Yes, not all people are at equal chance for developing periodontitis due different genetic constitution and epigenetic (effect of environmental on expression of certain genes) even in the same individual we can find different levels of the periodontal disease and even in the same tooth, this is because periodontal disease is a site specific disease and presence of pyrophosphate in the site can affect the disease process.

Patients with minimum amount of local factors that experience severe  periodontal disease have a factor that is unrecognized. Periodontal disease does not just happen.

In a gingivitis study, authors reported that two types of hosts were identified in the 50 subjects based on their plaque microbiota: the less gingivitis-sensitive Type-I and the highly sensitive Type-II (Huang, Li, et al, Predictive modeling of gingivitis severity and susceptibility via oral microbiota. ISME J, 2014.). So does periodontitis, i think.

No. Every patient have individual caracteristic according even to their genetic predisposition. Each patient could have a diferent answer according to the suceptibility of the host along with their cleaning habits and frequency of removing dental plaque.

Dear Faraedon,

it is based on local factors, genetic and epigenetic factors of an individual.

yes i think genetic predisposition which is determined by a compromised hot defense mechanism or type of bacterial flora in the sub-gingival area which harbors more periodontal pathogens and these two factors explain the familial tendency or predisposition to periodontal diseases that is why some families are reporting history of periodontal diseases for example aggressive periodontitis and other family not

Gene has not much importance, rather look and find the real primary factor which is gingivitis plaque or not plaque induced bringing PMN cells, and secondary parasitic infection (producing exonucleophagy and release of ghost cell) from environment, which is spouse, water (most tropical), home pets etc and direct and indirect contamination. Risk factor from gingivitis is x150 and risk factor for amiba parasite is 600x for periodontitis, compared to 3x for smoker... 2x for genetic... So look at real facts. This way, periodontitis is easily detectable, preventable and curable. https://youtu.be/8_8NyTANf6o?list=PL1DDBE20B71C14FA8

Best regards

Mark

https://youtu.be/8_8NyTANf6o?list=PL1DDBE20B71C14FA8

Thank you Mark all what you said new for me,,, I will check the links,, thanks

the systemic factors such as blood sugar, gastro esophageal reflux, sinusitis among others are conditions that should be considered in addition to those mentioned above

If you have a healthy biofilm on the tooth and root, the relevance of systemic and genetic factors decline in regard to periodontitis.

yes microbial plaque is the essential factor for developing periodontitis, how other local and systemic factors are contributing factors for example diabetes not causing periodontitis but increasing chances for developing periodontitis, as diabetic patient suffering from reduced host mechanism, therefore, presence of plaque is essential for periodontitis. how ever not all patient having high plaque score developing periodontitis, this is due to type of flora habituating his biofilm. when there is higher amount of periodontal pathogens in his plaque he will be at higher risk for developing periodontitis such as in cases of aggressive periodontitis which is characterized by minimum plaque, little gingival inflammation but sever periodontal destruction, furthermore reduced host combine together with microbial virulancy in developing this type of periodontitis.

Well said Zardawi. However, genetics however exerts an overriding influence on the ability of the host to combat chronic periodontitis. Any form of immune deficiency -- innate or acquired will increase the severity of chronic periodontitis.

On the other hand. an individual could have a hyperactive/hyper-responsive immune system the extreme of which is expressed in interleukin -1 polymorphism. This exposes the individual to 20× higher risk of chronic periodontitis. 

Such persons will likely benefit from host modulation therapy. The danger sign is exaggerated inflammation in the presence of little plaque!

 Thanl you Dr. Muhator,,, I think we can briefly say that genetic predisposition to specific microorganism and genetically determined individual or familial host defect put the patient at a high risk for developing periodontitis, this is explaining familial tendency for periodontitis some families suffering from early loss of teeth due to mobility and periodontitis

Dear Faraedon, I am 100% aware that you know the answer to this question as we all periodontists do incase if you don't you are requested to please read the Book "Etiology and Pathogenesis of Periodontal disease" by Alexandrina L Dumitrescu. The book is indeed worth a read and you wanna know the effect of genetics then the Book "Genetic Variants in Periodontal Health and Disease" by the same author. I by the way also went through the answers of great experts before me and was shocked by the findings brought out by Mark which were very new to me. With no offence I personally think that he urgently needs to read on periodontal literature, its theories etc before he gets us back to old age non specific plaque hypothesis esp as he is a DMD and registered with AAP. Dear Mark, if you happen to read then just moving the video camera on a slide (your videos on u tube) with not change the facts. Wake up buddy its an era of EBD i.e evidence based dentistry and sadly home pets don't cause contamination on your teeth unless u... . take care and Dr. Faraedon.. keep asking. Cheers.

thank you Dr. Munishwar, yes I know a lot a bout the answer but not all that is why I asked to know others ideas and experiences, Cheers