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Association Between Cardiovascular Diseases and Periodontal Disease - What Do We Know? Tobacco Smoke Causes Disease: the Biology Heart Diseases 2 Special Topic No. 8 References 1. Genco RJ & Williams RC 2010. Overview. 16. Herzberg MC & Weyer MW 1998. Dental plaque, 27. Howell TH, Ridker PM, Ajani UA, Hennekens CH In: Genco RJ, Williams RC (eds), Periodontal platelets and cardiovascular diseases. Annals of & Christen WG 2001. Periodontal disease and disease and overall health: a clinician’s Periodontology 3:151–160. risk of subsequent cardiovascular disease in guide. Pennsylvania: Professional Audience US male physicians. Journal of the American 17. US Surgeon General’s Report 2010. How Communications, 1–4. College of Cardiology 37:445–450. Association between cardiovascular diseases and periodontal disease - what do we know? Tobacco Smoke Causes Disease: The Biology Heart Diseases 2. Mattila KJ, Nieminen MS, Valtonen VV et al. and Behavioral Basis for Smoking-Attributable 28. Paquette DW & Genco RJ 2010. Association 1989. Association between dental health and Disease. Washington,DC: US Department of between periodontal disease and atheromatous acute myocardial infarction. British Medical Health and Human Services, pp. 3–12. diseases. In: Genco RJ, Williams RC (eds), Journal 298:779–781. Periodontal disease and overall health: a Seymour GJ, Ford PJ, Cullinan MP, Leishman 18. clinician’s guide. Pennsylvania: Professional There has been a growing body of research S & Yamazaki K 2007. Relationship between inspired researchers to revisit the relationship between 3. DeStefano F, Anda RF, Kahn HS, Williamson DF Audience Communications, 112–131. & Russell CM 1993. Dental disease and risk of periodontal infections and systemic disease. on periodontal disease carried out over the oral health and general health. This, in turn, led to a coronary heart disease and mortality. British European Journal of Clinical Microbiology & 29. Tonetti MS, D’Aiuto F, Nibali L et al. 2007. past five decades, and three distinctive series of research activities exploring the influence of Medical Journal 306:688–691. Infectious Diseases 13:3–10. Treatment of periodontitis and endothelial function. New England Journal of Medicine phases of this research, namely the periodontal disease on cardiovascular health to such an Figuero E, Sánchez-Beltrán M, Cuesta-Frechoso 4. Scannapieco FA 2006. Pneumonia in 19. 356:911–920. extent that publications on this theme have appeared in nonambulatory patients: the role of oral bacteria S et al. 2011. Detection of periodontal bacteria aetiopathologic phase, the risk factor nearly 200 different journals over the past two decades11. and oral hygiene. Journal of the American Dental in atheromatous plaque by nested polymerase 30. Paraskevas S, Huizinga JD & Loos BG 2008. phase and the periodontal disease–systemic Association 137:21S–25S. chain reaction. Journal of Periodontology A systematic review and meta-analyses on A new term—'periodontal medicine'—also evolved by the 1 82:1469–1477. C-reactive protein in relation to periodontitis. health phase, have been identified . More end of the 20th century, acknowledging the significance 5. Mealey BL 2006. Periodontal disease and Journal of Clinical Periodontology 35:277–290. diabetes: a two-way street. Journal of the 20. Loos BG, Craandijk J, Hoek FJ, Wertheim-van recently the focus has been on the third of periodontal–systemic relationships12. Notwithstanding American Dental Association 137:26S–31S. Dillen PM & van der Velden U 2000. Elevation 31. Offenbacher S, Beck JD, Moss K et al. 2009. phase, where the influence of periodontal this growing body of evidence, there may be a lack of of systemic markers related to cardiovascular Results from the Periodontitis and Vascular congruity among researchers with regard to comprehensive 6. Taylor GW & Borgnakke WS 2008. Periodontal diseases in the peripheral blood of periodontitis Events (PAVE) study: a pilot multicentered, disease on systemic diseases has been disease: associations with diabetes, glycemic patients. Journal of Periodontology 71:1528– randomized, controlled trial to study effects of considerably explored. Consequently, understanding of periodontal–cardiovascular relationships, control and complications. Oral Diseases 1534. periodontal therapy in a secondary prevention which further substantiates the need for this kind of 14:191–203. model of cardiovascular disease. Journal of the emerging evidence may point to a information sheet. 21. Lalla E, Lamster IB, Hofmann MA et Periodontology 80:190–201. 