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Impact of periodontal disease on atherothrombosis


Sang Thrombose Vaisseaux. Volume 24, Number 2, 63-8, Février 2012, Mini-revue

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Author(s) : Olivier Meilhac

Summary : Epidemiological, clinical and pathophysiological evidence shows an association between periodontal and cardiovascular pathologies. Whereas an increased level of general inflammation (cytokines allowing leukocyte recruitment and activation) could represent one explanation for this association, more and more studies show that periodontal bacteria could directly enhance the development of atherothrombotic plaques. In humans, DNA from these bacteria has been found in carotid, coronary and aortic samples. Moreover, antibodies against the two principal periodontal pathogens ( P. gingivalis and A. actinomycetemcomitans) were reported to be predictive of cardiovascular events including stroke and myocardial infarction. In animal models, injection of these bacteria promotes atheroma progression and chronic recruitment of neutrophils in models of abdominal aortic aneurysms, allowing maintenance of a biologically active mural thrombus that could be responsible for aortic wall weakening. The natural affinity of periodontal pathogens and in particular P. gingivalis for thrombus components could lead to binding to pre-existing plaques and then trigger clinical complications associated with an uncontrolled proteolytic host response. Some interventional studies have shown that periodontal treatment positively impacted endothelial function and intima-medial thickness with a tendancy to reduce the incidence of cardiovascular events. This requires confirmation before modification of current clinical practice by treating periodontal disease in patients at high risk of cardiovascular disease..

Keywords : atherothrombosis, periodontic bacteria, periodontal disease

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