Can Periodontal Diseases Be Cured or Just Managed?

Periodontitis, the most common inflammatory disease of man, is an infectious/inflammatory disease associated with dysbiosis of the commensal oral microbiome. The mildest, reversible form of the disease, gingivitis, is ubiquitous, affecting >90% of people, but periodontitis, with irreversible tissue destruction, affects more than 47% of the US population. Endogenous lipid mediators of resolution, including analogues under development for human use, have provided new approaches for the management of periodontitis through host response modulation using specialized proresolving lipid mediators (SPMs). Preclinical studies have demonstrated that SPMs are potent when topically applied in the prevention and treatment of periodontitis demonstrating significant regeneration of soft tissues and bone loss to disease. Clinical trials in humans reveal these compounds are safe and a specific lipoxin analog reduces gingivitis and established periodontitis. These first in human studies demonstrate safety and efficacy of a pro-resolving mimetic for the treatment of periodontal diseases in man. Newer studies of bone grafting materials combined with SPMs reveal more complete and rapid new bone formation demonstrating great potential for clinical use in periodontology.