Vasilica Toma

By Petra Surlin, Dorin Nicolae Gheorghe, Liliana Foia, Amelia Surdu, Vasilica Toma, Sorina Mihaela Solomon, Dan Nicolae Florescu and Ion Rogoveanu

Periodontal tissues exhibit important vascular, lymphatic, and nervous connections with the rest of the body. Thus, periodontal inflammation caused by the interaction between the subgingival bacterial biofilm and the host immune response has an impact reaching further than the oral cavity. The concept of “periodontal medicine” reunites the bidirectional relationships that exist between periodontal disease and systemic conditions such as diabetes mellitus or cardiovascular disease. The chronic inflammation of hepatic tissues during hepatitis C virus (HCV) infection causes changes in the general homeostasis that can reverberate at periodontal level and influence periodontal inflammation. Various mechanisms such as insulin resistance or pro-inflammatory cytokines production could be the link between the two conditions. In addition, periodontal inflammation could impact HCV transmission, as HCV RNA molecules and antibodies have been found in infected patients’ saliva and gingival fluid. During periodontal inflammation, gingival bleeding is frequent, and the viral molecules could enter oral fluids while being carried by peripheral blood cells. Clinical particularities that suggest the onset of periodontal disease have also been frequently observed in HCV-infected patients. The connections between periodontal disease and hepatitis C need to take into consideration by practitioners of both specialties due to their important implications on clinical manifestations and treatment strategies.

Part of the book: Hepatitis C

By Petra Surlin, Liliana Foia, Sorina Solomon, Dora Maria Popescu, Dorin Nicolae Gheorghe, Adrian Camen, Maria Alexandra Martu, Anne Marie Rauten, Madalina Olteanu, Allma Pitru, Vasilica Toma, Simona Popa, Mihail Virgil Boldeanu, Silvia Martu and Ion Rogoveanu

The bacterial challenge on the periodontal tissues triggers an inflammatory reaction, driven by pro-inflammatory cytokines, that eventually leads to the periodontal structures’ damage. The pathogenic mechanisms of this inflammatory reaction are complex and are influenced by the type of host-immune response and certain local and systemic factors. These factors can influence periodontal inflammation, through the action of the various pro-inflammatory cytokines. Periodontal disease and certain systemic conditions can have a mutual association, as the pathogenic mechanisms of these diseases can involve similar molecular and cellular elements. The concept of ‘periodontal medicine’ comprises these pathogenic connections, focusing on the key role that periodontal health has on the general homeostasis and well-being.

Part of the book: Cytokines

By Maria-Alexandra Martu, Elena Rezus, Diana Tatarciuc, Ionut Luchian, Irina-Georgeta Sufaru, George-Alexandru Maftei, Dorin Gheorghe, Liliana Pasarin, Sorina Mihaela Solomon and Liliana Georgeta Foia

The relationship between periodontitis and systemic diseases is an important part of clinical periodontal research, which has been growing steadily. Even though the etiologies of periodontal disease and rheumatoid arthritis (RA) differ, these pathologies have many common features, both being multifactorial diseases characterized by localized chronic inflammatory reactions, which are fuelled by an analogous set of cytokines (among many, the most prominent being Tumour Necrosis Factor (TNF), Interleukin (IL) 6 and 17), leading to high systemic circulating concentrations of inflammatory markers such as C-reactive protein (CRP). It was not until the discovery of peptidylarginine deiminase (PAD) mediated citrullination of proteins by Porphyromonas gingivalis that the link between the two diseases was purely speculative. This citrullination initiates a series of events which culminate in the production of anti-citrullinated protein antibodies (ACPA) and, finally, in the clinical manifestation of rheumatoid arthritis. Another common denominator is the bone destruction caused by proinflammatory cytokines secreted by T 17 helper cells (TH17) which is the pathological hallmark of both diseases. Other notable common areas are shared risk factors such as environmental and genetic risk factors. Regarding treatment, neither pathologies have a definitive cure, however, several strategies are employed, some of which are common, such as diet and lifestyle changes, and immunomodulating medication applied locally or systemically.

Part of the book: Periodontology

By Dora Maria Popescu, Dorin Nicolae Gheorghe, Flavia Nicolae, Lucian Paul Dragomir, Allma Pitru, Andrada Soanca, Cristina Florescu, Vasilica Toma, Liliana Georgeta Foia, Alexandra Livia Roman, Petra Surlin and Ion Rogoveanu

The oral cavity is an integral part of the digestive tract and thus significant diseases, including periodontitis, can have an important impact on the normal nutritional functions of the body. Certain diseases of the hepato-digestive system have an inflammatory component, such as chronic hepatitis, fatty liver disease, or gastric cancer. This inflammatory reaction is mainly driven by pro-inflammatory chemokines. This is also the case for periodontitis, a condition characterized by the inflammation of the supporting tissues of teeth. Thus, significant pathogenic connections mediated by pro-inflammatory chemokines could exist between periodontitis and diseases of the hepato-digestive system.

Part of the book: Chemokines Updates