By Rucardo Gapski, DDS, MS, and Charles M. Cobb, DDS, PhD
Abstract
This literature review discusses the findings of more recent studies investigating the relationship between chronic inflammatory periodontal disease and risk for cardiovascular disease and stroke. The intensity of inflammation in moderate and severe chronic periodontitis is clearly sufficient to induce a systemic response. The systemic response is commonly expressed by elevated serum levels of inflammatory mediators and acute-phase reactants like C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), serum amyloid A, fibrinogen, and haptoglobin. The presence of chronic oral inflammation may enhance atherosclerotic pathogenesis through one or more mechanisms, such as stimulation of humoral and cell-mediated inflammatory pathways, bacteremia leading to direct interaction of periodontal pathogenic microbes with the arterial wall, and increases in circulating mediators of inflammation.
