Laine M L, Rijkschroeff P, de Vries T J, Zaura E
Ned Tijdschr Tandheelkd. 2021 Dec;128(12):599-603. doi: 10.5177/ntvt.2021.12.21109.
Periodontitis is a complex, multifactorial disease. Multiple factors such as (epi)genetic factors, environmental factors (microbial biofilm), lifestyle (smoking, stress) and general health (diabetes mellitus) contribute to the development of periodontitis. A healthy subgingival microbiome is in balance with its host, is very stable and diverse, and keeps the host healthy. Changes, such as declining oral hygiene, lead to changes in the microbial composition in the subgingival sulcus: anaerobic and protein-degrading microorganisms with pro-inflammatory properties increase in number and disturb the proportions, leading in turn to changes in the subgingival environment and an increase in pro-inflammatory microorganisms. If the first line of the immune system is unable to restore subgingival equilibrium, microorganisms and their products invade the periodontal soft tissues, resulting in activation of osteoclasts and, ultimately, in the destruction of the periodontium and the onset of periodontitis.
牙周炎是一种复杂的多因素疾病。多种因素，如（表观）遗传因素、环境因素（微生物生物膜）、生活方式（吸烟、压力）和整体健康状况（糖尿病），都与牙周炎的发生有关。健康的龈下微生物群与其宿主保持平衡，非常稳定且多样，并使宿主保持健康。诸如口腔卫生下降等变化会导致龈下沟微生物组成的改变：具有促炎特性的厌氧和蛋白质降解微生物数量增加并扰乱比例，进而导致龈下环境的变化和促炎微生物的增加。如果免疫系统的第一道防线无法恢复龈下平衡，微生物及其产物就会侵入牙周软组织，导致破骨细胞活化，最终导致牙周组织破坏和牙周炎的发作。
