LANAP and Your Health

Gum Disease and your Health

John McAllister DDS Inc.
(562) 314-4439

Downey Dentsit

It takes a lot of work from the face to let out a smile, but just think what good smiling can bring to the most important muscle of the body... the heart.

The Mouth & Body Connection

In July of 1998, the American Academy of Periodontology launched an effort to educate the public about new findings which support what dental professionals had long suspected: Infections in the mouth can play havoc elsewhere in the body.

Periodontal disease is a bacterial infection, and all infections are cause for concern. Periodontal bacteria can enter the blood stream and travel to major organs and begin new infections. Research is suggesting that this may:

·         Contribute to the development of heart disease, the nation's leading cause of death.

·         Increase the risk of stroke.

·         Increase a woman's risk of having a preterm, low birth weight baby.

·         Pose a serious threat to people whose health is compromised by diabetes, respiratory disease, or osteoporosis.

Heart Disease and Stroke

Heart Disease

Several theories exist to explain the link between periodontal disease and heart disease. One theory is that oral bacteria can affect the heart when they enter the blood stream, attaching to fatty plaques in the coronary arteries (heart blood vessels) and contributing to clot formation. Coronary artery disease is characterized by a thickening of the walls of the coronary arteries due to the buildup of fatty proteins. Blood clots can obstruct normal blood flow, restricting the amount of nutrients and oxygen required for the heart to function properly. This may lead to heart attacks.

Another possibility is that the inflammation caused by periodontal disease increases plaque build up, which may contribute to swelling of the arteries. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Periodontal disease can also exacerbate existing heart conditions. Patients at risk for infective endocarditis may require antibiotics prior to dental procedures. Your dentist and cardiologist will be able to determine if your heart condition requires use of antibiotics prior to dental procedures.

Stroke

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

Preterm Low Birth Weight Births

For a long time we've known that risk factors such as smoking, alcohol use, and drug use contribute to mothers having babies that are born prematurely at a low birth weight. Now evidence is mounting that suggests a new risk factor – periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.

It appears that periodontal disease triggers increased levels of biological fluids that induce labor. Furthermore, data suggests that women whose periodontal condition worsens during pregnancy have an even higher risk of having a premature baby.

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Diabetes

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are. Research has emerged that suggests that the relationship between periodontal disease and diabetes goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications. Thus, diabetics who have periodontal disease should be treated to eliminate the periodontal infection.

Respiratory Diseases

Bacterial respiratory infections are thought to be acquired through aspiration (inhaling) of fine droplets from the mouth and throat into the lungs. These droplets contain germs that can breed and multiply within the lungs to cause damage. Recent research suggests that bacteria found in the throat, as well as bacteria found in the mouth, can be drawn into the lower respiratory tract. This can cause infections or worsen existing lung conditions. People with respiratory diseases, such as chronic obstructive pulmonary disease, typically suffer from reduced protective systems, making it difficult to eliminate bacteria from the lungs.

Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.

Chronic obstructive pulmonary diseases (COPD) cause persistent obstruction of the airways. The main cause of this disease is thought to be long-term smoking. Chemicals from smoke or air pollution irritate the airways to cause obstruction. Further damage to the tissue and working function of the lungs can be prevented, but already damaged tissue cannot be restored - untreated or undetected COPD can result in irreversible damage. Scientists believe that through the aspiration process, bacteria can cause frequent bouts of infection in patients with COPD. Studies are now in progress to learn to what extent oral hygiene and periodontal disease may be associated with more frequents bouts of respiratory disease in COPD patients.

Osteoporosis

Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation. However, hormone replacement therapy may offer some protection.

A study published in theJournal of Periodontology concludes that estrogen supplementation in women within five years of menopause slows the progression of periodontal disease. Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral bone loss following menopause, which could lead to tooth loss. The study concluded that estrogen supplementation may lower gingival inflammation and the rate of attachment loss (destruction of the fibers and bone that support the teeth) in women with signs of osteoporosis,thus helping to protect the teeth.

Some warning signs of gum disease include: tender, bleeding gums, persistent bad breath, receding gums, changes in your bite, and tooth movements such as migration and mobility.

We hope that this information was helpful in better understanding periodontal disease.

Treatment of Periodontal Disease

·         If you're diagnosed with periodontal disease, your dentist may recommend periodontal surgery. Periodontal surgery is necessary when your dentist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. An alternative treatment option to conventional periodontal surgery is laser periodontal surgery.

·         In 2004, the PerioLase® Nd:YAG Laser received FDA approval to perform a procedure known as: Laser Assisted New Attachment procedure (LANAP) which has been shown in a university study to regenerate a new periodontal attachment.

Don't Ignore Your Oral Health

If you value your oral as well as your overall health, a periodontal evaluation is a good idea. Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important if you:

·         Notice any symptoms of periodontal disease (bleeding or receding gums, bad breath, etc.)

·         Have heart disease, diabetes, respiratory disease or osteoporosis.

·         Are thinking of becoming pregnant.

·         Have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.

·         Have a sore or irritation in your mouth that does not get better within two weeks.

This was the key note speaker a Cardiologist that was voted by Time magazine as one of the 100 most influential people in the word.

It Periodontal disease according to The Guinness Book of world records is the most common infectious disease affecting mankind. The surgeon General has estimated that 80% of adult Americans have some form of gum disease. Healthcare costs could be reduced by focusing on the mouth. Medical insurance companies are saying we can save 4 to 1. That is, for every dollar invested in dental care they are saving $4 in medical costs.

The cost for treating diabetes is around $174 billion in the U.S. annually. Extrapolate what Columbia University and Aetna Medical found in their research that costs for diabetes care could be reduced by as much as 16 percent by treating gum disease. Take into consideration the Surgeon Generals estimate that gum disease affects approximately 80 percent of the U.S. population. Thus the potential savings by treating gum disease are approximately $22 billion.

This does not include the savings for cardiovascular disease, a probable savings of 11 percent, or another 9 percent for cerebral vascular disease or stroke. The same Aetna and Columbia University studies found that treating gum disease can reduce preterm low birth-weight babies by 50 percent. Preterm low birth-weight births account for more than 12 percent of all births, $13 billion annually in hospitalizations and uncounted social costs since babies born prematurely often require years of care. The whole total of dental expenditures in the U.S is approximately $75 billion annually. Only 3%, according to Dental Insurance statistics, is spent on periodontal disease. In other words only $2 Billion is spent on gum disease annually.

The important thing to take from this is to know your periodontal score. Unfortunately, gum disease does not hurt. When you visit your dentist make sure your gum pockets are being measured. The dentist needs to take six measurements per tooth. This score has been shown to be more important to your general health than your cholesterol level, body mass index, or blood pressure.

Remember that your gums should never bleed when you brush and floss thoroughly, no more than your hands should bleed when you wash them.
A new breakthrough in the treatment of Gum disease is Laser Assisted New Attachment Procedure LANAP. The Laser has been found to regenerate the attachment around the tooth.

Periodontal Gum Disease

Periodontal gum disease is a serious infection of the mouth that, if left untreated, can lead to tooth loss and is known to be a contributing factor in developing numerous serious diseases. Research has shown that chronic oral infections are associated with, and may contribute to life threatening health problems such as heart disease, strokes, diabetes, spontaneous pre-term births and low-weight babies.

Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on everyone's teeth) causes the gums to become infected and inflamed. In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene, especially lack of flossing and is reversible with professional treatment and good oral home care.

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate and inflame the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself and the gums, ligaments and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue, ligaments and bone are broken down and destroyed. Initially this destructive process has very mild symptoms and the patient may not be aware he has a serious infection and the damage it is causing below the gum line. Eventually, teeth can become loose and may be lost or have to be removed. This pernicious infection can be present for years and is believed to adversely affect the body's immune system making it more susceptible to numerous serious diseases.

More than 300 different types of bacteria exist in the human mouth, either alone or in combination. This makes treating periodontal disease difficult, time consuming and expensive as the periodontist tries various antibiotics and treatment modalities until an effective treatment plan is developed.

To add to the periodontist's difficulty, the existing manual pick and probe methodology currently used to diagnose periodontal disease and monitor its treatment (described below) is disruptive to the healing process and very inaccurate so the treatment plan's effectiveness may not be readily ascertainable. This can result in a trial and error approach that can last for many months and be very time consuming and expensive. In the meantime, as the patient's immune system fights this chronic and perhaps serious infection, it creates an opportunity for other serious diseases to develop. Like any other serious infection, if not promptly treated with the proper types and amounts of antibiotics, periodontitis can result in severe systemic infection that can even become life-threatening.

Refrences

Relationship of Periodontal Disease to Systemic Disease

Articles are arranged under subject headings in chronological sequence (descending order) with those published in medical or basic science journals listed first followed by those published in dental journals.

Atherosclerosis

Medical & Basic Science Journals

Friedewald VE, Kornman KS, Beck JD, Genco R, Goldfine A, Libby P, Offenbacher S, Ridker PM, Van Dyke TE, Roberts WC. The American Journal of Cardiology and Journal of Periodontology editors’ consensus: Periodontitis and atherosclerotic cardiovascular disease. Am J Cardiol 2009; 104:59–68.

Higashi Y, Goto C, Hidaka T, et al. Oral infection-inflammatory pathway: Periodntitis is a risk factor for endothelial dysfunction in patients with coronary artery disease. Atherosclerosis 2009;206(2):604-610.

Seymour GJ, Ford PJ, Cullinan MP, Leishman S, West MJ, Yamazaki K. Infection or inflammation: The link between periodontal and cardiovascular diseases. Future Cardiology 2009;5(1):5-9.

Oe Y, Soejima H, Nakayama H, et al. Significant association between score of periodontal disease and coronary artery disease. Heart Vessels 2009;24(2):103-107.

Wang Q, Zhou X, Huang D. Role for Porphyromonas gingivalis in the progression of atherosclerosis. Medical Hypotheses 2009;72(1):71-73.

Chen Y-W, Umeda M, Nagasawa T, Takeuchi y, Huang Y, Inoue Y, Iwai T, Izumi Y, Ishikawa I. Periodontitis may increase the risk of peripheral arterial disease. Eur J Vasc Endovas Surg 2008;35:153-158.

Niedzielska I, Janic T, Cierpka S, Swietochowska E. The effect of chronic periodontitis on the development of atherosclerosis: Review of the literature. Med Sci Monitor 2008;14(7):103-106.

Blum A, Front E, Peleg A. Periodontal care may improve systemic inflammation. Clin Investigative Med - Medecine Clinique et Experimentale. 2007;30:e114-e117.

Jacobs DR Jr., Crow RS. Subclinical cardiovascular disease markers applicable to studies of oral health: multiethnic study of atherosclerosis. Ann New York Acad Sci 2007;1098:269-287.

Paju S, Sinisalo J, Pussinen PJ, Valtonen V, Nieminen MS. Is periodontal disease behind the failure of antibiotics to prevent coronary events? Atheroscler 2007;193:193-195.

Roth GA, Moser B, Roth-Walter F, et al. Infection with a periodontal pathogen increases mononuclear cell adhesion to human aortic endothelial cells. Atheroscler 2007;190:271-281.

Tonetti MS, D’Aiuto F, Nibali L, et al. Treatment of periodontitis and endothelial function. N Eng J Med

2007;356:911-920.

Brodala N, Merricks EP, Bellinger DA, et al. Porphyromonas gingivalis bacteremia induces coronary and aortic atherosclerosis in normocholesterolemic and hypercholesterolemic pigs. Arterioscler Thromb Vasc Biol 2005;25:1446-1451.

D=Aiuto F, Tonetti MS. Contribution of periodontal therapy on individual cardiovascular risk assessment. Arch Intern Med 2005;165(16):1920-1921.

Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DR, Sacco RL, Papapanou PN. Periodontal microbiota and carotid intima-media thickness. The oral infections and vascular disease epidemiology study (INVEST). Circulation 2005;111:576-582.

Hannson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352:1685-1695.

Kozarov EV, Dorn BR, Shelburne CE, Dunn WA Jr., Progulske-Fox A. Human atherosclerotic plaque contains viable invasive Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis. Arterioscler Thrombo Vasc Biol 2005;25:e17-e18.

Offenbacher S, Beck JD. A perspective on the potential cardioprotective benefits of periodontal therapy. Am Heart J 2005;149:950-954.

Rufail ML, Schenkein HA, Barbour SE, Tew JG, van Antwerpen R. Altered lipoprotein subclass distribution and PAF-AH activity in subjects with generalized aggressive periodontitis. J Lipid Res 2005;46:2752-2760.

Schillinger T, Exner M, Mlekusch W, et al. Inflammation and Carotid Artery—Risk for Atherosclerosis Study (ICARAS). Circulation 2005;111:2203-2209.

Seinost G, Wimmer G, Skerget M, et al. Periodontal treatment improves endothelial dysfunction in patients with severe periodontitis. Am Heart J 2005;149:1050-1054.

Chi H, Messas E, Levine RA, Graves DT, Amar S. Interleukin-1 receptor signaling mediates atherosclerosis associated with bacterial exposure and/or a high-fat diet in a murine apolipoprotein-E heterozygote model: Pharmacotherapeutic implications. Circulation 2004;110:1678-1685.

Gibson FC, Hong, C, Chou HH, et al. Innate immune recognition of invasive bacteria accelerates athrerosclerosis in apolipoprotein E-deficient mice. Circulation 2004;109:2801-2806.

Pussinen PJ, Mattila K. Periodontal infections and atherosclerosis: Mere associations? Curr Opinion Lipidol 2004;15(5):583-588.

Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs DRJ, Papapanou PN, Sacco RL. Relationship between periodontal disease, tooth loss, and carotid artery plaque: The oral infections and vascular disease epidemiology study (INVEST). Stroke 2003;34:2120-2125.

Gonzalez MA, Selwyn AP. Endothelial function, inflammation, and prognosis in cardiovascular disease. Am J Med 2003;115:S99-S106.

Haynes WG, Stanford C. Periodontal disease and atherosclerosis: From dental to arterial plaque. Arterioscler Thrombo Vasc Biol 2003;23:1309-1311.

Comment on Above Paper: Arterioscler Thrombo Vasc Biol 2003;23:1245-1249.

Arterioscler Thrombo Vasc Biol 2003;23:1250-1254.

