loss. The disease often maintains bidirectional relationship with different systemic, genetic, autoimmune, immunodeficiency diseases and even psychological disorders. The disease can be diagnosed and predicted by various genetic, radiographic and computer-aided design (CAD) & computer-aided engineering (CAE) and artificial neural network (ANN). The elucidation of genetic background explains the inheritance of the disease. The therapeutic approaches commonly followed include mechanical removal of dental plaque with the use of systemic antibiotics. Awareness generation amongst local people, adoption of good practice of timely tooth brushing preferably with fluoride paste or with nanoconjugate pastes will reduce the chance of periodontal plaque formation. Modern tissue engineering technology like 3D bioprinting of periodontal tissue may help in patient specific flawless regeneration of tooth structures and associated bones.
Similar content being viewed by others
Data Availability
Not Applicable.
References
Page, R. C., & Schroeder, H. E. (1982). 3.0 Periodontitis in Other Mammalian Animals. In Periodontitis in Man and Other Animals (pp. 58–221). Karger Publishers.
Holmes, M., Thomas, R., & Hamerow, H. (2021). Periodontal disease in sheep and cattle: Understanding dental health in past animal populations. International Journal of Paleopathology, 33, 43–54.
Marshall, M. D., Wallis, C. V., Milella, L., Colyer, A., Tweedie, A. D., & Harris, S. (2014). A longitudinal assessment of periodontal disease in 52 Miniature Schnauzers. BMC veterinary research, 10, 166. https://doi.org/10.1186/1746-6148-10-166
Kim, J., & Amar, S. (2006). Periodontal disease and systemic conditions: A bidirectional relationship. Odontology, 94(1), 10–21.
Kumar, P. S. (2021). Microbial dysbiosis: The root cause of periodontal disease. Journal of Periodontology, 92(8), 1079–1087.
Belstrøm, D., Fiehn, N. E., Nielsen, C. H., Kirkby, N., Twetman, S., Klepac‐Ceraj, V., ... & Holmstrup, P. (2014). Differences in bacterial saliva profile between periodontitis patients and a control cohort. Journal of clinical periodontology, 41(2), 104-112.
Sudhakara, P., Gupta, A., Bhardwaj, A., & Wilson, A. (2018). Oral dysbiotic communities and their implications in systemic diseases. Dentistry journal, 6(2), 10.
Li, Y. H., Huang, X., & Tian, X. L. (2017). Recent advances in dental biofilm: Impacts of microbial interactions on the biofilm ecology and pathogenesis. AIMS Bioengineering, 4(3), 335–350.
Sedghi, L. M., Bacino, M., & Kapila, Y. L. (2021). Periodontal Disease: The Good, The Bad, and The Unknown. Frontiers in cellular and infection microbiology, 1210.
Ai, D., Huang, R., Wen, J., Li, C., Zhu, J., & Xia, L. C. (2017). Integrated metagenomic data analysis demonstrates that a loss of diversity in oral microbiota is associated with periodontitis. BMC Genomics, 18(1), 1–15.
Van Dyke, T. E., Bartold, P. M., & Reynolds, E. C. (2020). The nexus between periodontal inflammation and dysbiosis. Frontiers in Immunology, 11, 511.
Ogawa, T., Hirose, Y., Honda-Ogawa, M., Sugimoto, M., Sasaki, S., Kibi, M., ... & Maeda, Y. (2018). Composition of salivary microbiota in elderly subjects. Scientific reports, 8(1), 1-9.
Rosier, B. T., De Jager, M., Zaura, E., & Krom, B. P. (2014). Historical and contemporary hypotheses on the development of oral diseases: Are we there yet? Frontiers in Cellular and Infection Microbiology, 4, 92.
McLean, R. J., Lam, J. S., & Graham, L. L. (2012). Training the biofilm generation—a tribute to JW Costerton. Journal of Bacteriology, 194(24), 6706–6711.
Sztukowska, M. N., Dutton, L. C., Delaney, C., Ramsdale, M., Ramage, G., Jenkinson, H. F., ... & Lamont, R. J. (2018). Community development between Porphyromonas gingivalis and Candida albicans mediated by InlJ and Als3. MBio, 9(2), e00202-18.
Lamont, R. J., Koo, H., & Hajishengallis, G. (2018). The oral microbiota: Dynamic communities and host interactions. Nature Reviews Microbiology, 16(12), 745–759.
Dahlen, G., Fejerskov, O., & Manji, F. (2020). Current concepts and an alternative perspective on periodontal disease. BMC Oral Health, 20(1), 1–9.
