A long time periodontitis was believed to be an inevitable consequence of aging and uniformly
distributed in population. This age old belief was again supported by another belief that
disease severity was directly proportional to plaque levels. But in the mid 1990's early
insight about complex diseases like periodontitis led to new conceptual models of
pathogenesis. In recent years the role of microorganisms as the principle etiologic factor in
periodontal diseases has gained new perspectives. Periodontal disease is a multifactorial and
complex disease which is characterized by an upregulated or maladapted immune inflammatory
response to bacterial plaque which predisposes to periodontal breakdown. Although periodontal
disease is initiated by bacteria colonizing the tooth surface and gingival sulcus the host
response is believed to play an important role in the breakdown of connective tissue and bone.
Thus it can be summarized that periodontopathogens are necessary to cause periodontal disease
but they are not sufficient to cause the disease. In response to infectious or inflammatory
disease two distinct yet intricately linked immune responses occur - innate & adaptive. The
immune system is essential and the body has to marshal the innate and adaptive responses in
order to stave off infection. However in inflammatory disease the response becomes chronic and
tissues do not return to homeostasis. The development of an immune inflammatory response during
periodontitis in susceptible individuals results in the local production of a variety of
inflammatory mediators. The development of an immune inflammatory response during periodontitis
in susceptible individuals results in the local production of a variety of inflammatory
mediators. Pro-inflammatory cytokines molecules and the cytokine network play an essential role
in the pathogenesis of periodontal diseases. Therefore the aim of this review is to provide
comprehensive information and an update on various therapeutic methods to modify the host
response as an adjunctive treatment for periodontitis.