Jain A, Batista EL Jr., Serhan C, Stahl GL, Van Dyke TE. Role for periodontitis in the progression of lipid deposition in an animal model. Infect Immun 2003;71:6012-6018.

Lalla E, Lamster IB, Hofmann MA, et al. Oral infection with a periodontal pathogen accelerates early atherosclerosis in apolipoprotein-E null mice. Arterioscler Thromb Vasc Biol 2003;23:1405-1411.

Pearson TA, et al. Markers of inflammation and cardiovascular disease. Circulation 2003;107:499-511.

Pussinen PJ. Vilkuna-Rautiainen T. Alfthan G. Palosuo T. Jauhiainen M. Sundvall J. Vesanen M. Mattila K.

Asikainen S. Severe periodontitis enhances macrophage activation via increased serum lipopolysaccharide.

Arterioscler Thromb Vasc Bio 2004;24(11):2174-2180.

Slade GD, Ghezzi EM, Heiss G, Beck JD, Riche E, Offenbacher S. Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study. Arch Intern Med 2003;163:1172-1179.

Espinola-Klein C, Rupprecht HJ, Blankenberg S, et al. Impact of infectious burden on progression of carotid atherosclerosis. Stroke 2002;33:2581-2586.

Folsom AR, Aleksic N, Catellier D, Juneja HS, Wu KK. C-reactive protein and incident coronary heart disease in the Atherosclerosis Risk In Communities (ARIC) study. Am Heart J 2002;144:233-238.

Harats D, Yacov N, Gilburd B, et al. Oral tolerance with heat shock protein 65 attenuates Mycobacterium tuberculosis-induced and high fat-diet-driven atherosclerotic lesions. J Am Coll Cardiol 2002;40:1333-1338.

Li L, Messas E, Batista EL Jr., Levine RA, Amar S. Porphyromonas gingivalis infection accelerates the progression of atherosclerosis in a heterozygous apolipoprotein E-deficient murine model. Circulation 2002;105:861-867.

Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation 2002;105:1135-1143.

Beck JD, Elter JR, Heiss G, Couper D, Mauriello SM, Offenbacher S. Relationship of periodontal disease to carotid artery intima-media wall thickness: The Atherosclerosis Risk in Communities (ARIC) Study. Arterioscler Thromb Vasc Biol 2001;21:1816-1822.

Kiechl S, Egger G, Mayr M, et al. Chronic infections and the risk of carotid atherosclerosis: Prospective results from a large population study. Circulation 2001;103:1064-1070.

Fong IW. Emerging relations between infectious diseases and coronary artery disease and atherosclerosis. Can Med Assoc J 2000;163:49-56.

Pussinen PJ, Tumoisto K, Jousilahti P, Havulinna AS, Sundvall J, Salomaa V. Endotoxemia, immune response to periodontal pathogens, and systemic inflammation associated with increased incidence in cardiovascular disease events. Arterioscler Thromb Vasc Biol 2007;27:1433-1439.

Ross R. Atherosclerosis – an inflammatory disease. N Engl J Med 1999;340:115-126.

Deshpande RG, Khan MB, Genco CA. Invasion of aortic and heart endothelial cells by Phorphyromonas gingivalis. Infect Immun 1998;66(11):5337-5343.

Ebersole JL, Machen RL, Steffen MJ, Willmann DE. Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol 1997;107:347-352.

Atherosclerosis

Dental Journals

Liu J, Wu Y, Ding Y, Meng S, Ge S, Deng H. Evaluation of serum levels of c-reactive protein and lipid profiles in patients with chronic periodontitis and/or coronary heart disease in an ethnic Han population. Quintessence Int 2010;41:239-248.

Behle JH, Sedaghatfar MH, Demmer RT, Wolf DL, Celenti R, Kebschull M, Belusko PB, Herrera-Abreu M, Lalla E, Papapanou PN. Heterogeneity of systemic inflammatory responses to periodontal therapy. J Clin Periodontol 2009; 36: 287–294.

Bokhari SAH, Khan AA, Tatakis DN, Azhar M, Hanif M, Izhar M. Non-surgical periodontal therapy lowers serum inflammatory markers: A pilot study. J Periodontol 2009;80:1574-1580.

Buhlin K, Hultin M, Norderyd O, Persson L, Pockley AG, Rabe P, Klinge B, Gustafsson A. Risk factors for atherosclerosis in cases with severe periodontitis. J Clin Periodontol 2009; 36: 541–549.

Ekuni D, Tomofuji T, Sanbe T, et al. Periodontitis-induced lipid peroxidation in rat descending aorta is involved in the initiation of atherosclerosis. J Periodont Res 2009;44:434-442.

Inomata M, Ishihara Y, Matsuyama T, et al. Degradation of vascular endothelial thrombomodulin by arginine- and lysine-specific cysteine proteases from Porphyromonas gingivalis. J Periodontol 2009;80:1511-1517.

Nakano K, Nemoto H, Nomura R, Inaba H, Yoshioka H, Taniguchi K, Amano A, Ooshima T. Detection of oral bacteria in cardiovascular specimens. Oral Microbiol Immunol 2009:24:64-68.

Renvert S, Lindahl C, roos-Jans<ker A-M, Lessem J. Short-term effects of an anti-inflammatory treatment on clinical parameters and serum levels of C-reactive protein and proinflammatory cytokines in subjects with periodontitis. J Periodontol 2009;80:892-900.

S`der P-_, Meurman JH, Jogestrand T, Nowak J, S`der B. Matrix metalloproteinase-9 and tissue inhibitor of matrix metalloproteinase-1 in blood as markers for early atherosclerosis in subjects with chronic periodontitis. J Periodont Res 2009;44:452-458.

Sun XJ, Meng HX, Shi D, Xu L, Zhang L, Chen ZB, Feng XH, Lu RF, Ren XY. Elevation of C-reactive protein and interleukin-6 in plasma of patients with aggressive periodontitis. J Periodont Res 2009;44:311–316.

Tonetti MS. Periodontitis and risk for atherosclerosis: an update on intervention trials. J Clin Periodontol 2009; 36 (Suppl. 10): 15–19.

Cairo F, Castellani S, Gori AM, Nieri M, Baldelli G, Abbate R, Pini-Prato GP. Severe periodontitis in young adults is associated with sub-clinical atherosclerosis. J Clin Periodontol 2008;35: 465-472.

Colhoun HM, Slaney JM, Rubens MB, Fuller JH, Sheiham A, Curtis MA. Antibodies to periodontal pathogens and coronary artery calcification in type 1 diabetic and nondiabetic subjects. J Periodont Res 2008;43:103-110.

Dong S, Meng HX, Xu L, et al. Systemic inflammation markers in patients with aggressive periodontitis: A pilot study. J Periodontol 2008;79:2340-2346.

ElkaVm R, Dahan M, Kocgozlu L, Werner S, Kanter D, Kretz JG, Tenenbaum H. Prevalence of periodontal pathogens in subgingival lesions, atherosclerotic plaques and healthy blood vessels: a preliminary study. J Periodont Res 2008;43: 224-231.

Linden GJ, McClean K, Young I, Evans A, Kee F. Persistently raised C-reactive protein levels are associated with advanced periodontal disease. J Clin Periodontol 2008; 35: 741–747.

Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008;35:277-290.

Pitiphat W, Savetsilp W, Wara-Aswapati N. C-reactive protein associated with periodontitis in a Thai population. J Clin Periodontol 2008;35:120-125.

Ridker PM, Silvertown JD. Inflammation, C-reactive protein, and Atherothrombosis. J Periodontol 2008;79:1544-1551.

Ushida Y, Koshy G, Kawashima Y, Kiji M, Umeda M, Nitta H, Nagasawa T, Ishikawa I, Izumi Y. Changes in serum interleukin-6, C-reactive protein and thrombomodulin levels under periodontal ultrasonic debridement. J Clin Periodontol 2008; 35: 969-975.

Zhang M-Z, Li C-L, Jiang Y-T, et al. Porphyromonas gingivalis infection accelerates intimal thickening in iliac arteries in a balloon-injured rabbit model. J Periodontol 2008;79:1192-1199.

Soder B, Yakob M. Risk for the development of atherosclerosis in women with a high level of dental plaque and severe gingival inflammation. Inter J Dent Hyg 2007;5:133-138.

Yl`stalo PV, J@rvelin M-R, Laitinen J, Knuuttila MLE. Self-reported gingivitis and tooth loss poorly predict C-reactive protein levels: A study among Finnish young adults. J Clin Periodontol 2008;35:114-119.

D’Aiuto F, Parkar M, Tonetti MS. Acute effects of periodontal therapy on bio-markers of vascular health.

J Clin Periodontol 2007;34:124-129.

Ford PJ, Gemmell E, Timms P, Chan A, Preston FM, Seymour GJ. Anti-P. gingivalis response correlates with atherosclerosis. J Dent Res 2007;86:35-40.

Hettne KM, Weeber M, Laine ML, Cate Ht, Boyer S, Kors JA, Loos BG. Automatic mining of the literature to generate new hypotheses for the possible link between periodontitis and atherosclerosis: lipopolysaccharide as a case study. J Clin Periodontol 2007; 34: 1016–1024.

Mustapha IZ, Debrey S, Oladubu M, Ugarte R. Markers of systemic bacterial exposure in periodontal disease and cardiovascular disease risk: A systematic review and meta-analysis. J Periodontol 2007;78:2289-2302.

Pischon N, H@gewald S, Kunze M, et al. Influence of periodontal therapy on the regulation of soluble cell adhesion molecule expression in aggressive periodontitis patients. J Periodontol 2007;78:683-690.

Pucar A, Milasin J, Lekovic V, Vukadinovic M, Ristic M, Putnik S, Kenney EB. Correlation between atherosclerosis and periodontal putative pathogenic bacterial infections in coronary and internal mammary arteries. J Periodontol 2007;78:677-682.

Rufail ML, Schenkein HA, Koertge TE, Best AM, Barbour SE, Tew JG, van Antwerpen R. Atherogenic lipoprotein parameters in patients with aggressive periodontitis. J Periodont Res 2007;42:495–502.

Schenkein HA, Best AM, Brooks CN, et al. Anti-cardiolipin and increased serum adhesion molecule levels in patients with aggressive periodontitis. J Periodontol 2007;78:459-466.

Tabrizi F, Buhlin K, Gustafsson A, Klinge B. Oral health of monozygotic twins with and without coronary heart disease: A pilot study. J Clin Periodontol 2007;34: 220-225.

Zaremba M, G\rska R, Suwalski P, Kowalski J. Evaluation of the incidence of periodontitis-associated bacteria in the atherosclerotic plaque of coronary blood vessels. J Periodontol 2007;78:322-327.

Ford PJ, Gemmell E, Chan A, et al. Inflammation, heat shock proteins and periodontal pathogens in atherosclerosis: An immunohistologic study. Oral Microbiol Immunol 2006;21:206-211.

Gibson FC 3rd, Yumoto H, Takahashi Y, Chou HH, Genco RA. Innate immune signaling and Porphyromonas gingivalis-accelerated atherosclerosis. J Dent Res 2006;85:106-121.

Ioannidou E, et al. Effect of periodontal treatment on serum C-reactive protein levels: A systematic review and meta-analysis. J Periodontol 2006;77:1635-1642.

Padilla C, Lobos O, Hubert E, et al. Periodontal pathogens in atheromatous plaques isolated from patients with chronic periodontitis. J Periodont Res 2006; 41: 350–353.

D=Aiuto F, Nibali L, Parkar M, Suvan J, Tonetti MS. Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res 2005;84:269-273.

Feihn E, Larsen T, Christiansen N, Holmstrup P, Schroeder TV. Identification of periodontal pathogens in atherosclerotic vessels. J Periodontol 2005;76:731-736.

Leivadaros E, van der Velden U, Bizzarro S, et al. A pilot study into measurements of markers of atherosclerosis in periodontitis. J Periodontol 2005;76:121-128.

Loesche W, Marshal GJ, Apatzidou DA, Krause S, Kocher T, Kinane DF. Lipoprotein-associated phospholipase A2 and plasma lipids in patients with destructive periodontal disease. J Clin Periodontol 2005;32(6):640-644.

Offenbacher S, et al. Evidence for periodontitis as a tertiary vascular infection. J Inter Acad Periodontol 2005;7:39-48.

Yamazaki K, Honda T, Oda T. Effect of periodontal treatment on the C-reactive protein and proinflammatory cytokine levels in Japanese periodontitis patients. J Periodont Res 2005;40:53-58.

D=Aiuto F, Parkar M, Andreou G, Brett PM, Ready D, Tonetti MS. Periodontitis and atherogenesis: Casual association or simple coincidence. J Clin Periodontol 2004;31:402-411.

D=Aiuto FD, Parkar M, Andreou G. Periodontitis and systemic inflammation: Control of the local infection is associated with a reduction in serum inflammatory markers. J Dent Res 2004;83:156-160.

Choi JI, Chung SW, Kang HS, et al. Epitope mapping of Porphyromonas gingivalis heat-shock protein and human heat-shock protein in human atherosclerosis. J Dent Res 2004;83:936-940.

Geerts SO, Legrand V, Charpentier J, et al. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol 2004;75:1274-1280.

Mercanoglu F, Oflaz H, _z O, et al. Endothelial dysfunction in patients with chronic periodontitis and its improvement after initial periodontal therapy. J Periodontol 2004;75:1694-1700.

Miyakawa H, Honma K, Qi M, Kuramitsu HK. Interaction of Porphyromonas gingivalis with low-density lipoproteins: Implications for a role for periodontitis in atherosclerosis. J Periodont Res 2004;39:1-9.

Morita M, Horiuchi M, et al. Relationship between blood triglyceride levels and periodontal status. Community Dent Health 2004;21:32-36.

Nakib SA, Pankow JS, Beck JD, et al. Periodontitis and coronary artery calcification: The atherosclerosis risk in communities (ARIC) study. J Periodontol 2004;75:505-510.

Okuda K, Kato T, Ishihara K. Involvement of periodontopathic biofilm in vascular diseases. Oral Dis 2004;10:5-12.

Yamazaki K, Ohsawa Y, Itoh H, et al. T-cell clonality to Porphyromonas gingivalis and human heat shock protein 60s in patients with atherosclerosis and periodontitis. Oral Microbiol Immunol 2004;19:160-167.

