The influence of microbial persistence of dental plaque on the pathogenesis and course of generalized periodontitis

Abstract

Introduction. In the pathogenesis of chronic inflammation of periodontum, dental plaque penetrates to the bottom of the gingival sulcus and enters the connective tissue interstitium under the epithelium, causing inflammation. Aim. The aim of this research is to conduct an analysis of modern scientific publications regarding the influence of microbial persistence of dental plaque on the pathogenesis and course of generalized periodontitis. Materials and methods. The search and selection of publications, systematic reviews and current recommendations was carried out using PubMed and Google Scholar databases. Results. Іnflammation increases the outflow of cerebrospinal fluid and in this way significantly improves the conditions for the reproduction of microorganisms in the area of the newly created peculiar pathological ecological niche – the periodontal pocket. In addition, inflammation stimulates the vegetation of the epithelium in the direction of the apex of the root part of the tooth, which is limited by the compact plates of the periodontal gap. It is the vegetation of the epithelium that causes a defect in the epithelial cover of the bottom of the gingival sulcus and cuts off the periodontal ligaments. The periodontal ligaments are replaced by granulation tissue, significantly increasing the surface area of the outer covering infiltrated with plaque microbiota. P. gingivalis is one of the main pathogens involved in periodontitis. The predominance of Porphyromonas gingivalis in tissues is a bad prognostic sign in typical forms of periodontitis. After Aggregatibacter actinomycetemcomitans, it is the most prevalent causative agent of chronic generalized periodontitis. It is especially often found in fresh lesions of the periodontal complex. Among all representatives of the oral microbiocenosis and pathogens, Porphyromonas gingivalis shows the strongest correlation with chronic periodontitis. Conclusions. Microbiological diagnostics allows obtaining the necessary information for the selection of the drug and the method of systemic therapy using antibiotics, as well as for monitoring and evaluating the effectiveness of the selected method of antibacterial therapy.