The role of salivary cytokines in the etiology and progression of periodontal disease

Periodontal disease is a common oral disease in all segments of the population, regardless of their systemic health status. The disease is generalized or localized and the severity of lesions can vary at different sites. It is possible to recognize a number of different types of periodontal disease on the basis of clinical and pathological criteria, which include the extent of periodontal destruction, the age of onset and severity of disease, the distribution of lesions, the microflora involved, and the variation in host responses. The ultimate outcome of periodontal disease in adults, whether treated or untreated, depends on patient susceptibility. While periodontopathic bacteria are recognized as the etiologic agents in periodontal disease, their interaction with and modulation of the host immune response is of fundamental importance. An interplay of protection and pathology active in periodontal disease is that of T-lymphocyte cells and the subsequent production of cytokines within the periodontal tissues.     

Periodontal disease as a possible cause for Alzheimer's disease

Approximately 47 million people worldwide have been diagnosed with dementia, 60%-80% of whom have dementia of the Alzheimer’s disease type. Unfortunately, there is no cure in sight. Defining modifiable risk factors for Alzheimer’s disease may have a significant impact on its prevalence. An increasing body of evidence suggests that chronic inflammation and microbial dysbiosis are risk factors for Alzheimer’s disease. Periodontal disease is a chronic inflammatory disease that develops in response to response to microbial dysbiosis. Many studies have shown an association between periodontal disease and Alzheimer’s disease. The intent of this paper was to review the existing literature and determine, using the Bradford Hill criteria, whether periodontal disease is causally related to Alzheimer’s disease.     

牙龈卟啉单胞菌与冠心病之间的关系

牙龈卟啉单胞菌既是牙周病主要的可疑致病菌，亦是冠心病潜在的危险因素，因此牙周病是否为引起冠心病的危险因素之一引起了诸多研究者的兴趣。本文就牙龈卟啉单胞菌，牙龈卟啉单胞菌可能引起冠心病的致病过程和机制等研究进展作一综述。     

Screening for periodontal disease

Abstract The prime objective of screening is to detect disease at an earlier stage than would normally occur with people presenting with the disease, on the assumption that earlier treatment would alter the natural history of the disease in a significant proportion. However, before a screening survey is done a number of conditions should be fulfilled. The disease should be an important health problem; there should be effective and acceptable treatments available for those with the disease; the natural history of the disease should be adequately understood and there should be an agreed policy on whom to treat. Periodontal disease does not fulfil many of the requirements for a disease suitable for population screening. There is no reliable evidence that earlier detection alters the natural history of the disease or the survival and function of the teeth. Neither is there sufficient information on the importance of clinical signs of periodontal disease. We do not know whether screening tests are able to detect periodontal diesease which is likely to have an important impact on periodontal health. For example, is bleeding an important sign of destructive periodontal disease? Does gingivitis evidenced as redness progress to alveolar bone destruction? The lack of answers to these questions casts serious doubts on the accuracy of estimates of periodontal treatment needs which include all persons with a positive gingivitis score as needing treatment. A number of other gaps in our knowledge relating to periodontal disease are outlined. Because of these, it was concluded that screening for periodontal disease is not justified at present. Instead, research should be directed at answering questions about the natural history of periodontal diseases, the effectiveness of prevention and treatment, the significance of clinical signs of periodontal disease and the validity, sensitivity and specificity of the signs.     

牙周病与慢性肾病关系研究进展

慢性肾病是各种原因引起的肾脏结构或功能异常 ≥ 3个月,伴或不伴有肾小球滤过率下降,或不明原因的肾小球滤过率下降（< 60 mL/min/1.73 m2）超过3个月。牙周病是发生在牙齿支持组织的慢性炎症性疾病。许多研究发现,慢性肾病患者牙周病的发病率显著高于普通人群,牙周病亦可增加慢性肾病的发病率与严重程度,且与后者的不良预后密切相关。但目前关于牙周病诱发或加重慢性肾病的机制尚不明确,可能与牙周致病菌、炎症因子及氧化应激等途径有关。文章就近年关于牙周病与慢性肾脏病的关系、可能的关联机制以及牙周治疗对慢性肾病预后影响等方面的研究文献进行综述,以期为临床开展二者的联合防治提供借鉴。     

Oral Crohn's disease with late intestinal manifestations.

Oral Crohn's disease has been reported frequently in the last two decades with and without intestinal manifestations. In the latter case it is considered one of the orofacial granulomatoses. This reference is claimed to eliminate the patient's distress caused by the term Crohn's disease. There has been much doubt whether intestinal Crohn's disease will eventually develop in these patients. A case is reported in a 10-year-old West Indian girl in whom oral Crohn's disease developed at the age of 10 years and was followed by rectal Crohn's disease 9 years later. In this article the term Crohn's disease is used to describe those patients with intestinal manifestations with or without oral disease whereas oral Crohn's disease is used for those who have only oral manifestations.     

