UCLA School of Dentistry, Department of Periodontics, Faculty, Veterans Administration Greater Los Angeles Healthcare System, Los Angeles, CA 90017-4002, USA.
J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):20-8. doi: 10.1016/S1532-3382(12)70006-4.
Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. Currently, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm low birth weight babies, respiratory diseases, and rheumatoid arthritis.
Evidence was taken from systematic reviews, clinical trials, and mechanistic studies retrieved in searches of the PubMed electronic database. The available data provide the basis for applied practical clinical recommendations.
Evidence is summarized and critically reviewed from systematic reviews, primary clinical trials, and mechanistic studies
Surrogate markers for chronic periodontitis, such as tooth loss, show relatively consistent but weak associations with multiple systemic conditions. Despite biological plausibility, shorter-term interventional trials have generally not supported unambiguous cause-and-effect relationships. Nevertheless, the effective treatment of periodontal infections is important to achieve oral health goals, as well as to reduce the systemic risks of chronic local inflammation and bacteremias. Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. With pregnancy as a possible exception, the local and systemic effects of periodontal infections and inflammation are usually exerted for many years, typically among those who are middle-aged or older. It follows that numerous epidemiological associations linking chronic periodontitis to age-associated and biologically complex conditions such as diabetes, cardiovascular disease, osteoporosis, respiratory diseases, rheumatoid arthritis, certain cancers, erectile dysfunction, kidney disease and dementia, have been reported. In the coming years, it seems likely that additional associations will be reported, despite adjustments for known genetic, behavioral and environmental confounders. Determining cause-and-effect mechanisms is more complicated, especially in circumstances where systemic effects may be subtle. Currently, however, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm/low birth weight babies, respiratory diseases, and rheumatoid arthritis.
炎症性牙周病与多种全身疾病有关。目前，专家们对这些关联的性质缺乏共识，医疗保健提供者和公众对如何解释这一快速发展的科学领域也感到困惑。本文综述了牙周病与糖尿病、心血管疾病、骨质疏松症、早产/低出生体重婴儿、呼吸道疾病和类风湿性关节炎的关联的现有证据。
证据来自于在 PubMed 电子数据库中检索到的系统评价、临床试验和机制研究。现有数据为应用临床推荐提供了依据。
对系统评价、主要临床试验和机制研究进行总结和批判性评价。
慢性牙周炎的替代标志物，如牙齿缺失，与多种全身状况存在相对一致但较弱的关联。尽管具有生物学合理性，但短期干预试验通常不支持明确的因果关系。尽管如此，有效治疗牙周感染对于实现口腔健康目标以及减少慢性局部炎症和菌血症的全身风险仍然很重要。炎症性牙周病与多种全身疾病有关。除了妊娠可能是一个例外，牙周感染和炎症的局部和全身影响通常会持续多年，通常是在中年或老年人群中。因此，已经报道了许多将慢性牙周炎与糖尿病、心血管疾病、骨质疏松症、呼吸道疾病、类风湿性关节炎、某些癌症、勃起功能障碍、肾脏疾病和痴呆等与年龄相关和生物学复杂的疾病联系起来的流行病学关联。在未来几年，尽管对已知的遗传、行为和环境混杂因素进行了调整，但似乎还会有更多的关联被报道。确定因果关系机制更加复杂，尤其是在系统性影响可能较为微妙的情况下。目前，专家们对这些关联的性质缺乏共识，医疗保健提供者和公众对如何解释这一快速发展的科学领域也感到困惑。本文综述了牙周病与糖尿病、心血管疾病、骨质疏松症、早产/低出生体重婴儿、呼吸道疾病和类风湿性关节炎的关联的现有证据。
