Cardiovascular disease and periodontitis: an update on the associations and risk.
BACKGROUND
Associations between periodontitis and cardiovascular diseases have been recognized.


METHODS
New literature since the last European Workshop on Periodontology has been reviewed.


RESULTS
The lack of reliable epidemiological data on disease prevalence makes an assessment of the associations and risks between periodontitis and cardiovascular diseases difficult. Two recent meta-analysis reports have identified associations between periodontitis and cardiovascular diseases (odds ratios: 1.1-2.2). Different surrogate markers for both disease entities, including serum biomarkers, have been investigated. Brachial artery flow-mediated dilatation, and carotid intima media thickness have in some studies been linked to periodontitis. Studies are needed to confirm early results of improvements of such surrogate markers following periodontal therapy. While intensive periodontal therapy may enhance inflammatory responses and impair vascular functions, studies are needed to assess the outcome of periodontal therapies in subjects with confirmed cardiovascular conditions. Tooth eradication may also reduce the systemic inflammatory burden of individuals with severe periodontitis. The role of confounders remain unclear.


CONCLUSIONS
Periodontitis may contribute to cardiovascular disease and stroke in susceptible subjects. Properly powered longitudinal case-control and intervention trials are needed to identify how periodontitis and periodontal interventions may have an impact on cardiovascular diseases.
Persson
Gösta Rutger
GR
Department of Periodontology, University of Bern, Bern, Switzerland. rutger.persson@zmk.unibe.ch
Persson
Rigmor Elisabeth
RE
D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D002339:Carotid Arteries / Q000473:pathology; D004198:Disease Susceptibility; D005060:Europe / Q000453:epidemiology; D006801:Humans; D010518:Periodontitis / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors; D017540:Tunica Media / Q000473:pathology; D014664:Vasodilation / Q000502:physiology
D015415:Biomarkers