School of Dentistry, University of Southern California, Los Angeles, California.
University of Nevada at Reno School of Medicine, Reno, Nevada.
Periodontol 2000. 2019 Feb;79(1):210-220. doi: 10.1111/prd.12241.
Four billion individuals worldwide have a history of periodontitis, with the poorest people in society most affected. Periodontitis can lead to unsightly drifting of teeth and tooth loss that may interfere with the wellbeing of daily living and has also been linked to at least 57 medical diseases and disabilities. The etiology of severe periodontitis includes active herpesviruses, specific bacterial pathogens, and destructive immune responses, but herpesviruses seem to be the major pathogenic determinant. Periodontal herpesviruses that disseminate via the systemic circulation to nonoral sites may represent a major link between periodontitis and systemic diseases. Current treatment of periodontitis focuses almost exclusively on bacterial biofilm and will require revision. Periodontal therapy that targets both herpesviruses and bacterial pathogens can provide long-term clinical improvement and potentially reduces the risk of systemic diseases. Molecular diagnostic tests for periodontal pathogens may enable early microbial identification and preemptive therapy. This review details an efficient and reliable anti-infective treatment of severe periodontitis that can be carried out in minimal time with minimal cost.
全球有 40 亿人患有牙周炎,社会中最贫困的人受影响最大。牙周炎会导致牙齿难看地移位和脱落,这可能会影响日常生活的健康,并且至少与 57 种医学疾病和残疾有关。严重牙周炎的病因包括活跃的疱疹病毒、特定的细菌病原体和破坏性的免疫反应,但疱疹病毒似乎是主要的致病决定因素。通过全身循环传播到非口腔部位的牙周疱疹病毒可能是牙周炎和全身性疾病之间的主要联系。目前牙周炎的治疗几乎完全集中在细菌生物膜上,这需要进行修正。针对疱疹病毒和细菌病原体的牙周治疗可以提供长期的临床改善,并可能降低患系统性疾病的风险。牙周病病原体的分子诊断测试可以实现早期微生物鉴定和预防性治疗。这篇综述详细介绍了一种高效、可靠的严重牙周炎抗感染治疗方法,这种方法可以在最短的时间内以最低的成本进行。