Department of Periodontology, Dental School, University of Sevilla, Sevilla, Spain.
Periodontol 2000. 2019 Feb;79(1):117-128. doi: 10.1111/prd.12249.
The effects and consequences of periodontal diseases might not be confined to the oral cavity. A great body of evidence has arisen supporting the claim demonstrating an association with several systemic conditions and diseases. With different levels of evidence, an association between periodontal disease and cardiovascular disease, diabetes, psoriasis, rheumatoid arthritis, pregnancy outcomes and respiratory diseases has been established. However, the true nature of this association, if it is causal, still remains elusive. For a better understanding of the complex relationships linking different conditions, interventional studies now begin to focus on the possible outcomes of periodontal treatment in relation to the events, symptoms and biomarkers of several systemic disorders, assessing if periodontal treatment has any impact on them, hopefully reducing their severity or prevalence. Therefore, we proceeded to review the recent literature on the subject, attempting to present a brief explanation of the systemic condition or disease, what proposed mechanisms might give biological plausibility to its association with periodontal disease, and finally and more importantly, what data are currently available pertaining to the effects periodontal treatment may have. Raising awareness and discussing the possible benefits of periodontal treatment on overall systemic health is important, in order to change the perception that periodontal diseases are only limited to the oral cavity, and ultimately providing better and comprehensive care to patients.
牙周病的影响和后果可能不仅局限于口腔。大量证据支持这样一种说法,即牙周病与几种系统性疾病和病症之间存在关联。有不同证据级别的研究表明,牙周病与心血管疾病、糖尿病、银屑病、类风湿性关节炎、妊娠结局和呼吸道疾病之间存在关联。然而,如果这种关联确实存在因果关系,其真正性质仍然难以捉摸。为了更好地理解将不同病症联系起来的复杂关系,干预性研究现在开始关注牙周治疗与几种系统性疾病的事件、症状和生物标志物相关的可能结果,评估牙周治疗是否对它们有任何影响,希望能降低其严重程度或患病率。因此,我们查阅了该主题的最新文献,试图对系统性疾病或病症进行简要解释,提出可能使其与牙周病相关的生物学机制,并最终更重要的是,目前有哪些关于牙周治疗效果的数据。提高对牙周治疗对整体系统性健康可能有益的认识并进行讨论很重要,以便改变人们认为牙周病仅局限于口腔的观念,最终为患者提供更好、更全面的治疗。