Ajwani S, Mattila KJ, Tilvis RS, Ainamo A. Periodontal disease and mortality in an aged population. Spec Care Dent 2003:23:125-130.

Ajwani S, Mattila KJ, Narehi TO, et al. Oral health status, c-reactive protein and mortality – A 10 year follow-up study. Gerodontology 2003;20(1):32-40.

Chung SW, Kang HS, Park HR, Kim SJ, Kim SJ, Choi JI. Immune responses to heat shock protein Porphyromonas gingivalis-infected periodontitis and atherosclerosis patients. J Periodont Res 2003;38:388-393.

Craig RG, Yip JK, So MK, Boylan RJ, Socransky SS, Haffajee AD. Relationship of destructive periodontal disease to the acute-phase response. J Periodontol 2003;74:1007-1016.

Schenkein HA, Berry CR, Burmeister JA, et al. Anti-cardiolipin antibodies in sera from patients with periodontitis. J Dent Res 2003;82:919-922.

Hajishengallis G, et al. Interactions of oral pathogens with toll-like receptors: Possible role in athersclerosis. Ann Periodontal 2002;7:72-78.

Kolltveit KM, Eriksen HM. Is the observed association between periodontitis and atherosclerosis causal? Euro J Oral Sci 2001;109:2-7.

Haraszthy VI, Zambon JJ, Trevisan M, Zeid M, Genco RJ. Identification of periodontal pathogens in atheromatous plaques. J Periodontol 2000;71:1554-1560.

Cardiovascular Disease

Medical & Basic Science Journals

Franek E, Klamczynska E, Ganowicz E, et al. Association of chronic periodontitis with left ventricular mass and central blood pressure in treated patients with essential hypertension. Am J Hypertens. 2009;22:203-207.

Holmlund A, Hedin M, Pussinen PJ, Lerner UH, Lind L. Porphyromonas gingivalis: A possible link between impaired oral health and acute myocardial infarction. Int J Cardiol 2009;doi: 10.1016/j.ijcard.2009.10.034. Epub Nov 12, 2009.

Mucci LA, Hsieh C-C, Williams PL, et al. Do genetic factors explain the association between poor oral health and cardiovascular disease? A prospective study among Swedish twins. Am J Epidemiol 2009;170:615-621.

Pesonen E, El-Segaier M, Persson K, et al. Infections as a stimulus for coronary occlusion, obstruction, or acute coronary syndromes. Ther Adv Cardiovasc Dis 2009;3(6):447-454.

Dietrich T, Jimenez M, Kaye EAK, Vokonas PS, Garcia RI. Age-dependent associations between chronic

periodontitis/edentulism and risk of coronary heart disease. Circulation 2008;117:1668-1674.

Humphrey LL, et al. Periodontal disease and coronary heart disease incidence: A systematic review and meta-analysis. J Gen Intern Med 2008;23:2079-2086.

Oorni K, Kovanen PT. Proteolysis of low density lipoprotein particles by Porphyromonas gingivalis microorganisms: A novel biochemical link between periodontitis and cardiovascular diseases? J Internal Med 2008;263(5):553-557.

Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: A meta-analysis. Am Heart J 2007;154:830-837.

D’Aiuto F, Parkar M, Nibali L, et al. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: Results from a randomized controlled clinical trial. Am Heart J 2006;151:977-984.

Elter JR, Hinderliter AL, Offenbacher S, et al. The effects of periodontal therapy on vascular endothelial function: a pilot trial. Am Heart J 2006;151(1):47.

Spahr A, Klein E, Khuseyinova N, et al. Periodontal infections and coronary heart disease. Arch Intern Med 2006;166:554-559.

Beck JD, Eke P, Heiss G, Madianos P, Couper D, Lin D, Moss K, Elter J, Offenbacher S. Periodontal disease and coronary heart disease: A reappraisal of the exposure. Circulation 2005;112:19-24.

Okoro CA, Balluz LS, Eke PI, Adjoin UA, Strine TW, Town M, Mensah GA, Mokadad AH. Tooth loss and heart disease: Findings from the behavioral risk factor surveillance system. Am J Prev Med 2005;29(5S1):50-56.

Pussinen PJ, Nyyssönen K, Alfthan G, Salonen R, Laukkanen JA, Salonen JT. Serum antibody levels to Actinobacillus actinomycetemcomitans predict the risk for coronary heart disease. Arterioscler Thromb Vas Biol 2005;25:833-838.

Tiong AY, Brieger D. Inflammation and coronary artery disease. Am Heart J 2005;150(11):11-18.

Brown DL, Desai KK, Vakili BA, Nouneh C, Lee HM, Golub LM. Clinical and biochemical results of the metalloproteinase inhibition with subantimicrobial doses of doxycycline to prevent coronary syndromes (MIDAS) pilot trial. Arterioscler Thromb Vasc Biol. 2004;24:733–738.

Brown DL, Golub LM, Thomas JG. Subantimicrobial doses of tetracycline (letter). Arterioscl Thromb Vas Biol 2004;24:e163.

Deliargyris EN, Madianos PN, Kadoma W, et al. Periodontal disease in patients with acute myocardial infarction : Prevalence and contribution to elevated C-reactive protein levels. Am Heart J 2004;147:1005-1009.

Pai JK, Pischon T, Ma J, et al. Inflammatory markers and risk of coronary heart disease in men and women. N Engl J Med 2004;351:2599-2610.

Pussinen PJ. Alfthan G. Tuomilehto J. Asikainen S. Jousilahti P. High serum antibody levels to Porphyromonas gingivalis predict myocardial infarction. Eur J Cardiovas Prevent Rehab 2004;11(5):408-411.

Schwahn C, Volzke H, Robinson DM, et al. Periodontal disease , but not edentulism, is independently associated with increased plasma fibrinogen levels. Results from a population-based study. Thromb Haemost 2004;92:244-252.

Persson GR, et al. Chronic periodontitis a significant relationship with acute myocardial infarction. Eur Heart J 2003;24:2108-2115.

Peters RJ, Boekholdt SM. Gene polymorphisms and the risk of myocardial infarction - an emerging relation. N Engl J Med 2002;347:1963-1965.

Yamada Y, Izawa H, Ichihara S, et al. Prediction of the risk of myocardial infarction from polymorphisms in candidate genes. N Engl J Med 2002; 347:1916-1923.

Angeli F, Verdecchia P, Pellegrino C, et al. Association between periodontal disease and left ventricle mass in essential hypertension. Hypertension 2003;41:488-492.

Buhlin K, Gustafsson A, Pockley AG, Frostegard J, Klinge B. Risk factors for cardiovascular disease in patients with periodontitis. Eur Heart J 2003;24:2099-2107.

Howell TH, Ridder PM, Adjoin UA, Heineken CH, Christen WG. Periodontal disease and risk of subsequent cardiovascular disease in U. S. male physicians. J Am College Cardiology 2001;37:445-450.

Comment on Above Article: J Am College Cardiology 2001;38:1273-1274.

Danesh J, Whincup P, Walker M, et al. Low grade inflammation and coronary heart disease: Prospective study and updated meta-analyses. Brit Med J 200;321(7255):199-204.

Kiechl S, Egger G, Mayr M, et al. Chronic infections and the risk of carotid atherosclerosis: Prospective results from a large population study. Circulation 2001;103(8):1064-1070.

Wu T, Trevisan M, Genco RJ, et al. Examination of the relation between periodontal health status and cardiovascular risk factors: Serum total and high density lipoprotein cholesterol, C-reactive protein, and plasma fibrinogen. Am J Epidemiol 2000;5:273-282.

Morrison HI, Ellison, LF, Taylor GW. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7-11.

Cardiovascular Disease

Dental Journals

Dorn JM, Genco RJ, Grossi SG, et al. Periodontal disease and recurrent cardiovascular events in survivors of myocardial infarction (MI): The Western New York acute MI study. J Periodontol 2010;81:502-511.

Nakajima T, Honda T, Domon H, et al. Periodontitis-associated up-regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease. J Periodont Res 2010;45:116-122.

Marcaccini AM, Meschiari A, Sorgi CA, et al. Circulating interleukin-6 and high-sensitivity C-reactive protein decrease after periodontal therapy in otherwise healthy subjects. J Periodontol 2009;80:594-602.

Monteiro AM, Jardini MAN, Alves S, et al. Cardiovascular disease parameters in periodontitis. J Periodontol 2009;80:378-388.

Offenbacher S, Beck JD, Moss K, et al. Results from the Periodontitis and Vascular Events (PAVE) study: A pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. J Periodontol 2009;80:190-201.

Stein JM, Kuch B, Conrads G, et al. Clinical periodontal and microbiologic parameters in patients with acute myocardial infarction. J Periodontol 2009;80:1581-1589.

Vidal F, Figueredo CMS, Cordovil I, Fischer RG. Periodontal therapy reduces plasma levels of interleukin-6, C-reactive protein, and fibrinogen in patients with severe periodontitis and refractory arterial hypertension. J Periodontol 2009;80:786-791.

Yoshii S, Tsuboi S, Morita I, et al. Temporal association of elevated C-reactive protein and periodontal disease in men. J Periodontol 2009;80:734-739.

Beck JD, Couper DJ, Falkner KL, et al. The periodontitis and vascular events (PAVE) pilot study: Adverse events. J Periodontol 2008;79:90-96.

Couper DJ, Beck JD, Falkner KL, et al. The periodontitis and vascular events (PAVE) pilot study: Recruitment, retention, and community care controls. J Periodontol 2008;79:80-89.

DavJ S, Van Dyke TE. The link between periodontal disease and cardiovascular disease is probably inflammation. Oral Dis 2008;14:95-101.

Geismar K, Enevold C, Sørensen LK, Gyntelberg F, Bendtzen K, Sigurd B, Holmstrup P. Involvement of interleukin-1 genotypes in the association of coronary heart disease with periodontitis. J Periodontol 2008;79:2322-2330.

Goteiner D, Ashmen R, Lehrman N, Janal MN, Eskin B. Presence and significance of interleukin-1 polymorphism in patients who present with acute coronary syndrome, angina, and chronic periodontitis: An epidemiologic pilot study. J Periodontol 2008;79:138-143.

Hingorani AD, D’Aiuto F. Chronic inflammation, periodontitis and cardiovascular diseases. Oral Dis 2008;14:102-104.

Lund HDheim L, Olsen I, Nafstad P, Schwarze P, Rønningen KS. Antibody levels to single bacteria or in combination evaluated against myocardial infarction. J Clin Periodontol 2008;35: 473-478.

Persson GR, Persson RE. Cardiovascular disease and periodontitis: An update on the associations and risk. J Clin Periodontol 2008;35 (Suppl 8);362–379.

Starkhammar JC, Richter A, Lundstr`m C , Thorstensson H, Ravald N. Periodontal conditions in patients with coronary heart disease: A case-control study. J Clin Periodontol 2008;35:199-205.

Gotsman I, Lotan C, Soskolne A, et al. Periodontal destruction is associated with coronary artery disease and periodontal infection with acute coronary syndrome. J Periodontol 2007;78:849-858.

Ushida Y, Koshy G, Kawashima Y, et al. Changes in serum interleukin-6, C-reactive protein and thrombomodulin levels under periodontal ultrasonic debridement. J Clin Periodontol 2008;35:969-975.

S`der B, Jin LJ, Klinge B, S`der P-_. Periodontitis and premature death: A 16-year longitudinal study in a Swedish urban population. J Periodont Res 2007;42: 361–366.

Tabrizi F, Buhlin K, Gustafsson A, Klinge B. Oral health of monozygotic twins with and without coronary heart disease: A pilot study. J Clin Periodontol 2007;34:April Issue.

Thter G, KurtiÕ B, Serdar M, et al. Effects of scaling and root planing and sub-antimicrobial dose doxycycline on oral and systemic biomarkers of disease in patients with both chronic periodontitis and coronary artery disease. J Clin Periodontol 2007;34: 673–681.

Thter G, KurtiÕ B, Serdar M. Evaluation of gingival crevicular fluid and serum levels of high-sensitivity C-reactive protein in chronic periodontitis patients with and without coronary artery disease. J Periodontol 2007;78:2319-2324.

Andriankaja OM, Genco RJ, Dorn J, et al. The use of different measurements and definitions of periodontal disease in the study of the association between periodontal disease and risk of myocardial infarction. J Periodontol 2006;77:1067-1073.

Briggs JE, McKeown PP, Crawford VL, Woodside JV, Stout RW, Evans A, Linden GJ. Angiographically confirmed coronary heart disease and periodontal disease in middle-aged males. J Periodontol 2006;77:95-102.

Czerniuk MR, Górska R, Filipiak KJ, Opolski G. C-reactive protein in patients with coexistent periodontal disease and acute coronary syndromes. J Clin Periodontol 2006;33:415-419.

Holmlund A, Holm G, Lind L. Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects. J Periodontol

2006;77:1173-1178.

Renvert S, Pettersson T, Ohlsson O, Persson GR. Bacterial profile and burden of periodontal infection in subjects with a diagnosis of acute coronary syndrome. J Periodontol 2006;77:1110-1119.

Taylor BA, Tofler GH, Carey HMR. Full-mouth tooth extraction lowers systemic inflammatory markers of cardiovascular risk. J Dent Res 2006;85:74-78.

Beck JD, Offenbacher S. Systemic effects of periodontitis: Epidemiology of periodontal disease and cardiovascular disease. J Periodontol 2005;76:2089-2100.

Buhlin K, Gustafsson A, Ahnve S, Janszky I, Trabrizi F, Klinge B. Oral health in women with coronary heart disease. J Periodontol 2005;76(4):544-550.

Cueto A, Mesa F, Bravo M., et al. Periodontitis as a risk factor for acute myocardial infarction. J Periodont Res 2005;40:36-42.

Dolan B, Butanol E, Immingle G, et al. Characteristics of periodontal microflora in acute myocardial infarction. J Periodontol 2005;76:740-748.

Montebugnoli L, Servidio D, Miaton RA, Prati C, Tricoci P, Melloni C, Melandri G. Periodontal health improves systemic inflammatory and haemostatic status in subjects with coronary heart disease. J Clin Periodontol 2005;32:188-192.

