Inflammation and Periodontal Diseases: A Reappraisal

This interest by the media and public is being fueled by an explosion of scientific knowledge on inflammation and chronic diseases of aging. For example, a recent PubMed search for scientific publications on ‘‘inflammation’’ published within a 12-month period prior to May 1, 2008 returned >16,500 papers. During the same period, 161 papers were published on ‘‘periodontal disease’’ and ‘‘inflammation.’’ Recognition of the research advances and importance of inflammatory mechanisms in essentially all of the chronic diseases of aging, including periodontal diseases, led the American Academy of Periodontology to convene a conference on January 29 and 30, 2008 in Boston titled, ‘‘Inflammation and Periodontal Diseases: A Reappraisal.’’ This conference brought together opinion leaders in several major diseases and in the inflammatory mechanisms that seem to underlie and unify all of these diseases. Inflammation is now known to play a critical role in diseases that are not usually classified as inflammatory diseases, such as cardiovascular disease and Alzheimer’sdisease.Although thisconclusion is the result of many years of research, much of the knowledge has crystallized into coherent concepts only very recently. The Boston conference brought together many of the people who have lead the new thinking relative to inflammation. Much of this new knowledge and the new concepts are captured in outstanding short overview papers in this supplement to the Journal of Periodontology. The organizers of the conference perceived, correctly as it turned out, that the timing was right to discuss how periodontal disease fits with the new knowledge of inflammation. The conference included 2 full days of presentations and discussions in which the new knowledge about inflammation and knowledge about periodontal diseases were integrated to focus on how this information may be used to better manage periodontal diseases and other diseases that may be affected by periodontitis. This material is very nicely captured in multiple papers that are included in the supplement. Readers will find remarkable new information in each section of the supplement. The conference and supplementwereorganized to address the following questions: 1. What is inflammation, and what determines the variation in expression of inflammation among individuals? 2. What is the role of inflammatory mechanisms in common chronic diseases, including diabetes, Alzheimer’s disease, and cardiovascular disease? 3. What is the role of inflammatory mechanisms in periodontal disease, including bone and connective tissue destruction; regulation of inflammatory mediators; and host bacterial interactions in general? Although some of the thinking captured in these papers represents revolutionary changes in our understanding of chronic diseases of aging, the papers were written to communicate this information to a broad audience. Among the information you will find in various papers, be sure to draw your attention to the following highlights: