Host Modulatory Therapy in Aggressive Periodontitis

Abstract

Abstract Host modulatory therapy (HMTs) ia a treatment concept that goal to reduce tissue destruction and stabilize or even regenerate the periodontium. The aggressive periodontitis result in rapid destruction of the periodontium and can lead to early bone destruction, until tooth loss. HMTs modifying or downregulating dectructive aspects and upregulating protective aspectc of the host response, in combination with conventional treatments to reduce the bacterial burden, the balance between health and disease progression is tipped in the direction of a healing response. Many aspects of the host response can be affected, including modification of proteolytic enzymes such as matrix metalloproteinases, stimulation of cellular activity, and alteration of the extracellular matrix, all these aspects can be considered as host modulation. HMTs are systemically or locally delivered pharmacheuticals that are prescribed as part of periodontal therapy and are used as adjuncts to conventional periodontal treatments. A variety of different drug classes have been evaluated as host modulation agents, including the nonsteroidal antiinflammatory drugs (NSAIDs), biphosphonates, chemically modified tetracyclines (CMTs) or subantimicrobial-dose doxycycline (SDD). The concept of periodontal medicine is not only the bacterial challenge by scaling and rootplaning (SRP) but also the host side of the host-bacterial interactions. Subantimicrobial-dose doxycycline (SDD) is the only HMTs currently approved and indicated as an adjunct to SRP for treating aggressive periodontitis.