MODERN VIEWS ON LEADING FACTORS IN THE ORIGIN AND DEVELOPMENT OF GENERALIZED PERIODONTITIS

Abstract

The development of generalized periodontitis is preconditioned by two groups of factors – local and general. Local factors include the influence of the microflora of the dental biofilm on the background of changes in the local immunity of the oral cavity, anatomical and topographic features of the oral cavity, masticatory dysfunction due to abnormal jaw development, traumatic occlusion and early tooth loss. Common factors include stress, psycho-emotional stress, ionizing radiation, insufficient alimentary intake of vitamins, macro- and microelements, concomitant pathology of internal organs, endocrine and genetic disorders. In response to prolonged microbial persistence, an inflammatory process develops in the periodontal tissues, which is the complex of microcirculatory, hematological, immunological and connective tissue reactions to damage. Disruption of microcirculation provokes tissue hypoxia, activation of free radical oxidation, disorganization of biofilms with the release of physiologically active substances (prostaglandins, cytokines). The nature and rate of development, intensity and prevalence of the inflammatory process in periodontal tissues are determined by intercellular and intersystem interaction with the participation of different populations of leukocytes and substances produced by them. The leading role in the resorption of alveolar bone belongs to pro-inflammatory cytokines, prostaglandin E2 and the system of regulatory proteins RANKL-RANK-OPG, which determines the pathways of drug correction of alveolar bone remodeling. The level of the corresponding inflammatory reaction to damage is determined by the reactivity of the organism. The issues of clarifying the key mechanisms of the inflammatory process in periodontal tissues depending on the initial state of reactivity of the organism remain relevant, which determines the feasibility of further research.