慢性牙周炎与阿尔茨海默病相关性研究进展

慢性牙周炎是由菌斑微生物引起的牙周支持组织破坏的慢性感染性疾病,是造成我国成人失牙的最主要原因。随着牙周医学的兴起,牙周炎和全身性疾病的相互关系成为研究热点。阿尔茨海默病是一种常见的引起老年人群痴呆的神经退行性病变。慢性牙周炎和阿尔茨海默病都是以多种炎症介质参与的炎症反应为关键病理机制,该文就二者的特点及相互关联机制作一综述。     

神经-骨偶联机制促进骨关节退行性病发展的研究进展

骨组织会随着年龄的增长不断地发生改建,骨改建失衡会导致骨关节退行性疾病发生,包括骨关节病及骨质疏松等.针对骨退行性疾病的发病机制,以往的研究重点关注相关细胞的功能改变,却很少关注骨微环境中外周神经的作用.近年来研究显示,骨和神经间的信号交流在骨退行性疾病发生发展中发挥着重要作用,例如外周神经可通过分泌多种神经递质作用于...     

牙周炎与慢性肾脏病相关性研究现状

牙周炎与慢性肾脏病均为慢性炎症性疾病,患者伴有全身的炎症负担及机体的免疫异常。血糖、血压、血脂等异常以及炎症的刺激对疾病有显著影响。该文主要对牙周炎与慢性肾脏病相关性的流行病学研究情况,共同的影响因素,以及可能相关的生物学机制等进行综述。旨在实现早期预防,控制危险因素,降低二者互相影响的可能性,同时指导治疗,进而达到良好的预后。     

维生素D与慢性牙周炎及慢性阻塞性肺疾病的相关性研究进展

目的 慢性阻塞性肺疾病是一类严重影响人类健康的重大疾病,目前死亡率列居第4位.慢性牙周炎作为口腔的常见病和多发病,其发病率也在逐年增高.大量研究表明,慢性牙周炎不仅是一种局部的炎症反应,它与慢性阻塞性肺疾病有着密切的关系.最近研究发现维生素D在细胞增殖和分化、免疫功能的调节、抗炎抗肿瘤等方面的新作用,它在慢性牙周炎及慢性阻塞性肺疾病的发生、发展中的作用越来越引起重视.本文将对维生素D与慢性牙周炎和慢性阻塞性肺疾病的相关性研究进行综述.     

微小RNA与牙周炎

近十年,一类非编码蛋白的小RNA分子——微小RNA (miRNAs)证实参与免疫细胞发育以及多种疾病如肿瘤、炎症等生理和病理过程.而牙周炎作为危害人类口腔健康的常见慢性炎症,其发病机制的研究尚有不确切之处,也未能找到十分有效的治疗方法.近年,学者开始对牙周炎及miRNAs两者间的关系开展研究,以探索miRNAs参与牙周炎的发病机制.本文根据miRNAs与牙周炎研究的最新进展,就其在牙周组织及牙槽骨组织中异常表达及可能机制两方面作一综述.     

牙周炎通过菌群作用促进类风湿关节炎的研究进展

牙周炎是由菌斑微生物引发的多因素参与的炎症性疾病。类风湿关节炎是以慢性炎症和关节组织破坏为主要表现的全身免疫性疾病。牙周炎和类风湿关节炎在病理过程和破坏机制上具有相似性,包括骨破坏、软组织炎症及受相似环境因素等影响。近年来,肠道菌群在系统性疾病中的作用日益受到关注,牙周病原菌可能通过吞咽进入肠道影响肠道微生态,肠道菌群失调会进一步促进关节炎的发生发展。本文主要就牙周炎与类风湿关节炎之间可能通过肠道菌群发生的相互作用及相关机制进行综述,以期为牙周炎和类风湿关节炎潜在的相关机制研究提供新思路。     

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...     

白细胞介素-6-铁调素信号轴调控牙周炎相关性贫血致病机制的研究进展

牙周炎是由细菌感染引起的慢性感染性疾病,大量致病微生物及其毒性产物激活宿主防御系统,引起一系列免疫炎症反应,进而影响全身健康状况。牙周炎是很多系统性疾病的危险因素。炎症性贫血又称慢性病贫血,是临床上第二大常见贫血,其发生源于急性或慢性炎症状态,如感染、炎症或肿瘤等基础疾病。这些疾病可激活宿主防御系统,导致全身铁代谢紊乱,造成铁限制性血红蛋白生成障碍。牙周炎与炎症性贫血存在密切相关性,牙周炎引起的全身免疫炎症反应可能会增加罹患炎症性贫血的风险,白细胞介素-6-铁调素信号轴可能在牙周炎相关炎症性贫血的致病机制中起到关键的调控作用。本文就近年来牙周炎与炎症性贫血的相关性和机制等研究进行综述,以期为牙周炎相关炎症性贫血的预防、诊断和治疗提供依据。     

