Treatment of periodontitis in complex cases:
periodontal well-being as systemic health
Gaetano Isola & Alessandro Polizzi
DDS, PhD
Abstract
Periodontitis is a multifactorial, microbiome-driven inflammatory disease affecting the
tooth-supporting apparatus and has been epidemiologically associated with various
systemic conditions, including cardiometabolic, neurodegenerative, respiratory, and
autoimmune disorders. Evidence from interventional studies indicates that treating
periodontitis locally can reduce systemic inflammation and surrogate markers of comorbid diseases, suggesting a potential causal link. This putative cause-and-effect relationship is further supported by findings from preclinical and clinical models, which have provided mechanistic insights, although the underlying pathways remain incompletely understood.
Inflammation plays a central role in the onset and progression of periodontitis, initiated by the host’s immune response to periodontal pathogens within the biofilm. When this
inflammatory response becomes chronic, it leads to the destruction of periodontal tissues, bone loss, and ultimately tooth loss. Over recent decades, extensive research has demonstrated that this chronic inflammatory state not only contributes to periodontal breakdown but also exacerbates multiple systemic diseases, highlighting a bidirectional relationship between periodontitis and systemic health.
The aim of this lecture is to review and discuss recent advances in understanding the
biological connections between periodontitis and systemic diseases. These insights may pave the way for innovative therapeutic strategies aimed at reducing the risk of
periodontitis-associated comorbidities and improving the overall effectiveness of
periodontal therapy.
Learning Objectives
- How periodontitis could impact systemic diseases
- How periodontal treatment could improve overall quality of life
- How complex periodontitis cases need to be treated by a multidisciplinary approach