Modern views on the etiology and role of microbial persistence in the development of inflammatory processes in the periodontal complex (review)

Alveolar tissue diseases cause the appearance of dentition defects, thereby reducing the patients' work capacity and quality of life. The purpose of this research was to investigate, modern views on the etiology of periodontitis and the role of microbial persistence in the development of inflammatory processes of periodontal complex basing on a review of literary sources. Literature review was conducted using PubMed, Web of Science, Scopus, Google Scholar from 2018 to March 2024. There were no restrictions on the date of publication or the language of scientific sources. Searches were conducted according to MeSH (Medical Subject Headings) with using the following search terms: "periodontitis", "oral mucosa", "gums", "dental plaque", "periodontium", "traumatic occlusion", "microorganisms". In total, during the initial analysis 82 literary sources were selected and processed, after further systematization of the selected information using general scientific methods, 70 of them remained. Used methods: bibliographic and analytical. Generalized perio­dontitis is a chronic inflammatory-dystrophic process that occurs as a result of various factors. In the pathogenesis of this disease, the key role is played by the inflammatory process, which is a complex interaction of microcirculatory, he­matological and connective tissue reactions to the lesion. Local (exogenic) and general (endogenic) causative factors are distinguished. The main factors that cause pathological changes in periodontium are bacterial biofilm, traumatic occlusion and various anatomical anomalies. Dental plaque occupies a special and main place among the causes of periodontitis. At present, leading pathogenetic links in the development of the inflammation in the periodontium, in par­ticular, the disruption of free radical oxidation, the processes of peroxide oxidation of lipids and proteins, the disorder of the functional state of the antioxidant system, the formation of oxidative stress, as well as the humoral link of adaptive immune protection and cytokinesis, have not been sufficiently studied. There is no doubt about the role of the microbial factor in the etiology of periodontal diseases, but the penetration of microbes into the periodontium does not always lead to the development of the disease, because the organism has a number of protective mechanisms that counteract the development of inflammation.