Читать книгу Basic Guide to Oral Health Education and Promotion - Alison Chapman - Страница 95

Periodontitis is often, but not always, a progression of gingivitis, and is primarily caused by the enzymes and toxins of mature plaque bacteria, which gradually break down the tissues of the periodontium in a susceptible host [4].

For most patients, gingivitis does not progress to periodontitis, but 10–15% of patients are susceptible to periodontitis [3]. The onset of periodontitis in these patients is thought to be due to a genetic abnormality, which causes a change in the behaviour of cytokines (substances which regulate the movement of immune system cells), and subsequent destruction of bone. This genetic basis explains why periodontitis frequently affects members of the same family. Current thinking is that with periodontal disease, 20% of tissue damage is due to the direct effects of plaque by‐products on tissues and 80% due to indirect effects, i.e. host destruction triggered by the body’s own white blood cells [5].