Evaluating periodontal risk for patients at risk of or suffering from atherosclerosis: Recent biological hypotheses and therapeutic consequences

Abstract

Cardiovascular disease, such as atherosclerosis, is the main cause of mortality in developed countries. Most atherosclerosis risk factors have been identified and are treated, improving patient cardiovascular status and reducing mortality, but some remain unknown. Periodontal disease is generally defined as inflammatory disease initiated by accumulation of dental bacterial plaque, leading to the destruction of tissues that support the teeth. Severe forms have a high prevalence (15% of the population) and are associated with the presence of virulent pathogens such as Porphyromonas gingivalis. Epidemiological studies have shown that severe periodontal disease negatively influences cardiovascular status. The aim of this paper was to present a synthesis of the most recent biological data related to the link between periodontal and cardiovascular disease. The potential biological mechanisms involved in these two inflammatory diseases (bacteriological theory, inflammatory theory, immune theory) were developed. According to the observed positive effects of periodontal treatment on systemic conditions, the benefit of a reinforced collaboration between dentists and cardiologists was discussed, especially for patients at risk for cardiovascular disease.

Porphyromonas gingivalis and its lipopolysaccharide differentially regulate the expression of cathepsin B in endothelial cells

“…, 2009). This work reinforces the need to suppress or limit the amount of aggressive periodontal pathogens in patients at risk for cardiovascular disease (Huck et al , 2011; Ying Ouyang et al. , 2011).…”

“…The control of their cellular responses to P. gingivalis infection, such as cathepsin activation and cytokine production (Kocgozlu et al, 2009), appears to be a major element of atherosclerosis and periodontitis pathogenesis (Amar et al, 2009). This work reinforces the need to suppress or limit the amount of aggressive periodontal pathogens in patients at risk for cardiovascular disease (Huck et al, 2011;Ying Ouyang et al, 2011).…”

Adiposity Measurements and Non‐Surgical Periodontal Therapy Outcomes

“…Periodontitis is an infectious and inflammatory disease that is one of the most common chronic diseases throughout the world 7 and is closely related to diabetes 8 and stroke 9 . These diseases have some common risk factors, such as smoking 10 .…”

“…5 Periodontitis is an infectious and inflammatory disease that is one of the most common chronic diseases throughout the world 7 and is closely related to diabetes 8 and stroke. 9 These diseases have some common risk factors, such as smoking. 10 Periodontitis appears to affect more frequently and be more severe in obese individuals than in normal-weight (NW) individuals.…”

Increased risk of ischaemic stroke amongst patients with chronic osteomyelitis: a population‐based cohort study in Taiwan

“…The potential role of chronic inflammatory processes in causing endothelial dysfunction and accelerating atherosclerosis has been noted in rheumatoid arthritis , psoriasis and periodontitis . Atherosclerosis is an established mechanism in the development of cardiovascular diseases , including stroke .…”