Lahiri, D., Nag, M., Dutta, B., Dey, S., Mukherjee, D., Joshi, S. J., & Ray, R. R. (2021). Antibiofilm and anti-quorum sensing activities of eugenol and linalool from Ocimum tenuiflorum against Pseudomonas aeruginosa biofilm. Journal of Applied Microbiology, 131, 2821–2837.
MooreL, W. E. C., & MooreL, V. H. (1994). The bacteria of periodontal disease. Periodontology 2000, 5(1), 66–77.
Wade, W. G. (2013). The oral microbiome in health and disease. Pharmacological Research, 69(1), 137–143.
Wang, J., Qi, J., Zhao, H., He, S., Zhang, Y., Wei, S., & Zhao, F. (2013). Metagenomic sequencing reveals microbiota and its functional potential associated with periodontal disease. Scientific Reports, 3(1), 1–10.
Cai, Z., Lin, S., Hu, S., & Zhao, L. (2021). Structure and Function of Oral Microbial Community in Periodontitis Based on Integrated Data. Frontiers in Cellular and Infection Microbiology, 11, 538.
Monteiro, M. F., Altabtbaei, K., Kumar, P. S., Casati, M. Z., Ruiz, K. G. S., Sallum, E. A., ... & Casarin, R. C. V. (2021). Parents with periodontitis impact the subgingival colonization of their offspring. Scientific Reports, 11(1), 1-9.
Gita, J. B., Chandrasekaran, S. C., Darshani, D. D., & Gnanamani, A. (2016). Gram-positive anaerobes in periodontal pathogenesis: New kids on the block? A mini review. Journal of Bacteriology and Mycology: Open Access, 3(1), 00052.
Hoare, A., Soto, C., Rojas-Celis, V., & Bravo, D. (2019). Chronic inflammation as a link between periodontitis and carcinogenesis. Mediators of inflammation, 2019, 1029857. https://doi.org/10.1155/2019/1029857
Taba, M., Jr., Souza, S. L. S. D., & Mariguela, V. C. (2012). Periodontal disease: A genetic perspective. Brazilian oral research, 26(SPE1), 32–38.
Park, J. H., Lee, J. K., Um, H. S., Chang, B. S., & Lee, S. Y. (2014). A periodontitis-associated multispecies model of an oral biofilm. Journal of Periodontal & Implant Science, 44(2), 79–84.
Brogden, K. A., & Guthmiller, J. M., (Eds.) (2002). Polymicrobial diseases. ASM Press.
Zambon, J. J., Christersson, L. A., & Slots, J. (1983). Actinobacillus actinomycetemcomitans in human periodontal disease: Prevalence in patient groups and distribution of biotypes and serotypes within families. Journal of Periodontology, 54(12), 707–711.
Gasner, N. S., & Schure, R. S. (2021). Necrotizing periodontitis. StatPearls [Internet].
Loesche, W. J. (1996). Chapter 99. Microbiology of dental decay and periodontal disease. Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston.
Kapferer-Seebacher, I., Foradori, L., Zschocke, J., & Schilke, R. (2021). Rare Genetic Disorders Affecting the Periodontal Supporting Tissues in Adolescence. Frontiers in Dental Medicine, 40.
Morgan, J. (2007). Why is periodontal disease more prevalent and more severe in people with Down syndrome? Special Care in Dentistry, 27(5), 196–201.
Dumitrescu, A. L. (2016). Depression and inflammatory periodontal disease considerations—an interdisciplinary approach. Frontiers in Psychology, 7, 347.
Sundararajan, S., Muthukumar, S., & Rao, S. R. (2015). Relationship between depression and chronic periodontitis. Journal of Indian Society of Periodontology, 19(3), 294.
Coelho, J. M. F., Miranda, S. S., da Cruz, S. S., Dos Santos, D. N., Trindade, S. C., Cerqueira, E. D. M., ... & Gomes‐Filho, I. S. (2020). Common mental disorder is associated with periodontitis. Journal of Periodontal Research, 55(2), 221-228.
Nazir, M. A. (2017). Prevalence of periodontal disease, its association with systemic diseases and prevention. International Journal of Health Sciences, 11(2), 72.
Kamer, A. R., Pirraglia, E., Tsui, W., Rusinek, H., Vallabhajosula, S., Mosconi, L., ... & de Leon, M. J. (2015). Periodontal disease associates with higher brain amyloid load in normal elderly. Neurobiology of aging, 36(2), 627-633.
Hategan, S. I., Kamer, S. A., Craig, R. G., Sinescu, C., de Leon, M. J., Jianu, D. C., ... & Negrutiu, M. L. (2021). Cognitive dysfunction in young subjects with periodontal disease. Neurological Sciences, 42(11), 4511-4519.
