Periodontitis ve Kardiyovasküler Hastalıklar Arasındaki İlişki
Özet
Bu bölüm, periodontitis ile kardiyovasküler hastalıklar arasındaki çok yönlü ilişkiyi güncel bilimsel veriler ışığında ele almaktadır. Periodontitis, yalnızca lokal bir ağız hastalığı olmayıp, sistemik inflamasyonu tetikleyerek ateroskleroz gelişimine katkıda bulunabilen kronik bir inflamatuar durumdur. Oral patojenlerin dolaşıma katılması, proinflamatuar sitokinlerin salınımı, oksidatif stres artışı ve immün yanıtların aktivasyonu gibi mekanizmalar, bu iki hastalık arasındaki biyolojik bağlantının temelini oluşturmaktadır. Ayrıca, periodontal tedavinin sistemik inflamatuar belirteçleri azalttığı ve endotel fonksiyonlarını iyileştirdiği gösterilmiştir. Bu bulgular, periodontal sağlığın korunmasının kardiyovasküler hastalıkların önlenmesi ve yönetiminde önemli bir rol oynayabileceğini ortaya koymaktadır. Bölümde ayrıca, kardiyovasküler hastalığı olan bireylerde periodontal tedavi planlaması ve klinik yaklaşımlar da ele alınmaktadır. Sonuç olarak, periodontal ve kardiyovasküler hastalıkların yönetiminde multidisipliner bir yaklaşımın gerekliliği vurgulanmaktadır.
This chapter explores the multifaceted relationship between periodontitis and cardiovascular diseases in light of current scientific evidence. Periodontitis is not merely a localized oral condition but a chronic inflammatory disease that may contribute to the development of atherosclerosis through systemic effects. Mechanisms such as the dissemination of oral pathogens into the bloodstream, release of proinflammatory cytokines, increased oxidative stress, and activation of immune responses form the biological basis of this association. Furthermore, periodontal treatment has been shown to reduce systemic inflammatory markers and improve endothelial function. These findings highlight the potential role of maintaining periodontal health in the prevention and management of cardiovascular diseases. The chapter also discusses clinical approaches and considerations for periodontal treatment in patients with cardiovascular conditions. Overall, a multidisciplinary approach is emphasized for the effective management of both periodontal and cardiovascular diseases.
Referanslar
Liccardo D, Cannavo A, Spagnuolo G, et al. Periodontal disease: a risk factor for diabetes and cardiovascular disease. International Journal of Molecular Sciences. 2019;20(6):1414.
doi:10.3390/ijms20061414
Sanz M, Del Castillo ÁM, Jepsen S, et al. Periodontitis and cardiovascular diseases: consensus report. Journal of Clinical Periodontology. 2020;47(3):268-288.
doi: 10.1111/jcpe.13189
Lai Y, Liu S, Song C, et al. An update on the role and mechanisms of periodontitis in cardiovascular diseases. Cellular Signalling. 2025:132 111770.
doi: 10.1016/j.cellsig.2025.111770
Angjelova A, Jovanova E, Polizzi A, et al. Impact of periodontitis on endothelial risk dysfunction and oxidative stress improvement in patients with cardiovascular disease. Journal of Clinical Medicine. 2024;13(13):3781.
doi: 10.3390/jcm13133781
Carra M, Rangé H, Caligiuri G, et al. Periodontitis and atherosclerotic cardiovascular disease: A critical appraisal. Periodontology 2000. 2023.
doi: 10.1111/prd.12528.
Priyamvara A, Dey A, Bandyopadhyay D, et al. Periodontal inflammation and the risk of cardiovascular disease. Current Atherosclerosis Reports. 2020;22(7):1-6.
doi: 10.1007/s11883-020-00848-6
Orlandi M, Graziani F, D’Aiuto F. Periodontal therapy and cardiovascular risk. Periodontology 2000. 2020;83(1):107-124.
doi: 10.1111/prd.12299
Wehmeyer MM, Corwin CL, Guthmiller JM, et al. The impact of oral health literacy on periodontal health status. Journal Of Public Health Dentistry. 2014;74(1):80-87.
doi: 10.1111/j.1752-7325.2012.00375.x
Grossi SG, Zambon JJ, Ho AW, et al. Assessment of risk for periodontal disease. i. risk indicators for attachment loss. Journal of Periodontology. 1994;65(3):260-7.
doi: 10.1902/jop.1994.65.3.260
Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017;3(1):1-14.
doi: 10.1038/nrdp.2017.38
Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontology 2000. 2013;62(1):59-94.
doi: 10.1111/j.1600-0757.2012.00457.x
Coventry J, Griffiths G, Scully C, et al. ABC of oral health: periodontal disease. BMJ. 2000;321(7252):36-39.
doi: 10.1136/bmj.321.7252.36.
