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The Materials in This Pdf Document Are Not Required for Your Accreditation THE MATERIALS IN THIS PDF DOCUMENT ARE NOT REQUIRED FOR YOUR ACCREDITATION. THEY ARE BEING PROVIDED TO YOU IN THE EVENT YOU WOULD LIKE TO LEARN MORE ABOUT THE TOPICS PRESENTED IN UNIT 8: BIOLOGICAL PERIODONTAL THERAPY SUPPLEMENTARY (OPTIONAL) CONTENT FOR UNIT 8 Read the “The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease” study by Friedewald, Kornman, Beck, Genco, Goldfine, Libby, Offenbacher, Ridker, Van Dyke, and Roberts. Click here to go to pages 3-12. Watch the “Bad Bugs” video by Kennedy at https://www.youtube.com/watch?v=kKJgwR2RScw Read the “Herpesviruses in periodontal diseases” article by Slots. Click here to go to pages 13-42. Read the “Systemic Diseases Caused by Oral Infection” review by Li, Kolltveit, Tronstad, and Olsen. Click here to go to pages 43-54. Read the “Identification of Pathogen and Host-Response Markers Correlated With Periodontal Disease” study by Ramseier, Kinney, Herr, Braun, Sugai, Shelburne, Rayburn, Tran, Singh, and Giannobile. Click here to go to pages 55-65. Read the “Oral Bacteria and Cancer” research from Whitmore and Lamont. Click here to go to pages 66-68. Unit 8 OPTIONAL IAOMT Accreditation Materials as of December 18, 2017; Page 1 Read the “Use of PCR to detect Entamoeba gingivalis in diseased gingival pockets and demonstrate its absence in healthy gingival sites” study by Trim, Skinner, Farone, DuBois, and Newsome. Click here to go to pages 69-76. Read the “Periodontal disease may associate with breast cancer” study by Söder, Yakob, Meurman, Andersson, Klinge, and Söder. Click here to go to pages 77-93. Read the “Biocompatible Periodontal Therapy” IAOMT Scientific Review. Click here to go to pages 94-100. Read the “Oxygen/Ozone Applications in Dentistry” IAOMT Scientific Review. Click here to go to pages 101-102. Read the “Periowave Photodisinfection System” IAOMT Scientific Review. Click here to go to pages 103-108. Unit 8 OPTIONAL IAOMT Accreditation Materials as of December 18, 2017; Page 2 The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease† Vincent E. Friedewald, MDa,*, Kenneth S. Kornman, DDS, PhDb, James D. Beck, PhDc, Robert Genco, DDS, PhDd, Allison Goldfine, MDe, Peter Libby, MDf, Steven Offenbacher, DDS, PhD, MMscg, Paul M. Ridker, MD, MPHh, Thomas E. Van Dyke, DDS, PhDi, and William C. Roberts, MDj Acknowledgment sand Oaks, California. Dr. Ridker is a co-inventor on patents held by Brigham and Women’s Hospital that relate to the This Editors’ Consensus is supported by an educational use of inflammatory biomarkers in cardiovascular disease. grant from Colgate-Palmolive, Inc., New York, New York, Dr. Ridker is a research consultant for Schering-Plough, and is based on a meeting of the authors held in Boston, Kenilworth, New Jersey; Sanofi-Aventis; AstraZeneca; Isis, Massachusetts, on January 9, 2009. Carlsbad, California; Novartis; and Vascular Biogenics, Tel Aviv, Israel. Dr. Van Dyke is a co-inventor on patents held Disclosure by Boston University, Boston, Massachusetts, that relate to Dr. Friedewald has received honoraria for speaking from inflammation control, including consulting fees. Dr. Roberts Novartis, East Hanover, New Jersey. Dr. Kornman is a has received honoraria for speaking from Merck, White- full-time employee and shareholder of Interleukin Genetics, house Station, New Jersey; Schering-Plough; AstraZeneca; Waltham, Massachusetts, which owns patents on genetic and Novartis. All other individuals in a position to control biomarkers for chronic inflammatory diseases. Dr. Genco is content disclosed no relevant financial relationships. a consultant to Merck. Dr. Ridker has received research support from AstraZeneca, Wilmington, Delaware; Novar- Introduction tis; Pfizer, New York, New York; Roche, Nutley, New The organization of the health professions into specialties Jersey; Sanofi-Aventis, Bridgewater, New Jersey; and Ab- and subspecialties according to body organs and systems is bott Laboratories, Abbott Park, Illinois. Dr. Ridker has often more pragmatic than scientific. The human organism is a received nonfinancial research support from Amgen, Thou- single unit composed of a seemingly infinite number of bio- logic processes so intertwined that abnormalities of almost any a of its parts or processes have profound effects on multiple other Associate Editor, The American Journal of Cardiology, Research body areas, exemplified in this document by the common and Professor, University of Notre Dame, Notre Dame, Indiana, and Clinical Professor, Department of Internal Medicine, The University of Texas complex theme of inflammation. In recent years, the immune Medical School at Houston, Houston, Texas; bEditor-in-Chief, Journal