IAI parogentest periodontitis

Nowadays, there is no doubt that periodontitis is due to certain pathogenic bacteria that proliferate in an uncontrolled manner. The equilibrium of the normal bacterial population of the mouth and gums is disturbed and let some bad germs take the advantage.

The initial event that triggers the bacterial desequelibrium can be from multiple sources, as indicated in the periodontitis causes sub-chapter. Plaque deposit and ageing of gums are "natural" agents of periodontitis. However, others causes can contribute or worsen the situation. Those include:

Tobacco, Drugs, Diabetes, Hormonal changes, Food deficiencies, Stress, and Heredity.

The last cause, heredity, is the subject of this page. Sometimes, even with a perfect oral hygiene, certain people develop a severe periodontitis. These people, who represent a third of the population, have a genetic predisposition to develop this disease.

In all the people developing periodontitis, the periodontal infection induces an immunological reaction in host, who leads to the release of mediators of the ignition. It has been shown that a genetic polymorphism of interleukine 1 gene, present among certain patients with severe periodontitis, leads to a release of mediators of the ignition from 1 to 4 times higher than in genetically negative patients. This high amount of ignition mediators is very harmful and the patients with this genetic polymorphism suffer of very severe periodontitis. Moreover, when in addition these patients are smokers , the rate of dental loss increase of a factor of 7,7.

Whereas the PadoTest 4·5® analyses the microbiological situation of the periodontal pockets, the ParoGenTest® investigates the genetic predisposition to develop periodontitis.

parogene1

As written above, one polymorphism (genotype positive) of the interleukine -1 gene leads to a release of mediators of inflammation 1 to 4 times higher than the normal. The following figure 1 illustrates the IL-1 cascade.

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Figure 1: IL-1 Cascade

Genetically, (after genetic analyses) the polymorphism of the interleukine -1 gene is defined as follows:

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Figure 2: Polymorphism at the IL-1 Locus

As illustrated by the Table 1 here under, the clinical situation in peoples presenting the IL-1 positive genotype is more serious.

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Table 1 : Clinical observations between negative and positive genotype on non-smokers.

In a similar way, peoples with IL-1 positive genotype develop significantly more severe periodontitis in non-smokers.

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Table 2: Cumulative Frequency of severe periodontitis in non-smokers by genotype.

The following table 3 demonstrates that IL – 1 positive genotype and tobacco use increase dramatically the risks of periodontitis:

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Table 3 : Increase of the risk of the loss of the tooth according to genotype and tobacco use. From McGuire M. K. et Nunn M. E. (1999). J. Periodontol, 70, 49-56.

The IL-1 positive genotype clearly increases the frequences and the severity of periodontitis. It is then sometimes very helpful for the dentist to detect this genotype as soon as possible, to better prevent the disease.

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