Ruan Q, Guan P, Qi W, et al. Porphyromonas gingivalis regulates atherosclerosis through an immune pathway. Frontiers in Immunology. 2023;14:1103592.
doi: 10.3389/fimmu.2023.1103592
Kumar R, Dhanasekaran A, Venugopal P. A narrative review on bridging the gap between periodontitis and cardiovascular disease: exploring the cellular and molecular mechanisms of periodontitis-driven atherosclerosis. Molecular Biology Reports. 2025;52(1):690.
doi: 10.1007/s11033-025-10806-7
Schenkein H, Papapanou P, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontology 2000. 2020;83(1):90-106.
doi: 10.1111/prd.12304
Keşir SSS, Hendek MK, Olgun E. Periodontal hastalık ve kardiyovasküler hastalıklar. Selcuk Dental Journal. 2021;8(1):229-37. doi: 10.15311/selcukdentj.439697
Tran AH, Zaidi AH, Bolger AF, et al. Periodontal disease and atherosclerotic cardiovascular disease: a scientific statement from the american heart association. Circulation. 2025. doi: 10.1161/CIR.000000000000139
Wang Z, Bao J, Yang Y, Wei Y, et al. The Impact of periodontitis on cardiovascular disease: mechanisms, evidence, and therapeutic implications. International Journal of Dentistry. 2025:3694736
doi: 10.1155/ijod/3694736
Amato M, Lupi S, Polizzi A, et al. New trends in the impact of periodontal treatment on early cardiovascular diseases outcomes: insights and future perspectives. Reviews in Cardiovascular Medicine. 2023;24(10):287.doi: 10.31083/j.rcm2410287
Usmani W, De Courten M, Hanna F. Can oral health care be a gateway to improve cardiovascular disease? A scoping review. Frontiers in Oral Health. 2024;(5):1364765. doi: 10.3389/froh.2024.1364765
Lyu J, Zhang Y, Zhou R, et al. The effect of periodontal treatments on endothelial function in degrees of periodontitis patients: A systematic review and meta-analysis. Plos One. 2024;19(9): e308793. doi: 10.1371/journal.pone.0308793
Mask A. Medical management of the patient with cardiovascular disease. Periodontology 2000. 2000;(23):136-141. doi: 10.1034/j.1600-0757.2000.2230114.x
Alyami MAM, Shaker NA, Alshahrani TA, et al. Scoping review of dental management in patients with cardiovascular disease: roles of local anesthesia, echocardiographic assessment, emergency medical support, nursing care ,clinical pharmacology, and laboratory medicine. Journal of Posthumanism. 2024;4(2):180-186.
doi: 10.63332/joph.v4i2.2958
Gil Z., Miranda OA. Risks and complications of dental treatment for cardiac patients. Acta Scientific Dental Scienecs. 2023;7(10):73-94. doi:10.31080/ASDS.2023.07.1720
Referanslar
Liccardo D, Cannavo A, Spagnuolo G, et al. Periodontal disease: a risk factor for diabetes and cardiovascular disease. International Journal of Molecular Sciences. 2019;20(6):1414.
doi:10.3390/ijms20061414
Sanz M, Del Castillo ÁM, Jepsen S, et al. Periodontitis and cardiovascular diseases: consensus report. Journal of Clinical Periodontology. 2020;47(3):268-288.
doi: 10.1111/jcpe.13189
Lai Y, Liu S, Song C, et al. An update on the role and mechanisms of periodontitis in cardiovascular diseases. Cellular Signalling. 2025:132 111770.
doi: 10.1016/j.cellsig.2025.111770
Angjelova A, Jovanova E, Polizzi A, et al. Impact of periodontitis on endothelial risk dysfunction and oxidative stress improvement in patients with cardiovascular disease. Journal of Clinical Medicine. 2024;13(13):3781.
doi: 10.3390/jcm13133781
Carra M, Rangé H, Caligiuri G, et al. Periodontitis and atherosclerotic cardiovascular disease: A critical appraisal. Periodontology 2000. 2023.
doi: 10.1111/prd.12528.
