Abstract
We now understand that the presence of pathogenic biofilm, while a crucial requirement for the development of periodontitis, is alone insufficient to cause disease. The host immune response against the microbial challenge, in cooperation with the junctional epithelium (JE), are central to the pathoaetiology of periodontitis. Within the periodontium the most significant immune protective mechanism is the recruitment of the neutrophils; which along with the sustained release of proinflammatory cytokines, drives alveolar bone loss, leading to further tissue destruction.
Thus, the disease develops from intricate interactions between the biofilm and the host immune response. The outcome of the microbial challenge from the dental plaque depends, therefore, on the balance between the protective and destructive aspects of the host response. Fluctuations in the host- parasite relationship upset the balance between the protective and destructive aspects of the host response. Therefore, while gingivitis can remain stable for an extended period in a number of individuals, it can progress to periodontitis in susceptible individuals where there is an imbalance between the host and microbial factors.
In this chapter, the histopathological features of periodontal disease will be described through a series of stages: initial lesion gingivitis, early lesion gingivitis, established lesion gingivitis, and advanced lesion. It is important to note that these histopathological changes occur constitute a continuum. Additionally, histopathological features of acute periodontal abscesses and necrotising periodontal diseases are discussed. It is important that the reader relates these histopathological features to the clinical presentation of the disease.
Thus, the disease develops from intricate interactions between the biofilm and the host immune response. The outcome of the microbial challenge from the dental plaque depends, therefore, on the balance between the protective and destructive aspects of the host response. Fluctuations in the host- parasite relationship upset the balance between the protective and destructive aspects of the host response. Therefore, while gingivitis can remain stable for an extended period in a number of individuals, it can progress to periodontitis in susceptible individuals where there is an imbalance between the host and microbial factors.
In this chapter, the histopathological features of periodontal disease will be described through a series of stages: initial lesion gingivitis, early lesion gingivitis, established lesion gingivitis, and advanced lesion. It is important to note that these histopathological changes occur constitute a continuum. Additionally, histopathological features of acute periodontal abscesses and necrotising periodontal diseases are discussed. It is important that the reader relates these histopathological features to the clinical presentation of the disease.
| Original language | English |
|---|---|
| Title of host publication | Oral Histology and Oral and Maxillofacial Histopathology |
| Publisher | Springer Nature |
| Chapter | 19 |
| Edition | 1 |
| Publication status | Accepted/In press - 1 Dec 2023 |