PERIODONTAL DISEASE

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Pathogens and immunity

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Biochemical mediators of the immune system

MMPs

- Facilitate normal turnover of the connective tissue matrix - Collagen destruction

Prostaglandins

- Increase vascular permeability allowing inmune cells and complement to move to the infection site - PGE2 Alveolar bone destruction

Cytokines

- Recruit PMNs and macrophages to the infection site. - Initiate tissue destruction and bone

microbiome

bacteria

The presence of periodontal pathogens does not necessarily mean that an individual will experience periodontitis.

PERIODONTAL DISEASE

Pathogenesis

4. periodontitis - tissue destruction phase

3. Established gingivitis - subgingival plaque phase

2. Early gingivitis - plaque overgrowth phase

1. Early bacterial accumulation phase

Host response

Dysbiosis