The biology, prevention, diagnosis and treatment of periodontal diseases Scientific advances in the United States
The biology, prevention, diagnosis and treatment of periodontal diseases Scientific advances in the United States
复制标题
DOI：
10.14219/jada.archive.2009.0356
复制
发表时间：
2009-09-01
影响因子：
3.9
通讯作者：
Robertson, Paul B.
中科院分区：
文献类型：
--
作者：
Armitage, Gary C.;Robertson, Paul B.
背景资料。在过去的150年里，牙周学的重大科学进步从根本上改变了临床医生检测和治疗牙周病的方式。这些进展包括证明牙周炎和牙周炎是由本土口腔微生物区系的组成部分引起的生物被膜诱导的感染，以及宿主对这些微生物挑战的炎症免疫反应是大多数观察到的组织损伤的原因。在这个简短的概述中，作者集中在牙菌斑和宿主牙周组织之间的关系的发现。他们突出了美国的一些先驱，他们形成了预防和治疗牙周病的新方法。引起牙周炎和牙周炎的生物膜是复杂的多菌群落，对抗菌剂和宿主防御机制具有耐药性。对自然消炎机制的深入了解表明，在牙周感染的治疗中，控制炎症至少与抗菌治疗一样重要。来自随机对照临床试验的数据表明，只要患者遵守治疗后的维持程序，大多数传统形式的牙周治疗都是有效的。在牙周组织的修复和再生过程中，许多机制已经被发现。加强牙周病预防和治疗的因素的实验室研究结果已过渡到临床实践。分子生物学、人类遗传学和干细胞生物学领域的进展为重大发现奠定了基础，这些发现将为牙周组织可预测再生所需程序的发展铺平道路。因此，美国的新一代人有望终生保持健康和有功能的牙列。
Background. Major scientific advances in periodontology in the past 150 years have fundamentally changed how clinicians detect and treat periodontal diseases. These advances include the demonstration that gingivitis and periodontitis are biofilm-induced infections caused by components of the indigenous oral microbiota, and that host inflammatory-immunologic responses to these microbial challenges are responsible for most of the observed tissue damage.Types of Studies Reviewed. In this brief overview, the authors focus on the discovery of the relationships between dental plaque and the host periodontal tissues. They highlight some of the pioneers in the United States who shaped new approaches to prevention and treatment of periodontal disease.Results. Biofilms that cause gingivitis and periodontitis are complex polymicrobial communities that are resistant to antimicrobial agents and host defense mechanisms. An increased understanding of natural inflammation-resolving mechanisms suggests that control of inflammation is at least as important as is antimicrobial therapy in the treatment of periodontal infections. Data from randomized controlled clinical trials have shown that most conventional forms of periodontal therapy are effective as long as patients comply with posttreatment maintenance programs.Conclusions. Many mechanisms involved in the repair and regeneration of periodontal tissues have been identified. Results of laboratory studies of factors that enhance prevention and treatment of periodontal disease have made the transition to clinical practice. Advances in the fields of molecular biology, human genetics and stem cell biology have set the stage for significant discoveries that will pave the way for the development of procedures needed for the predictable regeneration of periodontal tissues. As a result, new generations of people in the United States can expect to retain a healthy and functional dentition for a lifetime.