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. 2020 Mar 31;11:511. doi: 10.3389/fimmu.2020.00511

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Copyright © 2020 Van Dyke, Bartold and Reynolds.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Inflammation-Mediated Polymicrobial Emergence and Dysbiotic Exacerbation (IMPEDE) Model. A proposal to demonstrate how inflammation is a principal driver of plaque-associated periodontitis. This model recognizes 5 stages (0-IV) through which health, gingivitis, and periodontitis may develop, be contained or progress. Stage 0: periodontal health; Stage I: Gingivitis (inflammation); Stage II: Initiation/early periodontitis (Polymicrobial diversity emerges); Stage III: Inflammation mediated dysbiosis and opportunistic infection and Stage IV: Late stage periodontitis.