Periodontol 2000. 2013 Jun;62(1):271-86. doi: 10.1111/prd.12007.
The concept of focal infection or systemic disease arising from infection of the teeth was generally accepted until the mid-20th century when it was dismissed because of lack of evidence. Subsequently, a largely silo approach was taken by the dental and medical professions. Over the past 20 years, however, a plethora of epidemiological, mechanistic and treatment studies have highlighted that this silo approach to oral and systemic diseases can no longer be sustained. While a number of systemic diseases have been linked to oral diseases, the weight of evidence from numerous studies conducted over this period, together with several systematic reviews and meta-analyses, supports an association between periodontitis and cardiovascular disease, and between periodontitis and diabetes. The association has also been supported by a number of biologically plausible mechanisms, including direct infection, systemic inflammation and molecular mimicry. Treatment studies have shown that periodontal treatment may have a small, but significant, systemic effect both on endothelial function and on glycemic control. Despite this, however, there is no direct evidence that periodontal treatment affects either cardiovascular or diabetic events. Nevertheless, over the past 20 years we have learnt that the mouth is an integral part of the body and that the medical and dental professions need to work more closely together in the provision of overall health care for all patients.
直到 20 世纪中叶，由于缺乏证据，牙齿感染引发局部感染或全身疾病的概念才被普遍接受。随后，牙科和医学专业采取了一种基本上孤立的方法。然而，在过去的 20 年中，大量的流行病学、机制和治疗研究强调，这种口腔和全身疾病的孤立方法已经不再可行。虽然许多全身性疾病与口腔疾病有关，但在此期间进行的大量研究、几项系统评价和荟萃分析的证据表明，牙周炎与心血管疾病之间以及牙周炎与糖尿病之间存在关联。许多生物学上合理的机制也支持这种关联，包括直接感染、全身炎症和分子模拟。治疗研究表明，牙周治疗可能对内皮功能和血糖控制都有较小但有意义的全身作用。然而，尽管如此，并没有直接证据表明牙周治疗会影响心血管或糖尿病事件。尽管如此，在过去的 20 年中，我们已经了解到口腔是身体的一个组成部分，医疗和牙科专业需要更紧密地合作，为所有患者提供整体医疗保健。
