ENDOTHELIAL ACTIVATION: THE BASIS FOR THE INITIAL ASSOCIATION BETWEEN CHRONIC PERIODONTITIS AND CARDIOVASCULAR DISEASE
A significant association between chronic periodontitis and cardiovascular disease has been described in various meta-analysis studies. Various potential molecular mechanisms linking chronic periodontitis and subclinical atherosclerosis has been studied, and although no direct causal relationship has been proven, a possible associated increased risk of cardiovascular disease in periodontally affected patients has been described. Bacteraemias, endotoxemias, systemic inflammatory mediators, reactive oxygen species and acute phase reactants generated by chronic periodontitis has been shown to be statistically associated with endothelial activation. Interactions between these various pathognomonic elements of chronic periodontitis and vascular endothelial cells may cause a shift from normal endothelial function to that of activation, including a proinflammatory and prothrombotic state of the endothelium. An updated summary and illustration of these potential interactions is given whereby an overall and improved understanding by both the dental and medical practitioner of these mechanisms will positively influence the comprehensive clinical care of especially periodontally diseased patients who may also be experiencing an increased risk of cardiovascular disease.
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