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Viruses, are they
culprits of periodontal
disease
Sai Deepika
3rd BDS
Dept of periodontics
Contents
 Introduction
Herpes viruses
herpes simplex
ebstein-barr virus
human cytomegalovirus
Human immunodefiency virus
Human papilloma virus
Conclusion
Introduction
Periodontal diseases are multifactorial in nature and many
etiological agents are suggested to play a role in their
etiopathogenesis.
Until recently, specific bacteria were considered the major
pathogens for the disease. The current evidence strongly
suggests the presence of many strains of viruses in the
periodontal environment.
Periodontal disease
gingivitis periodontitis
Various viruses like HIV, Herpes
simplex viruses, human papilloma
viruses, ebstein bar viruses, cytomegalo
viruses, Entero virus species Coxsacki
virus play an important role in
periodontal diseases
Herpes viruses
Herpes viruses can lead to the development of severe types of
periodontitis, and outlines potential mechanisms by which it
contributes to periodontal tissue breakdown.
Data in the literature
suggest an increased
frequency of detection of
specific members of the
Herpes viridae family,
such as EBV-1, HCMV,
and herpes simplex virus
(HSV) in various forms of
periodontal disease.
Mechanism
Healthy gingiva
Bacterial plaque
Gingivitis influx of inflammatory cells
containing latent herpesviruses
Herpesvirus activation immunosuppression,infection,
stress, hormones, etc.
Periodontopathic propertycytokines,
immunosuppression, direct cytotoxicity,overgrowth of
pathogenic bacteria
Destructive periodontal disease
Herpes simplex viruses
Infections HSV-1 and HSV-2 are worldwide spread and usually
affect skin and mucosa. HSV 1 most commonly effects the oral
cavity causing various lesions.
Recurrent herpetic
gingivostomatitis and
chronic herpetic
gingivostomatitis in
immunocompromised
Patients are some of the
clinical features of
herpes virus infection on
periodontium.
Ebstein–Barr virus
Ebstein–Barr virus affects over 90% of humans and is
usually transmitted by oral secretions or blood. The virus
replicates in epithelial cells or B cells of the oropharynx.
Most common symptoms of infectious mononucleosis
are fever, lymphadenopathy and pharyngitis. Oral ulcers,
palatal petechia and less commonly gingival ulcerations,
periodontitis Recurrent aphthous stomatitis, infectious
mononucleosis .
Human
cytomegalovirus
Human cytomegalovirus infests mainly the t lymphocytes and
macrophages. The gB protien in the viron envelop participates
in virus- cell interaction and is a major target of immune
response.
Human cytomegalovirus is the most common cause of
congenital and perinatal infections. HCMV infects
many different epithelial cells, endothelial cells,
smooth muscle cells, mesenchymal cells, hepatocytes,
granulocytes and monocyte-derived macrophages and
hence causing various periodontal diseases.
Human immunodefiency virus
HIV is associated with the following periodontal conditions:
linear gingival erythema (LGE), necrotizing gingivitis (NG),
necrotizing periodontitis (NP), and chronic periodontitis
HIV causes decrease in
CD4 call count which
makes the person prone
to various bacterial
infections effecting
periodontium and
causing periodontal
disease
Clinical features :
Linear gingival erythema is defined as a distinct
erythematous band of marginal gingiva with either diffuse or
punctuate erythema of the attached gingiva .
Linear marginal erythema
Most studies show a higher prevalence of NG and NP in HIV
infected patients than in non-HIV infected patients
NG results in the destruction of one or more interdental papillae
and remains confined to the marginal gingiva. NP extends beyond
the marginal gingiva, involves the periodontal ligament and the
alveolar bone, leading to a loss of attachment. NS extends past the
mucogingival line into the mucosa and osseous tissue.
Necrotizing ulcerative periodontitis
Human papilloma virus
Human papilloma virus (HPV) has also been known to
contribute to periodontal infection.
Mechanism:
HPV causes characteristic cytopathic effects (koilocytosis) and
proliferation of epithelial cells.
proliferation and migration of the junctional epithelium are a
major hallmark of periodontal breakdown and hence causing
periodontal disease.
Theoretically, the junctional epithelium attached to the tooth
surface appears to fully serve the cellular functions required by
HPV. It has a basal cell like phenotype and does not differentiate.
The basal cells are exfoliated through the gingival crevice before
differentiation occurs.
HPV virus mainly causes
oral cancers , tumors and
periodontitis.
Other less common viruses like picornavirus, enterovirus,
coxsackie virus can cause periodontal disease to an extent
Conclusion
Several studies, most of them from the same research
group, have demonstrated an association of herpes
viruses with periodontal disease. Viral DNA has been
detected in gingival tissue, GCF and subgingival
plaque from periodontaly diseased sites. In addition
markers of herpes viral activation have been
demonstrated in the GCF from periodontal lesions.
