Smoking is the greatest cause of periodontal disease. However, genetic predisposition plays a role in severity and susceptibility.

Vertical defects are more easily treated than generalized, uniform bone loss. MMPs are inhibited as part of treatment

MMP1 is induced by inflammation, MMP8 is constitutively expressed. They are part of remodeling extracellular matrix and collagens 1 and 3.

The benefit of guided tissue regeneration using enamel matrix proteins is that acellular cementum can be generated, not just junctional epithelium. Periodontal surgery is pointless for patients that are noncompliant in alteration of smoking and oral hygiene habits.