Importance of Microbiological and Genetic Testing in Severe Periodontitis: Lessons From a Clinical Case

Periodontitis is complex and multifactorial disease. In patient’s sub-gingival dental biofilm provokes a host-mediated inflammatory and immune response, culminating in irreversible destruction of the periodontium, including the alveolar bone and periodontal ligament. Severe periodontitis (SP) is a chronic inflammatory disease characterized by the destruction of periodontal tissues and alveolar bone loss. Several bacterial species have been implicated in their pathogenesis, including Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Treponema denticola (Td), and Prevotella intermedia (Pi). These microorganisms, components of the subgingival microbiota, contribute to disease progression through mechanisms such as pro-inflammatory cytokine induction, immune modulation, and direct tissue destruction. Effective management is needed for understanding the disease’s pathogenesis, risk factors and therapeutic protocols. This study presents a clinical case of a severe smoker with SP, highlighting the microbial and genetic factors influencing disease progression and therapeutic considerations.