Abstract
Periodontitis is an inflammatory condition affecting the supporting structures of teeth and is often characterized by the loss of periodontal attachment. There are various etiological factors contributing towards the etiopathogenesis of this disease. Until recently bacterial species colonizing the tooth surfaces were considered to have the primary role in the etiology of periodontitis. This was further enhanced by the presence of other factors such as smoking, presence of underlying systemic conditions and the host response. However, recent studies have shown that although tooth surfaces are constantly colonized by various types and numbers of bacteria, their effective removal from the tooth surfaces by surgical or non-surgical periodontal therapy does not necessarily prevent the progression of the periodontal disease i.e. further periodontal attachment loss and bone destruction still persists. This brings us to the hypothesis that factors beyond the plaque bacteria have a significant role in the pathogenesis of periodontal disease. Evidence strongly suggests the presence of various viruses in the periodontal environment. In this review, we analyze the role of various viruses that cause periodontal disease and categorize the various aspects of viral role in the etiopathogeneis of periodontal disease, the bacterial-viral model of disease and the therapeutic implications. A better understanding of the viral aspect of periodontal disease progression can bring about a significant change in the future perspective of diagnosis, prevention and treatment of periodontal disease.
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