To be technically correct, it is inflammatory periodontitis. Periodontal disease and peri-implantitis are infectious diseases that are caused by a specific group of bacteria. These marker germs actively destroy periodontal soft tissue and bone tissue, leading to massive inflammatory reactions and ultimately to the loss of natural teeth and implants. Targeted control of these bacteria is crucial for successful long-term treatment.
Like gingivitis, periodontitis is triggered by bacterial plaque, a tough biofilm. The main distinguishing feature is the radiologically demonstrable bone resorption present in periodontitis, while the recessed gingival pockets in gingivitis are due to the inflammatory swelling of the gingiva. Prolonged gingivitis can spread to the jawbone, the periodontal membrane and the cementum. However, this transition is not inevitable, especially in children and adolescents, gingivitis can persist for months and years without interfering with other structures.
The exact mechanisms are not yet fully understood. In both gingivitis and periodontitis, bacterial metabolites and decay products are released from the biofilm, triggering the body's defence reactions (e.g. inflammation). The body’s own immune system, which tries to eliminate the bacteria, plays the main role in tissue destruction. This immune response consists of a diverse sequence of reactions and actions involving various inflammatory agents and cells. Among other things, enzymes are formed, with the intention of destroying the bacteria, but these also lead to the destruction of intrinsic tissue. This ultimately leads to the loss of connective tissue and bone. Reaction to the bacteria results in bleeding gums, pocket formation, gum retraction and finally loosening and loss of teeth.