Regeneration of supporting tissue to tooth surfaces affected by periodontitis has long been an ideal goal of periodontal therapy. Periodontitis affected root surfaces are hyper mineralized and contaminated with cytotoxic and other biologically active substances. Such surfaces are not biocompatible with adjacent periodontal cells, the proliferation of which is pivotal for periodontal wound healing. Traditional surgical and non-surgical periodontal therapies aim at arresting periodontal disease by removal of plaque-"invested" tissues from disease-affected roots. However complete removal appears not possible with only mechanical debridement. Thus, root conditioning has been recommended as an adjunct to mechanical root surface debridement to remove smear layer and root associated endotoxins and to expose collagen fibers on the dentin surface. A number of agents have been proposed which when applied remove the smear layer, eliminate the cytotoxic material like endotoxins, uncover and widen the orifices of dentinal tubules and expose the dentin collagen matrix. This collagen matrix is thought to provide a substrate which supports chemotaxis, migration and attachment.

Periodontitis is an inflammatory condition of the supporting tissues of the teeth. Intracellular enzymes are increasingly released from the damaged cells of periodontal tissues into the gingival crevicular fluid and saliva. It has been a great challenge to determine biomarkers for screening and predicting the early onset of disease (prognostic tests) or evaluating the disease activity and the efficacy of therapy.Various enzymes evaluated for the early diagnosis of periodontal disease are aspartate and alanine aminotransferases ( AST, ALT ), lactate dehydrogenase ( LDH ), creatine kinase ( CK ), alkaline and acid phosphatase ( ALP, ACP ) and gamma glutamiltransferase ( GGT ), myeloperoxidase ( MPO ). The activities of CK, LDH, AST, ALT, GGT, ALP, ACP, MPO, enzymes are found to be increased in periodontal diseases. Thus, an attempt has been made to review the diagnostic value of salivary enzymes in the diagnosis and progression of periodontal disease.

The influence of genetic variability on treatment outcomes has its effect both in medicine as well as in field of periodontics.While there have been dramatic successes in identification of mutations responsible for rare syndromic forms of periodontitis, few genetic polymorphisms reported for more complex genetic forms of periodontitis have been demonstrated to be clinically valid or to have clinical utility.This book reviews the fundamentals necessary to enhance functional polymorphisms for new therapeutic approaches to treat diseases and will allow the targeting of new and existing therapies to those patients who will derive the most benefit without the risk of serious side effects.The text has been taken from various standard books, e-books, journals and websites etc.