Vicious circles in chronic generalized periodontitis pathogenesis

Relevance. The high prevalence of periodontal diseases, late presentation of patients, especially at the early stages, the ineffectiveness of the provided treatment, and complex still-not-fully-understood mechanisms of the pathogenesis of periodontal diseases render chronic generalized periodontitis (CGP) a socio-medical problem.The study aims to consider the pathogenic mechanisms which characterize the development of CGP.Materials and methods. The study conducted a systematic literature search, which included publications from 2005 to 2022. The studies were found by searching electronic databases PubMed and Google Search.Results. The dental plaque microbiota is a common cause contributing to the initiation of the inflammatory process in the periodontal tissues. But its presence alone is not enough for the manifestation of all periodontal pathological reactions. The principal role in regulating the phases of the inflammation belongs to cytokines and other mediators, the imbalance of which causes the chronification of the process. Microvascular blood flow disorders, which determine the clinical manifestations, are an important part of the pathogenesis at all stages of CGP. Cellular reactions that occur during CGP as a response to the periodontal pathogen invasion protect periodontal tissues and simultaneously induce their destruction, thereby increasing bacterial contamination.Conclusion. The formation of intricately related several key vicious circles, including cytokine, vascular, leukocyte and reparative, is one of the most important particularities of CGP pathogenesis.