Periodontal disease: A systemic condition.

IF 17.5 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
German E M Villoria, Ricardo G Fischer, Eduardo M B Tinoco, Joerg Meyle, Bruno G Loos
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Abstract

For decades, periodontitis has been considered to be a local inflammatory disease of the periodontal tissues in the oral cavity. Initially, associations of periodontitis with a multitude of noncommunicable diseases were each studied separately, and relationships were shown. The associations of periodontitis with morbidities, such as cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, respiratory diseases, have been demonstrated. As most such studies were cross-sectional in nature, questions about causality cannot be univocally answered. And periodontitis as an independent risk factor for one systemic disease, becomes even more difficult to assess since recently periodontitis has also been associated with multimorbidity. Periodontitis and many systemic diseases share environmental, lifestyle and genetic risk factors, and share immunopathology. Moreover, suffering from one common noncommunicable disease may increase the susceptibility for another such chronic disease; the systemic effects of one condition may be one of various risk factors for another such disease. The overarching effect of any systemic disease is it causing a pro-inflammatory state in the individual; this has also been shown for periodontitis. Moreover, in periodontitis a prothrombotic state and elevated immunological activity have been shown. As such, when we consider periodontal disease as another systemic disease, it can affect the susceptibility and progression of other systemic diseases, and importantly, vice versa. And with this, it is not surprising that periodontitis is associated with a variety of other noncommunicable diseases. The medical definition of a systemic disease includes diseases that affect different organs and systems. Thus, the aim of this opinion paper is to propose that periodontitis should be considered a systemic disease in its own right and that it affects the individual's systemic condition and wellbeing. The dental and medical profession and researchers alike, should adapt this paradigm shift, advancing periodontal disease out of its isolated anatomical location into the total of chronic noncommunicable diseases, being for some conditions a comorbid disease and, vice versa, comorbidities can affect initiation and progression of periodontal disease.

牙周病:一种全身性疾病。
几十年来,牙周炎一直被认为是口腔牙周组织的局部炎症性疾病。起初,人们分别研究了牙周炎与多种非传染性疾病的关系,并显示了两者之间的关系。牙周炎与心血管疾病、类风湿性关节炎、糖尿病、呼吸系统疾病等疾病的关系已经得到证实。由于这些研究大多是横断面研究,因此无法明确回答因果关系问题。而牙周炎作为一种全身性疾病的独立危险因素,就更加难以评估了,因为近来牙周炎也与多疾病相关。牙周炎和许多系统性疾病都有共同的环境、生活方式和遗传风险因素,并且有共同的免疫病理学。此外,罹患一种常见的非传染性疾病可能会增加对另一种慢性疾病的易感性;一种疾病的系统性影响可能是另一种疾病的各种风险因素之一。任何全身性疾病的主要影响都是导致个人处于促炎症状态;牙周炎也是如此。此外,牙周炎还会导致血栓形成和免疫活性升高。因此,当我们将牙周病视为另一种全身性疾病时,它可能会影响其他全身性疾病的易感性和进展,重要的是,反之亦然。因此,牙周炎与其他各种非传染性疾病相关也就不足为奇了。根据医学定义,全身性疾病包括影响不同器官和系统的疾病。因此,本文旨在提出牙周炎本身应被视为一种系统性疾病,它影响着个人的系统状况和健康。牙科和医学界以及研究人员都应适应这种范式的转变,将牙周病从孤立的解剖学位置推进到慢性非传染性疾病的范畴,在某些情况下,牙周病是一种合并症,反之亦然,合并症也会影响牙周病的发生和发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Periodontology 2000
Periodontology 2000 医学-牙科与口腔外科
CiteScore
34.10
自引率
2.20%
发文量
62
审稿时长
>12 weeks
期刊介绍: Periodontology 2000 is a series of monographs designed for periodontists and general practitioners interested in periodontics. The editorial board selects significant topics and distinguished scientists and clinicians for each monograph. Serving as a valuable supplement to existing periodontal journals, three monographs are published annually, contributing specialized insights to the field.
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