Blaizot, A., Vergnes, J. N., Nuwwareh, S., Amar, J., & Sixou, M. (2009). Periodontal diseases and cardiovascular events: Meta-analysis of observational studies. International Dental Journal, 59(4), 197–209.
Bale, B. F., Doneen, A. L., & Vigerust, D. J. (2017). High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis. Postgraduate Medical Journal, 93(1098), 215–220.
Kebschull, A. M., Demmer, R. T., & Papapanou, P. N. (2010). “Gum bug, leave my heart alone!”—epidemiologic and mechanistic evidence linking periodontal infections and atherosclerosis. Journal of Dental Research, 89(9), 879–902.
Munoz Aguilera, E., Suvan, J., Buti, J., Czesnikiewicz-Guzik, M., Barbosa Ribeiro, A., Orlandi, M., ... & D’Aiuto, F. (2020). Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovascular Research, 116(1), 28-39.
Kinane, D. F., & Marshall, G. J. (2001). Peridonatal manifestations of systemic disease. Australian Dental Journal, 46(1), 2–12.
Teeuw, W. J., Gerdes, V. E., & Loos, B. G. (2010). Effect of periodontal treatment on glycemic control of diabetic patients: A systematic review and meta-analysis. Diabetes Care, 33(2), 421–427.
Ioannidou, E., & Swede, H. (2011). Disparities in periodontitis prevalence among chronic kidney disease patients. Journal of Dental Research, 90(6), 730–734.
Ioannidou, E., Hall, Y., Swede, H., & Himmelfarb, J. (2013). Periodontitis associated with chronic kidney disease among Mexican Americans. Journal of Public Health Dentistry, 73(2), 112–119.
Iwasaki, M., Taylor, G. W., Nesse, W., Vissink, A., Yoshihara, A., & Miyazaki, H. (2012). Periodontal disease and decreased kidney function in Japanese elderly. American Journal of Kidney Diseases, 59(2), 202–209.
Ricardo, A. C., Athavale, A., Chen, J., Hampole, H., Garside, D., Marucha, P., & Lash, J. P. (2015). Periodontal disease, chronic kidney disease and mortality: Results from the third National Health and Nutrition Examination Survey. BMC nephrology, 16(1), 1–7.
Dominy, S. S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., ... & Potempa, J. (2019). Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science advances, 5(1), eaau3333.
Gurav, A. N. (2014). Alzheimer’s disease and periodontitis-an elusive link. Revista da Associação Médica Brasileira, 60, 173–180.
Mercado, F. B., Marshall, R. I., & Bartold, P. M. (2003). Inter-relationships between rheumatoid arthritis and periodontal disease: A review. Journal of Clinical Periodontology, 30(9), 761–772.
Vavricka, S. R., Manser, C. N., Hediger, S., Vögelin, M., Scharl, M., Biedermann, L., ... & Frei, P. (2013). Periodontitis and gingivitis in inflammatory bowel disease: a case–control study. Inflammatory bowel diseases, 19(13), 2768-2777.
Michaud, D. S., Liu, Y., Meyer, M., Giovannucci, E., & Joshipura, K. (2008). Periodontal disease, tooth loss and cancer risk in a prospective study of male health professionals. The lancet oncology, 9(6), 550.
Tezal, M., Sullivan, M. A., Reid, M. E., Marshall, J. R., Hyland, A., Loree, T., ... & Scannapieco, F. A. (2007). Chronic periodontitis and the risk of tongue cancer. Archives of Otolaryngology–Head & Neck Surgery, 133(5), 450-454.
Fitzpatrick, S. G., & Katz, J. (2010). The association between periodontal disease and cancer: A review of the literature. Journal of Dentistry, 38(2), 83–95.
Peacock, M. E., Arce, R. M., & Cutler, C. W. (2017). Periodontal and other oral manifestations of immunodeficiency diseases. Oral Diseases, 23(7), 866–888.
Mataftsi, M., Skoura, L., & Sakellari, D. (2011). HIV infection and periodontal diseases: An overview of the post-HAART era. Oral Diseases, 17(1), 13–25.
Khan, S. A., Kong, E. F., Meiller, T. F., & Jabra-Rizk, M. A. (2015). Periodontal diseases: Bug induced, host promoted. PLoS Pathogens, 11(7), e1004952.
Taylor, G. W. (2001). Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiologic perspective. Annals of Periodontology, 6(1), 99–112.
