Periodontal and peri-implant diseases are common, chronic inflammatory conditions involving the supporting tissues around teeth and dental implants. Both conditions are caused by a pathogenic shift in the oral microbiome that triggers host expression of inflammatory mediators locally and systemically. Treatment strategies for periodontal and peri-implant diseases in general focus on reducing the pathogenic microbiome via mechanical procedures. While the majority of patients show improvements in the clinical signs of disease with treatment, there is a fair amount of variability with regard to the extent and duration of these clinical improvements. In addition, patients may vary with regard to shifts in the oral microbiome or reductions in inflammatory mediators secondary to therapy. Much of this variability in responses may be credited to risk or prognostic factors occurring in the population. This presentation will introduce the working model of periodontal and peri-implant disease etiology and pathogenesis and discuss treatment strategies and challenges for clinicians.
David W. Paquette, DMD, MPH, DMSc, received his doctor of dental medicine degree, masterís of public health, doctor of medical sciences, and certificate in periodontics from Harvard University. He is now a professor and associate dean for education at Stony Brook University School of Dental Medicine. Dr Paquette is active in many international and national organizations, including the American Academy of Periodontology, the American Dental Education Association, and the American Dental Association. He is an associate editor for the Journal of Periodontology. His major research interests include clinical trials, novel interventions for periodontal disease, and the interplay between periodontal disease and systemic conditions, in particular cardiovascular disease and obesity. Dr Paquette is a Diplomate of the American Board of Periodontology and maintains a private practice limited to periodontics in Stony Brook, New York.
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