Preface

Periodontal diseases are a group of chronic immune-inflammatory diseases that, according to their severity, may induce different levels of periodontal destruction. Such diseases could range from mild gingivitis to severe periodontitis. Although there is similarity in the nature of the periodontal diseases in general, each disease has special characteristics. These characters could differ if the disease is solitary or it could be a reflection of a systemic disease.

The goal of this book is to clarify the main structure of periodontal diagnosis and discuss the most recent modalities in non-surgical adjunctive therapeutic aids.

Unfortunately, in 2019, periodontal diseases became some of the most common diseases that affect human beings all over the world. Periodontal diseases reported relatively higher prevalence in developing countries, especially in children due to nutrition deficiency, hygiene problems, awareness, low educational and social levels, limited financial aids, and limited diagnostic privilege.

The multifactorial nature of the disease makes the early identification and diagnosis more difficult. Therefore, it is clear that there is no single diagnostic aid that can provide full clinical assessment of the different periodontal conditions.

The higher prevalence of periodontal diseases is mainly due to the delay of the patients asking for dental examination and treatment at the onset stage of the disease. Unfortunately, patients usually ask for diagnosis and treatment when the disease reaches an advanced stage. Late diagnosis could lead to loss of the affected teeth as well as severe damage to the remaining structures. Nowadays, there is great improvement in the diagnostic aids that could facilitate the early discovery of such diseases.

The main requirements that are needed for an ideal diagnostic aid is to be easy to use, informative, non-invasive, cost effective, and accepted by patients. Nowadays, biomarkers, radiographic evaluations, and genetic analysis are the main informative and most recent diagnostic aids in the periodontal field.

In the last few decades, biomarkers have developed great potential to be used for diagnosis of periodontal diseases. The main function of the biomarker is to indicate the presence and severity of the disease and report the responses of the periodontal tissues to any therapeutic interventions.

The great evolution in the radiographic aids makes the early monitoring of the changes of periodontal hard structure easier. There has been development of a wide spectrum of radiographic techniques such as the subtractive and topographic technique.

Lately, the literature has recorded several non-surgical techniques that could act as adjunctive modalities to treat mild to moderate conditions and serve as a treatment aid in severe conditions. LASER therapy, photodynamic therapy, oral mesotherapy, and locally delivered antibiotics and anti-inflammatories are all examples of this.

Hopefully, this book will serve as a guide and an overview for researchers and practitioners who are interested in the periodontal diagnosis and non-surgical therapeutic modalities. I really hope this book could inspire researchers for future research and innovative ideas. The book consists of six chapters, with each chapter focussing on a certain point of the diagnostic aids. All chapters attempt to cover the topic in a systematic way starting with background information on the subject, with a detailed description for the advantages, limitations, types, methods to apply the technique, and points of future research.

**Chapter 1** describes an overview of the pathogenesis of periodontal diseases and the contributing factors in periodontal destruction. **Chapter 2** describes in-depth the role of biomarkers in diagnosis of periodontal diseases. The advantages and limitations of the various biomarkers will be discussed in order to recognize new points of research. In **Chapter 3,** the genetic biomarkers are discussed to clarify the role of the diagnostic aids in specifying the association between the periodontal disease and genetic disorders such as gene polymorphism. **Chapter 4** gives a detailed description about the role of the radiographic revolution as a diagnostic aid for periodontal diseases. In **Chapter 5**, an overview of one of the most recent non-surgical adjunctive modalities, oral mesotherapy, is presented. This technique provides promising results in the management of periodontal diseases and is considered as a virgin point for future research.