of system, once believed to be only a vital defense against infec- Periodontology, and Chief Scientific Officer, Interleukin Genetics, tion and a promoter of healing—except in the instances of a Waltham, Massachusetts; cDistinguished Professor and Associate Dean for few uncommon connective tissue disorders—is now recog- Research, University of North Carolina School of Dentistry, Chapel Hill, nized as a significant active participant in many chronic dis- North Carolina; dDistinguished Professor, Departments of Oral Biology eases, including hypertension, diabetes mellitus, arthritis, in- and Microbiology, University at Buffalo, State University of New York, flammatory bowel disease, psoriasis, and the 2 diseases Amherst, New York; eAssociate Professor, Harvard Medical School, and addressed in this Editors’ Consensus: atherosclerotic cardio- Section Head of Clinical Research, Joslin Diabetes Center, Boston, Mas- f vascular disease (CVD) and periodontitis. sachusetts; Chief, Cardiovascular Medicine, Brigham and Women’s Hos- This aim of this document is to provide health profes- pital, and Malinckrodt Professor of Medicine, Harvard Medical School, Boston, Massachusetts; gDistinguished Professor of Periodontology and sionals, especially cardiologists and periodontists, a better Dental Research, University of North Carolina, Chapel Hill, North Caro- understanding of the link between atherosclerotic CVD and lina; hEugene Braunwald Professor of Medicine, Harvard Medical School, periodontitis and, on the basis of current information, an Brigham and Women’s Hospital, Boston, Massachusetts; iProfessor and approach to reducing the risk for primary and secondary Program Director, Postdoctoral Periodontology, and Director, Clinical Re- atherosclerotic CVD events in patients with periodontitis. search Center, Boston University, Goldman School of Dental Medicine, Periodontitis, a bacterially induced, localized, chronic Boston, Massachusetts; and jEditor-in-Chief, The American Journal of inflammatory disease, destroys connective tissue and bone Cardiology and Baylor University Medical Center Proceedings, Executive that support the teeth. Periodontitis is common, with mild to Director, Baylor Heart and Vascular Institute, Baylor University Medical moderate forms affecting 30% to 50% of adults and the Center, and Dean, A. Webb Roberts Center for Continuing Medical Edu- severe generalized form affecting 5% to 15% of all adults in cation of Baylor Health Care System, Dallas, Texas. 1 *Corresponding author: Tel: 574-631-6675; fax: 574-631-4505. the United States. Periodontitis has even higher prevalence E-mail address: [email protected] (V.E. Friedewald). in developing countries and considerable global variation, although the prevalence of the severe generalized disease 2 † Published simultaneously in the Journal of Periodontology, the Of- appears to be similar in most populations. ficial Journal of the American Academy of Periodontology. Patients with periodontitis are often asymptomatic. When Am J Cardiol 2009;104:000–000 www.AJConline.org 0002-9149/09/$ – see front matter © 2009 Elsevier Inc. and the American Academy of Periodontology. All rights reserved. doi:10.1016/j.amjcard.2009.05.002 Unit 8 OPTIONAL IAOMT Accreditation Materials as of December 18, 2017; Page 3 2 The American Journal of Cardiology (www.AJConline.org) romonas gingivalis, Treponema denticola, and Tannerella for- sythia, which consistently associate with periodontitis. These bacteria activate many host immunoinflammatory processes and disrupt host mechanisms involved in bacterial clearance and are considered pathogens in periodontitis. Environmen- tal and genetic factors as well as acquired risk factors such as diabetes mellitus and exposure to tobacco accelerate inflammatory processes in periodontitis. Although bacteria initiate periodontitis, host-modifying risk factors appear to influence the severity and extent of disease. Risk factors (nonoral): The following nonoral risk fac- tors associate strongly with increased risk for periodontitis and disease severity: smoking, diabetes mellitus, genetics, mental anxiety, depression, obesity, and physical inactivity. a b Individuals who smoke (cigarettes and pipes) have 6 to 7 times more alveolar bone loss than nonsmokers in studies in Figure 1. In this patient with untreated moderate periodontitis, changes in the United States and other countries.4–7 Patients with pe- tissue contours and color are present (A). The yellow-brown discolored riodontitis defined by tooth attachment loss are 3 to 5 times areas of the teeth (B) are root surfaces that have been exposed with gingival 8 recession due to destruction of the connective tissue attachment. The more likely to smoke than those without
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