Active HCMV replication in periodontal sites may
suggest that HCMV reactivation triggers periodontal
disease activity
viruses in periodontal disease

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viruses in periodontal disease

  • 1. Viruses, are they culprits of periodontal disease Sai Deepika 3rd BDS Dept of periodontics
  • 2. Contents  Introduction Herpes viruses herpes simplex ebstein-barr virus human cytomegalovirus Human immunodefiency virus Human papilloma virus Conclusion
  • 3. Introduction Periodontal diseases are multifactorial in nature and many etiological agents are suggested to play a role in their etiopathogenesis. Until recently, specific bacteria were considered the major pathogens for the disease. The current evidence strongly suggests the presence of many strains of viruses in the periodontal environment. Periodontal disease gingivitis periodontitis
  • 4. Various viruses like HIV, Herpes simplex viruses, human papilloma viruses, ebstein bar viruses, cytomegalo viruses, Entero virus species Coxsacki virus play an important role in periodontal diseases
  • 5. Herpes viruses Herpes viruses can lead to the development of severe types of periodontitis, and outlines potential mechanisms by which it contributes to periodontal tissue breakdown. Data in the literature suggest an increased frequency of detection of specific members of the Herpes viridae family, such as EBV-1, HCMV, and herpes simplex virus (HSV) in various forms of periodontal disease.
  • 6. Mechanism Healthy gingiva Bacterial plaque Gingivitis influx of inflammatory cells containing latent herpesviruses Herpesvirus activation immunosuppression,infection, stress, hormones, etc. Periodontopathic propertycytokines, immunosuppression, direct cytotoxicity,overgrowth of pathogenic bacteria Destructive periodontal disease
  • 7. Herpes simplex viruses Infections HSV-1 and HSV-2 are worldwide spread and usually affect skin and mucosa. HSV 1 most commonly effects the oral cavity causing various lesions. Recurrent herpetic gingivostomatitis and chronic herpetic gingivostomatitis in immunocompromised Patients are some of the clinical features of herpes virus infection on periodontium.
  • 8.
  • 9. Ebstein–Barr virus Ebstein–Barr virus affects over 90% of humans and is usually transmitted by oral secretions or blood. The virus replicates in epithelial cells or B cells of the oropharynx. Most common symptoms of infectious mononucleosis are fever, lymphadenopathy and pharyngitis. Oral ulcers, palatal petechia and less commonly gingival ulcerations, periodontitis Recurrent aphthous stomatitis, infectious mononucleosis .
  • 10. Human cytomegalovirus Human cytomegalovirus infests mainly the t lymphocytes and macrophages. The gB protien in the viron envelop participates in virus- cell interaction and is a major target of immune response. Human cytomegalovirus is the most common cause of congenital and perinatal infections. HCMV infects many different epithelial cells, endothelial cells, smooth muscle cells, mesenchymal cells, hepatocytes, granulocytes and monocyte-derived macrophages and hence causing various periodontal diseases.
  • 11. Human immunodefiency virus HIV is associated with the following periodontal conditions: linear gingival erythema (LGE), necrotizing gingivitis (NG), necrotizing periodontitis (NP), and chronic periodontitis HIV causes decrease in CD4 call count which makes the person prone to various bacterial infections effecting periodontium and causing periodontal disease
  • 12. Clinical features : Linear gingival erythema is defined as a distinct erythematous band of marginal gingiva with either diffuse or punctuate erythema of the attached gingiva . Linear marginal erythema
  • 13. Most studies show a higher prevalence of NG and NP in HIV infected patients than in non-HIV infected patients NG results in the destruction of one or more interdental papillae and remains confined to the marginal gingiva. NP extends beyond the marginal gingiva, involves the periodontal ligament and the alveolar bone, leading to a loss of attachment. NS extends past the mucogingival line into the mucosa and osseous tissue. Necrotizing ulcerative periodontitis
  • 14.
  • 15. Human papilloma virus Human papilloma virus (HPV) has also been known to contribute to periodontal infection. Mechanism: HPV causes characteristic cytopathic effects (koilocytosis) and proliferation of epithelial cells. proliferation and migration of the junctional epithelium are a major hallmark of periodontal breakdown and hence causing periodontal disease.
  • 16. Theoretically, the junctional epithelium attached to the tooth surface appears to fully serve the cellular functions required by HPV. It has a basal cell like phenotype and does not differentiate. The basal cells are exfoliated through the gingival crevice before differentiation occurs. HPV virus mainly causes oral cancers , tumors and periodontitis. Other less common viruses like picornavirus, enterovirus, coxsackie virus can cause periodontal disease to an extent
  • 17. Conclusion Several studies, most of them from the same research group, have demonstrated an association of herpes viruses with periodontal disease. Viral DNA has been detected in gingival tissue, GCF and subgingival plaque from periodontaly diseased sites. In addition markers of herpes viral activation have been demonstrated in the GCF from periodontal lesions. Active HCMV replication in periodontal sites may suggest that HCMV reactivation triggers periodontal disease activity