Lecture 1: Host response modulation: an evolving treatment concept
Periodontal therapy is changing. While plaque control and root surface debridement continue to be of fundamental importance, novel treatment paradigms are emerging. These include strategies for risk factor assessment and modification, and management of inflammation. Systemic therapeutics have long been investigated as potential adjunctive treatments for periodontal disease. Systemic therapeutics of the future will likely target aspects of the host immune-inflammatory response, and this is referred to as host response modulation (HMT). HMT is a treatment concept in which destructive aspects of the inflammatory response that develops in the periodontal tissues are modified by the use of pharmaceuticals. Various different categories of pharmaceuticals have been studied for their role in ameliorating destructive aspects of the host response, including non-steroidal anti-inflammatory drugs (NSAIDs), bisphosphonates and inhibitors of matrix metalloproteinases (MMPs). Clinical data relating to one such host response modulator (a subantimicrobial dose of doxycycline that functions as an MMP inhibitor) will be presented. These developments will increase the potential for successful treatment of periodontal diseases and will expand the role of dentists to include pharmaceutical management of periodontitis in addition to the provision of local cause-related therapy.