Persson GR, Pettersson T, Ohlsson O, Renvert S. High-sensitivity serum C-reactive protein levels in subjects with or without myocardial infarction or periodontitis. J Clin Periodontol 2005;32:219-224.

Rahman AU, Rashid S, Noon R, Samuel ZS, Lu B, Borgnakke WS, Williams RC. Prospective evaluation of the systemic inflammatory marker C-reactive protein in patients with end-stage periodontitis getting teeth replaced with dental implants: A pilot investigation. Clin Oral Impl Res 2005;16(1):128-131.

Czerniuk MR, Gorska R, Filipiak KJ, Opolski G. Inflammatory response to acute coronary syndrome in patients with coexistent periodontal disease. J Periodontol 2004;75:1020-1026.

DavJ S, Batista EL Jr., Van Dyke TE. Cardiovascular disease and periodontal diseases: Commonality and causation. Compendium 2004;25:26-37.

D=Aiuto FD, et al. Periodontitis and systemic inflammation: Control of the local infection is associated with a reduction in serum inflammatory markers. J Dent Res 2004;83:156-160.

D=Aiuto F, Red D, Tonetti MS. Periodontal disease and C-reactive protein-associated cardiovascular risk. J Periodontol Res 2004;39:236-241.

Elter JR, Champagne CM, Offenbacher S, Beck JD. Relationship of periodontal disease and tooth loss to prevalence of coronary heart disease. J Periodontol 2004;75:782-790.

Hung HC, Joshipura KJ, Colditz G, Manson JE, Rimm EB, Speizer FE, Willett WC. The association between tooth loss and coronary heart disease in men and women. J Pub Health Dent 2004;64:209-215.

Ide M, Jagdev D, Coward PY, Crook M, Barclay GR, Wilson RF. The short-term effects of treatment of chronic periodontitis on circulating levels of endotoxin, C-reactive protein, tumor necrosis factor-alpha, and interleukin-6. J Periodontol 2004;75:420-428.

Khader YS, Albashaireh ZS, Alomari MA. Periodontal disease and the risk of coronary heart and cerebrovascular diseases: A meta-analysis. J Periodontol 2004;75:1046-1053.

Montebugnoli L, Servidio D, Miaton RA, Prati C, Tricoci P, Melloni C. Poor oral health is associated with coronary heart disease and elevated systemic inflammatory and haemostatic factors. J Clin Periodontol 2004;31:25-29.

Renvert S, Ohlsson O, Persson S, Lang NP, Persson GR. Analysis of periodontal risk profiles in adults with or without a history of myocardial infarction. J Clin Periodontol 2004;31:19-24.

Shimazaki Y, Saito T, Kiyohara Y, et al. Relationship between electrocardiographic abnormalities and periodontal disease: The Hisayama study. J Periodontol 2004;75:791-797.

Janket S-J, Baird AE, Chuang SK, Jones JA. Meta-analysis of periodontal disease and risk for coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:559-569.

Kuramitsu HK, Kang IC, Qi M. Interactions of Porphyromonas gingivalis with host cells: Implications for cardiovascular diseases. J Periodontol 2003;74:85-89.

Lessem J, Drosky C, Greenwald H, et al. Are cardiac transplant patients more likely to have periodontitis? A case record study. J Int Acad Periodontol 2002;4(3):95-100.

Beck JD, Offenbacher S. The association between periodontal diseases and cardiovascular diseases: a state-of-the-science review. Ann Periodontol 2001;6:9-15.

De Nardin E. The role of inflammatory and immunological mediators in periodontitis and cardiovascular disease. Ann Periodontol 2001;6:30-40.

Beck JD, Slade G, Offenbacher S. Oral disease, cardiovascular disease and systemic inflammation. Periodontol 2000 2000;23:110-120.

Kinane DF, Lowe GD. How periodontal disease may contribute to cardiovascular disease. Periodontol 2000 2000;23:121-126.

Loos BG, Craandijk J, Hoek FJ, et al. Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol 2000;71:1528-1534.

Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol 1996;67(suppl):1123-1137.

Ischemic Stroke

Medical & Basic Science Journals

Dietrich T. Periodontitis could be an important marker of risk for cerebrovascular disease, given its relatively high prevalence and the strength of the association. Ann Neurology 2009: In Press.

Jimenez M, Krall EA, Garcia RI, Vokonas PS, Dietrich T. Periodontitis and incidence of cerebrovascular disease in men. Ann Neurol 2009;66(4):505-512.

You Z, Cushman M, Jenny NS, Howard G. Tooth loss, systemic inflammation and prevalent stroke among participants in the Reasons for Geographic and Racial Difference in Stroke (REGARDS) study. Atherosclerosis 2009;203(2):615-619.

Chamorro, Ángel MD; Hallenbeck, John MD. The harms and benefits of inflammatory and immune responses in vascular disease. Stroke 2006; 37:291-293.

Schillinger T, Kluger W, Exner M, et al. Dental and periodontal status and risk for progression of carotid atherosclerosis: The inflammation and carotid artery risk for atherosclerosis study (ICARAS) dental substudy. Stroke 2006;37:2271-2276.

Comment on Above Article: Stroke 2007;38:12.

Engebretson SP, et al. Radiographic measures of chronic periodontitis and carotid artery plaque. Stroke 2005;36:561-566.

Grau AJ, Becher H, Ziegler CM, et al. Periodontal disease as a risk factor for ischemic stroke. Stroke 2004;35:496-501.

Pussinen PJ, Alfthan G, Rissanen H, Reunanen A, Asikainen S, Kneckt P. Antibodies to periodontal pathogens and stroke risk. Stroke 2004;35:2020-2023.

Joshipura KJ, Hung H-C, Rimm EB, Willett WC, Ascherio A. Periodontal disease, tooth loss, and incidence of ischemic stroke. Stroke 2003;34:47-52.

Wu T, Trevisan M, Genco RJ, Dorn JP, Falkner KL, Sempos CT. Periodontal disease and risk of cerebrovascular disease: The First National Health and Nutrition Examination Survey and its follow-up study. Arch Intern Med 2000;160:2749-2755.

Morrison HI, Ellison, LF, Taylor GW. Periodontal disease and risk of fatal coronary heart and cerebrovascular diseases. J Cardiovasc Risk 1999;6:7-11.

Grau AJ, Buggle F, Ziegler C, et al. Association between acute cerebrovascular ischemia and chronic and recurrent infection. Stroke 1997;28:1724-1729.

Ischemic Stroke

Dental Journals

Pradeep AR, Hadge P, Raju PA, Shetty SR, Shareef K, Guruprasad CN. Periodontitis as a risk factor for cerebrovascular accident: A case-control study in the Indian population. J Periodont Res 2010;45:223-228.

Sim S-J, Kim H-D, Moon J-Y, et al. Periodontitis and the risk for non-fatal stroke in Korean adults. J Periodontol 2008;79:1652-1658.

Lee H-J, Garcia RI, Janket S-J, et al. The association between cumulative periodontal disease and stroke history in older adults. J Periodontol 2006;77:1744-1754.

Dorfer CE, Becher H, Ziegler CM, et al. The association of gingivitis and periodontitis with ischemic stroke. J Clin Periodontol 2004;31:396-401.

Khader YS, Albashaireh ZS, Alomari MA. Periodontal disease and the risk of coronary heart and cerebrovascular diseases: A meta-analysis. J Periodontol 2004;75:1046-1053.

Elter JR, Offenbacher S, Toole JF, Beck JD. Relationship of periodontal disease and edentulism to stroke/TIA. J Dent Res 2003;82:998-1001.

Literature Reviews: Periodontitis, Cardiovascular Disease & Ischemic Stroke

Iwai T. Periodontal bacteremia and various vascular diseases. J Periodont Res 2009;44: 689–694.

American Academy of Periodontology. Implications of genetic technology for the management of periodontal diseases. J Periodontol 2005;76:850-857.

Beck JD, Offenbacher S. Systemic effects of periodontitis: Epidemiology of periodontal disease and cardiovascular disease. J Periodontol 2005;76(Suppl.):2089-2100.

Chun YH, Chun KR, Olguin D, Wang HL. Biological foundation for periodontitis as a potential risk factor for atherosclerosis. J Periodont Res 2005;40:87-95.

Lessee J. Periodontitis in cardiology: A clinical perspective. J Internat Acad Periodontol 2005;7(2):49-54.

Loos BG. Systemic markers of inflammation and periodontitis. J Periodontol 2005;76(Suppl.):2106-2115.

Loos BG. Systemic effects of periodontitis. Ann Royal Australasian College Dent Surg 2006;18:27-29.

Mattila KJ, Pussinen PJ, Paju S. Dental infections and cardiovascular diseases: A review. J Periodontol 2005;76(Suppl.):2085-2088.

Meurman JH, Sanz M, Janket SJ. Oral health, atherosclerosis, and cardiovascular disease. Crit Rev Oral Biol Med 2004;15:403-413.

Scannapieco FA, Bush RB, Paju S. Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease, and stroke. A systematic review. Ann Periodontol 2003;8:38-53.

Paquette DW. The periodontal infection-systemic disease link: A review of the truth or myth. J Internat Acad Periodontol 2002;4:101-109.

American Academy of Periodontology. Proceedings of the Periodontal-Systemic Connection: A State-of-the-Science Symposium. Ann Periodontol 2001; Vol. 6, No.1.

Li X, Kolitveit KM, Tronstad L, et al. Systemic diseases caused by oral infection. Clin Microbiol Rev. 2000;13(4):547-558.

Pregnancy

Medical & Basic Science Journals

Kavoussi SK, West BT, Taylor GW, Lebovic DI. Periodontal disease and endometriosis: Analysis of the National Health and Nutrition Examination Survey. Fertility Sterility 2009;91:335-341.

Newnham JP, Newnham IA, Ball CM, et al. Treatment of periodontal disease during pregnancy: A randomized controlled trial. Obstet Gynecol 2009;114:1239-1248.

Offenbacher S, Beck JD, Jared HL, et al. Effect of periodontal therapy on rate of preterm delivery. Obstet Gynecol 2009;114:557-559.

Boggess KA. Maternal oral health in pregnancy. Obstet Gynecol 2008;111:976-986.

Conde-Agudelo A, Villar J, Lindheimer M. Maternal infection and risk of preeclampsia: Systematic review and meta-analysis. Am J Obstet Gynecol 2008;198:7-22.

Dasanayake AP, Gennaro S, Hendricks-MunozKD, Chhun N. Maternal periodontal disease, pregnancy, and neonatal outcomes. Am J Maternal Child Nursing 2008;33:45-49.

Goldenberg RL, Culhane JF, Iams JD. Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371(9606):75-84.

Kushtagi P, Kaur G, Kukkamalla MA, Thomas B. Periodontal infection in women with low birth weight neonates. Int J Gynaecol Obstet 2008;101:296-298.

Ruma M, Moss K, Jared H, Murtha A, Beck A, Offenbacher S. Maternal periodontal disease, systemic inflammation and preeclampsia. Am J Obstet Gynecol 2008;19(4):389.e1-5.

Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Family Physician 2008;77(8):1139-1144.

Ferguson JE, Hansen WF, Novak KF, Novak JM. Should We Treat Periodontal Disease During Gestation to Improve Pregnancy Outcomes? Current Controversies in Obstetrics. Clin Obstet Gynecol 2007;50(2):454-467.

Herrera JA, Parra B, Herrera E, et al. Periodontal disease severity is related to high levels of C-reactive protein in pre-eclampsia. J Hypertension 2007;25:1459-1464.

Klebanoff M. Searle K. The role of inflammation in preterm birth--focus on periodontitis. BJOG: Inter J Obstet Gynaecol 2006;113(Suppl 3):43-45.

Romero R, Espinoza J, Goncalves LF, Kusanovic JP, Friel L, Hassan S. The role of inflammation and infection in preterm birth. Semin Reprod Med 2007;25:21-39.

Vergnes JN, Sixou M. Preterm low birth weight and maternal periodontal status: A meta-analysis. Am J Obstet Gynecol 2007:196(2):135.el-137.

Comment on above artice: Am J Obstet Gynecol 2007;196(2):93-104.

Boggess KA, Beck JD, Murtha AP, et al. Maternal periodontal disease in early pregnancy and risk for a small-for-gestational-age infant. Am J Obstet Gynecol 2006;194:1316-1322.

Esplin MS. Preterm birth: A review of genetic factors and future directions for genetic study. CME review article. Obstet Gynecol 2006;61(12):800-806.

Hampton T. Genetic link found for premature birth risk. JAMA 2006;296(14):1713-1714.

Michalowicz BS, Hodges JS, DiAngelis AJ, et al. Treatment of periodontal disease and the risk of preterm birth. N Eng J Med 2006;355(18):1885-1894.

Comment on Above Article: Goldenberg RL, Culhane JF. Preterm birth and periodontal disease.

N Eng J Med 2006;355(18):1925-1927.

Moutsopoulos NM, Madianos PN. Low-grade inflammation in chronic infectious diseases: Paradigm of periodontal infections. Ann N Y Acad Sci 2006;1088:251-264.

Nugent JL, Baker PN. Periodontal disease and adverse pregnancy outcomes: A systematic review. Inter J Obstet Gynacol 2006;113:135-143.

Offenbacher S, Boggess KA, Murtha AP, Jared HL, Lieff S, McKaig G, Mauriello SM, Moss KL, Beck JD.

Progressive periodontal disease and risk of very preterm delivery. Obstet Gynecol 2006;107:29-36.

Ot<vio L, Cota M, Guimarn AN, et al. Association between maternal periodontitis and an increased risk of preeclampsia. J Periodontol 2006;77:2063-2069.

Sadowsky DW, Adams KM, Gravett MG, et al. Preterm labor is induced by intraamniotic infusions of interleukin-1-beta and tumor necrosis factor-alpha but not by interleukin-6 or interleukin-8 in a nonhuman primate model. Am J Obstet Gynecol 2006;195:1578-1589.

Siristatidis C, Nisiotakis C, Zokaris N, Chrelias C, Iakovidou H, Salamalekis E. Hormonal alterations in gum disease leading to preterm labor. Arch Gynecol Obstet 2006;274:13-18.

Shub A, Swain JR, Newnham JP. Periodontal disease and adverse pregnancy outcomes. J Matern Fetal Neonatal Med 2006;19:521-528.