Preshaw, P. M., Alba, A. L., Herrera, D., Jepsen, S., Konstantinidis, A., Makrilakis, K., & Taylor, R. (2012). Periodontitis and diabetes: A two-way relationship. Diabetologia, 55(1), 21–31. https://doi.org/10.1007/s00125-011-2342-y
Touyz, L. Z. G. (1984). Vitamin C, oral scurvy and periodontal disease. South African Medical Journal, 65(21), 838–842.
Touger-Decker, R., Mobley, C. C., & Association, A. D. (2003). Position of the American Dietetic Association: Oral health and nutrition. Journal of the American Dietetic Association, 103(5), 615–625. https://doi.org/10.1053/jada.2003.50130
Kornman, K. S., Crane, A., Wang, H. Y., di Giovine, F. S., Newman, M. G., Pirk, F. W., Wilson, T. G., Jr., Higginbottom, F. L., & Duff, G. W. (1997). The interleukin-1 genotype as a severity factor in adult periodontal disease. Journal of Clinical Periodontology, 24(1), 72–77. https://doi.org/10.1111/j.1600-051x.1997.tb01187.x
Scott, D. A., & Krauss, J. (2012). Neutrophils in periodontal inflammation. Frontiers of Oral Biology, 15, 56–83. https://doi.org/10.1159/000329672
Pischon, N., Heng, N., Bernimoulin, J. P., Kleber, B. M., Willich, S. N., & Pischon, T. (2007). Obesity, inflammation, and periodontal disease. Journal of Dental Research, 86(5), 400–409. https://doi.org/10.1177/154405910708600503
Spector, A. M., Postolache, T. T., Akram, F., Scott, A. J., Wadhawan, A., & Reynolds, M. A. (2020). Psychological stress: A predisposing and exacerbating factor in periodontitis. Current Oral Health Reports, 7(3), 208–215.
Jotwani, R., & Cutler, C. W. (2003). Multiple dendritic cell (DC) subpopulations in human gingiva and association of mature DCs with CD4+ T-cells in situ. Journal of dental research, 82(9), 736–741. https://doi.org/10.1177/154405910308200915
Figueredo, C. M., Lira-Junior, R., & Love, R. M. (2019). T and B Cells in Periodontal Disease: New Functions in A Complex Scenario. International journal of molecular sciences, 20(16), 3949. https://doi.org/10.3390/ijms20163949
Laine, M. L., Jepsen, S., & Loos, B. G. (2014). Progress in the identification of genetic factors in periodontitis. Current Oral Health Reports, 1(4), 272–278.
Dosseva-Panova, V., Mlachkova, A., & Popova, C. (2015). Gene polymorphisms in periodontitis. Overview. Biotechnology & Biotechnological Equipment, 29(5), 834–839.
da Silva, M. K., de Carvalho, A., Alves, E., da Silva, F., Pessoa, L., & Vasconcelos, D. (2017). Genetic Factors and the Risk of Periodontitis Development: Findings from a Systematic Review Composed of 13 Studies of Meta-Analysis with 71,531 Participants. International Journal of Dentistry, 2017, 1914073. https://doi.org/10.1155/2017/1914073
Wankhede, A. N., Wankhede, S. A., & Wasu, S. P. (2017). Role of genetic in periodontal disease. Journal of the International Clinical Dental Research Organization, 9(2), 53.
Delima, A. J., Karatzas, S., Amar, S., & Graves, D. T. (2002). Inflammation and tissue loss caused by periodontal pathogens is reduced by interleukin-1 antagonists. The Journal of Infectious Diseases, 186(4), 511–516.
Tugnait, A., & Carmichael, F. (2005). Use of radiographs in the diagnosis of periodontal disease. Dental Update, 32(9), 536–542.
Cafiero, C., Spagnuolo, G., Marenzi, G., Martuscelli, R., Colamaio, M., & Leuci, S. (2021). Predictive periodontitis: The most promising salivary biomarkers for early diagnosis of periodontitis. Journal of Clinical Medicine, 10(7), 1488.
Kim, E. H., Kim, S., Kim, H. J., Jeong, H. O., Lee, J., Jang, J., ... & Lee, S. (2020). Prediction of chronic periodontitis severity using machine learning models based on salivary bacterial copy number. Frontiers in Cellular and Infection Microbiology, 10, 698.
Chang, H. J., Lee, S. J., Yong, T. H., Shin, N. Y., Jang, B. G., Kim, J. E., ... & Yi, W. J. (2020). Deep learning hybrid method to automatically diagnose periodontal bone loss and stage periodontitis. Scientific reports, 10(1), 1-8.
