Private Practice, Keene, NH, USA.
Stony Brook University School of Dental Medicine, Stony Brook, NY, USA.
Int Dent J. 2021 Dec;71(6):462-476. doi: 10.1111/idj.12630. Epub 2021 Feb 19.
Periodontitis is a common disorder affecting >40% of adults in the United States. Globally, the severe form of the disease has a prevalence of 11%. In advanced cases, periodontitis leads to tooth loss and reduced quality of life. The aetiology of periodontitis is multifactorial. Subgingival dental biofilm elicits a host inflammatory and immune response, ultimately leading to irreversible destruction of the periodontium (i.e. alveolar bone and periodontal ligament) in a susceptible host. In order to successfully manage periodontitis, dental professionals must understand the pathogenesis, primary aetiology, risk factors, contributing factors and treatment protocols. Careful diagnosis, elimination of the causes and reduction of modifiable risk factors are paramount for successful prevention and treatment of periodontitis. Initial non-surgical periodontal therapy primarily consists of home care review and scaling and root planing. For residual sites with active periodontitis at periodontal re-evaluation, a contemporary regenerative or traditional resective surgical therapy can be utilised. Thereafter, periodontal maintenance therapy at a regular interval and long-term follow-ups are also crucial to the success of the treatment and long-term retention of teeth. The aim of this review is to provide current concepts of diagnosis, prevention and treatment of periodontitis. Both clinical and biological rationales will be discussed.
牙周炎是一种常见的疾病，影响了美国超过 40%的成年人。在全球范围内，这种疾病的严重形式的患病率为 11%。在晚期病例中，牙周炎会导致牙齿脱落和生活质量下降。牙周炎的病因是多因素的。龈下牙菌斑会引发宿主的炎症和免疫反应，最终导致在易感宿主中牙周组织（即牙槽骨和牙周韧带）的不可逆转破坏。为了成功治疗牙周炎，牙科专业人员必须了解其发病机制、主要病因、危险因素、促成因素和治疗方案。仔细的诊断、消除病因和减少可改变的危险因素对于牙周炎的成功预防和治疗至关重要。初始非手术牙周治疗主要包括家庭护理复查、洁治和根面平整。对于牙周重新评估时仍有活动性牙周炎的残留部位，可以使用现代再生或传统的切除性手术治疗。此后，定期进行牙周维护治疗和长期随访对于治疗的成功和牙齿的长期保留也至关重要。本综述的目的是提供牙周炎的诊断、预防和治疗的最新概念。将讨论临床和生物学的合理性。