Tucker R. Periodontitis and pregnancy. J Royal Soc Health 2006;126:24-27.

Urban E, Radnai M, Novak T, et al. Distribution of anaerobic bacteria among pregnant periodontitis patients who experience preterm delivery. Anaerobe 2006;12:52-57.

WHO Oral Health Country/Area Profile Programme. Systemic and oral health: Adverse pregnancy outcomes and periodontal disease. Http://www.whocollab.od.mah.se/expl/systpreterm.html 2006

Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: A systematic review. Brit JObstet Gynecol 2006;113:135-143.

Yiping, W. H., Ikegami, A., Bissada, N. F., Herbst, M., Redline, R. W. & Ashmead, G. G. Transmission of an uncultivated Bergeyella strain from the oral cavity to amniotic fluid in a case of preterm birth. J Clin Microbiol 2006;44:1475-1483.

Boggess KA, Price WA, Preisser JS, et al. Insulin-like growth factor and interleukin-1beta levels and subsequent fetal size in response to chronic Porphyromonas gingivalis exposure in the pregnant rabbit. Am J Obstet Gynecol 2005;193:1219-1223.

Boggess KA, Moss K, Madianos P, et al. Fetal immune response to oral pathogens and risk of preterm birth. Am J Obstet Gynecol 2005;193:1121-1226.

Oittinen J, Kurki T, Kekki M, et al. Periodontal disease and bacterial vaginosis increase risk for adverse pregnancy outcome. Infect Disease Obstet Gynecol 2005;13:213-216.

Pitiphat W, et al. Plasma C-reactive protein in early pregnancy and preterm delivery. Am J Epidemiol

2005;162:1108-1113.

Canakci V. Canakci CF. Canakci H et al. Periodontal disease as a risk factor for pre-eclampsia: a case control study. Austral N Zealand J Obstet Gynaecol 2004;44:568-573.

Goepfert AR, Jeffcoat MK, Andrews WW, et al. Periodontal disease and upper genital tract inflammation in early spontaneous preterm birth. Obstet Gynecol 2004;104:777-783.

Moore S, Ide M, Randhawa M, Walker JJ, Reid JG, Simpson NAB. An investigation into the association among preterm birth, cytokine gene polymorphisms and periodontal disease. BJOG: Inter J Obstet Gynaecol 2004;111:125-132.

Offenbacher S. Maternal periodontal infections, prematurity and growth restriction. Clin Obstet Gynecol 2004;47:808-821.

Boggess KA, Lieff S, Murtha AP, Moss K, Beck J, Offenbacher S. Maternal periodontal disease associated with increased risk for preeclampsia. Obstet Gynecol 2003;101:227-231.

Lin D, Smith MA, Elter J, et al. Porphyromonas gingivalis infection in pregnant mice is associated with placental dissemination, an increase in the placental Th1/Th2 cytokine ratio, and fetal growth restriction. Infect Immun 2003;71:5163-5168.

Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med 2000;342:1500-1507.

Leviton a, Paneth N, Reuss ML, et al. Maternal infection, fetal inflammatory response, and brain damage in very low birth weight infants. Development Epidemiology Network Investigators. Pediatr Res 1999;46:566-575.

Romero R, Mazor M. Infection and preterm labor. Clin Obstet Gynecol 1988;31:553-584.

Pregnancy

Dental Journals,

Carrillo-de-Albornoz A, Figuero E, Herrera D, Bascones-MartRnez A. Gingival changes during pregnancy: II. Influence of hormonal variations on the subgingival biofilm. J Clin Periodontol 2010;37:230-240.

Ebersole JL, Stevens J, Steffen MJ, Dawson D, Novak MJ. Systemic endotoxin levels in chronic indolent periodontal infections. J Periodont Res 2010;45:1-7.

Guimarnes, AN, Silva-Mato A, Cota LOM, Siqueria FM, Costa FO. Maternal periodontal disease and preterm or extreme preterm birth: An ordinal logistic regression analysis. J Periodontol 2010;81:350-358.

Horton AL, Boggess KA, Moss KL, Beck J, Offenbacher S. Periodontal disease, oxidative stress, and risk for preeclampsia. J Periodontol 2010;81:199-204.

Nabet C, Lelong N, Colombier M-L, et al. Maternal periodontitis and the causes of preterm birth: the case-control Epipap study. J Clin Periodontol 2010;37:37-45.

Rakoto-Alson S, Tenenbaum H, Davideau J-L. Periodontal diseases, preterm births, and low birth weight: Findings from a homogenous cohort of women in Madagascar. J Periodontol 2010;81:205-213.

Ebersole JL, Novak MJ, Michalowicz BS, et al. Systemic immune responses in pregnancy and periodontitis: Relationship to pregnancy outcomes in the obstetrics and periodontal therapy (OPT) study. J Periodontol 2009;80:953-960.

Heimonen A, Janket S-J, Kaaja R, Ackerson LK, Muthukrishnan P, Meuman JH. Oral inflammatory burden and preterm birth. J Periodontol 2009;80:884-891.

Horton AL, Boggess KA, Moss KL, Beck J, Offenbacher S. Maternal periodontal disease and soluble Fms-like tyrosine kinase-1expression. J Periodontol 2009;80:1506-1510.

Jared H, Boggess KA, Moss K, Bose C, Auten R, Beck J, Offenbacher S. Fetal exposure to oral pathogens and subsequent risk for neonatal intensive care admission. J Periodontal 2009;80:878-883.

Michalowicz BS, Novak MJ, Hodges JS, et al. Serum inflammatory mediators in pregnancy: Changes after periodontal treatment and association with pregnancy outcomes. J Periodontol 2009;80:1731-1741.

Michalowicz BS, Hodges JS, Novak MJ, et al. Change in periodontitis during pregnancy and the risk of pre-term birth and low birthweight. J Clin Periodontol 2009;36:308-314.

Radnai M, P<l A, Nov<k T, Urb<n E, Eller J, Gorz\ I. Benefits of periodontal therapy when preterm birth threatens. J Dent Res 2009;88:280-284.

Agueda A, Ram\n J^Ma, Manau C, Guerrero A, EcheverrRa JJ. Periodontal disease as a risk factor for adverse pregnancy outcomes: A prospective cohort study. J Clin Periodontol 2008; 35: 16–22.

Dasanayake AP, Chun N, Tanner ACR, et al. Periodontal Pathogens and Gestational Diabetes Mellitus. J Dent Res 2008;87:328-333.

Horton AL, Boggess KA, Moss KL, Jared HL, Beck J, Offenbacher S. Periodontal disease early in pregnancy is associated with maternal systemic inflammation among African American women. J Periodontol 2008;79:1127-1132.

Novak MJ, Novak KF, Hodges JS, et al. Periodontal bacterial profiles in pregnant women: Responses to treatment and associations with birth outcomes in the obstetrics and periodontal therapy (OPT) study. J Periodontol 2008;79:1870-1879.

Pitiphat W, Joshipura KJ, Gillman MW, Williams PL, Douglass CW, Rich-Edwards JW. Maternal periodontitis and adverse pregnancy outcomes. Community Dent Oral Epidemiol. 2008;36:3-11.

Siqueira FM, Cota LOM, Costa JE, Haddad JPA, Lana AMQ, Costa FO. Maternal periodontitis as a potential risk variable for preeclampsia: A case-control study. J Periodontol 2008;79:207-215.

Vettore MV, Leal M doC, Leão AT, Monteiro da Silva AM, Lamarca GA, Sheiham A. The Relationship between Periodontitis and Preterm Low Birthweight. J Dent Res 2008;87:73-78.

Vettore MV, Lean AT, Leal M do C, Feres M, Sheiham A. The relationship between periodontal disease and preterm low birthweight: clinical and microbiological results. J Periodont Res 2008;43: 615-626.

Wimmer G, Pihlstrom BL. A critical assessment of adverse pregnancy outcome and periodontal disease. J Clin Periodontol 2008;35(Suppl 8):380–397.

Yokoyama M, Hinode D, Yoshioka M, Fukui M, Tanabe S, Grenier D, Ito H-O. Relationship between Campylobacter rectus and periodontal status during pregnancy. Oral Microbiol Immunol 2008: 23: 55–59.

Barak S, Barak-Oettinger O, Machtei EE, Sprecher H, Ohel G. Evidence of periopathogenic microorganisms in placentas of women with preeclampsia. J Periodontol 2007;78:670-676.

Canakci V, Canakci CF, Yildirim A, Ingec M, Eltas A, Erturk A. Periodontal disease increases the risk of severe pre-eclampsia among pregnant women. J Clin Periodontol 2007;34: 639-645.

Gazolla C, Ribeiro A, MoysJs MR, Oliveira LAM, Pereira LJ, Sallum AW. Evaluation of the incidence of preterm low birth weight in patients undergoing periodontal therapy. J Periodontol 2007;78:842-848.

Gomes-Filho IS, Cruz SS, Rezende EJC, et al. Exposure measurement in the association between periodontal disease and prematurity/low birth weight. J Clin Periodontol 2007;34:957-963.

Ide R, Hoshuyama T, Takahashi K. The effect of periodontal disease on medical and dental costs in a middle-aged Japanese population : A longitudinal worksite study. J Periodontol 2007;78:2120-2126.

Kunnen A, Blaauw J, van Doormaal JJ, et al. Women with a recent history of early on-set pre-eclampsia have a worse periodontal condition. J Clin Periodontol 2007;34:202-207.

Le\n R, Silva N, Ovalle A, et al. Detection of Porphyromonas gingivalis in the amniotic fluid in pregnant women with a diagnosis of threatened premature labor. J Periodontol 2007;78:1249-1255.

Lin D, Moss K, Beck JD, Hefti A, Offenbacher S. Persistently high levels of periodontal pathogens associated with preterm pregnancy outcome. J Periodontol 2007;78:833-841.

Offenbacher S, Beck J. Has periodontal treatment failed to reduce adverse pregnancy outcomes? The answer may be premature. J Periodontol 2007;78:195-197.

Santos-Pereira SA, Giraldo PC, Saba-Chujfi E, et al. Chronic periodontitis and pre-term labour in Brazilian pregnant women: an association to be analysed. J Clin Periodontol 2007;34:208-213.

Siqueria FM, Cota LOM, Costa JE, Haddad JPA, Lana AMQ, Costa FO. Intrauterine growth restriction, low birth weight, and preterm birth: Adverse pregnancy outcomes and their association with maternal periodontitis. J Periodontol 2007:78:2266-2276.

Tarannum F, Faizuddin M. Effect of periodontal therapy on pregnancy outcome in women affected by periodontitis. J Periodontol 2007;78:2095-2103.

Toygar HU, Seydaoglu G, Kurklu S, Guzeldemir E, Arpak N. Periodontal health and adverse pregnancy outcome in 3,576 Turkish women. J Periodontol 2007;78:2081-2094.

Contreras A, Herrera JA, Soto JE, Arce RM, Jaramillo A, Botero JE. Periodontitis is associated with preeclampsia in pregnant women. J Periodontol 2006;77:182-188.

Cota LO, Guimaraes AN, Costa JE, et al. Association between maternal periodontitis and an increased risk of preeclampsia. J Periodontol 2006;77:2063-2069.

Offenbacher S, Lin D, Strauss R, et al. Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: A pilot study. J Periodontol 2006;77:2011-2024.

Radnai M, Gorz\ I, Urb<n E, et al. Possible association between mother’s periodontal status and preterm delivery. J Clin Periodontol 2006;33:791-796.

Butanol N, Baylas H, Butanol E, Turkoglu O, Kose T, Dahlen G. Periodontal infections and pre-term low birth weight: A case-control study. J Clin Periodontol 2005;32:174-181.

Dörtbudak O, Eberhardt R, Ulm M, Persson GR. Periodontitis, a marker of risk in pregnancy for preterm birth. J Clin Periodontol 2005;32:45-52.

Khader YS, Ta=ani Q. Periodontal diseases and the risk of preterm birth and low birth weight: A meta-analysis. J Periodontol 2005;76:161-165.

Pitiphat W, et al. Periodontitis and plasma C-reactive protein during pregnancy. J Periodontol 2006;77:821-825.

López NJ, da Silva I, Ipinza J, Gutiérrez J. Periodontal therapy reduces the rate of preterm low birth weight in women with pregnancy-associated gingivitis. J Periodontol 2005;76(Suppl.):2144-2153.

Marin C, Segura-Egea JJ, Martinez-Sahuquillo A, Bullon P. Correlation between infant birth weight and mother=s periodontal status. J Clin Periodontol 2005;32:299-304.

Moreu G, Téllez MG, González-Jaranay M. Relationship between maternal periodontal disease and low-birth-weight pre-term infants. J Clin Periodontol 2005;32:622-627.

Moss KL, Beck JD, Offenbacher S. Clinical risk factors associated with incidence and progression of periodontal conditions in pregnant women. J Clin Periodontol 2005;35(5):492-498.

Oettinger-Barak O, Barak S, Ohel G, Oettinger M, Kreutzer H, Peled M, Machtei EE. Severe pregnancy complication (preeclampsia) is associated with greater periodontal destruction. J Periodontol 2005;76:134-137.

Offenbacher S, Riché EL, Barros SP, Bobetsis YTA, Lin D, Beck JD. Effects of maternal Campylobacter rectus infection on murine placenta, fetal and neonatal survival, and brain development. J Periodontol 2005;76(Suppl.):2133-2143.

Lieff S, Boggess KA, Murtha AP, et al. The oral conditions and pregnancy study: Periodontal status of a cohort of pregnant women. J Periodontol 2004;75:116-126.

Mokeem SA, Molla GN, Al-Jewair TS. The prevalence and relationship between periodontal disease and pre-term low birth weight infants at King Khalid University Hospital in Riyadh, Saudi Arabia. J Contemp Dent Pract 2004;5:40-56.

Moore S, Ide M, Coward PY, et al. A prospective study to investigate the relationship between periodontal disease and adverse pregnancy outcome. Br Dent J 2004;197:251-258.

Radnai M, Gorzo I, Nagy E, Urban E, Novak T, Pal A. A possible association between preterm birth and early periodontitis. A pilot study. J Clin Periodontol 2004;31:736-741.

Jeffcoat MK, Hauth JC, Geurs NC, Reddy MS, Oliver SP, Hodgkins PM, Goldenberg RL. Periodontal disease and preterm birth: Results of a pilot intervention study. J Periodontol 2003;74:1214-1218.