7. Offenbacher S, Katz V, Fertik G. et al. 1996. al. 2003. Oral infection with a periodontal significant association between periodontal Periodontal infection as a possible risk factor pathogen accelerates early atherosclerosis 32. Budoff MJ, Achenbach S, Blumenthal RS et al. disease and certain systemic diseases Risk Factors for preterm low birth weight. Journal of in apolipoprotein E-null mice. Arteriosclerosis 2006. Assessment of coronary artery disease Periodontology 67:1103–1113. Thrombosis & Vascular Biology 23:1405–1411. by cardiac computed tomography. A scientific and conditions including cardiovascular The aetiology for both cardiovascular diseases (CVD) statement from the American Heart Association 2,3 4 11 8. AIHW 2010. Australia’s health 2010. Australia’s Li L, Messas E, Batista EL Jr, Levine RA & Amar diseases , respiratory diseases , diabetes and periodontal disease (PD) is multifactorial in nature . 22. Committee on Cardiovascular Imaging and Health Series no. 12. cat. no. AUS 122. S 2002. infection 5,6 Porphyromonas gingivalis Intervention, Council on Cardiovascular and complications of diabetes and Modifiable risk factors for CVD include dyslipidemia, Canberra: AIHW. accelerates the progression of atherosclerosis Radiology and Intervention, and the Committee 7 smoking, diabetes mellitus, hypertension, physical inactivity in a heterozygous apolipoprotein E-deficient adverse pregnancy outcomes . Of these, 9. Claffey NM, Polyzois IN & Williams RC 2010. on Cardiac Imaging, Council on Clinical and obesity, while non-modifiable risk factors associated History of the oral-systemic relationship. In: murine model. Circulation 105:861–867. cardiovascular diseases are regarded as the Cardiology. Circulation 114:1761–1791. with CVD are age, ethnicity, sex and family history of Genco RJ, Williams RC (eds), Periodontal 23. Senba T, Kobayashi Y, Inoue K et al. 2008. The 33. Nichols TC & Paquette DW 2010. Dental and leading cause of mortality in Australians, 11,12 disease and overall health: a clinician’s association between self-reported periodontitis cardiovascular diseases . It has been established that medical comanagement of cardiovascular guide. Pennsylvania: Professional Audience and coronary heart disease—from MY Health accounting for not only over 16% of all these factors play a prominent role in atherosclerosis, disease. In: Genco RJ, Williams RC (eds), Communications, 42–54. Up Study. Journal of Occupational Health Periodontal disease and overall health: a deaths but also 16% of the total disease and that timely intervention in modifiable risk factors, in 50:283–287. 10. Crocombe LA & Slade GD 2007. Decline of the clinician’s guide. Pennsylvania: Professional burden in 20078. The aim of this information particular, is crucial in halting the atherosclerotic process edentulism epidemic in Australia. Australian 24. Geismar K, Stoltze K, Sigurd B, Gyntelberg Audience Communications, 238–249. as well as the clinical manifestations associated with it. Dental Journal 52:154–156. F & Holmstrup P 2006. Periodontal disease sheet is to update dental professionals 34. Johnson RK, Appel LJ Brands M et al. 2009. and coronary heart disease. Journal of 11. Lockhart PB, Bolger AF, Papapanou PN et al. Dietary sugars intake and cardiovascular health. on the cardiovascular–periodontal disease Local colonisation of dental plaque-forming bacteria, Periodontology 77:1547–1554. 2012. Periodontal disease and atherosclerotic A scientific statement from the American Heart relationship. systemic conditions including diabetes mellitus, vascular disease: does the evidence support an Association. Circulation 120:1011–1020. 25. Andriankaja O, Trevisan M, Falkner K et al. 2011. osteoporosis, rheumatoid arthritis and respiratory independent association? A scientific statement Association between periodontal pathogens and 35. Friedewald VE, Kornman KS, Beck JD et al. from the American Heart Association. Circulation risk of nonfatal myocardial infarction. Community diseases are associated with the aetiology of PD, whereas 2009. The American Journal of Cardiology and Background 125:2520–2544. Dentistry & Oral Epidemiology 39:177–185. Journal of Periodontology Editors’ Consensus: age, ethnicity, sex, smoking, stress and poor coping Oral sepsis had been cited as a cause for systemic illness 12. Williams RC & Offenbacher S 2000. Periodontal 26. Lund Håheim L, Olsen I, Nafstad P, Schwarze periodontitis and atherosclerotic cardiovascular behaviour, and obesity have a key role in the development medicine: the emergence of a new branch of P & Rønningen KS 2008. Antibody levels to disease. American Journal of Cardiology as far back as 1880 when an American dentist named Miller of the disease1,11,13–16. In fact, smoking has been implicated periodontology. Periodontology 2000 23:9–12. 104:59–68. single bacteria or in combination evaluated postulated the focal infection theory where microbes in the as a cause of PD in the US Surgeon General’s report17. 13. Hujoel PP, Drangsholt M, Spiekerman C & against myocardial infarction. Journal of Clinical oral cavity were implicated in systemic diseases9. This
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