Role of Genetics in Pathogenesis of Periodontitis
Presentation Category
Research, Other
Introduction/Context/Diagnosis
Periodontitis is a chronic bacterial inflammatory disease that affects tissues supporting the teeth. It can result in irreversible loss of periodontal attachment and destruction of adjacent alveolar bone leading to increased tooth mobility and finally to exfoliation. Etiology is complex and multifactorial including genetic and non-genetic environmental factors. Non-genetic factors are well known and confirmed by many studies. However, it is not clear how a genetic susceptibility to periodontitis is determined. Families with several individuals suffering from aggressive periodontitis are not rare. When life style habits and nutritional factors are excluded as major etiological factors, a genetic background shared with close relatives and passed over generations becomes an important factor.
Methods/Treatment Plan
As the new classification system of periodontitis was introduced in 2017, many present and previous studies used classification into two major clinical forms: aggressive periodontitis (AgP, AP) and chronic periodontitis (CP). We used search engines PubMed, Google Scholar,Scorpius, and Science Direct with keywords periodontitis, genetics, AgP, AP, CP, and polymorphism. We ran the search with no language and time restrictions.
Results/Outcome
The search yielded 47 relevant articles and we selected 6 articles for a detailed review. Those selected articles dealt with candidate genes involved in pathogenesis of periodontitis. Many studies focused on role of interleukin 4 gene polymorphisms, especially 590C/T and 33 C/Tand their association with CP. Polymorphism IL-4 590 C/T increased risk for CP in studies from Germany, Brazil, and China, while polymorphism IL-4 33 C/T was found protective for CP in a study from Indian population.
The second intensively studied genetic factor are polymorphisms of toll-like receptors TLR2 and TLR4. Some of them were shown to increase risk for CP. An autosomal recessive pattern of inheritance was observed for CP in TLR4 C/G (rs7873784) and TLR4 299 A/G polymorphisms. While the TLR4 299A/G was found to increase risk for CP, the TLR4 399 C/T seemed to be protective for AP.
Significance/Conclusions
A take-home message of this presentation is to realize importance of taking detailed family history of a patient with chronic periodontitis by the clinician. Genetics in periodontics is important and highly researched field. Many studies published in recent years support the evidence that gene polymorphisms influence initiation and progression of periodontal disease on an individual basis. Although association between different candidate gene polymorphisms and its periodontal effects is still very controversial, itappears that several gene polymorphisms can be analyzed and the diagnosed genotypes can be taken into account when a treatment plan is designed.
There is a possibility for managing a periodontal disease before it becomes chronical, so that needed measures can be taken early and prophylactically. It is also possible to personalize the treatment of an individual early, rather than treat the symptoms and complications later. There is no doubt that further detailed combined genetic and clinical studies are needed.
Format
Event
Role of Genetics in Pathogenesis of Periodontitis
Periodontitis is a chronic bacterial inflammatory disease that affects tissues supporting the teeth. It can result in irreversible loss of periodontal attachment and destruction of adjacent alveolar bone leading to increased tooth mobility and finally to exfoliation. Etiology is complex and multifactorial including genetic and non-genetic environmental factors. Non-genetic factors are well known and confirmed by many studies. However, it is not clear how a genetic susceptibility to periodontitis is determined. Families with several individuals suffering from aggressive periodontitis are not rare. When life style habits and nutritional factors are excluded as major etiological factors, a genetic background shared with close relatives and passed over generations becomes an important factor.
