The new concept of periodontal disease pathogenesis requires new and novel therapeutic strategies

J Clin Periodontol. 2007 May;34(5):367-9. doi: 10.1111/j.1600-051X.2007.01065.x.


In this issue Bostanci et al. (2007) demonstrate that receptor activator of NF-kappaB ligand (RANKL) and osteoprotegerin (OPG) were oppositely regulated in gingival crevice fluid (GCF) from periodontitis patients. RANKL, RANK and OPG are key molecules that regulate osteoclast recruitment, differentiation and activation. New concepts of the pathogenesis of periodontitis have implicated inflammation triggered by host immune response to periodontal biofilm microorganisms(s) in disease. Host response to bacteria involves activation of T and B cells in the inflammatory infiltrate which bear abundant RANKL that promotes osteoclastic bone resorption. Periodontal tissue destruction can be ameliorated by immunobiological interference with immune cell RANKL expression or function. The new disease concepts provide a foundation to build biological approaches to target RANKL production in periodontal lesions.

Publication types

  • Comment
  • Editorial

MeSH terms

  • Alveolar Bone Loss / immunology*
  • Alveolar Bone Loss / metabolism
  • Alveolar Bone Loss / therapy*
  • Animals
  • Gingival Crevicular Fluid / chemistry
  • Humans
  • Immunotherapy
  • Lymphocytes / metabolism
  • Osteoclasts / metabolism
  • Osteoprotegerin / metabolism
  • Porphyromonas gingivalis / immunology
  • RANK Ligand / antagonists & inhibitors
  • RANK Ligand / metabolism
  • Receptor Activator of Nuclear Factor-kappa B / antagonists & inhibitors
  • Receptor Activator of Nuclear Factor-kappa B / metabolism


  • Osteoprotegerin
  • RANK Ligand
  • Receptor Activator of Nuclear Factor-kappa B