Chapter 9

Insight: In response to plaque bacteria the body forms large intracellular complexes called inflammasomes that process inactive inflammatory cytokines, including pro-IL-1β and pro-IL-18 into active forms.

Clinical Consideration: Inflammasome activation may bridge innate and adaptive immunity with periodontal bone loss. The clinical manifestation of periodontal breakdown is explained by the production of cytokines and is crucial step for the establishment of a competent innate immune response and also for the subsequent activation of adaptive immunity. Interestingly, some periodontopathogens from the subgingival biofilm may evade immune surveillance by avoiding the activation of inflammasomes. This is relevant because development of therapies that may target these pathways are actively being developed to manage rheumatoid arthritis and inflammatory bone diseases. They have also been applied in periodontal disease models with noteworthy accomplishments. These therapies may provide the next wave of adjunctive chemotherapeutics that may be used to manage chronic periodontitis.