Gorham disease in the maxilla

Gorham disease is a rare condition that is characterized by the proliferation of thin-walled vascular channels associated with regional osteolysis. The exact etiology of Gorham disease is unknown. The diagnosis of Gorham disease is based on clinical, radiological, and histological features after excluding osteolysis, which is secondary to other pathologic processes. Those pathologic processes include congenital, metabolic, neoplastic, and immunologic etiologies and infections. The appearance of the disease in the craniofacial region often involves the mandible. In the reported literature (English language only), there is 1 reported case of the disease located in the maxilla alone. In this study, we present another case of Gorham disease that presents in the maxilla of a 37-year-old man.     

Relationship between periodontitis and cardiovascular diseases: A literature review

Periodontitis and cardiovascular disease have a complex etiology and genetics and share some common risk factors (i.e., smoking, age, diabetes, etc.). In recent years, the relationship between periodontal disease and cardiovascular disease has been investigated extensively. This research mostly focused on the fact that periodontitis is an independent risk factor for cardiovascular disease. Our aim in this article is to investigate the etiological relationship between periodontal disease and cardiovascular disease and the mechanisms involved in this association. According to the current literature, it is concluded that there is a strong relationship between these chronic disorders.     

牙周炎与阿尔兹海默症相关性研究进展

阿尔兹海默症是一种最常见的老年痴呆症,与环境因素密切相关。牙周炎是发生在牙周支持组织的一种慢性感染性疾病。研究表明,牙周炎与阿尔兹海默症的发生发展密切相关,但作用机制尚未完全明确,炎症反应及血管结构的改变可能是两种疾病的中介,共同的危险因素促进两种疾病的发生发展。文章就近年来牙周炎与阿尔兹海默症相关性的研究进展做一综述。     

Destructive membranous periodontal disease (ligneous periodontitis): a case report and 3 years follow-up

Destructive membranous periodontal disease is a rare, destructive and poorly defined entity, which is the part of a systemic disease due to plasminogen deficiency and fibrin deposition. The disease is characterised by gingival enlargement and periodontal tissue destruction that leads to rapid tooth loss despite treatment attempts. Biopsy is essential to rule out other periodontal disease in the differential diagnosis.     

下颌骨溶骨症1例报告及文献复习

溶骨症又称Gorham综合征，临床罕见，其病因及发病机制尚不清楚，以自发性进行性骨溶解吸收为主要临床表现。溶骨症可发生于任何年龄，特别好发于5-25岁，无明显性别差异，可发生于单一骨骼，也可跨过关节，侵犯多个骨骼。目前认为，早期彻底切除可有效阻止病变进展。作者报告1例，并结合相关文献，对该病的临床特点，好发部位，诊断与鉴别诊断及治疗方法进行讨论。     

浅谈牙周病与呼吸道疾病之间的相关性

牙周病是由牙菌斑引起的慢性感染性疾病。研究发现, 牙周病与多种全身系统性疾病相关,如糖尿病、不良妊娠结局、心脑血管疾病、消化道和呼吸道疾病等。近年来, 牙周病与呼吸道疾病之间的关系备受关注。现根据以往的研究报道以及近几年的研究前沿就牙周病与呼吸道疾病的相关性做一介绍。     

Periodontal disease and anemias associated with Crohn's disease. A case report

Crohn's disease (CD) is an inflammatory bowel disease with oral findings, including periodontal manifestations. Anemias, such as iron deficiency and anemia of chronic disease (ACD), are the most common hematologic complications of CD. Periodontitis has systemic effects, and may tend toward anemia, which can be explained by depressed erythropoiesis. In the report presented here, the authors review a case of Crohn's disease diagnosed 10 years previous to the patient presenting with a changing anemic profile and periodontal disease. A discussion of patient and disease management is included.     

慢性牙周炎与慢性肾病相关性研究进展

慢性牙周炎是发生在牙周支持组织的一种慢性炎症性破坏性疾病,牙周炎不仅影响口腔健康,也与全身健康密切相关。慢性肾病被认为是一种严重危害生命健康的非传染性慢性疾病。近年来有研究发现慢性牙周炎与慢性肾病之间有密切联系。本文就慢性牙周炎与慢性肾病相关性研究进展作一综述。     