Scannapieco FA, Bush RB, Paju S. Periodontal disease as a risk factor for adverse pregnancy outcomes. A systematic review. Ann Periodontol 2003;8:70-78.

Davenport ES, Williams CE, Sterne JA, et al. Maternal periodontal disease and preterm low birth weight: Case-control study. J Dent Res 2002;81:313-318.

Lopez NJ, Smith PC, Gutierrez J. Higher risk of preterm birth and low birth weight in women with periodontal disease. J Dent Res 2002;81:58-63.

Jeffcoat MK, Geurs NC, Reddy MS, Cliver SP, Goldenberg RL, Hauth JC. Periodontal infection and preterm birth: Results of a prospective study. J Am Dent Assoc 2001;132:875-880.

Offenbacher S, Lieff S, Boggess S, et al. Maternal periodontitis and prematurity: Part I. Maternal infection and fetal exposure. Ann Periodontol 2001;6:164-174.

Madianos PN, Lieff S, Murtha AP, et al. Maternal periodontitis and prematurity: Part II. Maternal infection and fetal exposure. Ann Periodontol 2001;6:175-182.

Williams CE, Davenport ES, Sterne JA, Sivapathasundaram V, Fearne JM, Curtis MA. Mechanisms of risk in preterm low-birth weight infants. Periodontol 2000 2000;23:142-150.

Dasanayake AP. Poor periodontal health of the pregnant woman as a risk factor for low birth weight. Ann Periodontol 1998;3:206-212.

Offenbacher S, Katz V, Fertik G, et al. Periodontal infection as a possible risk factor for preterm low birth weight. J Periodontol 1996;67(suppl):S1 103-113.

Literature Reviews: Periodontal Disease and Pregnancy

Michalowicz BS, Durand R. Maternal periodontal disease and spontaneous preterm birth. Periodontol 2000 2007;44:103-112.

Nugent JL, Baker PN. Periodontal disease and adverse pregnancy outcomes: A systematic review. Inter J Obstet Gynacol 2006;113:135-143.

Tucker R. Periodontitis and pregnancy. J Royal Soc Health 2006;126:24-27.

Xiong X, Buekens P, Fraser WD, Beck J, Offenbacher S. Periodontal disease and adverse pregnancy outcomes: A systematic review. BJOG 2006;113:135-143.

Offenbacher S, Beck J. Has periodontal treatment failed to reduce adverse pregnancy outcomes? The answer may be premature. J Periodontol 2007;78:195-197.

Lieff S, Boggess KA, Murtha AP, et al. The oral conditions and pregnancy study: Periodontal status of a cohort of pregnant women. J Periodontol 2004;75:116-126.

Diabetes

Medical & Basic Science Journals

American Diabetes Association. Standards of Medical Care in Diabetes – 2007. Diabetes Care 2007;30:S4-

S41.

Herring ME, Shah SK. Periodontal disease and control of diabetes mellitus. J Am Osteopath Assoc 2006;106(7):416-421.

Khader YS, et al. Periodontal status of diabetics compared with nondiabetics: A meta-analysis. J Diabetes Complications 2006; 20:59-68.

Nishimura F . Taniguchi A . Yamaguchi-Morimoto M, et al. Periodontal infection and dyslipidemia in type 2 diabetics: association with increased HMG-CoA reductase expression. Hormone & Metabolic Res 2006;38:530-535.

Reeves AF, Rees JM, Schiff M, Hujoel P. Total body weight and waist circumference associated with chronic

periodontitis among adolescents in the United States. Arch Pediatr Adolesc Med 2006;160:894-899.

Malik S, Wong ND, Franklin S, et al. Cardiovascular disease in U. S. patients with metabolic syndrome, diabetes, and elevated C-reactive protein. Diabetes Care 2005;28:690-693.

Saremi A, Nelson RG, Tulloch-Reid M, et al. Periodontal disease and mortality in Type 2 diabetes. Diabetes Care 2005;28:27-32.

Savage DB, et al. Mechanisms of insulin resistance in humans and possible links with inflammation. Hypertension 2005;45:828-833.

Southerland JH, Taylor GW, Offenbacher S. Diabetes and periodontal infection: Making the connection. Clin Diabetes 2005;23(4):171-178.

Hu FB, et al. Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 2004;53:693-700.

Festa A, et al. Inflammation in the prediabetic state is related to increased insulin resistance rather than decreased insulin secretion. Circulation 2003;108:1822-1830.

Festa A, D’Agostino R Jr., Howard G, et al. Chronic subclinical inflammation as part of the isulin resistance syndrome: The Insulin Resistance Atherosclerosis Study (IRAS). Circulation 2000;102:42-47.

Löe H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 1993;16:329-334.

Diabetes

Dental Journals

Chen L, Wei B, Li J, et al. Association of periodontal parameters with metabolic level and systemic inflammatory markers in patients with type 2 diabetes. J Periodontol 2010;81:364-371.

Correa FOB, GonHalves D, Figueredo CMS, Bastos AS, Gustafsson A, Orrico SRP. Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes. J Clin Periodontol 2010;37:53-58.

Katz J, Wallet S, Cha S. Periodontal disease and the oral-systemic connection: “Is it all the RAGE?” Quintessence Int 2010;41:229-237.

Morita T, Yamazaki Y, Mita A, et al. A cohort study on the association between periodontal disease and the development of metabolic syndrome. J Periodontol 2010;81:512-519.

Salvi GE, Franco LM, Braun TM, et al. Pro-inflammatory biomarkers during experimental gingivitis in patients with type 1 diabetes mellitus: A proof-of-concept study. J Clin Periodontol 2010;37:9-16.

Andriankaja OM, Barros SP, Moss K, et al. Levels of serum interleukin (IL)-6 and gingival crevicular fluid of IL-1$ and prostaglandin E₂ among non-smoking subjects with gingivitis and type 2 diabetes. J Periodontol

2009;80:307-316.

Ch<varry NGM, Vettore MV, Sansone C, Sheiham A. The relationship between diabetes mellitus and destructive periodontal disease: A meta-analysis. Oral Health Prev Dent 2009;7:107-127.

Fento?lu _, _z G, TaÕdelen P, Uskun E, AykaH Y, Bozkurt FY. Periodontal status in subjects with hyperlipidemia. J Periodontol 2009;80:267-273.

Haffajee AD, Socransky SS. Relation of body mass index, periodontitis and Tannerella forsythia. J Clin Periodontol 2009; 36: 89-99.

Kaur G, Holtfreter B, Rathmann WG, et al. Association between type 1 and type 2 diabetes with periodontal disease and tooth loss. 2009:36:765-774.

Khader YS, Bawadi HA, Haroun TF, Alomari M, Tayyem RF. The association between periodontal disease and obesity among adults in Jordan. J Clin Periodontol 2009; 36:18-24.

Kongstad J, Hvidtfeldt UA, Grrnbaek M, Stoltze K, Holmstrup P. The relationship between body mass index and peridontitis in the Copenhagen City Heart Study. J Periodontol 2009;80:1246-1253.

Kushiyama M, Shimazaki Y, Yamashita Y. Relationship between metabolic syndrome and periodontal disease in Japanese adults. J Periodontol 2009;80:1610-1615.

Matsumoto S, Ogawa H, Soda S, Hirayama S, Amarasena N, Aizawa Y, Miyazaki H. Effect of antimicrobial periodontal treatment and maintenance on serum adiponectin in Type 2 Diabetes Mellitus. J Clin Periodontol 2009; 36: 142-148.

Nesse W, Linde A, Abbas F, et al. Dose–response relationship between periodontal inflamed surface area and HbA1c in type 2 Diabetics. J Clin Periodontol 2009;36:295-300.

Nishihara R, Sugano N, Takano M, et al. The effect of Porphyromonas gingivalis infection on cytokine levels in type 2 diabetic mice. J Periodont Res 2009;44:305-310.

Peng L, He L, Sha Y, Luan Q. Relationship of metabolic syndrome to chronic periodontitis. J Periodontol 2009;80:541-549.

Raunio T, Knuuttila M, Hiltunen L, Karttunen R, Vainio O, Tervonen T. IL-6_174 genotype associated with the extent of periodontal disease in type 1 diabetic subjects. J Clin Periodontol 2009; 36:11-17.

Santos VR, Lima JA, De MendonHa AC, Maximo MBB, Faveri M, Duarte PM. Effectiveness of full-mouth and partial-mouth scaling and root planing in treating chronic periodontitis in subjects with type 2 diabetes. J Periodontol 2009;80:1237-1245.

Saxlin T, Suominen-Taipale L, Leiviska¨ J, Jula A, Knuuttila M, Yl`stalo P. Role of serum cytokines tumour necrosis factor-a and IL-6 in the association between body weight and periodontal infection. J Clin Periodontol 2009; 36: 100-105.

Sun XJ, Meng HX, Shi D, et al. Elevation of C-reactive protein and interleukin-6 in plasma of patients with aggressive periodontitis. J Periodont Res 2009;44:311-316.

Wolff RE, Wolff LF, Michalowicz BS. A pilot study of glycosylated hemoglobin levels in periodontitis cases and healthy controls. J Periodontol 2009;80:1057-1061.

Xiong X, Elkind-Hirsch KE, Vastardis S, Delarosa RL, Pridjian G, Buekens P. Periodontal disease is associated with gestational diabetes mellitus: A case-control study. J Periodontol 2009;80:1742-1749.

da Cruz GA, de Toledo S, Sallum EA, et al. Clinical and laboratory evaluations of non-surgical periodontal treatment in subjects with diabetes mellitus. J Periodontol 2008;79:1150-1157.

Dakovic D, Pavlovic MD. Periodontal disease in children and adolescents with type I diabetes in Serbia. J Periodontol 2008;79:987-992.

Ebersole JL, Holt SC, Hansard R, Novak MJ. Microbiologic and immunologic characteristics of periodontal disease in Hispanic Americans with type 2 diabetes. J Periodontol 2008;79:637-646.

Ekuni D, Yamamoto T, Koyama R, Tsuneishi M, Naito K, Tobe K. Relationship between body mass index and periodontitis in young Japanese adults. 2008;43:417-421.

Goteiner D, Craig RC, Asmen R, Janal MN, Eskin B, Lehrman N. Endotoxin levels are associated with high-density lipoprotein, triglycerides, and troponin in patients with acute coronary syndrome and angina: Possible contributions from periodontal sources. J Periodontol 2008;79:2331-2339.

Khader Y, Khassawneh B, Obeidat B, Hammad M, El-Salem K, Bawadi H, Al-aknour N. Periodontal status of patients with metabolic syndrome compared to those without metabolic syndrome. J Periodontol 2008;79:2048-2053.

King GL. The role of inflammatory cytokines in diabetes and its components. J Periodontol 2008;79:1527-1534.

Murillo J, Wang, Y, Xu X, et al. Advanced glycation of type I collagen and fibronectin modifies periodontal cell behavior. J Periodontol 2008;2190-2199.

Novak MJ, Potter RM, Blodgett J, Ebersole JL. Periodontal disease in Hispanic Americans with type 2 diabetes. J Periodontol 2008;79:629-636.

O’Connell PAA, Taba M Jr., Nomizo A, et al. Effects of periodontal therapy on glycemic control and inflammatory markers. J Periodontol 2008;79:774-783.

Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: Update on associations and risks. J Clin Periodontol 2008;35(8 Suppl):398-409.

Silva JAF, Lorencini M, Peroni LA, De La Hoz CLR, Carvalho HF, Stach-Machado DR. The influence of type I diabetes mellitus on the expression and activity of gelatinases (matrix metalloproteinases-1 and -9) in induced periodontal disease. J Periodont Res 2008;43:48-54.

Taylor GW, Borgnakke WS. Periodontal disease: Associations with diabetes, glycemic control and complications. Oral Dis 2008; 14, 191–203.

Watanabe K, Petro BJ, Shlimon AE, Unterman TG. Effect of periodontitis on insulin resistance and the onset of type 2 diabetes mellitus in Zucker diabetic fatty rats. J Periodontol 2008;79:1208-1216.

Bakhshandeh S, Murtomaa H, Mofid R, Vehkalahti MM, Suomalainen K. Periodontal treatment needs of diabetic adults. J Clin Periodontol 2007;34 :53-57.

Borrell LN, Kunzel C, Lamster I, Lalla E. Diabetes in the dental office: using NHANES III to estimate the probability of undiagnosed disease. J Periodont Res 2007;42:559-565.

PM Duarte PM, Neto2 JBC, Casati3 MZ, Sallum3 EA, FH Nociti FH, Jr. Diabetes modulates gene expression in the gingival tissues of patients with chronic periodontitis. Oral Dis 2007;13:594-599.

Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Gerbic J. Plasma levels of tumor necrosis factor-" in patients with chronic periodontitis and type 2 diabetes. J Clin Periodontol 2007;34:18-24.

Graves DT, Liu R, Oates TW. Diabetes-enhanced inflammation and apoptosis –impact on periodontal pathosis. Periodontol 2000 2007;45:128–137.

Hein, C., Cobb, C. M., Iacopino, A. Report of Independent Panel of Experts of The Scottsdale Project. The Independent Study Initiative for Collaboration in Diabetes, Cardiovascular Disease and Periodontal Disease Intervention. Grand Rounds Oral-Syst Med 2007; 2;3(Suppl):2-27.

Ishihara Y, Anan H, Yoneda M, Maeda K, Hirofuji T. Susceptibility of type 2 diabetic mice to low-virulence bacterial infection: Induction of abscess formation by gingipain-deficient Porphyromonas gingivalis. J Periodont Res 2007;42:253-258.

Lalla E. Periodontal infections and diabetes mellitus: When will the puzzle be complete? J Clin Periodontol 2007;34:913-916.

Lalla E, et al. Diabetes mellitus promotes periodontal destruction in children. J Clin Periodontol 2007; 34:294–298

Lalla E, et al. Diabetes-related parameters and periodontal conditions in children. J Periodont Res 2007;42:345-349..

Lalla E, et al. Effects of periodontal therapy on serum C-reactive protein, serum E-selectin and tumor necrosis factor-alpha secretion by peripheral bllod-derived macrophages in diabetics. A pilot study. J Periodontal Res 2007;42:274-282.

