Amato Mariacristina, Lupi Saturnino Marco, Polizzi Alessandro, Santonocito Simona, Viglianisi Gaia, Cicciù Marco, Isola Gaetano
Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy.
Department of Clinico-Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy.
Rev Cardiovasc Med. 2023 Oct 8;24(10):287. doi: 10.31083/j.rcm2410287. eCollection 2023 Oct.
Cardiovascular diseases represent the primary worldwide cause of mortality, and periodontitis is the main cause of tooth loss. The incidence of atherosclerotic disease has been reported to be higher in individuals affected by periodontitis than in individuals without, regardless of many common risk factors are present. Various pathogenetic models have been presented to clarify the close correlation between these two diseases. First, periodontal bacteria and their toxins can enter the circulation both during dental procedures and normal activities such as eating and teeth brushing. Periodontal bacteria may indirectly contribute to coronary artery disease (e.g., by causing immunological reactions) or directly by damaging coronary arteries. Periodontal treatment significantly reduces periodontal pathogens such as () or () in deep periodontal pockets. Moreover, periodontal treatment may lower blood inflammatory mediators, enhance the lipid profile, and cause favourable changes in various surrogate markers for cardiovascular disease. The way in which oral bacteremia and periodontal inflammation cause atherosclerosis is still unclear and needs further studies. The real effectiveness of periodontal treatment in preventing cardiovascular events is a topic of current interest. In this regard, this review article explores new insights and provides an indication of future directions on the function of periodontal inflammation and oral bacteria in the incidence and progression of atherosclerosis and cardiovascular diseases, with the main focus on assessing the impact of periodontal treatment on cardiovascular disease outcome biomarkers.
心血管疾病是全球主要的死亡原因，而牙周炎是牙齿缺失的主要原因。据报道，无论是否存在许多常见风险因素，患有牙周炎的个体患动脉粥样硬化疾病的发生率都高于未患牙周炎的个体。已经提出了各种发病机制模型来阐明这两种疾病之间的密切关系。首先，牙周细菌及其毒素在牙科手术以及进食和刷牙等正常活动期间都可进入循环系统。牙周细菌可能间接导致冠状动脉疾病（例如，通过引起免疫反应），或直接损害冠状动脉。牙周治疗可显著减少深牙周袋中的牙周病原体，如（）或（）。此外，牙周治疗可能会降低血液中的炎症介质，改善血脂状况，并引起心血管疾病各种替代标志物的有利变化。口腔菌血症和牙周炎症导致动脉粥样硬化的方式仍不清楚，需要进一步研究。牙周治疗在预防心血管事件方面的实际效果是当前关注的一个话题。在这方面，这篇综述文章探讨了新的见解，并指出了牙周炎症和口腔细菌在动脉粥样硬化和心血管疾病的发生与发展中的作用的未来方向，主要侧重于评估牙周治疗对心血管疾病结局生物标志物的影响。
