title: The implication of periodontitis in vascular endothelial dysfunction.
abstract: BACKGROUND
  Periodontitis is the most common oral infection seen in humans worldwide. It is characterized by gradual destruction of tooth supporting tissues, eventually leading to loss of tooth. The periodontal biofilm associated with periodontitis comprises of gram-positive and gram-negative bacteria, instrumental for the initiation and progression of periodontitis. Evidence-based literature has identified the nature of periodontal infection as a possible causative condition in the inducement of 'low-grade systemic inflammation and infection'. The periodontal pathogens exert systemic effects via the haematogenous route.
  
  
  OBJECTIVE
  The present review provides an insight into the pathophysiology of the endothelial dysfunction with reference to periodontal infection and highlights the association between periodontitis and endothelial dysfunction. Various studies addressing the implication of periodontitis on endothelial dysfunction will be described, with a focus of periodontal treatment on improvement of endothelial function.
  
  
  METHODS
  Studies examining the effects of periodontitis on vascular endothelial function were segregated. Studies conducted on both animal and human models were identified using MEDLINE database search with key search terms such as 'Periodontitis', 'vascular endothelium', 'endothelial dysfunction', 'periodontal bacteria' and 'periodontal therapy'. Systematic reviews and meta-analysis were also screened. Only studies published in English language were considered. The review has been prepared by screening MEDLINE database from 1989 to 2012.
  
  
  CONCLUSIONS
  Chronic periodontitis results in altered vascular response, increased expression of pro-inflammatory cytokines and adhesion molecules inducing vascular endothelial dysfunction. Periodontal therapy may ameliorate the perturbed vascular endothelial function.
authors.affiliation: Department of Periodontics, Tatyasaheb Kore Dental College & Research Centre, Kolhapur, India.
authors.forename: Abhijit N
authors.initials: AN
authors.lastname: Gurav
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D018441:Biofilms; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D003729:Dental Care / Q000379:methods; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D010518:Periodontitis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers
keywords: Endothelial dysfunction; periodontal bacteria; periodontal therapy; periodontitis; vascular endothelium