Nassar H, Kantarci A, Van Dyke TE. Diabetic periodontitis: A model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000 2007;43:233-244.

Nishimura F, Iwamoto Y, Soga Y. The periodontal host response with diabetes. Periodontol 2000 2007;43:245-253.

Pischon N, Heng N, Bernimoulin JP, Kleber BM, Willich SN, Pischon T. Obesity, inflammation, and periodontal disease. J Dent Res 2007;86:400-409.

Saito T, Shimazaki Y. Metabolic disorders related to obesity and periodontal disease. Periodontol 2000 2007;43:254-266.

Faria-Almeida R, et al. Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis. J Periodontol 2006;77:591-598.

Kumar MS, Vamsi G, Sripriya R, et al. Expression of matrix metalloproteinases (MMP-8 and -9) in chronic periodontitis patients with and without diabetes mellitus. J Periodontol 2006;77:1803-1808.

Lalla E, et al. Periodontal infection profiles in type I diabetes. J Clin Periodontol 2006;33:855-862.

Mattout C, Bourgeois D, Bouchard P. Type 2 diabetes and periodontal indicators: epidemiology in France 2002–2003. J Periodont Res 2006; 41: 253–258.

Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodontol 2006;77:1289-1303.

Schara R, et al. Periodontal disease and diabetes metabolic control: A full-mouth disinfection approach. J Int Acad Periodontol 2006;8:61-66.

Southerland JH, et al. Commonality in chronic inflammatory diseases: Periodontitis, diabetes, and coronary artery disease. Periodontol 2000 2006;40:130-143.

Campus G, et al. Diabetes and periodontal disease: a case-control study. J Periodontol 2005;76:418-425.

Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y. A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 2005;76(Suppl.):2075-2084.

Janket S-J, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 2005;84:1154-1159.

Kiran M, Arpak N, Ünsal E, et al. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol 2005;32:266-272.

Lim LP, Tay FBK, Sum CF, Thai AC. Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus. J Clin Periodontol 2007;34:118-123.

Nishimura F, et al. Periodontal disease as part of the insulin resistance syndrome in diabetic patients. J Int Acad Periodontol 2005;7:16-20.

Promsudthi A, Pimapansri , Deerochanawong C, Kanchanavasita W. The effect of periodontal therapyt on uncontrolled type 2 diagetes mellitus in older patients. Oral Dis 2005;84:1154-1159.

Engebretson SP, Hey-Hadavi J, Ehrhardt FJ, et al. Gingival crevicular fluid levels of interleukin-1$ and glycemic control in patients with chronic periodontitis and type 2 diabetes. J Periodontol 2004;75:1203-1208.

Skaleric U, Schara R, Medvescek M, et al. Periodontal treatment by Arestin and its effects on glycemic control in type 1 diabetes patients. J Int Acad Periodontol 2004;6(Suppl 4):160-165.

Guzman S, Karima M, Wang H-Y, Van Dyke TE. Association between interleukin-1 genotype and periodontal disease in a diabetic population. J Periodontol 2003;74:1183-1190.

Ide M, et al. Effect of treatment of chronic periodontitis on levels of serum markers of acute-phase inflammatory and vascular responses. J Clin Periodontol 2003;30:334-340.

Nishimura F, Iwatomo Y, Minisheba J, et al. Periodontal disease and diabetes mellitus: The role of tumor necrosis factor-alpha in a two-way relationship. J Periodontol 2003;74:97-102.

Rodrigues DC, et al. Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol 2003;74:1361-1367.

Iacopino AM. Periodontitis and diabetes interrelationships: Role of inflammation. Ann Periodontol 2001;6:125-137.

Iwamotyo Y, Nishimura F, Nakagawa M, et al. The effects of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol 2001;72:774-778.

Lalla E, Lamster IB, Stern DM, Schmidt AM. Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetes: Mechanisms and insights into therapeutic modalities. Ann Periodontol 2001;6:113-118.

Nishimura F, Murayama Y. Periodontal inflammation and insulin resistance – lessons from obesity. J Dent Res 2001;80:1690-1694.

Soskolne WA, Klinger A. The relationship between periodontal diseases and diabetes: An overview. Ann Periodontol 2001;6:91-98.

Stewart JE, Pager KA, Friedlander AH, Zadeh HH. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol 2001;28:306-310.

Taylor GW. Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiological perspective. Ann Periodontol 2001;6:99-112.

Tervonen T, Karajalainen K, Knuuttila M, Huumonen S. Alveolar bone loss in type 1 diabetic subjects. J Clin Periodontol 2000;27:567-571.

Taylor GW. Periodontal treatment and its effects on glycemic control: A review of the evidence. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:311-316.

Christgau M, Palitzsch KD, Schmalz G, et al. Healing response to non-surgical periodontal therapy in patients with diabetes mellitus: Clinical, microbiological, and immunological results. J Clin Periodontol 1998;25:112-124.

Grossi S, Genco R. Periodontal disease and diabetes mellitus: A two-way relationship. Ann Periodontol 1998;3:51-61.

Grossi SG, Skrepcinski FB, DeCaro T, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol 1997;68:713-719.

Taylor GW, Burt BA, Becker MP, et al. Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 1996;67:1085-1093.

Thorstensson H, Kuylenstierna J, Hugoson A. Medical status and complications in relation to periodontal disease experience in insulin-dependent diabetics. J Clinical Periodontol 1996;23(3 Pt 1):194-202.

Westfelt E, Rylander H, Blohme G, et al. The effect of periodontal therapy in diabetics. Results after 5 years. J Clin Periodontol 1996;23:92-100.

Aldridge JP, Lester V, Watts TLP, et al. Single-blind studies of the effects of improved periodontal health on metabolic control of type I diabetes mellitus. J Clin Periodontol 1995;22:271-275.

Rheumatoid Arthritis

Medical & Basic Science Journals

de Pablo P, chapple IL, Buckley CD, Dietrich T. Periodontitis in systemic rheumatic diseases.

Nature Rev Rheumatol 2009;5(4):218-224.

Liao F, Li Z, Wang Y, et al. Porphyromonas gingivalis may play an important role in the pathogenesis of periodontitis-associated rheumatoid arthritis. Medical Hypotheses 2009;Feb 24 epub ahead of print.

Molitor J, et al. Moderate to severe adult periodontitis is associated with increased risk of seropositive rheumatoid arthritis in non-smokers: The ARIC study. Ann Eur Congress Rheumatol 2009; Abst FRIO129.

Molitor JA, Alonso A, Wener MH, et al. Moderate to severe adult periodontitis increases risk of rheumatoid arthritis in non-smokers and is associated with elevated ACPA titers: The ARIC study. Am College Rheumatol Ann Meeting 2009;Abst 1160.

Nesse W, Westra J, van der Wal JE, et al. The periodontium contains citrullinated proteins, PAD-1 enzymes and HC Gp-39. Am College Rheumatol Ann Meeting 2009;Abst 1165.

Abou-Raya S, Abou-Raya A, Naim A, et al. Rheumatoid arthritis, periodontal disease and coronary artery disease. Clin Rheumatol 2007;August 29^th.

Al-Katma MK, Bissada N, Bordeaux JM, et al. Control of periodontal infection reduces the severity of active rheumatoid arthritis. J Clin Rheumatol 2007;13:134-137.

Hallegua DS, Weisman MH. Potential therapeutic uses of interleukin-1 receptor antagonists in human diseases. Ann Rheumatic Dis 2002;61:960-967.

Greenwald RA, Kirkwood K. Adult periodontitis as a model for rheumatoid arthritis with emphasis on treatment strategies. J Rheumatol 1999;26:1650-1653.

Gleissner C, Willershausen B, Kaesser U, et al. The role of risk factors for periodontal disease in patients with rheumatoid arthritis. Eur J Med Res 1998;3:387-392.

Kasser UR, Gleissner C, Dehne F, et al. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arthritis Rheum 1997;40:228-251.

Rheumatoid Arthritis

Dental Journals

Dissick A, Redman RS, Jones M, et al. Association of periodontitis with rheumatoid arthritis: A pilot study. J Periodontol 2010;81:223-230.

Martinez-Martinez RE, Abud-Mendoza C, PatiZo-Marin N, Rizo-RodrRguez JC, Little JW, Loyola-RodrRguez JP. Detection of periodontal bacteria DNA in serum and synovial fluid in refractory rheumatoid arthritis patients. J Clin Periodontol 2009;36:1004-1010.

Biyiko?lu B, Buduneli N, KardeÕler L, Aksu K, Pitkala M, Sorsa T. Gingival crevicular fluid MMP-8 and -13 and TIMP-1 levels in patients with rheumatoid arthritis and inflammatory periodontal disease. J Periodontol 2009;80:1307-1314.

Martinez-Martinez RE, Abud-Mendoza C, PatiÁo-Marin N, Rizo-RodrRguez JC, Little JW, Loyola-RodrRguez JP. Detection of periodontal bacterial DNA in serum and synovial fluid in refractory rheumatoid arthritis patients. J Clin Periodontol 2009;36:1004–1010.

Mayer Y, Balbir-Gurman A, Machtei EE. Anti-tumor necrosis factor-alpha therapy and periodontal parameters in patients with rheumatoid arthritis. J Periodontol 2009;80:1414-1420.

Ortiz P, Bissada NF, Palomo L, Han YW, Al-Zahrani MS, Panneerselvam A, Askari A. Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors. J Periodontol 2009;80:535-540.

Srrensen LK, Havemose-Poulsen A, Bendtzen K, Holmstrup P. Aggressive periodontitis and chronic arthritis: Blood mononuclear cell gene expression and plasma protein levels of cytokines and cytokine inhibitors. J Periodontol 2009;80:282-289.

Nilsson M, Kopp S. Gingivitis and periodontitis are related to repeated high levels of circulating tumor necrosis factor-alpha in patients with rheumatoid arthritis. J Periodontol 2008;79:1689-1696.

Pers J-O, Saraux A, Pierre R, Youinou P. Anti-TNF-" immunotherapy is associated with increased gingival inflammation without clinical attachment loss in subjects with rheumatoid arthritis. J Periodontol 2008;79:1645-1651.

Pischon N, Pischon T, Kröger J, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol 2008;79:979-986.

Cengiz MI, Bal S, Gokcay S, Cengiz K. Does periodontal disease reflect atherosclerosis in continuous ambulatory peritoneal dialysis patients? J Periodontol 2007;78:1926-1934.

Kobayashi T, Ito S, Kuroda T, et al. The interleukin-1 and Fc( receptor gene polymorphisms in Japanese patients with rheumatoid arthritis and periodontitis. J Periodontol 2007;78:2311-2318.

Miranda LA, Islabno AG, Fischer RG, et al. Decreased interleukin-1 and elastase in the gingival crevicular fluid of individuals undergoing anti-inflammatory treatment for rheumatoid arthritis. J Periodontol 2007;78:1612-1619.

Biyikoglu B, Buduneli N, Kardesler L, et al. Evaluation of t-PA, PAI-2, IL-1beta and PGE2 in gingival crevicular fluid of rheumatoid arthritis patients with periodontal disease. J Clin Periodontol 2006;33:605-611.

Havemose-Poulsen A, Westegaard J, et al. Periodontal and hematological characteristics associated with aggressive periodontitis, juvenile idiopathic arthritis and rheumatoid arthritis. J Periodontol 2006;77:280-

288.

Bartold PM, MNarshall RI, Haynes DR. Periodontitits and rheumatoid arthritis: A review. J Periodontol 2005;76:2066-2074.

Ramamurthy NS, Greenwald RA, Celiker MY, et al. Experimental arthritis in rats induces biomarkers of periodontitis which are ameliorated by gene therapy with tissue inhibitor of matrix metalloproteinases. J Periodontol 2005;76:229-233.

Ribeiro J, Leno A, Novaes A. Periodontal infection as a possible severity factor for rheumatoid arthritis. J Clin Periodontol 2005;32:412-416.

Mercado FB, Marshall RI, Bartold PM. Inter-relationships between rheumatoid arthritis and periodontal disease. A review. J Clin Periodontol 2003;30:761-772.

Miranda LA, Fischer RG, Sztajnbok FR, et al. Periodontal conditions in patients with juvenile idiopathic arthritis. J Clin Periodontol 2003;30:969-974.

Mercado FB, Marshall RI, Klestov AC, et al. Relationship between rheumatoid arthritis and periodontitis. J Periodontol 2001;72:779-787.

Mercado F, Marshall RI, Klestov AC, et al. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol 2000;27:267-272.

Kidney Disease

Medical & Basic Science Journal

Kaysen GA. Biochemistry and biomarkers of inflamed patients: why look, what to assess. Clin J Am Soc Nephrol 2009;4(Suppl. 1, Dec.):S56-S63.

Borawski J, Wilczynska-Borawska M, Stokowska W, Mysliwiec M. The periodontal status of pre-dialysis chronic kidney disease and maintenance dialysis patients. Nephrol Dial Transplant 2007;22:457-464.

Kshirsagar AV, Offenbacher S, Moss KL, Barros SP, Beck JD. Antibodies to periodontal organisms are associated with decreased kidney function. The Dental Atherosclerosis Risk in Communities study. Blood Purif 2007;25:125-132.

Shultis WA, Weil EJ, Looker HC, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care 2007;30:306-311.

Chen LP . Chiang CK . Chan CP . Hung KY . Huang CS . Does periodontitis reflect inflammation and malnutrition status in hemodialysis patients? Am J Kidney Dis 2006;47:815-822.

Kadiroglu AK, Kadiroglu ET, Sit D, Dag A, Yilmaz ME. Periodontitis is an important and occult source of inflammation in hemodialysis patients. Blood Purification 2006;24:400-404.

Stenvinkel P. Inflammation in end-stage renal disease: The hidden enemy. Nephrology (Carlton) 2006;11:36-41.

Kshirsagar AV, Moss KL, Elter JR, Beck JD, Offenbacher S, Falk RJ. Periodontal disease is associated with renal insufficiency in the Atherosclerosis Risk in Communities (ARIC) study. Am J Kidney Dis 2005;45:650-657.

Kidney Disease

Dental Journals

Fisher MA, Taylor GW. A prediction model for chronic kidney disease includes periodontal disease. J Periodontol 2009;80:16-23.

