Periodontitis as a Risk Factor for Cardiovascular Disease (CVD)
A. introduction periodontal disease and CVD
1. Statistics: Cardiovascular Diseases
a. Cardiovascular disease was 16.7 million, or 29.2% of the total mortality in the world according to World Health Report 2003. By 2010, CVD is the leading cause of death in developing countries .
B. According to estimates, 80,700,000 American adults (1 of 3) have one or more types of CVD. Of these, 38,200,000 estimated 60 and over .
c. Atherosclerosis, a major component of cardiovascular diseases, the process is characterized by the thickening of artery walls. Complications that arise from atherosclerosis cause of death from heart attack or stroke, and reportedly account for almost three quarters of all deaths from CVD .
2. Plaque Biofilm, as a large supply of bacteria
a. Subgingival plaque biofilm provides a large and constant source of periodontal pathogens to the owner.
B. Waite and Bradley  it is estimated that a patient who has 28 teeth with pocket at depths from 6 to 7 mm and bone loss has a large Total surface area of the infection and inflammation, which may be the size of the palm of an adult hand or more.
c. Bacteria and products of their processing from the oral cavity is injected into the bloodstream (bacteremia) when brushing, flossing, and subgingival irrigation. Periodontal infections in the bacteremias that can have systemic effects on the vascular system.
B. summary of research
1. The results of several studies indicate persistent connection between periodontal disease and cardiovascular disease (box 18-2).
2. The evidence for the beneficial effect of treatment of parodontium on CVD outcomes is limited. Several studies have shown that periodontal patients with a favorable clinical responses to non-surgical periodontal therapy exhibited improvements in serum C-reactive protein (CRP) concentration [7-9].
3. It is important to note, however, there is sufficient evidence to show that the treatment of periodontitis can reduce the risk of cardiovascular disease. The impact of periodontitis treatment on cardiovascular disease is an area of ongoing research.
C. Possible Biological Explanation. As Periodontits related to cardiovascular disease? Four biological ways have been proposed to explain the possible links between periodontits and cardiovascular diseases. These ways include biological
1. The path hypothesis 1: direct effect of periodontal pathogens on platelets
a. In the proposed biological way, periodontal pathogens to cause blood clots on platelets, and this can lead to blockage of a blood vessel, blood clot (Fig. 18-1).
B. Periodontitis patients are at increased risk thickening of the walls of the large coronary arteries . A number of studies of fatty deposits on the inner walls of the blood vessels received from people, more than half of periodontal lesions contained pathogens [11,12].
c. Porphyromonas gingivalis and Streptococcus sanguis Express virulence factors that encourage clot and blood clots [11,12]. Thus, one possible route between periodontal disease and CVD that periodontal pathogens to cause a clot and thrombus formation.