Priyamvara A, Dey A, Bandyopadhyay D, et al. Periodontal inflammation and the risk of cardiovascular disease. Current Atherosclerosis Reports. 2020;22(7):1-6.
doi: 10.1007/s11883-020-00848-6
Orlandi M, Graziani F, D’Aiuto F. Periodontal therapy and cardiovascular risk. Periodontology 2000. 2020;83(1):107-124.
doi: 10.1111/prd.12299
Wehmeyer MM, Corwin CL, Guthmiller JM, et al. The impact of oral health literacy on periodontal health status. Journal Of Public Health Dentistry. 2014;74(1):80-87.
doi: 10.1111/j.1752-7325.2012.00375.x
Grossi SG, Zambon JJ, Ho AW, et al. Assessment of risk for periodontal disease. i. risk indicators for attachment loss. Journal of Periodontology. 1994;65(3):260-7.
doi: 10.1902/jop.1994.65.3.260
Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017;3(1):1-14.
doi: 10.1038/nrdp.2017.38
Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontology 2000. 2013;62(1):59-94.
doi: 10.1111/j.1600-0757.2012.00457.x
Coventry J, Griffiths G, Scully C, et al. ABC of oral health: periodontal disease. BMJ. 2000;321(7252):36-39.
doi: 10.1136/bmj.321.7252.36.
Ruan Q, Guan P, Qi W, et al. Porphyromonas gingivalis regulates atherosclerosis through an immune pathway. Frontiers in Immunology. 2023;14:1103592.
doi: 10.3389/fimmu.2023.1103592
Kumar R, Dhanasekaran A, Venugopal P. A narrative review on bridging the gap between periodontitis and cardiovascular disease: exploring the cellular and molecular mechanisms of periodontitis-driven atherosclerosis. Molecular Biology Reports. 2025;52(1):690.
doi: 10.1007/s11033-025-10806-7
Schenkein H, Papapanou P, Genco R, et al. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontology 2000. 2020;83(1):90-106.
doi: 10.1111/prd.12304
Keşir SSS, Hendek MK, Olgun E. Periodontal hastalık ve kardiyovasküler hastalıklar. Selcuk Dental Journal. 2021;8(1):229-37. doi: 10.15311/selcukdentj.439697
Tran AH, Zaidi AH, Bolger AF, et al. Periodontal disease and atherosclerotic cardiovascular disease: a scientific statement from the american heart association. Circulation. 2025. doi: 10.1161/CIR.000000000000139
Wang Z, Bao J, Yang Y, Wei Y, et al. The Impact of periodontitis on cardiovascular disease: mechanisms, evidence, and therapeutic implications. International Journal of Dentistry. 2025:3694736
doi: 10.1155/ijod/3694736
Amato M, Lupi S, Polizzi A, et al. New trends in the impact of periodontal treatment on early cardiovascular diseases outcomes: insights and future perspectives. Reviews in Cardiovascular Medicine. 2023;24(10):287.doi: 10.31083/j.rcm2410287
Usmani W, De Courten M, Hanna F. Can oral health care be a gateway to improve cardiovascular disease? A scoping review. Frontiers in Oral Health. 2024;(5):1364765. doi: 10.3389/froh.2024.1364765
Lyu J, Zhang Y, Zhou R, et al. The effect of periodontal treatments on endothelial function in degrees of periodontitis patients: A systematic review and meta-analysis. Plos One. 2024;19(9): e308793. doi: 10.1371/journal.pone.0308793
Mask A. Medical management of the patient with cardiovascular disease. Periodontology 2000. 2000;(23):136-141. doi: 10.1034/j.1600-0757.2000.2230114.x
Alyami MAM, Shaker NA, Alshahrani TA, et al. Scoping review of dental management in patients with cardiovascular disease: roles of local anesthesia, echocardiographic assessment, emergency medical support, nursing care ,clinical pharmacology, and laboratory medicine. Journal of Posthumanism. 2024;4(2):180-186.
doi: 10.63332/joph.v4i2.2958
Gil Z., Miranda OA. Risks and complications of dental treatment for cardiac patients. Acta Scientific Dental Scienecs. 2023;7(10):73-94. doi:10.31080/ASDS.2023.07.1720
