Review. The Link between Periodontal Disease, Inflammation and Atherosclerosis — an Interdisciplinary Approach

Abstract

Periodontal disease is a chronic inflammatory disease that results from the activity of altered oral microbiome, leading to altered immune reaction, destruction of tissues supporting the teeth, and oral bone loss. This disease is particularly associated with an expressed systemic inflammation, being considered nowadays an inflammatory disorder. At the same time, inflammation has been recognized to play a major role in the development of atherosclerotic lesions. Atheromatous plaque formation is triggered by alterations in the structure of the endothelium, which lead to the expression of adhesion molecules and recruitment of immune cells such as macrophages, in the arterial wall. While the association between periodontal disease, inflammation and cardiovascular diseases has been well established, the causality relation between these three entities has not been demonstrated so far. This review presents the most common advances in understanding the complex link between periodontal disease, inflammation and atherosclerosis, as a common pathway leading to increased cardiovascular risk.

Effect of Scaling and Root Planing Treatment on Levels Hs-CRP in Indonesian Patients with Risk of Cardiovascular Disease

“…Recently, the possible links between periodontitis and atherosclerosis have intensified and are being investigated for possible association and causality. Common risk factors for these diseases include increasing age, smoking, alcohol abuse, ethnicity, educational and socioeconomic status, being male, diabetes mellitus, and obesity [12,13].…”

Periodontal Disease Is Associated with Increased Vulnerability of Coronary Atheromatous Plaques in Patients Undergoing Coronary Computed Tomography Angiography—Results from the Atherodent Study

“…The PD is defined as a chronic inflammatory state produced by the imbalance of the normal oral microbiota, being characterized by the damage of the soft and hard structures that support the teeth as a result of repeated bacterial infections [ 1 , 4 , 6 ]. This inflammatory state leads to the local occurrence of a complex host inflammatory response, which is responsible for the progressive destruction of the supporting tooth tissue and leads to tooth loss [ 7 , 8 , 9 , 10 ].…”

“…Due to repeated bacteremia, pathogens are able to enter into the systemic circulation, favoring activation of the inflammatory cascade [ 6 ]. In addition, local inflammation causes changes in plaque morphology.…”

Association of Coronary Wall Shear Stress With Atheromatous Plaque Vulnerability: A Systematic Review

“…Such a VP carries inside several biomarkers considered as "signatures of vulnerability", which, if identified, can prompt timely initiation of therapeutic measures in order to prevent the development of an acute myocardial infarction (AMI) [1,2]. Therefore, image-based identification of the VPs represented a "holy grail" for many years in interventional cardiology and in related imaging specialities.…”