Gokhale, S.R., Padhye, A.M.

Periodontitis is an inflammatory disease caused by microbial infection that leads to destruction of supporting tissues of the teeth. The periodontal tissue destruction is a result of both microbial activity and host response. The best chance for clinical improvement may come from implementing complementary treatment strategies that target different aspects of the periodontal balance. Host response modulation, in combination with conventional treatment, offers to restore the balance between health and disease progression in the direction of a healing response. Various host modulatory therapies (HMT) have been developed or proposed to block pathways responsible for periodontal tissue breakdown. The newer drugs, like bortezomib, infliximab, etanercept, vasoactive intestinal peptide, nitric oxide synthase inhibitors and denosumab, have been developed as a result of better understanding of pathogenesis of inflammatory tissue destruction and may represent the future of periodontal therapy. This review article focuses on the potential systemic host modulatory agents that target cell signalling pathways, cytokines and enzymes.

British Dental Journal 2013; 214 (9): 467-471.