El Chaar Edgard
Department of Periodontics, University of Pennsylvania, Denta Medicine, Philadelphia, Pennsylvania, USA.
J Diabetes. 2025 Aug;17(8):e70136. doi: 10.1111/1753-0407.70136.
Periodontal disease is a prevalent and chronic inflammatory condition increasingly recognized for its systemic implications beyond oral health. While traditionally confined to dentistry, recent evidence reveals strong associations between periodontitis and chronic systemic conditions such as cardiovascular disease, diabetes mellitus, rheumatoid arthritis, inflammatory bowel disease, Alzheimer's disease, and various cancers. Mechanistic studies have identified plausible biological pathways, including systemic dissemination of periodontal pathogens and immune mediators, which can exacerbate distant organ inflammation and dysfunction. Experimental models highlight how oral bacteria influence immune responses, disrupt gut and vascular homeostasis, and contribute to oncogenesis and autoimmunity. Notably, bidirectional relationships, such as those between periodontitis and diabetes, underscore the need for integrated care approaches. Effective periodontal therapy has demonstrated systemic benefits, including improved glycemic control and reduced inflammation. Given the mounting evidence, periodontal disease should be approached as a critical component of systemic health, necessitating interdisciplinary collaboration among healthcare providers to optimize patient outcomes and public health.
牙周病是一种普遍存在的慢性炎症性疾病，其对全身健康的影响日益受到重视，已超出了口腔健康范畴。虽然传统上牙周病仅局限于牙科领域，但最近的证据表明，牙周炎与心血管疾病、糖尿病、类风湿性关节炎、炎症性肠病、阿尔茨海默病以及各种癌症等慢性全身性疾病之间存在密切关联。机制研究已经确定了一些合理的生物学途径，包括牙周病原体和免疫介质的全身扩散，这可能会加剧远处器官的炎症和功能障碍。实验模型突出了口腔细菌如何影响免疫反应、破坏肠道和血管稳态，并促进肿瘤发生和自身免疫。值得注意的是，牙周炎与糖尿病之间的双向关系等，强调了综合治疗方法的必要性。有效的牙周治疗已显示出对全身的益处，包括改善血糖控制和减轻炎症。鉴于证据越来越多，牙周病应被视为全身健康的关键组成部分，医疗保健提供者之间需要跨学科合作，以优化患者治疗效果和公共卫生。
