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Chronic periodontitis is initiated by Gram-negative tooth-associated microbial biofilms that elicit a host response, which results in bone and soft tissue destruction. In response to endotoxin derived from periodontal pathogens, several osteoclast-related mediators target the destruction of alveolar bone and supporting connective tissue such as the periodontal ligament.
Aggregatibacter actinomycetemcomitans is a Gram-negative, facultative anaerobe, nonmotile bacterium that is often found in association with localized aggressive periodontitis, a severe infection of the periodontium. It is also suspected to be involved in chronic periodontitis. [1]
Full mouth disinfection typically refers to an intense course of treatment for periodontitis typically involving scaling and root planing in combination with adjunctive use of local antimicrobial adjuncts to periodontal treatment such as chlorhexidine in various ways of application.
Dental plaque, the precursor of periodontal disease, is a complex biofilm consisting mainly of bacteria, but also archaea, protozoa, fungi and viruses. Viruses that specifically infect bacteria—bacteriophages—are most common in the oral cavity. Viral roles in the progression of periodontal disease as of 2017 remains poorly explored. [1]
The most common causes for odontogenic infection to be established are dental caries, deep fillings, failed root canal treatments, periodontal disease, and pericoronitis. [2] Odontogenic infection starts as localised infection and may remain localised to the region where it started, or spread into adjacent or distant areas.
The first line of treatment is the removal of the source of inflammation or infection by local operative measures. [9] Generally, the abscess can be eradicated through surgical drainage alone; however this is sometimes inadequate. Therefore, systemic antibiotic treatment may be required, but only if there is evidence of spreading infection. [9]
As the overall treatment concepts and goals for AgP are not significantly different from that of chronic periodontitis, the different treatment phases (cause related therapy; re-examination for response to therapy; definitive therapy; and maintenance) are similar for both types of periodontitis.
Chronic periodontitis is generally slow to moderate in terms of disease progression, although short bursts of increased tissue destruction may occur. Ultimately, tooth loss may occur if the condition is not halted. It is termed localized when less than 30% of sites around teeth are involved, and generalised when more than 30% are involved.
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