Periodontology

Periodontology is the study of diseases of the tooth supporting tissues, i.e. gingiva, periodontal ligament, cement, and surrounding bone. The most common of these diseases are gingivitis and periodontitis. Both diseases are caused by accumulation of bacteria in a biofilm on the tooth surface and the bacteria initiate an inflammatory reaction in the periodontal tissue. The subject area also comprise the study of similar diseases around dental implants including peri-implant mucositis (without bone loss) and peri-implantitis (with bone loss).

Gingivitis, affecting 50-90% of the population, is a condition of inflammation of the gingiva. This condition is usually reversible with no loss of the supporting tissues after effective treatment.

Untreated, however, gingivitis can further develop into periodontitis, which is a multifactorial inflammatory disease characterized by deepening of the gingival crevice resulting in formation of a periodontal pocket with an anaerobic environment. The associated dysbiosis of the microbiota invading the gingival pocket leads to a non-resolving and destructive tissue response with irreversible destruction of the gingival connective tissue, the periodontal ligament and the alveolar jawbone. About 40% of the population over the age of 40 yrs. has some degree of periodontitis, which is the most common non-transmissible inflammatory disease in humans worldwide. An important characteristic of periodontitis is the deepened periodontal pockets, the epithelial lining of which becomes ulcerated due to inflammation. Thereby bacteria from the pockets can invade the gingival soft tissue and the circulation resulting in bacteremia. This happens because of everyday procedures like chewing, tooth brushing and flossing. Bacteremia and the associated increased systemic low-grade inflammation is the major background of periodontitis affecting other inflammatory diseases including diabetes, cardio-vascular diseases, and rheumatoid arthritis.

The susceptibility to acquire periodontitis and the course of the disease shows great inter-individual variation. With early treatment, the disease activity can be stopped or limited, but 7-8% develop a particularly serious form of disease with widespread destruction, which often leads to tooth loss. The characteristic of the serious form of the disease is that it often debuts at a young age and that the tissue degradation is rapidly progressing.

Education

Based on the results of available research the overall aim of teaching periodontology is to enable the students to prevent, diagnose and treat periodontal diseases. Treatment must be based on the oral biology and on the present knowledge regarding the etiology of periodontal diseases, their pathology, pathogenesis, and treatment methods. The students must have sufficient knowledge on general diseases and be able to adapt the treatment protocol to the individual patient and if necessary refer to the relevant specialist department. Furthermore, it is an educational aim that the students gain knowledge and professional attitude that will enable them to act responsibly according to scientific background, ethical standards, and recommendations from the Danish health authorities.

Research

The research in the field of Periodontology aims to increase our knowledge about periodontal disease, in particular the immunological aspects of periodontitis, the treatment of this disease and its association with and influence on a number of medical diseases. Our current research is conducted in collaboration with the Department of Cardiology at Herlev-Gentofte Hospital, the Institute for Inflammation Research and Center for Rheumatology and Spine Diseases, Rigshospitalet, and a number of other medical and immunological departments. Greater Copenhagen Health Science Partners have awarded the group as a "Clinical Academic Group" entitled "Greater Copenhagen Research Center for Systemic Low-Grade Inflammation”, whose main purpose is to develop the understanding of periodontitis associated with cardiovascular disease, rheumatoid arthritis and diabetes, and other inflammatory diseases.

Course director/contact

Associate Professor Christian Damgaard
chrd@sund.ku.dk