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Today's VeTerinary PracTice | January/February 2016 | tvpjournal.com PracTical denTisTry Peer reviewed 88 Figure 5. Indications for periodontal fap therapy and treatment of a deep periodontal pocket on a maxillary canine. (A) Preoperative intraoral dental picture of a right maxillary canine (104) in a dog. This patient had a 10-mm periodontal pocket with 2 mm of gingival enlargement (8- mm attachment loss). The tooth has been ultrasonically cleaned and hand scaled as evidenced by the clean crown. ( B ) intraoperative intraoral dental picture of a right maxillary canine (104) in a dog following gingivectomy and periodontal fap elevation. The residual calculus and alveolar bone loss is evident. (C) intraoperative intraoral dental picture of a right maxillary canine (104) in a dog demonstrating open root planing with a gracey curette. (D) intraoperative intraoral dental picture of a right maxillary canine (104) in a dog following open root planing. Note that the root surfaces are clean and should support reattachment. superior to moist foods with regard to improving oral health. 32 HOST MODULATION as stated previously, plaque has been identifed as the etiologic agent of periodontal disease. • Bacteria and their byproducts create inflammatory changes that may result in alveolar bone loss in susceptible individuals. • The inflammation is caused by bacteria; however, the patient's immune response to the inflammation determines (or controls) the progression of the disease. 33-36 • if the acute inflammatory response is resolved quickly, tissue injury is prevented. However, inadequate resolution and failure to return tissue to homeostasis result in neutrophil- mediated destruction and chronic inflammation of the periodontal ligament and alveolar bone. 8,34-37 Host modulation is a new technique for treating periodontal disease that controls the patient's response to infection and infammation. numerous preparations have shown promise in decreasing the amount of infammation and What is nrf2? Nrf2 is a protein messenger in cells that regulates the expression of antioxidant proteins that protect against oxidative damage triggered by injury and infammation. Several drugs that stimulate the Nrf2 pathway are being studied for treatment of diseases that are caused by oxidative stress. A B C D