Segelnick SL, Weinberg MA. The periodontist’s role in obtaining clearance prior to patients undergoing a kidney transplant. J Periodontol 2009;80:874-877.

Andersen CCP, Holmstrup P, Buschard K, Flyvbjerg. Renal alteration in prediabetc rats with periodontitis. J Periodontol 2008;79:684-690.

Bayraktar G, Kurtulus I, Kazancioglu R, et al. Evaluation of periodontal parameters in patients undergoing peritoneal dialysis or hemodialysis. Oral Dis 2008;14:185-189.

Craig RG. Interactions between chronic renal disease and periodontal disease. Oral Dis 2008;14:1-7.

Fisher MA, Taylor GW, Papapanou PN, Rahman M, Debanne SM. Clinical and serologic makers of periodontal infection and chronic kidney disease. J Periodontol 2008;79:1670-1678.

Kotanko P. Chronic inflammation in dialysis patients - periodontal disease, the new kid on the block. Oral Dis 2008;14:8-9.

Scannapieco FA, Panesar M. Periodontitis and chronic kidney disease. Commentary. J Periodontol 2008;79:1617-1619.

Buhlin K, Barany P, Heimburger O, Stenvinkel P, Gustafsson A. Oral health and pro-inflammatory status in end-stage renal disease patients. Oral Health Prev Dent 2007;5:235-244.

Castillo A, Mesa F, Liebana J, et al. Periodontal and oral microbiological status of an adult population undergoing haemodialysis: A cross-sectional study. Oral Dis 2007;13:198-205.

Cengiz MI, Bal S, G`kHay, Cengiz K. Does periodontal disease reflect atherosclerosis in continuous ambulatory peritoneal dialysis patients? J Periodontol 2007;78:1928-1934.

Yoshihara A, Y, Deguchi T, Hanada N, Miyazaki H. Renal function and periodontal disease in elderly Japanese. J Periodontol 2007;78:1241-1248.

Davidovich E, Schwarz Z, Davidovich M, Eldelman E, Bimstein E. Oral findings and periodontal status in children, adolescents and young adults suffering from renal failure. J Clin Periodontol 2005;32:1076-1082.

Klassen JT, Krasko BM. The dental health status of dialysis patients. J Can Dent Assoc 2002;68:34-38.

Alzheimer’s Disease

Medical & Basic Science Journals

Kamer AR, Craig RG, Dasanayake AP, Brys M, Glodzik-Sobanska L, de Leon MJ. Inflammation and Alzheimer's disease: Possible role of periodontal diseases. Alzheimer's & Dementia 2008;4:242-250.

Kamer AR, Dasanayake AP, Craig RG, Glodzik-Sobanska L. Bry M. de Leon MJ. Alzheimer's disease and peripheral infections: The possible contribution from periodontal infections, model and hypothesis. J Alzheimer's Dis 2008;13:437-449.

Kim JM, Stewart R, Prince M, Kim SW, Yang SJ, Shin IS, Yoon JS. Dental health, nutritional status and recent-onset dementia in a Korean community population. Inter J Geriatric Psychiatry 2007;22:850-855.

Gatz M, et al. Potentially modifiable risk factors for dementia in identical twins. Alzheimer’s and Dementia 2006;2:110-117.

Griffin WS. Inflammation and neurodegenerative diseases. Am J Clin Nutr 2006;83:470S-474S.

McGeer PL, McGeer EG. Polymorphisms in inflammatory genes and the risk of Alzheimer disease. Arch Neurol 2001;58:1790-1792.

Akiyama H, et al. Inflammation and Alzheimer’s disease. Neurobiol Aging 2000;21:383-421.

Alzheimer’s Disease

Dental Journals

Rogers J. The inflammatory response in Alzheimer’s disease. J Periodontol 2008;79:1535-1543.

Iacopino AM. Maintaining oral health in the aging population: The importance of the “periodontal-systemic in the elderly. Grand Rounds Oral Syst Med 2006;1(3):25-37.

Stein PS, et al. Alzheimer’s disease and periodontal disease: Mechanisms underlying a potential bidirectional relationship. Grand Rounds Oral Syst Med 2006;1(3):14-24.

Shimazaki Y, et al. Influence of dentition status on physical disability, mental impairment, and mortality in institutionalized elderly people. J Dent Res 2001;80:340-345.

Ghezzi EM, Ship JA. Dementia and oral health. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:2-5.

Cancer & Periodontal Disease

Tezal M, Sullivan MA, Hyland A, et al. Chronic periodontitis and the incidence of head and neck squamous cell carcinoma. Cancer Epidemiol Biomarkers Prev 2009;18(9):2406-2412.

Tezal M, Sullivan NM, Stoler DL, et al. Chronic periodontitis-human papillomavirus synergy in base of tongue cancers. Arch Otolaryngol Head Neck Surg 2009;135(4):391-396.

Mantovani A, et al. Cancer-related inflammation. Nature 2008;454:436-444.

Meyer MS, Joshipura K, Giovannucci E, Michaud DS. A review of the relationship between tooth loss, periodontal disease, and cancer. Cancer Causes & Control 2008;19(9):895-907.

Michaud DS, Joshipura K, Giovannucci E, Fuchs CS. A prospective study of periodontal disease and pancreatic cancer in US male health professionals. J Nat Cancer Institute 2007;99(2):171-175.

Michaud D, et al. Periodontal disease, tooth loss, and cancer risk in male health professionals: A prospective cohort study. Lancet Oncology. 2008;9:550-558.

National Cancer Institute, National Institutesof Health. Cancer & Inflammation. October 9-10, 2007

Tezal M, et al. Chronic periodontitis and the risk of tongue cancer. Arch Otolaryngol Head Neck Surg 2007;133;450-454.

Mager DL, et al. The salivary microbiota as a diagnostic indicator of oral oral cancer: A descriptive, non-randomized study of cancer-free and oral squamous cell carcinoma subjects. J Transl Med 2005;3:27-37.

MacArthur M, Hold GL, El-Omar EM. Inflammation and Cancer. II. Role of chronic inflammation and cytokine gene polymorphisms in the pathogenesis of gastrointestinal malignancy. Am J Physiol Gastrointest Liver Physiol 2004;286:G515-G520.

Miscellaneous

Fitzsimmons TR, Sanders AE, Bartold PM, Slade GD. Local and systemic biomarkers in gingival crevicular fluid increase odds of periodontitis. J Clin Periodontol 2010;37:30-36.

Quijano A, Shah AJ, Schwarcz AI, Lalla E, Ostfeld RJ. Knowledge and orientations of internal medicine trainees toward periodontal disease. J Periodontol 2010;81:359-363.

Stathopoulou PG, Benakanakere MR, Galicia JC, Kinane DR. Epithelial cell pro-inflammatory cytokine response differes across dental plaque bacterial species. J Clin Periodontol 2010;37:24-29.

Behle JH, Sedaghatfar MH, Demmer RT, et al. Heterogeneity of systemic inflammatory responses to periodontal therapy. J Clin Periodontol 2009;36:287-294.

Rosania AE, Low KG, McCormick CM, Rosania DA. Stress, depression, cortisol, and periodontal disease. J Periodontol 2009;80:260-266.

Wang Z, Zhou X, Zhang J, et al. Periodontal health, oral health behaviours, and chronic obstructive pulmonary disease. 2009;36:750-755.

Michalowicz BS. DiAngelis AJ. Novak MJ. Buchanan W. Papapanou PN. Mitchell DA. Curran AE. Lupo VR. Ferguson JE. Bofill J. Matseoane S. Deinard AS Jr. Rogers TB. Examining the safety of dental treatment in pregnant women. J Am Dent Assoc 2008;139(6):685-695.

Williams RC, Barnett AH, Claffey N, Davis M. Gadsby R. Kellett M. Lip GY. Thackray S. The potential impact of periodontal disease on general health: A consensus view. Curr Med Res & Opin 2008;24(6):1635-1643.

Airila-Månsson S, Söder B, Kari K, Meurman JH. Influence of combinations of bacteria on the levels of prostaglandin E₂, interleukin-1ß, and granulocyte elastase in gingival crevicular fluid and on the severity of periodontal disease. J Periodontol 2006;77:1025-1031.

Albert DA, Sadowsky D, Papapanou P, Conicella ML, Ward A. An examination of periodontal treatment and per member per month (PMPM) medical costs in an insured population. BMC Health Services Res, 2006;6:103-112.

Awano S, Ansai T, Takata Y, et al. Oral health and mortality risk from pneumonia in the elderly. J Dent Res 2008;87:334-339.

Ebersole JL, Cappelli D. Acute-phase reactants in infections and inflammatory diseases. Periodontol 2000 2000;23:19-49.

Geerts SO, Nys M, De MP, Charpentier J, Albert A, Legrand V, Rompen EH. Systemic release of endotoxins induced by gentle mastication: Association with periodontitis severity. J Periodontol 2002;73:73-78.

Gibson FC. Innate immune signaling and Porphyromonas gingivalis-accelerated atherosclerosis. J Dent Res 2006;85:106-1221.

Hasturk H, Kentarci A, Goguet-Surmenian E, et al. Resolvin E1 Regulates Inflammation at the Cellular and Tissue Level and Restores Tissue Homeostasis In Vivo. J Immunol 2007;November 15: 179: 7021 - 7029

Inoue K, Kobayashi Y, Hanamura H, Toyokawa S. Association of periodontitis with increased white blood cell count and blood pressure. Blood Pressure 2005;14(1):53-58.

Iwamoto Y, Nishimura F, Soga Y, et al. Antimicrobial periodontal treatment decreases serum C-reactive protein, tumor necrosis factor-alpha, but not adiponectin levels in patients with chronic periodontitis. J Periodontol 2003;74:1231-1236.

Kesavalu L, Chandrasekar B, Ebersole JL. In vivo induction of proinflammatory cytokines in mouse tissue by Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans. Oral Microbiol Immunol 2002;17:177-180.

Liu R, Desta T, Raptis M, Darveau RP, Graves DT. P. gingivalis and E. coli lipopolysaccharides exhibit different systemic but similar local induction of inflammatory markers. J Periodontol 2008;79:1241-1247.

Manau C, Echeverria A, Agueda A, Guerrero A, Echeverria JJ. Periodontal disease definition may determine the association between periodontitis and pregnancy outcomes. J Clin Periodontol 2008;35:385-397.

Mendez MV, Scott T, LaMorte W, et al. An association between periodontal disease and peripheral vascular disease. Am J Surg 1998;176(2):153-157.

Molloy J, Wolff LF, Lopez-Guzman A, Hodges JS. The association of periodontal disease parameters with systemic medical conditions and tobacco use. J Clin Periodontol 2004;31:625-632.

Noack B, Genco RJ, Trevisan M, et al. Periodontal infections contribute to elevated system C-reactive protein level. J Periodontol 2001;72:1221-1227.

Paju S, Scannapieco FA. Oral biofilms, periodontitis, and pulmonary infections. Oral Dis 2007;13:508-513.

Qi M, Miyakawa H, Kuramitsue HK. Porphyromonas gingivalis induces murine macrophage foam cell formation. Microbial Pathogenesis 2003;35:259-267.

Schenkein HA, Berry CR, Burmeister JA, et al. Anti-cardiolipin antibodies in sera from patients with periodontitis. J Dent Res 2003;82:919-922.

Soder B, Airila-Mansson S, Soder PO, Kari K, Meurman J. Levels of matrix metalloproteinases-8 and -9 with simultaneous presence of periodontal pathogens in gingival crevicular fluid as well as matrix metalloproteinase-9 and cholesterol in blood. J Periodont Res 2006;41:411-417.

Takaaki T, Ekuni D, Yamanaka R, et al. Chronic administration of lipopolysaccharide and proteases induces periodontal inflammation and hepatic steatosis in rats. J Periodontol 2007;78:1999-2006.

Volzke H, Schwahn C, Hummel A, et al. Tooth loss is independently associated with the risk of acquired aortic valve sclerosis. Am Heart J 2005;150:1198-1203.

Yamazaki K, Honda T, Oda T, Ueki-Maruyama K, Nakajima T, Yoshie H, Seymour GJ. Effect of periodontal treatment on the C-reactive protein and proinflammatory cytokine levels in Japanese periodontitis patients. J Periodont Res 2005;40:53-38.

Yl`stalo P, Suominen-Taipale L, Reunanen A, Knuuttila M. Association between body weight and periodontal infection. J Clin Periodontol 2008; 35: 297-304.

Literature Reviews: Periodontal Disease and Systemic Disease

Joshipura K, Zevallos JC, Ritchie CS. Strength of evidence relating periodontal disease and atherosclerotic disease. Compendium 2009;30(7):430-439.

Journal of Periodontology. Proceedings of the 2008 workshop on inflammation. Inflammation and periodontal diseases: A reappraisal. J Periodontol 2008;79(Suppl):1501-1614.

Kinane D, Bouchard P. Periodontal diseases and health: Consensus report of the sixth European workshop on periodontology. J Clin Periodont 2008;35(Suppl 8):333–337.

Wolcott RD, Ehrlich GD. Biofilms and chronic infections. JAMA 2008;299(22):2682-2684.

Barksby HE, Lea SR, Preshaw PM, Taylor JJ. The expanding family of interleukin-1cytokines and their role in destructive inflammatory disorders. Clin Exper Immunol 2007;149:217-225.

Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between periodontal infections and systemic disease. Clin Microbiol Infect 2007;13(Suppl 4):3-10.

Oral and Whole Body Health. Scientific American 2006, Supplement, October Issue

The Oral-Systemic Disease Connection. J Am Dent Assoc 2006;137(October Suppl):1S-36S

Hung HC, Willett WC, Merchant A, et al. Oral health and peripheral artery disease. Circulation 2003;107(8):1152-1157.

Williams RC, Offenbacher S. Periodontal medicine: The emergence of a new branch of periodontology. Periodontol 2000 2000;23:9-12

Schematic showing the basic concept of periodontal disease by showing a healthy tooth on the left and one with periodontal disease on the right. The diseased tooth has already lost part of the gum, ligament attachment and bone. If the periodontal condition is not diagnosed and corrected, the tooth may be lost or have to be removed . The Perio-Imager accurately and painlessly measures the depth of the pocket that has been created by the periodontal disease and the loss of gum tissue, the ligament attachment and bone.

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