Associations between Periodontitis and Systemic Inflammatory Diseases: Response to Treatment

ISSN: 2212-3334 (Online)
ISSN: 1872-2148 (Print)

Volume 11, 2 Issues, 2017

Download PDF Flyer

Recent Patents on Endocrine Metabolic & Immune Drug Discovery

This journal supports open access

Aims & ScopeAbstracted/Indexed in

Submit Abstracts Online Submit Manuscripts Online

View Full Editorial Board

Subscribe Purchase Articles Order Reprints

Associations between Periodontitis and Systemic Inflammatory Diseases: Response to Treatment

Recent Patents on Endocrine Metabolic & Immune Drug Discovery, 7(3): 169-188.

Author(s): Una El-Shinnawi and Mena Soory.

Affiliation: Periodontology, King’ s College London Dental Institute, Denmark Hill, London SE5 9RW, UK.


There is a significant prevalence of subjects with periodontitis presenting with other inflammatory conditions such as coronary heart disease, insulin resistance and arthritis. This pattern of disease presentation underscores the importance of inflammatory loading from chronic diseases, in driving their pathogeneses in a multidirectional manner. Pro-inflammatory cytokines and other agents play an important role in this process; for example, a single nucleotide polymorphism of the TNFα- gene is associated with significant periodontal attachment loss in patients with coronary heart disease. Changes in gene expression associated with inflammation and lipid metabolism in response to oral infection with the periodontal pathogen Porphyromonas gingivalis (Pg) have been demonstrated in mouse models, independent of the demonstration of atherosclerotic lesions. Insulin resistance is considered to be a chronic low-grade inflammatory condition, associated with altered glucose tolerance, hypertriglyceridemia, central obesity and coronary heart disease. It is accompanied by elevated levels of IL-1, IL-6 and TNFα- also relevant to the progression of periodontitis. There is evidence that uncontrolled periodontal disease contributes to maintenance of systemic diseases, including rheumatoid arthritis (RA), with increased risk of periodontitis in subjects with RA. The periodontal pathogen Pg is significant in contributing to citrullination of proteins resulting in immune dysregulation and autoimmune responses, seen in RA. However, they are both multifactorial chronic diseases with complex etiopathogeneses that affect their presentation. Consistent but weak associations are seen for surrogate markers of periodontitis such as tooth loss, with multiple systemic conditions. Effective treatment of periodontitis would be important in reducing systemic inflammatory loading from chronic local inflammation and in achieving systemic health. Lack of a consistent cause and effect relationship in all subjects would be influenced by genetic, epigenetic and other subject variables, although there are clear mechanisms that link the associations. This article includes an appraisal of patents and their applications.


Arthritis, coronary heart disease, diabetes mellitus, inflammatory agents, inflammatory loading, periodontitis.

Purchase Online Order Reprints Order Eprints Rights and Permissions

Article Details

Volume: 7
Issue Number: 3
First Page: 169
Last Page: 188
Page Count: 20
DOI: 10.2174/18715303113139990040
Price: $100

Related Journals

Webmaster Contact: Copyright © 2016 Bentham Science