Impact of Periodontitis on Systemic Health: Concerns and Future Perspectives
by Gaetano Isola,
Assist Prof, DDS, PhD
by Vincenzo Iorio Siciliano,
Prof, DDS, PhD
Abstract
Periodontitis, a multifactorial microbiome-driven inflammatory disease of the tooth-attachment apparatus, is epidemiologically linked with several systemic conditions, including cardio-metabolic, cognitive neurodegenerative, respiratory and autoimmune diseases. These associations may, in part, be causal, as suggested by interventional studies showing that local treatment of periodontitis reduces systemic inflammation and surrogate markers of comorbid diseases. In this regard, the potential cause-and-effect connection between periodontitis and comorbidities, is corroborated in some preclinical and clinical models of disease, which additionally provided mechanistic insights into these associations but is still not fully understood.The role of inflammation has been widely demonstrated to be central to the early diagnosis and treatment of periodontitis, triggered by the body’s response to periodontal pathogens in the biofilm. When the inflammatory response to bacterial infection becomes chronic, it may cause damage to the supporting structures of the teeth, causing the well-known process of periodontal bone loss and eventually even tooth loss. In the last few decades, the relationship between periodontitis and associated inflammation has been shown to be linked to negatively impacting and worsening several systemic health diseases bilaterally.The objective of the present lecture is to discuss and update the recent advances in understanding the periodontitis-systemic disease connection, which may lead to innovative therapeutic options to reduce the risk of periodontitis-linked comorbidities and, in general, impact the overall efficacy of periodontal treatment.