Mediators of periodontal osseous destruction and remodeling: principles and implications for diagnosis and therapy.
Osteoclastic bone resorption is a prominent feature of periodontal disease. Bone resorption via osteoclasts and bone formation via osteoblasts are coupled, and their dysregulation is associated with numerous diseases of the skeletal system. Recent developments in the area of mediators of osteoclastic differentiation have expanded our knowledge of the process of resorption and set the stage for new diagnostic and therapeutic modalities to treat situations of localized bone loss as in periodontal disease. This review describes the current state of knowledge of osteoclast differentiation and activity, mediators, and biochemical markers of bone resorption and their use and potential use in clinical periodontics. Finally, therapeutic strategies based on knowledge gained in the treatment of metabolic bone diseases and in periodontal clinical trials are discussed, and the potential for future strategies is proposed relative to their biologic basis. The intent is to update the field of periodontics on the current state of pathophysiology of the osteoclastic lesion and outline diagnostic and therapeutic strategies with a rational basis in the underlying biology.
McCauley
Laurie K
LK
Department of Periodontics/Prevention/Geriatrics, School of Dentistry, Medical School, University of Michigan, Ann Arbor, MI 48109-1078, USA. mccauley@umich.edu
Nohutcu
Rahime M
RM
D016301:Alveolar Bone Loss / Q000188:drug therapy / Q000201:enzymology / Q000503:physiopathology*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015415:Biomarkers; D016723:Bone Remodeling / Q000502:physiology*; D002454:Cell Differentiation; D016207:Cytokines / Q000502:physiology; D004164:Diphosphonates / Q000627:therapeutic use; D016326:Extracellular Matrix Proteins / Q000378:metabolism; D006023:Glycoproteins / Q000627:therapeutic use; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D010010:Osteoclasts / Q000502:physiology; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013754:Tetracyclines / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D016207:Cytokines; D004164:Diphosphonates; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; D018836:Inflammation Mediators; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; D020845:Selective Estrogen Receptor Modulators; C506030:TNFRSF11B protein, human; D013754:Tetracyclines