Current concepts in diagnosis and treatment of periodontitis.

This article describes some areas of periodontal research and current opinions regarding detection of disease progression, as well as risk indicators and risk factors associated with disease progression. Longitudinal probing of periodontal attachment level is considered the gold standard for detection of disease activity although there are problems with this concept. Digital subtraction radiography can assist in the detection of minor changes of alveolar bone height and density. Risk factors such as composition of subgingival plaque and gingival crevicular fluid, as well as the effect of smoking are discussed. Adjunctive treatment with both antibiotics and nonsteroidal anti-inflammatory drugs, systemic or local, seems to be helpful in some forms of disease. Immunization to prevent colonization of tooth surfaces and pockets by periodontal pathogens does not seem to be feasible in the near future.