牙周炎与炎症性肠病的相关性研究进展

牙周炎（periodontitis，PD）和炎症性肠病（inflammatory bowel disease，IBD）都是由宿主免疫炎症反应与菌群之间复杂的相互作用所介导的慢性炎症性疾病。两者具有相似的致病途径，其中一种疾病可能由于其导致的菌群失调及系统性炎症反应而诱发另一种疾病的产生或加重其严重程度。文章就PD与IBD的相关性研究进展做一综述，旨在探究两者相互影响的可能机制，并为未来PD与IBD双向关联研究指出方向。     

慢性牙周炎与前列腺疾病相关性的研究进展

近年来,慢性牙周炎与前列腺疾病的相关性研究受到广泛关注,衰老、肥胖、吸烟和精神心理等是这两种疾病的共同危险因素,但关键的相关性机制目前尚未明确。该文就慢性牙周炎与前列腺疾病的相关研究及可能的生物学机制作一综述,为今后的疾病管理和临床研究提供依据。     

Oral inflammation and infection,and chronic medical diseases: implications for the elderly

Oral diseases, such as caries and periodontitis, not only have local effects on the dentition and on tooth‐supporting tissues but also may impact a number of systemic conditions. Emerging evidence suggests that poor oral health influences the initiation and/or progression of diseases such as atherosclerosis (with sequelae including myocardial infarction and stoke), diabetes mellitus and neurodegenerative diseases (such as Alzheimer's disease, rheumatoid arthritis and others). Aspiration of oropharyngeal (including periodontal) bacteria causes pneumonia, especially in hospitalized patients and the elderly, and may influence the course of chronic obstructive pulmonary disease. This article addresses several pertinent aspects related to the medical implications of periodontal disease in the elderly. There is moderate evidence that improved oral hygiene may help prevent aspiration pneumonia in high‐risk patients. For other medical conditions, because of the absence of well‐designed randomized clinical trials in elderly patients, no specific guidance can be provided regarding oral hygiene or periodontal interventions that enhance the medical management of older adults.     

口腔微生物种群与阿尔茨海默病相关发病机制的研究进展

口腔微生物种群如细菌、真菌等能引起龋病和牙周病等一系列口腔疾病,其代谢产物能进入血液,引起系统性炎症。阿尔茨海默病(AD)是一种中枢神经系统变性疾病,是痴呆症最常见的形式。据世界卫生组织统计,AD占痴呆症病例的60%~70%,并且其发病率仍在逐年攀升,给全球社会经济造成沉重负担。AD的临床病理特征为β-淀粉样蛋白沉积(Aβ)形成细胞外老年斑、tau蛋白过度磷酸化引起神经原纤维缠结,以及神经元丢失伴胶质细胞增生等。但目前为止,AD的病因及发病机制尚未阐明。近期研究发现,引起慢性牙周炎的微生物种群是Aβ沉积和AD发病的重大风险因素。因此,本文围绕口腔微生物种群与AD潜在的发病机制进行综述。     

Periodontal disease in HIV-infected adults in the HAART era: Clinical,immunological, and microbiological aspects

The introduction of highly active antiretroviral therapy (HAART) has decreased the incidence and prevalence of several oral manifestations such as oral candidiasis, hairy leukoplakia, and Kaposi's sarcoma in HIV-infected patients. Regarding periodontal disease the findings are not clear. This disease represents a group of chronic oral diseases characterized by infection and inflammation of the periodontal tissues. These tissues surround the teeth and provide periodontal protection (the gingival tissue) and periodontal support (periodontal ligament, root cementum, alveolar bone). Clinical, immunological, and microbiological aspects of these diseases, such as linear gingival erythema (LGE), necrotizing periodontal diseases (NPD) (necrotizing ulcerative gingivitis [NUG], necrotizing ulcerative periodontitis [NUP] and necrotizing stomatitis), and chronic periodontitis, have been widely studied in HIV-infected individuals, but without providing conclusive results. The purpose of this review was to contribute to a better overall understanding of the probable impact of HIV-infection on the characteristics of periodontal infections.     

