Pirih's Lab

As a periodontist, I witness first-hand the challenges of treating periodontitis and peri-implantitis. As a clinician, some of the major issues I face include: a) the lack of information on how genetics (host) affects periodontitis and peri-implantitis initiation and progression, b) how to best treat patients that have developed periodontitis or peri-implantitis, and c) how periodontitis and systemic conditions can affect one another.

My interest in the role of genetics in periodontitis was sparked during my time as a periodontal resident and post-doc. According to studies performed in twins by Michalowicz et al., approximately 50% of periodontitis is heritable; however, most of the contributing factors have not been identified/validated because periodontitis is a complex trait disease. As clinicians, this lack of information impairs our ability to better treat our patients. Therefore, a better understanding of periodontitis is crucial for our dental profession. To address this problem, we performed Genome-Wide Association Studies utilizing the hybrid mouse diversity panel. This study: a) suggested that there are many potential contributors in periodontitis, b) reinforced that some genes should be further investigated, and c) validated the importance of many genes that we know are relevant in periodontitis.

In addition to periodontitis, periodontists are faced with the challenge of treating peri-implantitis. According to Derks et al., 14.5% of patients with dental implants will develop moderate to severe peri-implantitis. Unfortunately, peri-implantitis can only be successfully treated in approximately 50% of cases.  As a practicing periodontist, I have experienced the frustration from both the patient and provider perspective, of managing peri-implantitis. It is with this background in mind that my research group developed murine and porcine model of peri-implantitis. These models will allow us to understand the pathogenesis of peri-implantitis and develop new treatment strategies.