Recent advances in our understanding of the microbial populations that colonize the human mouth, their acquisition, interdependency, and coevolution with the host, bring a different perspective to the mechanisms underpinning the maintenance of periodontal health and the development of disease. In this work we suggest that our knowledge map of the etiology of periodontal health and disease can be viewed as a broad, highly connected, and integrated system that spans the entire spectrum of microbe/host/clinical interactions. The overall concept of present Periodontology 2000, that the microbial biofilm can be considered a human tissue of bacteriological origin, is entirely consistent with this integrated system view. The health‐associated community structure of microbial biofilms can be considered a system that is normally resilient to perturbation. Equally, there is evidence to suggest that the dysbiotic community structure in disease may share similar resilience properties. In both instances, the resilience may be governed by the precise makeup of the acquired microbiome and by the genetics of the host. Understanding the mechanisms that enable the resistance to change of healthy and dysbiotic microbial populations may be important in the development of approaches to prevent the progression of disease and to restore health in diseased individuals.

中文翻译：

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微生物从健康到疾病的转变

我们对人类口腔中的微生物种群、它们的获得、相互依赖性以及与宿主的共同进化的理解的最新进展，为维持牙周健康和疾病发展的机制带来了不同的视角。在这项工作中，我们建议我们的牙周健康和疾病病因学知识图谱可以被视为一个广泛的、高度关联的、集成的系统，涵盖了微生物/宿主/临床相互作用的整个范围。当前牙周病学2000的总体概念，即微生物生物膜可以被认为是细菌学起源的人体组织，与这种综合系统观点完全一致。与健康相关的微生物生物膜群落结构可以被认为是一个通常对扰动具有弹性的系统。同样，有证据表明疾病中的生态失调群落结构可能具有类似的恢复特性。在这两种情况下，恢复力可能由获得的微生物组的精确组成和宿主的遗传学决定。了解健康和失调微生物群体抵抗变化的机制对于开发预防疾病进展和恢复患病个体健康的方法可能很重要。