牙周炎与全身因素的关系

Denis F. Kinane Dr.
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引用次数: 137

摘要

微生物牙菌斑是牙周病的发起者,但它是否影响特定的受试者,疾病的形式,以及如何发展,都取决于宿主对这种挑战的防御。全身因素主要通过对正常免疫和炎症防御的影响来改变所有形式的牙周炎。这种影响存在一些很好的例子,例如当多形核白细胞(pmn)的数量或功能减少时,可能导致牙周破坏的速度和严重程度增加。许多其他的系统性因素不太明确,很难与牙周炎产生因果关系。在许多情况下,文献不足以对系统性因素与牙周炎之间的联系作出明确的陈述。有时也很难准确地确定全身暴露的致病因子,例如吸烟,甚至是处方药物治疗。全身性疾病和全身性暴露在引发或改变牙周病进展中的可能作用显然是一个复杂的问题。然而,人们普遍认为,有几种情况可能导致牙龈炎和牙周炎的患病率、发病率或严重程度增加。本文就引起牙周炎的系统调节因子的分类及支持这些因子作用的证据作一综述。已尝试在广泛的标题下考虑这些条件,但很明显,许多条件属于不止一个类别,并且对于一些条件只有病例报告,而在其他领域则有广泛的文献。牙周病杂志1999;4:54-63。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Periodontitis Modified by Systemic Factors

Microbial dental plaque is the initiator of periodontal disease but whether it affects a particular subject, what form the disease takes, and how it progresses, are all dependent on the host defenses to this challenge. Systemic factors modify all forms periodontitis principally through their effects on the normal immune and inflammatory defenses. Some good examples of this effect exist such as when there is a reduction in number or function of polymorphonuclear leukocytes (PMNs) that may result in an increased rate and severity of periodontal destruction. Many other systemic factors are much less clear cut and are difficult to causally link to periodontitis. In many cases the literature is insufficient to make definite statements on links between systemic factors and periodontitis. It is also at times dif- ficult to be precise regarding the causative agent in systemic exposures such as smoking and even prescribed drug therapy. The possible role of systemic diseases and systemic exposures in initiating or modifying the progress of periodontal disease is clearly a complex issue. It is however generally agreed that several conditions may give rise to an increased prevalence, incidence, or severity of gingivitis and periodontitis. The categorization of the systemic modifying factors causing periodontitis and the evidence to support the role of these factors are the focus of this review. An attempt has been made to consider the conditions under broad headings, but it will be clear that many conditions fall within more than one category and that for several conditions only case reports exist whereas in other areas an extensive literature is present. Ann Periodontol 1999;4:54-63.

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