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Periodontal and systemic interrelationship
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The pathogenesis of periodontitis in causing systemic disease is incompletely understood. It is also possible that periodontitis might not be directly related to the causation of systemic conditions, but both of them might share common risk factors. Among the environmental risk factors and indicators shared by periodontitis and systemic diseases (such as cardiovascular disease, diabetes mellitus, respiratory diseases, osteoporosis, rheumatoid arthritis and adverse pregnancy outcomes) are tobacco smoking, stress, aging, race or ethnicity. The proinflammatory cytokines TNF-a, IL-ip, and gamma interferon as well as prostaglandin E2 (PGE2) reache high tissue concentrations in periodontitis. The periodontium can serve as a renewing reservoir for spillover of these mediators, which can enter the circulation and induce and perpetuate systemic effects. If properly identified, the presence of periodontitis in a patient will aid in identification of these risk factors and warn the physician about several systemic disorders.
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