Bacterial endotoxins in periodontal health and diseases

Abstract

Bacterial endotoxins are a major concern in periodontal health and diseases owing to their structure and biological activity. With up-to-date knowledge of endotoxins and the recent findings about the influence of endotoxins in dental health, their probable mode of pathogenesis, and standard detection methods, this review analyzes the potential efficacy and benefits of probiotics in combination with conventional and contemporary treatment measures. In the oral cavity, Gram-negative bacteria are documented to predominate in the pulpal lesions with radiolucent areas and in the root canal with pulp necrosis, where they pose an absolute threat by promoting a series of inflammatory reactions. Endotoxin, a constituent of Gram-negative bacteria establishes a nexus between cytokine stimulation and proinflammatory reactions, therefore plays a critical role in decaying dental pulp and modulating periodontal diseases. Currently, the treatment regimen involves several biochemical preparations. In addition, probiotics have been reported to control endotoxin in gingivitis and contribute to the overall improvement of dental health. A potential benefit of a combination of probiotics as a complementary treatment along with the conventional treatment warrant more empirical evidence to elucidate its role and mechanism in resolving the clinical manifestations associated with endotoxins in the periodontal region.