Perio-Systemic Connection Flashcards
Cardio Vascular Disease Proposed Mechanisms (2)
(1) Hyperinflammatory Macrophage Phenotype, Common Susceptibility Model – Genetic factors or Diet/Environmental factors (excess glucose) cause **ANGRY MACROPHAGES*phenotype that releases more inflammatory cytokines –> HYPERINFLAMMATORY STATE
(2) Direct INVASION/Injury by Periodontal Pathogens
- Bacteria enter the periodontium, circulate in the blood (bacteremia), stick in places such as the coronary arteries
- Internalized bacteria are safe from neutrophils in the epithelium or smooth muscle
- P. gingivalis was found in atherosclerotic plaques
Hyperinflammatory Macrophage Phenotype, Common Susceptibility Model –
– Genetic factors or Diet/Environmental factors (excess glucose) cause “angry” macrophage phenotype that releases more inflammatory cytokines
Direct Invasion/Injury by Periodontal Pathogens
- Bacteria enter the periodontium, circulate in the blood (bacteremia), stick in places such as the coronary arteries
- Internalized bacteria are safe from neutrophils in the epithelium or smooth muscle
- P. gingivalis was found in atherosclerotic plaques
Systemic Consequences of Periodontal Infection (2)
- Cardio Vascular Disease
2. Increased Inflammation throughout the body that disrupts normal function
What percentage of people have a perio issue
1/2
Risk Factors of Perio Disease (9)
Smoking Diabetes Poor OH Genetics Lack of Dental Care Obesity Alcohol Stress Medications
Hypothesis of Perio disease having a connection to systemic health issues- The causes include what (6 things are a result of poor perio health)
- Periodontitis
- Pro-inflammatory cytokines (from gram negative anaerobic bacteria causing inflammation)
- Bacteremia
- Cytokine spillover causes activation of the liver
- Acute phase reactants (CRP/IL-6)
- Activation and Bacterial Invasion of Endothelium - Atheroma (plaque formation)
Acute phase reactants include what (2)
CRP and IL-6
Which bacteria was found in atherosclerotic plaques?
P. Gingivalis-also the other red complex bacteria a.a and T. Forsynthia
Once the bacteria get into the blood stream, bacteria will try to end up where?
Places with endothelial receptors and often end up in places like the coronary arteries
Once bacteria is in the blood it can evade what?
Neutrophils
% of population with severe periodontitis?
Moderate?
5-10% severe
~30%
Focal infection theory
the place containing the epidemiological factors needed for infection (place, vector, targets, characteristics for spreading)
Sepsis caused by spread of microbes from distant, chronically infected sites (including the oral cavity) has been proven to be responsible for inflammatory diseases such as arthritis, peptic ulcers, and appendicitis
Sepsis caused by spread of microbes from distant, chronically infected sites (including the oral cavity) has been proven to be responsible for things like what? What theory is this based on?
inflammatory diseases such as arthritis, peptic ulcers, and appendicitis
This is based on focal infection theory
Bradford Hill Criteria for Causation Says what/tries to do what in general
How Do We Go from Association to Causation – prove that an exposure caused a morbid event (criteria can be fulfilled for an association to show that is was causal for an event)
Bradford hill (BH) strength of association
stronger association the more likely the casual connection
BH Consistency
relationship observed repeatedly such that designs are done across different populations
BH specificity
A factor influences a specific outcome or population