Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/87059
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Type: Journal article
Title: Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts
Author: Bartold, P.M.
Van Dyke, T.E.
Citation: Periodontology 2000, 2013; 62(1):203-217
Publisher: Wiley
Issue Date: 2013
ISSN: 0906-6713
1600-0757
Statement of
Responsibility: 
P. Mark Bartold and Thomas E. Van Dyke
Abstract: New concepts evolve when existing ones fail to address known factors adequately or are invalidated by new evidence. For decades periodontitis has been considered to be caused by specific bacteria or groups of bacteria and, accordingly, treatment protocols have largely been based on anti-infective therapies. However, close inspection of current data leads one to question whether these bacteria are the cause or the result of periodontitis. Good evidence is emerging to suggest that it is indeed the host response to oral bacteria that leads to the tissue changes noted in gingivitis. These changes lead to an altered subgingival environment that favors the emergence of 'periodontal pathogens' and the subsequent development of periodontitis if the genetic and external environmental conditions are favorable for disease development. Thus, it seems that it is indeed the initial early host-inflammatory and immune responses occurring during the development of gingivitis, and not specific bacteria or their so-called virulence factors, which determine whether periodontitis develops and progresses. In this review we consider these concepts and their potential to change the way in which we view and manage the inflammatory periodontal diseases.
Keywords: Humans; Gingivitis; Periodontitis; Disease Progression; Disease Susceptibility; Inflammation Mediators; Homeostasis; Host-Pathogen Interactions; Bacterial Physiological Phenomena
Description: Article first published online: 11 APR 2013
Rights: © 2013 John Wiley & Sons A/S
RMID: 0030007672
DOI: 10.1111/j.1600-0757.2012.00450.x
Grant ID: http://purl.org/au-research/grants/nhmrc/1023747
http://purl.org/au-research/grants/nhmrc/627143
Appears in Collections:Dentistry publications

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