Periodontitis as inflammatory burden to systemic diseases

PhD cremony: Mr. H. Susanto, 11.00 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Periodontitis as inflammatory burden to systemic diseases

Promotor(s): prof. F. Abbas, prof. A. Vissink, prof. P.U. Dijkstra

Faculty: Medical Sciences

Periodontitis is an inflammatory process in tooth supporting tissue caused by bacteria in the oral biofilm. In the literature an association has been demonstrated between periodontitis and several systemic diseases such as Diabetes mellitus type 2 (DM2), Rheumatoid arthritis (RA) and Cardiovascular disease (CVD). Variation in this association may be influenced by differences in population-backgrounds and definitions of periodontitis. Little information is available from Asian populations. Therefore, the aim of our studies was to investigate the association between periodontitis and several systemic diseases in an Indonesian population.

We demonstrated that Indonesian patients with DM2 had more prevalent and more severe periodontitis than healthy Indonesians, independent of the methods used to diagnose periodontitis. It was also shown that periodontitis severity and c-reactive protein (CRP) levels, as inflammatory markers, predicted HbA1c levels in a group of healthy Indonesians. In Indonesian RA patients we were not able to demonstrate higher periodontitis prevalence and severity as compared to controls. However, we found that periodontitis was associated with increased CRP levels in RA patients. A systemic review and meta-analyses on the effect of periodontal treatment demonstrated significant differences in weighted means for inflammatory markers (CRP, IL-6), and for metabolic markers (total cholesterol, HbA1c) favoring periodontal intervention especially in patients suffering from CVD and DM2. This reduction of biomarkers emphasizes the effectiveness and need for periodontal treatment in these individuals to improve general health. Periodontal treatment should be an integral part of health care, not only to improve oral heath but also health in general and quality of life.