Periodontal Disease and Systemic Inflammatory Disorders
Summary
Periodontal disease encompasses a spectrum of chronic inflammatory conditions affecting the gingiva and supporting structures of the teeth. Initiated by microbial biofilms in subgingival niches, this process provokes a host immune reaction that, if unabated, leads to tissue destruction, pocket formation and eventual tooth loss. Beyond the oral cavity, accumulating evidence has linked periodontitis with systemic inflammatory disorders including cardiovascular disease, diabetes mellitus, rheumatoid arthritis and psoriasis. Mechanistically, the translocation of periodontal pathogens and their by-products into the circulation, coupled with elevated levels of pro-inflammatory mediators such as interleukin-1, interleukin-6 and tumour necrosis factor-alpha, appears to fuel low-grade systemic inflammation. This bi-directional relationship suggests that periodontal therapy may contribute to improved glycaemic control, attenuated joint inflammation and reduced cardiovascular risk. Given its high global prevalence, periodontitis represents both a public health challenge and an opportunity for integrated medical-dental care to mitigate systemic disease burden.
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Periodontal Disease and Systemic Inflammatory Disorders publication trend
The graph below shows the total number of articles in periodontal disease and systemic inflammatory disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Periodontitis: Chronic inflammatory disease of the periodontium characterised by destruction of gingival tissue and alveolar bone.
Systemic inflammation: Persistent, low-grade immune activation affecting multiple organ systems beyond the initial site of insult.
Gingival crevicular fluid (GCF): Serum-derived fluid found in the crevice between tooth and gum, rich in host mediators and microbial products.
Cytokine: Soluble protein secreted by immune cells that modulates inflammation and cell signalling.
Microbiome: The collective community of microorganisms inhabiting a specialised environment, such as the periodontal pocket.
Vascular endothelial growth factor A (VEGF-A): Key angiogenic cytokine promoting blood vessel formation and vascular permeability.
References
- Direct impact of psoriasis on gingival crevicular fluid levels of VEGF-A in periodontitis patients: a mediation analysis. Frontiers in Immunology (2024).
- Changes in Periodontal Parameters and Microbiome Composition of Periodontal Pocket in Patients with Chronic Inflammatory Diseases Receiving Targeted Anti-Cytokine Therapy. Microorganisms (2024).
- Periodontitis in patients with psoriasis: A systematic review and meta‐analysis. Oral Diseases (2020).
- Periodontal Systemic Connections-Novel Associations-A Review of the Evidence with Implications for Medical Practitioners.. International Journal of Health Sciences (2016).
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