Chronic Periodontitis as a Risk Marker for Systemic Diseases with Reference to Cardiometabolic Disorders: Common Pathways in their Progression

Abstract

Periodontitis, an inflammatory condition of the supporting structures of teeth resulting from dental plaque biofilm attached to tooth surfaces is potentially an important nidus of systemic inflammation and its sequelae. Relevant risk markers common to periodontitis co-existing with coronary heart disease and diabetes mellitus play an important role in their pathogeneses and abate in response to treatment. An over-exuberant host-response to periodontal pathogen- mediated inflammation, triggers a cycle of events which is not dissimilar to an autoimmune response in a cohort of susceptible individuals. Some variation in documented findings regarding correlations with co-morbidities and periodontitis could be explained by the lack of uniformity in studies with regard to stipulation of periodontal inflammatory status in the context of risk factors examined. There are several genetic and environmental factors which influence the progression of inflammatory periodontitis in response to plaque biofilm, also relevant to associated cardiometabolic disorders in the same subject. Some common mechanisms in the pathogeneses of periodontitis and cardiometabolic disorders based on regulation of inflammation are addressed in this review. There is some evidence of an improved systemic inflammatory profile in response to periodontal treatment which emphasizes the importance of periodontal management for systemic health in relevant cases.