Alzheimer’s disease (AD) is the leading cause of cognitive impairment in the elderly. Recent evidence suggests that preventive interventional trials could significantly reduce the risk for development of dementia. Periodontitis is the most common dental disease characterized by chronic inflammation and loss of alveolar bone and perialveolar attachment of teeth. Growing number of studies propose a potential link between periodontitis and neurodegeneration. In the first part of the paper, we overview case-control studies analyzing the prevalence of periodontitis among AD patients and healthy controls. Second, we survey observational libraries and cross-sectional studies investigating the risk of cognitive decline in patients with periodontitis. Next, we describe the current view on the mechanism of periodontitis linked neural damage, highlighting bacterial invasion of neural tissue from dental plaques, and periodontitis induced systemic inflammation resulting in a neuroinflammatory process. Later, we summarize reports connecting the four most common periodontal pathogens to AD pathology. Finally, we provide a practical guide for further prevalence and interventional studies on the management of cognitively high-risk patients with and without periodontitis. In this section, we highlight strategies for risk control, patient information, dental evaluation, reporting protocol and dental procedures in the clinical management of patients with a risk for periodontitis and with diagnosed periodontitis. In conclusion, our review summarizes the current view on the association between AD and periodontitis and provides a research and intervention strategy for harmonized interventional trials and for further case-control or cross-sectional studies.

Alzheimer’s disease is the leading cause of cognitive deterioration. Alois Alzheimer described it for the first time in 1907. In the last five decades, there were emerging numerous hypotheses about the pathomechanism of this condition. The first one, the cholinergic hypothesis resulted in important antidementia medications. Amyloid cascade theory set the direction for many years in Alzheimer research. Currently, it also contributed to the licencing of a novel pharmaceutical Aducanumab. Additionally, the latest hypotheses shed light on the new aspects of the pathology of dementia. This study emphasizes the historical landmarks of Alzheimer’s research and reveals their interactions as well.

Recently, drugs targeting the remodelling, vascular circulation and homeostasis of bone are frequently applied with an unquestionable benefit in the therapy of numerous severe medical conditions. Besides bisphosphonates, other antiresorptive and antiangiogenic drugs are also used, however, limited publications are focusing on data of their results. Increasing number of patients arrives the mentioned medication is increasing in the daily dental practice, especially when accurate anamnesis is taken. Our aim is to highlight the preventive considerations that help minimize the occurence of medication-related osteonecrosis of the jaw by presentating a complex dental rehabilitation of a patient at risk. The synchronization of dental surgery, conservative and prosthodontic treatment is essential in the case of an elderly patient having many concomitant disorders. Our aim is also to draw the attention of our colleagues working on different medical fields to the timing of dental procedures. The best and simplest way to prevent jaw necrosis is to achieve good oral health and hygiene before the introduction of antiresorptive therapy. If, however, our patient is already taking this medication, we still have a chance to prevent the appearance of this devastating condition by following the preventive measures. The medication-related necrosis of the jaw is a severe condition leading to a decreased life quality and having a reduced healing expectancy. Orv Hetil. 2018; 159(48): 2031–2036.