Contribution of periodontal disease in atherosclerosis

Abstract

Periodontitis is a disease that leads to destruction of the soft and hard tissues of periodontium, which can result in periodontal bone loss and tooth loss in severe cases. Atherosclerosis is a disease characterized by artery wall thickening as a result of invasion and accumulation of foam cells. Epidemiologic studies have suggested the association with periodontitis and atherosclerosis. Periodontopathogens are frequently found in atheroma plaque. The possible mechanisms for systemic dissemination of oral bacteria have been suggested: 1) direct translocation of bacteria from dental plaque to systemic circulation through transcellular mechanism or by physical perturbations of the gingiva, 2) indirect dissemination to distant sites via survival in immune cells including macrophages and dendritic cells. There are several mechanisms by which oral bacteria may contribute to atherosclerosis development: 1) activation of innate immune response, 2) mediators activated by oral bacteria and 3) involvement of cytokines and heat shock proteins from oral bacteria. Thus, better understanding the role of periodontitis in atherosclerosis may be the key to improve the prevention and treatment of atherosclerosis.