The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
The Pathobiology of Periodontal Diseases May Affect Systemic Diseases: Inversion of a Paradigm
Abstract
A new paradigm for the pathobiology of periodontitis is presented, and the manner in which periodontitis may relate to susceptibility for certain systemic diseases such as cardiovascular disease and preterm labor is described. Periodontitis is caused by a small group of Gram‐negative bacteria present on the tooth root surfaces as biofilms. Lipopolysaccharide (LPS) and other substances gain access to the gingival tissues, initiate and perpetuate immunoinflammation, resulting in production of high levels of proinflammatory cytokines. These induce production of matrix metalloproteinases which destroy the connective tissues of the gingiva and periodontal ligament, and prostaglandins which mediate alveolar bone destruction. Periodontitis may enhance susceptibility to systemic diseases in several ways. LPS and viable Gram‐negative bacteria from the biofilms and proinflammatory cytokines from the inflamed periodontal tissues may enter the circulation in pathogenic quantities. In addition, periodontitis and certain systemic diseases, such as cardiovascular disease, share risk factors including tobacco smoking, male gender, race/ethnicity, stress, and aging. Ann Periodontol 1998;3:108–120.
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“Periodontal disease shares many associative and causative links with systemic disease, and it increases susceptibility to systemic diseases via shared risk factors, such as by harboring pathogenic gram‐negative anaerobes in subgingival biofilms, and by fashioning the periodontium as a reservoir for pro‐inflammatory mediators.199”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [199]
In the citing paper
“Periodontal disease predisposes humans to cardiovascular pathologies, such as atherosclerosis and myocardial infarction, as a result of inducing increased levels of systemic pro‐inflammatory cytokines, inflammatory cells and infiltrates, and white blood cell counts.199”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [199]
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“Periopathogenic bacteria such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans are anaerobic, gram‐negative bacteria that colonize sub gingival biofilms in periodontitis patients [78].”
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Metadata
- Authors
- Page, R. C.
- Affiliations
- University of Washington (US)
- Corresponding author
- Page, Roy C.
- Venue
- Annals of Periodontology
- Publisher
- Wiley
- Published
- 1998-07
- Volume
- 3
- Issue
- 1
- Pages
- 108-120
- ISSN
- 1553-0841 (ISSN-L)
- 2162-5131
- OpenAlex
- W1967814211
- Cited by
- 420
- References
- 45
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 16 · 2023: 8 · 2022: 17 · 2021: 20 · 2020: 14 · 2019: 16 · 2018: 12 · 2017: 18 · 2016: 12 · 2015: 18 · 2014: 18 · 2013: 26 · 2012: 34
- FWCI
- 19.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Periodontology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p01de008555-10)
- National Institute of Dental and Craniofacial Research (T32 DE 07063, P30 DE09743, P01DE08555, T32DE007063, P30DE009743)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Periodontics › Periodontal Regeneration and Treatments
- Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
- Keywords
- periodontitis, cardiovascular disease, preterm labor, Gram-negative bacteria, biofilm, lipopolysaccharide, immune inflammation, inflammatory cytokines, matrix metalloproteinases, prostaglandins, alveolar bone loss, periodontal ligament, risk factors, smoking
- MeSH terms
- Animals, Cardiovascular Diseases, Disease Susceptibility, Focal Infection, Dental, Gram-Negative Anaerobic Bacteria, Health Status, Humans, Periodontitis, Risk Factors, Cytokines, Biofilms, Inflammation Mediators
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