Clinical and public health implications of periodontal and systemic diseases: An overview

Severe periodontitis is defined by extensive loss of the tooth attachment apparatus. It is the sixth most common human disease and is estimated to affect 11.2% of the global adult population, hence representing a significant healthcare, social, and economic burden. Since the 1990s, multiple epidemiologic, experimental, and interventional studies have evidenced how periodontitis may also impact systemic health and it has been independently associated with the majority of chronic noncommunicable diseases. The evidence supporting these associations, mainly focusing on diabetes, pregnancy complications, and cardiovascular disease, was thoroughly reviewed in 2012 by an international consensus workshop. In the last 5 years, however, important advances have been made, not only in our understanding of the etiopathogenesis of periodontitis, or concerning the mounting evidence regarding the independent associations between periodontitis, diabetes, and cardiovascular disease, but also with many other systemic diseases including metabolic disease and obesity, rheumatoid arthritis, certain cancers, respiratory diseases, and cognitive disorders including Alzheimer's disease. This review describes these scientific advances by gathering together the existing evidence on the importance and relevance of the associations between periodontitis and many systemic diseases.     

Obesity,diabetes mellitus,atherosclerosis and chronic periodontitis: a shared pathology via oxidative stress and mitochondrial dysfunction?

As many diseases have been shown to have several or indirect causes (i.e. are multifactorial) the question is what is the relative importance of each factor in a given disease? Also, what happens when some diseases, although apparently disparate, share causative factors and/or tissue pathologies? Host inflammation response mechanisms are largely shared by the body’s different tissues and systems and only recently has special attention been paid to the possible linkages among chronic periodontitis and other chronic systemic diseases. The aim of this review was to consider and discuss the mounting evidence that the basis for the inter‐relationships between chronic periodontitis and atheromatous disease and diabetes lie at a fundamental intracellular level, namely oxidative stress and mitochondrial dysfunction, as a meeting background among such chronic diseases and periodontitis.     

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。     

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??Alzheimer's disease is the most common form of dementia associated with environmental factors. Periodontitis is a chronic infectious disease that occurs in periodontal supporting tissues. Studies have found a close association between periodontitis and Alzheimer′s disease??but the potential mechanism linking periodontitis with Alzheimer′s disease is not fully clear. It might be that the inflammatory response and vascular changes are the two mediators of the disease??and the common risk factors promote the development of both diseases. The recent findings of the association between periodontitis and Alzheimer′s disease were discussed in this paper.     

Chronic oral infection: An emerging risk factor of cerebral small vessel disease

Chronic oral infections (gingivitis/periodontitis) have been associated with age‐related diseases such as diabetes, coronary heart disease, and acute ischemic stroke. In addition, imaging surrogates of cerebrovascular ischemia beyond acute ischemic stroke (i.e., silent strokes and brain white matter hyperintensities) may also be associated with chronic oral infections. The pathology underlying lacunar strokes and brain white matter hyperintensities (WMH) relates to small vessel disease in the brain. In this review, we highlight recent progress in exploring potential associations of oral infections with cerebral small vessel disease and its surrogates (silent strokes, white matter hyperintensities) and clinical sequelae (i.e., vascular dementia). Recent evidence suggests that periodontitis aggravates cerebral small vessel disease and increases lacunar stroke risk. Moreover, periodontitis interacts with Alzheimer's disease to increase the severity of clinical dementia and to accelerate its manifestations. The results suggest that periodontitis may be an emerging risk factor of small vessel disease‐associated cerebrovascular disorders and that the risk increase may be mediated by the systemic inflammation resulting from chronic oral infections. Large cohort studies employing state‐of‐the‐art magnetic resonance techniques to identify specific cerebral pathologies as a function of time, oral health status, and systemic inflammation are needed to further substantiate the hypothesis.     

The “sufficient cause” model framework applied to the periodontitis-systemic diseases link

The premise for the oral-systemic diseases relationship dates to the early 20th century with the introduction of the focal infection theory that posited that oral disease affects overall health and wellbeing. While the biological plausibility for the link has been supported by experimental animal models and observational studies in humans, findings from interventional studies in which periodontal therapy failed to alleviate systemic health outcomes have often been interpreted as evidence against periodontitis contribution to the etiology of systemic health conditions. One concept of causation assumes a one-to-one correspondence between cause and effect. Nevertheless, common chronic diseases to which periodontitis is associated have multifactorial etiologies. This commentary provides an overview of Rothman's “sufficient cause” model as a framework for consideration of the oral-systemic diseases link.     

Association between Chronic Apical Periodontitis and Coronary Artery Disease

Introduction

Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease.

Methods

This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís–Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software.

Results

The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease.

Conclusions

In these study patients, chronic apical periodontitis was independently associated with coronary artery disease.