Inflammatory and Immunological Basis of Periodontal Diseases

作者：Giacomo Baima, Marion Arce, Mario Romandini, Thomas E. Van Dyke · 发表于：Journal of Periodontal Research · 年份：2025 · DOI：10.1111/jre.70040 · 被引用次数：41 · 研究领域：Oral microbiology and periodontitis research、Immune Response and Inflammation、Cell Adhesion Molecules Research

In its most common form, periodontitis is viewed as a chronic immunoinflammatory disorder of the tooth supporting tissues, shaped by host-microbiome disequilibrium, exaggerated immune activation, and impaired resolution mechanisms. This review explores the periodontal battlefield through its inflammatory and immunological lens, beginning with the transformation of the lesion from silent immune surveillance to sustained inflammation, connective tissue degradation, and alveolar bone loss. The classical Page and Schroeder model is used as a foundation but reinterpreted in light of current evidence derived from advanced molecular techniques. The immunological architecture is subsequently dissected through the involvement of its principal cellular players, acting in a dynamic battleground composed of saliva, crevicular fluid, epithelial barriers, and connective tissues. On the frontlines, neutrophils act as double-edged defenders, capable of both microbial clearance and bystander tissue damage. Like macrophages and dendritic cells, they also serve as strategic sensors and shapers of immunity, bridging innate and adaptive responses. Among these, the T cell arsenal includes inflammatory subsets such as Th1, Th17, and cytotoxic cells, balanced by regulatory T cells. B lymphocytes and plasma cells emerge not only as antibody producers but also as pro-inflammatory effectors, with growing evidence implicating autoreactive subsets in tissue damage, particularly in aggressive forms of the...