Animal Health Solutions

12 Covetrus | ph: 855.724.3461 | fx: 888.329.3861 | northamerica.covetrus.com tumor necrosis factor-alpha and matrix metalloproteinases). Those activated mediators subsequently influence a number of cellular processes such as recruitment and chemotaxis of neutrophils to the site; increase extravasation of plasma proteins from the blood vessels into the tissues from increased permeability of the gingival vessels; stimulate smooth muscle contraction; induce pain or mediate oxidative damage. Through the epithelium the innate defense is induced, producing antimicrobial peptides (defensins, calprotectin, etc.). The salivary flow is increased limiting bacterial growth via the flushing action by clearing bacteria from the surfaces, clearing bacterial-aggregation factors, antimicrobial proteins, etc. If the bacterial plaque biofilm continues to develop expanding to populate the subgingival space (gingival sulculus), further stimulation of the epithelium will result. This results in production of bioactive mediators which results in recruitment of various cell types including neutrophils, T-cells, B-cells, monocytes, etc. Continued exacerbations of the bacterial plaque biofilm results in signaling of underlying cell types, such as fibroblasts, to increase production of proinflammatory cytokines in the tissues. This acute phase response is associated with gingival inflammation including the production of C-reactive proteins, fibrinogen, complement, etc. by both the local cells and also the liver. These proteins possess biological activities that could further exacerbate the inflammatory response, but additionally impact the initiation or progression of systemic disease processes. Oral bacteria live in a highly vascular peridontium and The etiology of periodontal disease has been proven for over a hundred years, but it is not just the number of bacteria; rather, it is the bacterial types. In the 80's research indicated that the areas of periodontitis contained mainly gram negative anaerobic organisms while in health the gingiva contained gram positive aerobic organisms. In the 90's research indicated that the inflammatory response of the host and certain specific bacteria were associated with periodontitis. These bacteria are found in ecologic complexes as biofilms. Initial dental plaque bacteria (gm + cocci) release a variety of chemical compounds during their normal metabolism (organic acids, peptides; etc.). Those chemicals are soluble and cross the superficial layers of the sulcular epithelium. Then, those chemicals signal the gingival epithelium to produce a variety of biologically active mediators (cytokines as interleukin-1 beta, interleukin 8, prostaglandins, histamine, leukotriens, serotonin, TGF-ß TIMP's sTNF-r, IL-1ra IL-10, IL-4, IL-11, IL-13 Host modulation therapy Reduced risk factors Chemical plaque control Non surgical & surgical periodontal therapy Adequate plaque control & patient owner compliance FGF, PDGF, VEGF GM-CSF, M-CSF IL-1, TNF-a MMP's Risk factor e.g. genetics, diabetes etc. Hypo or hyper-active host immune response Poor patiet acceptance, poor owner compliance Poor plaque control subgingival burden Chemokines IL-12, IL-15 Periodontal inflammation Periodontal health Interactive Balance Between Inflammatory Cytokines

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