Kikuchi Takeshi, Hayashi Jun-Ichiro, Mitani Akio
Department of Periodontology, School of Dentistry, Aichi Gakuin University, 2-11 Suemori-dori, Chikusa-ku, Nagoya 464-8651, Aichi, Japan.
J Pers Med. 2022 Oct 20;12(10):1743. doi: 10.3390/jpm12101743.
Periodontal disease, a major cause of tooth loss, is an infectious disease caused by bacteria with the additional aspect of being a noncommunicable disease closely related to lifestyle. Tissue destruction based on chronic inflammation is influenced by host and environmental factors. The treatment of periodontal disease varies according to the condition of each individual patient. Although guidelines provide standardized treatment, optimization is difficult because of the wide range of treatment options and variations in the ideas and skills of the treating practitioner. The new medical concepts of "precision medicine" and "personalized medicine" can provide more predictive treatment than conventional methods by stratifying patients in detail and prescribing treatment methods accordingly. This requires a new diagnostic system that integrates information on individual patient backgrounds (biomarkers, genetics, environment, and lifestyle) with conventional medical examination information. Currently, various biomarkers and other new examination indices are being investigated, and studies on periodontal disease-related genes and the complexity of oral bacteria are underway. This review discusses the possibilities and future challenges of precision periodontics and describes the new generation of laboratory methods and advanced periodontal disease treatment approaches as the basis for this new field.
牙周病是牙齿脱落的主要原因，它是一种由细菌引起的传染病，同时也是一种与生活方式密切相关的非传染性疾病。基于慢性炎症的组织破坏受宿主和环境因素影响。牙周病的治疗因每个患者的病情而异。尽管指南提供了标准化治疗，但由于治疗选择范围广泛以及治疗医生的理念和技能存在差异，优化治疗仍很困难。“精准医学”和“个性化医学”等新医学概念可以通过对患者进行详细分层并相应地规定治疗方法，提供比传统方法更具预测性的治疗。这需要一个新的诊断系统，将个体患者背景信息（生物标志物、遗传学、环境和生活方式）与传统医学检查信息整合起来。目前，正在研究各种生物标志物和其他新的检查指标，关于牙周病相关基因和口腔细菌复杂性的研究也在进行中。本综述讨论了精准牙周病学的可能性和未来挑战，并描述了作为这一新领域基础的新一代实验室方法和晚期牙周病治疗方法。
