Presence of a healthy periodontium is of utmost importance in terms of dental tissue harmony.esthetic relevance of these supporting tissues play a major role in the final out come of any treatment procedures. Smile designing is a complex traetment modality which comprises s of various periodontal tissue modifications where ever required. This article is a compilation of those aspects related to periodontium.

Pulpal and periodontal problems are responsible for more than 50% of tooth mortality today. There is general agreement today that the vast majority of pulpal and periodontal lesions are a result of bacterial infection. Under which conditions and especially in which direction spread of the disease occurs in the pulpo-periodontal continuum remains a matter of controversy. Diagnosis is complicated by the fact that these diseases are too frequently viewed as independent entities when recognition of their interrelationship is critical to successful resolution & treatment of these lesions often requires combined periodontic & endodontic therapy

Periodontal diseases, dental caries, malocclusion and oral cancer are among the most prevalent dental diseases affecting people worldwide as well as in Indian community. There is no national oral health data bank in India which reflects the prevalence of different oral diseases and risk factors responsible for them. No national oral health survey has been conducted in the country till date. Prevalence of disease is the key factor for effective and sound oral health care planning. Some cross sectional surveys has been conducted in various regions of the country at local level but those observations cannot be generalized for the whole community because of the great diversity in composition of Indian populations e.g. literacy rate in Kerala is more than 90% and in Bihar it is about 40%. Males are more literate than females. 70% of the population in India continues to live in rural areas. Different cross sectional surveys or studies showing prevalence of periodontal diseases mainly in the last twenty years have been collected from different sources and compiled in this article to give a comprehensive outlook of the present status and scenario of periodontal diseases in different population of Indian community.

Stress is nevertheless a confirmed and important factor in the etiology and maintenance of many inflammatory diseases, including periodontal disease. Stress results in delayed healing of the connective tissues and bone, apical migration of the junctional epithelium and formation of periodontal pocket. This paper describes general overview of stress, the relationship between stress & periodontium, the current models for understanding how stress mechanisms interact to regulate the onset and course of the disease and the evidence in favor of stress and against the stress being the etiological factor. Thus, it is important to recognize patient who are in stress and to be able to advise patients about the possible effects of stress on periodontal disease if the level of stress cannot be lowered.

Vaccination is a process that induces specific immune resistance to a bacterial or viral infectious disease. Vaccines have prevented several infectious diseases for many years, and are still being investigated. In late eighteenth century, Edward Jenner developed and established the principle of vaccination using the cross protection conferred by cowpox virus, which is non pathogenic in humans.

Regarding a vaccine against the periodontal disease, the complexity of the periodontopathic bacteria might be a problem in determination of Antigens. Among some 300 species of bacteria involved in subgingival plaque, 5-7 species have been implicated in the etiology of periodontitis but one or two species; P.gingivalis or B. forsythus might play an important role as primary pathogens.

Vaccination accomplished can be active immunization, passive immunization or DNA vaccination, made from the antigenic epitopes in periodontopathic bacteria. In light of the increasing evidence that periodontitis significantly increases risk for potentially fatal diseases such as coronary heart disease, stroke and complications from diabetes mellitus a successful vaccine for periodontitis could have health benefits far exceeding the prevention of periodontitis.

Among commonly used lasers in dentistry viz CO₂, Nd:YAG, Ho:YAG, Er: YAG, Er, Cr:YSGG, Nd:YAP, GaAs (diode) and argon, Er:YAG laser, at appropriate settings, possesses the best property for selective subgingival calculus removal without a thermal change of the root surface, soft tissue surgical procedures, root surface alterations, degranulation and implant surface decontamination alongwith proposed application in osseous surgery. Epithelial exclusion using CO₂ laser has been suggested to retard its downward growth. Waterlase® and Periowave^TM systems are recent devices that have further revolutionised the laser techonology for its favourable clinical applications; however, the procedural cost with the laser device still constitutes an obstacle for its routine application.

Probiotics are live micro-organisms that when administered in adequate amounts confer health benefits upon the host. Although a lot of work has been done regarding the effects of probiotic applications on systemic health particularly gastro-intestinal, the impact of probiotics on oral health is relatively new with lots of research going on; the area of probiotics and periodontal disease is still in its infancy. The present article summarizes the role of probiotics in periodontal health and disease and its effectiveness in periodontal therapy.

The management of periodontal defects has been an ongoing challenge in clinical periodontics. In the recent past, attention has been focused more on regenerative and reconstructive therapies i.e. bone grafts, guided tissue regeneration, root conditioning, polypeptide growth factors, rather than on respective therapies. These therapeutic measures are shown to be limited in the predictability of healing and regenerative response in the modern clinical practice because oral environment presents several complicating factors that border regeneration. The 21st century appears to represent a time in history when there is a convergence between clinical dentistry and medicine, human genetics, developmental and molecular biology, biotechnology, bioengineering, and bioinformatics, resulting in the emergence of novel regenerative therapeutic approaches viz. tissue engineering, gene therapy and RNA interference. The focus of this review paper is to furnish and update the current knowledge of periodontal tissue engineering, gene therapy and RNA interference i.e. the future of periodontal regeneration.