Autoimmune conditions and epigenetic challenges in periodontitis

Periodontal diseases are biofilm-induced pathological conditions that disrupt the periodontium homeostasis, affecting the gingival tissue, underlying alveolar bone, periodontal ligament, and root cementum. Despite our current understanding of periodontal diseases and advances in periodontal therapy during the last 50 years, recent reports from the National Health and Nutrition Examination Survey (NHANES) indicated that nearly 50% of the United States’ population is affected by periodontal diseases. Host-derived factors are known to influence the onset and pathogenesis of periodontitis, including tooth-anatomical factors, tissue structural factors, and immune-regulatory mechanisms. This chapter discusses the current understanding of the role of the host immune response, primarily related to autoimmune disorders and epigenetic modifications, in periodontal diseases.