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The osteoclast and periodontitis.

The osteoclast may play an important rŏle in the variable rate of osseous destruction seen in periodontitis. Current understanding of various aspects of the osteoclast may help explain this fact. This review paper will first look at two theories of cell origin of the osteoclast: the multipotential osteoprogenitor cell theory and the hemopoietic stem cell theory. Next, ultrastructural features characteristic to the cell such as the ruffled border, clear zone, and lysosomal system, will be discussed. Thirdly, current and proposed theories on the actual mechanism of bone degradation are considered. This includes the one-cell theory and the two-cell theory. Finally, elements which activate the osteoclast are enumerated and their delicate interplay is outlined. In the context of this information, pathways found in the periodontal lesion (microbial agents, inflammatory cells and their products) which attract and activate elements of the osteoclastic system are discussed.