Epidemiology of periodontal disease: a review and clinical perspectives

The purpose of this paper is to assimilate epidemiological evidence for the prevalence of periodontal disease in human populations, and for comprehensive understanding of the disease for health care providers. Periodontal disease is a pathological condition affecting the supporting structures of teeth. It is characterised by a bacterial challenge that can instigate a destructive host response leading to periodontal attachment loss, bone loss and ultimately, possible tooth loss. The specifics of the disease process are obscured by our incomplete understanding of the role of various risk factors. Periodontal epidemiology literature lacks consistency in methodology of research, which includes various definitions for periodontal disease and health; different approaches to measuring periodontal indices of pocket depth, and attachment loss; inconsistent study designs and lack of adjustments to known risk factors. These inconsistencies do not allow for effective comparison of epidemiological studies, which is essential to find strong associations of risk factors with periodontal disease, which in turn is necessary for the interpretation of risk and causality. This paper will address several areas within the topic of periodontal disease epidemiology, including definitions of periodontal disease instituted by researchers, approaches to epidemiological studies in periodontitis, and risk factors in periodontal disease. Consideration is given to aspects of design and analyses relevant to evaluation of reports in the literature. For the clinical practitioner this review provides a theoretical framework to approach patients with comprehensive knowledge of not only the disease presentation, but also the environmental factors that govern past history, present condition and future response to treatments and interventions.     

Can we successfully maintain risk patients?

The most fundamental premise in the current view of periodontal disease is that not all individuals are at equal risk for disease and disease progression. Studies reveal that about 5-20% of the population is at risk for severe disease progression. The purpose of this paper is to define at-risk patients, review risk factors and indicators of disease progression, and outline an evidence-based strategy that includes both self-care and professional care for maintaining periodontal health. Risk factors/risk indicators considered include history of previous disease, increased pocket depth and loss of clinical attachment, frequency of dental care, specific bacterial pathogens, and systemic/environmental host factors such as smoking, diabetes mellitus, genetics, and stress. Because host factors may have more influence on disease progression than periodontal pathogens, personal and professional maintenance care must include the role of the host in periodontal disease progression. By examining the evidence surrounding these complex issues, dentists and dental hygienists are able to determine the extent to which evidence supports available approaches to maintain periodontal health and control disease progression.     

Management of early stage cutaneous Merkel cell carcinoma of the head and neck

Merkel cell carcinoma (MCC) is a rare but aggressive skin cancer of neuroendocrine origin. As a result, few large studies have been published, and we know of even fewer on disease of the head and neck alone. The most appropriate way to manage patients with early local disease and no sign of metastases neck is controversial. We reviewed management of early cutaneous MCC of the head and neck in 8 hospitals in the United Kingdom over 12 years between 1999 and 2011 (the largest head and neck series in Europe to date), and identified 39 patients (19 men and 20 women) with early disease according to a well recognised classification. A total of 24 patients had stage Ia disease, 11 had stage Ib disease, and 4 were unclassified. Five of those with stage Ia disease developed regional metastases and 7 with stage Ib disease developed regional recurrence. The 2-year overall survival for stage Ia and Ib disease was 62% and 27%, respectively. Our study shows that prognosis is poor after conservative surgical management of stage I disease. Management of the neck is still controversial, and a meta-analysis of all the published data is needed to establish best practice statistically.     

慢性牙周炎与慢性肾脏病

大量研究证据表明,慢性牙周炎与全身系统性疾病存在密切的相关性,其主要通过牙菌斑中的内毒素、炎性介质、细胞因子等随血运到全身诱导各系统疾病。在慢性肾脏病的病因研究方面,也同样有炎性介质、细胞因子等致病因素,慢性肾脏病与慢性牙周炎之间可能存在联系。现就慢性牙周炎与慢性肾脏病之间的相互关系做一概述。     

慢性牙周炎和慢性肾病相关关系的 研究进展

慢性牙周炎不仅可以导致牙周支持组织的破坏和丧失,还与多种全身系统性疾病如高血压、糖尿病等有关.慢性肾病是一种破坏肾功能的威胁人类健康的常见的全身性疾病.近年来大量研究显示,慢性牙周炎与慢性肾病可能具有相关关系,通过治疗牙周炎有可能改善肾功能.本文就慢性牙周炎与慢性肾病相关性的流行病学调查研究、牙周治疗对慢性肾病的影响以...     

Periodontal disease in sickle cell disease subjects

Various systemic diseases and conditions have been associated with an increase in periodontal disease severity. These studies indicate that host-response mechanisms influence the initiation and/or progression of inflammatory periodontal diseases. Diseases that have been associated with an increased severity of periodontal disease include various neutrophil abnormalities, Down's syndrome, diabetes, and recently, the acquired immunodeficiency syndrome. Sickle cell disease is strongly associated with a predisposition to various infections; therefore, the objective of this study was to determine whether sickle cell disease is also associated with an increase in the severity of periodontal disease. A total of 78 patients with sickle cell anemia (SS), hemoglobin SC disease (SC) or S Thalassemia were evaluated blind and compared with an appropriate control population using clinical and radiographic indices of periodontal disease severity. The results clearly indicate that, in this population of patients, sickle cell disease is not associated with increased levels of gingivitis or periodontitis.