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Dental Disease, Inflammation, Cardiovascular Disease, Nutrition and Nutritional Supplements
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Douglas G. Thompson, Gregori M. Kurtzman, Chelsea Q. Watkins
As outlined, periodontal disease is identified by the presence of gingival bleeding, increased probing depth, evidence of bone loss on radiographs and potential tooth mobility during routine examination. Once identified, goal of treatment is the mechanical debridement (scaling and root planing) of the periodontal pockets and the associated teeth to remove hard formations (calculus), and disrupt and remove the soft sulcular biofilm (plaque) to levels that do not provoke a host response. Additionally, other host modulatory strategies, for example better nutrition, may be employed to alter the host response and to strengthen the autoimmune system. Salivary testing is performed prior to treatment to identify those patients who are at higher risk based on pathogenicity of the bacteria present and their concentrations. This information serves as a pretreatment baseline to compare to a post-treatment report confirming if the flora has been altered and if additional care is required. Genetic testing can also be obtained to learn information about the possible severity of the innate and acquired host response.
Gingiva and Periodontal Tissue Regeneration
Published in Vincenzo Guarino, Marco Antonio Alvarez-Pérez, Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Avita Rath, Preena Sidhu, Priyadarshini Hesarghatta Ramamurthy, Bennete Aloysius Fernandesv, Swapnil Shankargouda, Sultan Orner Sheriff
The mucosa immediately surrounding an erupted tooth is known as the gingiva. In functional terms, the gingiva consists of two parts: (1) the part facing the oral cavity, which is masticatory mucosa, and (2) the part facing the tooth, which is involved in attaching the gingiva to the tooth and forms part of the periodontium (Tencate 2017).
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The periodontium consists of the tissues that surround and support the teeth, which are the gingiva, periodontal ligament, cementum, and alveolar bone. The gingiva is the part of the oral mucosa that covers the alveolar process of the jaw and surrounds the neck of the tooth. Periodontal ligaments serve to attach teeth to the bone; to maintain gingival tissues in the proper relationship to teeth, as shock absorbers; and to provide a casing to protect the vessels and nerves. Cementum is the calcified or hardened tissue that forms the outer covering of the anatomic root. The process of its formation is variable, but continuous. The alveolar bone or tooth socket is the socket in the maxilla (upper jawbone) or mandible (lower jawbone) into which each tooth fits.
Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis
Published in Journal of Oral Microbiology, 2023
Ali A. Abdulkareem, Firas B. Al-Taweel, Ali J.B. Al-Sharqi, Sarhang S. Gul, Aram Sha, Iain L.C. Chapple
Periodontal disease is a broad term used to encompass diseases and conditions of the periodontal tissues. The two major forms induced by dental plaque biofilm accumulation are gingivitis and periodontitis. Gingivitis is an inflammatory lesion that remains confined to the gingiva, but which may, in susceptible people, progress to a more severe and destructive form, periodontitis [1]]. A causal relationship between periodontitis and systemic diseases has not yet been robustly established, however studies indicate that periodontal pathogens and consequent immune-inflammatory responses to them are independently associated with the pathogenesis of several systemic diseases such as diabetes mellitus, atherosclerotic cardiovascular diseases, chronic obstructive pulmonary diseases, Alzheimer’s, chronic kidney disease, rheumatoid arthritis and certain cancers [2–5]. The ulcerated pocket epithelium provides a direct portal of vascular entry for periodontal pathogens, e.g. Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Eikenella corrodens, and Fusobacterium nucleatum to the systemic circulation, which may directly or indirectly affect other organ systems [6–8]. A report issued in 2018 estimated the economic burden arising due to periodontal diseases as approximately $154.06 billion in the US and €158.64 billion in Europe [9].
Critical roles of adherens junctions in diseases of the oral mucosa
Published in Tissue Barriers, 2023
Christina Kingsley, Antonis Kourtidis
The gingival epithelium has been extensively studied due to its implication in periodontal disease. The gingival epithelium is composed of keratinizing stratified epithelium and covers the external surface of the gingiva, which surrounds the teeth (Figure 1).6 An important function of the gingival epithelium is to provide the first line of defense in the oral cavity against pathogens.7 There are several components of the gingiva. The attached gingiva is firmly bonded to the connective tissue over the alveolar bone and is separated from the oral mucosa by the mucogingival line (Figure 1). The attached gingiva is located apically to the gingival sulcus, which is the space surrounding each tooth and is lined by the oral sulcular epithelium (Box 1; Figure 1). This epithelium is stratified and non-keratinized.2 The junctional epithelium is a specialized epithelial component. This epithelium is derived from the enamel epithelium and mediates the attachment of the gingival epithelium to the enamel on the tooth surface (Figure 1).8 This is an important function of the junctional epithelium, because it forms a barrier against pathogens passing from the oral cavity into the tissue that supports the tooth.9 Due to its role, the junctional epithelium isan area of extensive study in periodontal disease,10 where tooth mobility and loss are found. In comparison to the gingival epithelium, the junctional epithelium shows no keratinization and exhibits much higher proliferation and turnover rate2,7,8 (Figure 1).
Microemulsion-thermosensitive gel composites as in situ-forming drug reservoir for periodontitis tissue repair through alveolar bone and collagen regeneration strategy
Published in Pharmaceutical Development and Technology, 2023
Yang Ding, Yuxiao Wang, Jiaxin Li, Maomao Tang, Hairong Chen, Guichun Wang, Jian Guo, Shuangying Gui
Periodontitis is a chronic inflammatory disease caused by biofilms. It results in the destruction of periodontal tissues, the supporting structures of the teeth (such as the gingiva) and the underlying alveolar bone (Darveau 2010). According to epidemiologic data, periodontitis is a widespread non-communicable disease, potentially becoming severe and affecting 11.2% of the world population; it is the sixth most common disease in the world (Kassebaum et al. 2014). Severe periodontitis threatens human health and may increase the incidence of type 2 diabetes mellitus, Alzheimer’s disease (Sadrameli et al. 2020), cardiovascular disease (Sanz et al. 2020), inflammatory bowel disease (Read et al. 2021), and rheumatoid arthritis (Schenkein et al. 2020). Periodontitis is treated by surgical therapy and non-surgical therapy. Local delivery of drugs (antibiotics and anti-inflammatory drugs) is the widely used non-surgical therapy to cure periodontal diseases. However, salivary flow decreases the adhesion of the drug, lowering its local concentration in the drug in the periodontal pocket. In addition, most patients may develop drug resistance after frequent dosing.