Vascular Changes and Hypoxia in Periodontal Disease as a Link to Systemic Complications

Abstract

The hypoxic microenvironment caused by oral pathogens is the most important cause of the disruption of dynamic hemostasis between the oral microbiome and the immune system. Periodontal infection exacerbates the inflammatory response with increased hypoxia and causes vascular changes. The chronicity of inflammation becomes systemic as a link between oral and systemic diseases. The vascular network plays a central role in controlling infection and regulating the immune response. In this review, we focus on the local and systemic vascular network change mechanisms of periodontal inflammation and the pathological processes of inflammatory diseases. Understanding how the vascular network influences the pathology of periodontal diseases and the systemic complication associated with this pathology is essential for the discovery of both local and systemic proactive control mechanisms.

PGC‐1 alpha regulates mitochondrial biogenesis to ameliorate hypoxia‐inhibited cementoblast mineralization

“…4 However, cementum destruction frequently occurs in patients with periodontitis and apical periodontitis (AP), which are often accompanied by tissue hypoxia. [5][6][7] Hypoxia is defined as the absence of sufficient oxygen, which is required to maintain normal cellular function. 8 Hypoxia can cause inflammation, thereby, inflammatory diseases are often accompanied by hypoxia.…”

“…Cementum maintains tooth stability, shielding the pulp from pathogen invasion 4 . However, cementum destruction frequently occurs in patients with periodontitis and apical periodontitis (AP), which are often accompanied by tissue hypoxia 5–7 …”

From organ injury to disability: a proposed model for 5-alpha reductase inhibitor syndrome

“…The interaction of distant tissues and organs via the vascular network and common inflammatory mediators, which may trigger the systemic inflammation in the circulation, make this link even more probable." 114 To summarize, recent research supports a link from kidney dysfunction to an elevated risk of cerebrovascular events, owing in part to proinflammatory activity and potentially systemic endothelial dysfunction. Likewise, periodontal disease is implicated in systemic inflammatory disease.…”

“…85 In a recent review on systemic aspects of periodontal disease, Celik & Kantarci note that hypoxia may trigger a cascade of pathological angiogenesis and inflammatory processes, contributing to the progression of periodontal disease. 114 Their conclusion notes: "The relationship between periodontal diseases and systemic inflammatory diseases includes uncontrolled inflammation. The interaction of distant tissues and organs via the vascular network and common inflammatory mediators, which may trigger the systemic inflammation in the circulation, make this link even more probable."…”

Editorial for the Special Issue: Oral Immunology and Periodontitis

“…In their reviews, Celik and Kantarci [ 9 ] emphasized vascular changes and hypoxia while discussing systemic disease–periodontitis interactions. Grant [ 10 ] discussed the role of pyruvate kinase in the pathogenesis of periodontitis.…”