The study examined periodontal health in 64 pairs of identical and 53 pairs of fraternal twins. The study found that between 48 and 59 percent of the differences in measures of periodontal disease, such as attachment loss and probing depth, could be attributed to genetics. When correlating eight different clinical measures for periodontal disease among the two types of twins, all eight measures were statistically significant in the identical twins, while only two measures were significantly greater than zero in the fraternal twins.

“Periodontal disease is multifactorial, meaning that susceptibility involves genetic and environmental factors,” explained John C. Gunsolley, D.D.S., M.S., one of the authors of the study. “The basic question of what portion of periodontal disease risk among individuals is genetic versus environmental is important because it may lead to a better understanding of disease susceptibility. Identification of people at high risk for periodontal disease before they even display symptoms may provide new avenues for treatment.”

Gunsolley cautions that there are likely a number of genes that play a role in susceptibility, and these may differ in different races and ethnic groups. “I hope future studies will determine the genetic determinates underlying the risk for periodontal disease,” he said.

Michael McGuire, D.D.S., president of the American Academy of Periodontology (AAP), agrees. “I’m pleased that the role of genetics in oral health continues to be studied. I’m convinced that genetic research, such as the Human Genome Project, is going to revolutionize the way we treat diseases in general, including periodontal disease.”

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

Japanese clinicians were presented with a 49-year-old patient whose right maxillary premolar furcation had a bony defect with poor biologic width resulting from extensive subgingival caries. The condition originated about 15 years earlier when his canine was extracted resulting in epithelial cell down growth from the extraction socket to the furcation defect. And the patient was diagnosed with chronic periodontitis.

Knowing that furcation invasion treatment remains one of the most difficult clinical problems, this case presented Dr. Shigeki Ogihara, a private practitioner in Tokyo who is trained in periodontics, orthodontics and restorations, with a greater challenge.

“In this case, we saw comprehensive problems and could not solve them with providing orthodontic or regenerative therapy alone,” said Ogihara. “In fact, we could have caused other problems, such as further periodontal tissue break down. We were in a dilemma. Thus, we decided that combination therapy would result in predictable outcomes.”

After nine months of combined therapy, periodontal and orthodontic treatment proved to be a success and final restoration was completed.

“This is an example of how periodontal regenerative therapy appropriately sequenced with orthodontic treatment saved a tooth that would have otherwise been lost,” said Gordon Douglass, D.D.S., president of the American Academy of Periodontology. “It further demonstrates that regenerative periodontal tissues are strong enough to adapt to orthodontic movement.”

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

The Interleukin-1 (IL-1) genotype that puts more than 30 percent of people of European heritage at increased risk for periodontal disease is barely existent in Chinese populations. The study tested 300 people of Chinese heritage, and only about 2 percent carried the IL-1genotype. “Periodontal disease is a multifactorial disease,” said the study’s lead author, Gary Armitage, D.D.S., M.S., professor and chairman of the Division of Periodontology at the University of California San Francisco. “We don’t know yet whether oral hygiene, genetics or any other risk factor is most important in explaining why periodontal disease is widespread in Chinese populations.”

A separate study in this month’s Journal of Periodontology confirmed that people of Northern European origin who have the IL-1 genotype are more than five times as likely to develop periodontal disease, making oral hygiene habits, smoking and genetics among the top risk factors for periodontal disease. Study Abstract *

The study concluded that giving dental patients a genetic test, which can be performed through a saliva sample, before they even show signs of periodontal disease and getting them into early interventive treatment might help them keep their teeth for a lifetime. “IL-I genotyping, combined with finding out a patient’s smoking history, could go a long way in helping dental professionals estimate the future course of the disease. This helps us provide treatment and modify patients’ behavior to improve their odds,” said Michael McDevitt, the study’s lead researcher and a periodontist practicing in Atlanta.

However, McDevitt said at this time it is cost-prohibitive to perform the test on every patient. He said he has found the test useful for specific cases, such as for patients with advanced periodontal disease who seem to lack other major risk factors, for adults considering orthodontic treatment that could make them more susceptible to bone loss around the teeth, and for patients considering extensive treatment to save teeth jeopardized by periodontal disease.

Armitage’s study questions the usefulness of genetic testing for Chinese patients until further research is done. “In future studies, it will be interesting to determine if other gene candidates contribute to periodontal disease in Asians,” said Armitage. He noted that past research has found different genes in Asians than in Caucasians play roles in susceptibility to other diseases, such as heart disease and diabetes.

The presence of IL-1 affects the inflammatory response in the gum tissue when bacteria are present, making the gum tissue more susceptible to reacting negatively. “The IL-1 genotype can play a role in making periodontal disease more severe,” explained Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology (AAP). “However, if the harmful bacteria are kept under control with good oral hygiene and frequent dental visits, a person with the IL-1 genotype is certainly not sentenced to having periodontal disease.”

Caton adds, “Avoiding periodontal disease is not just important for keeping teeth for a lifetime, but also in keeping the rest of the body healthy.” Recent research has linked periodontal disease to more serious conditions, such as heart disease, diabetes, respiratory disease and pre-term, low-birth-weight babies.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Disease: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

“Currently, no therapies exist that can predictably regenerate tooth-supporting structures destroyed due to periodontal disease,” said William Giannobile, D.D.S., D.M.S., associate professor of dentistry at the University of Michigan and lead investigator of the study. “This study represents a tissue engineering approach to repair periodontal defects in animals. Human trials will be necessary to determine the feasibility of gene therapy to treat periodontal and other oral diseases.”

The main cause of periodontal disease is a hard substance called plaque, a sticky colorless film that constantly forms on the teeth. Toxins produced by bacterial plaque irritate the gums and stimulate a chronic inflammatory response in which the tissues and bone that support the teeth are broken down and damaged. Gums separate from the teeth and form deepening pockets that become infected. As the disease progresses, the pockets deepen further and more gum tissue attachment and bone are lost. Eventually, teeth can become loose and may have to be removed.

Researchers inserted a gene called bone morphogenetic protein that encodes a bone-stimulating factor into an inactivated virus in a rat. The virus then transferred the genes into grown skin cells. These genetically-engineered cells were transplanted into large periodontal bone defects surrounding the teeth, which regenerated tooth-supporting structures, such as the jawbone, periodontal ligament and the protective coating on the teeth called cementum.

“We’ve been talking about the possibility of gene therapy in dentistry for quite some time and now it’s here,” said Gordon Douglass, D.D.S., president of the American Academy of Periodontology. “We have seen recent reports of tissue-engineered teeth in pigs and now we can consider its use in treating a silent epidemic that’s been making its way in the mouth of millions of Americans each year – periodontal disease.”

A referral to a periodontist in your area and free brochure samples on periodontal disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for