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]
Citations
Cites
Microbial complexes in subgingival plaque
Socransky, S. S., Haffajee, A. D., Cugini, M. A., Smith, C., & Kent, R. L. (1998) · Journal of Clinical Periodontology · doi:10.1111/j.1600-051x.1998.tb02419.x · Cited by 5,050
Microbial etiological agents of destructive periodontal diseases
Haffajee, A. D., & Socransky, S. S. (1994) · Periodontology 2000 · doi:10.1111/j.1600-0757.1994.tb00020.x · Cited by 1,623
Periodontal infection as a possible risk factor for preterm low birth weight
Offenbacher, S., Katz, V., Fertik, G., Collins, J., Boyd, D., Maynor, G., McKaig, R., & Beck, J. (1996) · Journal of Periodontology · doi:10.1902/jop.1996.67.10s.1103 · Cited by 1,455
Periodontal Disease and Cardiovascular Disease
Beck, J. D., García, R. I., HEISS, G. M., Vokonas, P., & Offenbacher, S. (1996) · Journal of Periodontology · doi:10.1902/jop.1996.67.10s.1123 · Cited by 1,453
The interleukin‐1 genotype as a severity factor in adult periodontal disease
Kornman, K. S., Crane, A., Wang, H., Giovlne, F. S. D., Newman, M. G., Pirk, F. W., Wilson, T. G., Higginbottom, F. L., & Duff, G. W. (1997) · Journal Of Clinical Periodontology · doi:10.1111/j.1600-051x.1997.tb01187.x · Cited by 1,180
Variation in the TNF-α promoter region associated with susceptibility to cerebral malaria
McGuire, W. L., Hill, A. V. S., Allsopp, C. E. M., Greenwood, B. M., & Kwiatkowski, D. P. (1994) · Nature · doi:10.1038/371508a0 · Cited by 1,166
Assessment of Risk for Periodontal Disease. I. Risk Indicators for Attachment Loss
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The pathogenesis of human periodontitis: an introduction.
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Self-citationPeriodontal Diseases: Pathogenesis
Offenbacher, S. (1996) · Annals of Periodontology · doi:10.1902/annals.1996.1.1.821 · Cited by 1,031
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Items 401–419 of 419
Gingivitis in Mice and the Role of AngiogenesisPreprint
Saghiri, M. A., Moghadam, M. M., Fakharzadeh, A., Morgano, S. M., Asatourian, A., & Sheibani, N. (2019) · Research Square · doi:10.21203/rs.2.14246/v1
Periodontal ve Sistemik Hastalıklar: Erektil Disfonksiyon
Hatipoğlu, H., & Kabay, Ş. (2022) · Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi · doi:10.17517/ksutfd.928767
Oral Health Condition and Cardiovascular Disease in Greece: Results of a Questionnaire Research
Chrysanthakopoulos, N. A. (2022) · Journal of Dentistry and Oral Epidemiology · doi:10.54289/jdoe2200105
ASSOCIAÇÃO ENTRE DOENÇA PERIODONTAL E DOENÇAS CARDIOVASCULARES: REVISÃO DE LITERATURA.
Franco, M. M., Fernandes, L. L., Lopes, T. D. O., & Mouchrek, M. M. M. (2022) · Instituto Scientia eBooks · doi:10.55232/10830011.32
Dı́az-Romero, R. M., & Robles-Andrade, M. S. (2023) · Springer eBooks · doi:10.1007/978-3-031-25519-9_54
Choi, Y.-K., Jeon, H.-M., Joo, J., Kim, H., & Kwon, E.-Y. (2024) · Journal of Dental Rehabilitation and Applied Science · doi:10.14368/jdras.2024.40.2.46
Basuoni, A., & Kamel, A. H. M. (2024) · Exploration of Cardiology · doi:10.37349/ec.2024.00040
Planning and Implementation of Oral Health Services for Older Adults in India: The Immediate Need
Talwar, M. (2025) · Springer eBooks · doi:10.1007/978-981-99-7842-7_191
Autologous platelet rich fibrin with or without bovine porous bone (Bio-Oss) in socket preservation
Ashmawy, M. F., Saudi, H. I., & Saeed, A. E. A. (2025) · Tanta Dental Journal · doi:10.4103/tdj.tdj_101_25
Sangha, V. (2012) · doi:10.21007/etd.cghs.2012.0276
“In addition, periodontitis and certain systemic diseases (such as cardiovascular disease) share risk factors including tobacco smoking, male gender, race/ethnicity, stress, and aging [16].”
BackgroundPeriodontitis and Ocular Diseases: Emerging Evidence of a Relationship
Abdulkareem, A. A., Gul, S. S., Sha, A. M., Omer, K. S., & Preshaw, P. M. (2026) · Current Oral Health Reports · doi:10.1007/s40496-026-00427-9
Elsaka, Y., Nassar, M., ElGammal, L. A. A., El-Bermawy, M. I., & Badr, A. (2026) · Tanta Dental Journal · doi:10.4103/tdj.tdj_331_25
Antimicrobial Gelatin Methacryloyl (GelMA)/Bioactive Glass Dental Adhesives
Zhao, T., Edwards, A. M., Celiz, A. D., & Jones, J. R. (2026) · Journal of Functional Biomaterials · doi:10.3390/jfb17080394
“Among these, matrix metalloproteinases are upregulated, impairing new collagen formation and promoting degradation of existing collagen fibres within the periodontal connective tissue [4].”
Role of Oral–Lung Infection Axis on Respiratory Health
Ünlü, Ö., Demırci, M., & Kantarcı, A. (2026) · Biomedicines · doi:10.3390/biomedicines14081817 · Cited by 1
"Aggregatibacter actinommycetemcomitans": su susceptibilidad a los antimicrobianos
Patón, C. E. (2007) · Tesis Doctorals en Xarxa (Consorci de Serveis Universitaris de Catalunya)
Oral education for nursing home staff: minimum data set 3.0
Pudwill, K. (2013)
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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