Alalharith, D. M., Alharthi, H. M., Alghamdi, W. M., Alsenbel, Y. M., Aslam, N., Khan, I. U., ... & Barouch, K. K. (2020). A deep learning-based approach for the detection of early signs of gingivitis in orthodontic patients using faster region-based convolutional neural networks. International Journal of Environmental Research and Public Health, 17(22), 8447.
Jiang, L., Chen, D., Cao, Z., Wu, F., Zhu, H., & Zhu, F. (2022). A two-stage deep learning architecture for radiographic staging of periodontal bone loss. BMC Oral Health, 22(1), 1–9.
Papantonopoulos, G., Takahashi, K., Bountis, T., & Loos, B. G. (2014). Artificial neural networks for the diagnosis of aggressive periodontitis trained by immunologic parameters. PLoS One, 9(3), e89757.
Johnston, W., Rosier, B. T., Artacho, A., Paterson, M., Piela, K., Delaney, C., ... & Culshaw, S. (2021). Mechanical biofilm disruption causes microbial and immunological shifts in periodontitis patients. Scientific reports, 11(1), 1-14.
Prakasam, A., Elavarasu, S. S., & Natarajan, R. K. (2012). Antibiotics in the management of aggressive periodontitis. Journal of Pharmacy & Bioallied Sciences, 4(Suppl 2), S252–S255. https://doi.org/10.4103/0975-7406.100226
Cieplik, F., Deng, D., Crielaard, W., Buchalla, W., Hellwig, E., Al-Ahmad, A., & Maisch, T. (2018). Antimicrobial photodynamic therapy - what we know and what we don’t. Critical Reviews in Microbiology, 44(5), 571–589. https://doi.org/10.1080/1040841X.2018.1467876
Sui, L., Wang, J., Xiao, Z., Yang, Y., Yang, Z., & Ai, K. (2020). ROS-scavenging nanomaterials to treat periodontitis. Frontiers in Chemistry, 1035.
de Freitas, L. M., Calixto, G. M., Chorilli, M., Giusti, J. S., Bagnato, V. S., Soukos, N. S., Amiji, M. M., & Fontana, C. R. (2016). Polymeric Nanoparticle-Based Photodynamic Therapy for Chronic Periodontitis in Vivo. International journal of molecular sciences, 17(5), 769. https://doi.org/10.3390/ijms17050769
Wang, L., Li, Y., Ren, M., Wang, X., Li, L., Liu, F., ... & Song, J. (2022). pH and lipase-responsive nanocarrier-mediated dual drug delivery system to treat periodontitis in diabetic rats. Bioactive materials, 18, 254-266.
Garg, V., Chawla, K., & Pawar, S. K. (2018). Nanotechnology controlled local drug delivery system for the treatment of periodontitisc. Journal in Advanced Medicine Medical Research, 26, 1–17.
Galli, M., Yao, Y., Giannobile, W. V., & Wang, H. L. (2021). Current and future trends in periodontal tissue engineering and bone regeneration. Plastic and Aesthetic Research, 8, 3.
Gul, M., Arif, A., & Ghafoor, R. (2019). Role of three-dimensional printing in periodontal regeneration and repair: Literature review. Journal of Indian Society of Periodontology, 23(6), 504–510. https://doi.org/10.4103/jisp.jisp_46_19
Oberoi, G., Nitsch, S., Edelmayer, M., Janjić, K., Müller, A. S., & Agis, H. (2018). 3D Printing—encompassing the facets of dentistry. Frontiers in bioengineering and biotechnology, 172.
Reddy, M. S., Shetty, S. R., Shetty, R. M., Vannala, V., Sk, S., & Rajasekar, S. (2020). Focus on periodontal engineering by 3D printing technology–A systematic review. Journal of Oral Research, 9(6), 522–531.
Lahiri, D., Nag, M., Dutta, B., et al. (2021). Artificial Neural Network and Response Surface Methodology-Mediated Optimization of Bacteriocin Production by Rhizobium leguminosarum. Iranian Journal of Science and Technology Transaction A: Science, 45, 1509–1517. https://doi.org/10.1007/s40995-021-01157-6
Funding
No. funding of any kind has been received for the present work.
Author information
Authors and Affiliations
Contributions
The entire paper is written by the author.
Corresponding author
Ethics declarations
Ethical Approval
Not applicable.
Consent to Participate
Not applicable.
Consent to Publish
Not applicable.
Competing Interests
The author does not have any conflict of interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Ray, R.R. Periodontitis: An Oral Disease with Severe Consequences. Appl Biochem Biotechnol 195, 17–32 (2023). https://doi.org/10.1007/s12010-022-04127-9
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12010-022-04127-9