1 Department of Periodontology, University of North Carolina School of Dentistry, Chapel Hill, NC, USA.
2 Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York City, NY, USA.
J Dent Res. 2019 Sep;98(10):1053-1062. doi: 10.1177/0022034519846113.
is a term used to describe how periodontal infection/inflammation may impact extraoral health. Periodontitis has been linked to over 50 systemic diseases and conditions. As part of the 's Centennial Celebration, this narrative review discusses periodontal medicine research done over the past 100 y, with particular focus on the effects of periodontal disease on 3 pathological conditions: cardiovascular disease, diabetes mellitus, and adverse pregnancy outcomes. We selected 29 total studies that were the "first" of their kind, as they provided novel observations or contributed to shifting paradigms as well as important studies that made strong contributions to progress in understanding relationships to the systemic conditions. These studies were organized in an overview timeline and broken down into timelines by topic: cardiovascular disease ( = 10), diabetes ( = 12), and adverse pregnancy outcomes ( = 7). Overall, the majority of cross-sectional, case-control, and longitudinal studies have revealed positive associations between poor periodontal status and cardiovascular disease, diabetes metabolic control, and a number of adverse pregnancy outcomes, and these associations are upheld in systematic reviews. Findings from randomized controlled trials testing the effects of periodontal therapy on systemic health outcomes were conflicting and inconsistent. While there has been a great deal of progress, we highlight lessons learned and make comments and suggestions on a number of key aspects, including the heterogeneity of case definitions of periodontal disease across studies, accounting for features of the periodontal phenotype that are most relevant to the biological link between periodontitis and systemic outcomes, the role of other comorbid inflammatory conditions, selection of study participants, and timing and intensity of the periodontal intervention.
牙周炎是一种用于描述牙周感染/炎症如何影响口腔外健康的术语。牙周炎与 50 多种全身性疾病和病症有关。作为百年庆典的一部分，这篇叙述性评论讨论了过去 100 年来牙周医学研究，特别关注牙周病对 3 种病理状况的影响：心血管疾病、糖尿病和不良妊娠结局。我们选择了总共 29 项研究，这些研究都是“首创”的，因为它们提供了新的观察结果或有助于改变范式，以及对理解与系统性疾病关系的进展做出重要贡献的重要研究。这些研究按概述时间线和主题时间线进行组织：心血管疾病（=10）、糖尿病（=12）和不良妊娠结局（=7）。总体而言，大多数横断面、病例对照和纵向研究都揭示了牙周状况不良与心血管疾病、糖尿病代谢控制以及许多不良妊娠结局之间存在正相关关系，这些关联在系统评价中得到了支持。测试牙周治疗对系统健康结果影响的随机对照试验的结果存在矛盾和不一致。尽管已经取得了很大进展，但我们强调了经验教训，并对许多关键方面发表了评论和建议，包括牙周病病例定义在研究中的异质性、考虑与牙周炎和系统性结果之间生物学联系最相关的牙周表型特征、其他合并炎症性疾病的作用、研究参与者的选择以及牙周干预的时间和强度。
