Periodontal Disease - History

History

Investigation into the causes and characteristics of periodontal diseases began in the 18th century with pure clinical observation, and this remained the primary form of investigation well into the 19th century. During this time, the signs and symptoms of periodontal diseases were firmly established:

1. Rather than a single disease entity, periodontal disease is a combination of multiple disease processes that share a common clinical manifestation.
2. The etiology (cause) includes both local and systemic factors.
3. The disease consists of a chronic inflammation associated with loss of alveolar bone.
4. Advanced disease features include pus and exudates.
5. Essential aspects of successful treatment of periodontal disease include initial debridement and maintenance of proper oral hygiene.

The advent of microscopy allowed later studies performed at the turn of the 19th century to report the histological structures and features of periodontal lesions, but most were limited to advanced stages of the disease. Progress in microscopy in the 1960s, such as advances in histopathology and stereology, allowed researchers to focus on earlier stages of inflammatory processes while the innovation of experimentally-induced periodontal disease in both human and animal models allowed for more detailed research into the temporal progression of the pathogenesis of plaque-induced periodontal disease.

Historically, chronic plaque-induced periodontal diseases were divided into three categories:

1. subclinical gingivitis
2. clinical gingivitis
3. periodontal breakdown