Systemic Effects of Periodontal Diseases

Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York, 109 Foster Hall, Buffalo, NY 14214, USA.
Dental Clinics of North America 08/2005; 49(3):533-50, vi. DOI: 10.1016/j.cden.2005.03.002
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A number of studies suggest an association between periodontal disease and cardiovascular disease, pulmonary disease, diabetes,and pregnancy complications. Presently, the data must be regarded as preliminary. Additional large-scale longitudinal epidemiologic and interventional studies are necessary to validate these associations and to determine whether the associations are causal. The goal of this article is to review the history of this concept, describe the biologically plausible circumstances that may underlie these potential associations, and provide a summary of the published literature that supports or refutes them.

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Available from: Frank Scannapieco, Jul 26, 2014
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    • "In dental clinics, current disease activity and responses to treatment can be easily monitored at a chair-side. A POC device for diagnosing periodontitis would also assist medical doctors in assessing the periodontal status of their patients because periodontitis is associated with many systemic diseases, such as atherosclerosis, coronary heart disease, diabetes mellitus, and rheumatoid arthritis (Scannapieco, 2005; Kobayashi and Yoshie, 2015). When medical doctors prescribe bisphosphonate or other medicines associated with medication-related osteonecrosis of the jaw (MRONJ), they can consider the periodontal status of their patients in advance to prevent the development of MRONJ, a common complication of medication combined with tooth extraction (Katsarelis et al., 2015). "
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    ABSTRACT: Periodontitis is a chronic inflammation of the periodontium caused by persistent bacterial infection that leads to the breakdown of connective tissue and bone. Because the ability to reconstruct the periodontium is limited after alveolar bone loss, early diagnosis and intervention should be the primary goals of periodontal treatment. However, periodontitis often progresses without noticeable symptoms, and many patients do not seek professional dental care until the periodontal destruction progresses to the point of no return. Furthermore, the current diagnosis of periodontitis depends on time-consuming clinical measurements. Therefore, there is an unmet need for near-patient testing to diagnose periodontitis. Saliva is an optimal biological fluid to serve as a near-patient diagnostic tool for periodontitis. Recent developments in point-of-care (POC) testing indicate that a diagnostic test for periodontitis using saliva is now technically feasible. A number of promising salivary biomarkers associated with periodontitis have been reported. A panel of optimal biomarkers must be carefully selected based on the pathogenesis of periodontitis. The biggest hurdle for the POC diagnosis of periodontitis using saliva may be the process of validation in a large, diverse patient population. Therefore, we propose the organization of an International Consortium for Biomarkers of Periodontitis, which will gather efforts to identify, select, and validate salivary biomarkers for the diagnosis of periodontitis.
    Frontiers in Cellular and Infection Microbiology 09/2015; 5:65. DOI:10.3389/fcimb.2015.00065 · 3.72 Impact Factor
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    • "response and lifestyle factors such as oral healthcare, smoking , age, race, hormonal changes, obesity, and diabetes (Kornman et al., 1997; Kinane and Chestnutt, 2000; Van Dyke and Sheilesh, 2005; Carrillo-De-Albornoz et al., 2010; Pretzl et al., 2012). The presence of periodontitis has been linked to systemic diseases beyond the periodontium, such as diabetes mellitus, cardiovascular disease, osteoporosis, pulmonary disease, and rheumatoid arthritis (Scannapieco, 2005; Otomo-Corgel et al., 2012). Periodontal disease in pregnant women has been associated with an increased relative risk of adverse pregnancy outcomes such as late miscarriage, preterm birth, and delivery of low birth weight infants (Jeffcoat et al., 2001; Moore et al., 2004; Jarjoura et al., 2005; Offenbacher et al., 2006a; Shub et al., 2006). "
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    ABSTRACT: Periodontal disease (PD) in pregnancy is associated with an increased risk of adverse pregnancy outcomes including miscarriage and preterm birth. Evidence exists that periodontal disease treatment may reduce inflammatory mediators in gingival crevicular fluid (GCF) and the risk of inflammation-associated pregnancy complications. The aim was to determine if periodontal disease treatment during mid-pregnancy alters local inflammation in GCF and has beneficial effects on clinical dental parameters. Eighty pregnant women with clinically diagnosed PD were recruited from a randomised controlled trial on the treatment of periodontal disease in pregnancy conducted in Perth, Australia. The treatment group underwent intensive PD treatment (20-28 weeks' GA), while the control group underwent the same treatment postnatally. GCF was collected at 20 and 28 weeks' gestation and concentrations of cytokines determined by multiplex assay: IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17, TNF-α and MCP-1. Periodontal treatment significantly reduced the GCF levels of IL-1β, IL-10, IL-12p70 and IL-6 at 28 weeks' GA compared with controls, while levels of MCP-1, IL-8 and TNF-α exhibited a significant gestational age-dependent increase, but no treatment response. Post-treatment clinical parameters improved with significant reductions in bleeding on probing, clinical attachment loss, and probing depth. No changes in pregnancy-related outcomes were observed, although the severity of periodontal disease was significantly associated with an increased risk of infants born small for gestational age. PD treatment in pregnancy reduces the levels of some inflammatory mediators in the GCF and improves dental parameters, with no overt effects on pregnancy outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Journal of Reproductive Immunology 05/2015; 112. DOI:10.1016/j.jri.2015.05.002 · 2.82 Impact Factor
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    • "Porphyromonas gingivalis, a Gram-negative black-pigmented anaerobic rod residing in subgingival biofilms, is widely recognized as a contributor to development of periodontal infections together with other oral pathogens (1–5). The species has also been reported to cause extraoral infections (6–9) and is suggested to play a role in the development of coronary heart disease, stroke, and diabetes mellitus, as well as preterm delivery of low birth-weight infants (7–13). "
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    ABSTRACT: Marginal periodontitis is not a homogeneous disease but is rather influenced by an intricate set of host susceptibility differences as well as diversities in virulence among the harbored organisms. It is likely that clonal heterogeneity of subpopulations with both high and low levels of pathogenicity exists among organisms harbored by individuals with negligible, slight, or even severe periodontal destruction. Therefore, specific virulent clones of periodontal pathogens may cause advanced and/or aggressive periodontitis. Porphyromonas gingivalis is a predominant periodontal pathogen that expresses a number of potential virulence factors involved in the pathogenesis of periodontitis, and accumulated evidence shows that its expression of heterogenic virulence properties is dependent on clonal diversity. Fimbriae are considered to be critical factors that mediate bacterial interactions with and invasion of host tissues, with P. gingivalis shown to express two distinct fimbria-molecules, long and short fimbriae, on the cell surface, both of which seem to be involved in development of periodontitis. Long fimbriae are classified into six types (I to V and Ib) based on the diversity of fimA genes encoding FimA (a subunit of long fimbriae). Studies of clones with type II fimA have revealed their significantly greater adhesive and invasive capabilities as compared to other fimA type clones. Long and short fimbriae induce various cytokine expressions such as IL-1α, IL-β, IL-6, and TNF-α, which result in alveolar bone resorption. Although the clonal diversity of short fimbriae is unclear, distinct short fimbria-molecules have been found in different strains. These fimbriae variations likely influence the development of periodontal disease.
    Journal of Oral Microbiology 05/2013; 5(2013). DOI:10.3402/jom.v5i0.20265
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