Clinical and epidemiological implications of immune mechanisms in periodontitis

Abstract

Periodontitis, considered a chronic inflammatory disease rather than a conventional bacterial infection, is characterized by a dysregulated immune response to the accumulation of bacterial biofilm in periodontal tissue. This inflammatory imbalance contributes to the loss of periodontal support and is influenced by factors such as unhealthy habits and systemic conditions. In Ecuador, the high prevalence of periodontal diseases reflects a significant problem, exacerbated by economic barriers, lack of access to adequate dental care and lack of knowledge about oral hygiene. The immune response to periodontitis involves both innate and adaptive immunity. Chronic inflammation, mediated by proinflammatory cytokines such as TNF-α and IL-1β, and the activity of matrix metalloproteinases (MMPs) are key determinants in the destruction of periodontal tissue. The interplay between microbial dysbiosis and inflammation reflects the need for therapeutic approaches that address both the control of bacterial biofilm and the modulation of the immune response. This study highlighted the complexity of periodontitis, underscoring the importance of strategies that integrate the understanding of chronic inflammation and the development of targeted therapies. The results indicated that personalization of treatment, based on individual profiles and specific biomarkers, influences the clinical outcomes of periodontal disease management. It is advisable to explore new technologies to effectively address this oral health challenge