Association Between Periodontitis and Risk of Alzheimer's Disease: A Systematic Review of Current Evidence
Association Between Periodontitis and Risk of Alzheimer's Disease: A Systematic Review of Current Evidence
Mohammad Hosein Amirzade-Iranaq,1,*Bahamin moosa akbari - bezenjani,2Fatemeh Aff,3Daniyal Mohaghegh,4
1. Universal Network of Interdisciplinary Research in Oral and Maxillofacial Surgery (UNIROMS), Universal Scientific Education and Research Network (USERN), Tehran, Iran 2. DDS student, Students Research Committee, Islamic Azad University , School of Dentistry, Isfahan branch , Iran 3. Medical university of Alborz, Karaj 4. DDS student, Students Research Committee, IAU, School of Dentistry, Tehran branch , Iran
Introduction: Alzheimer's disease (AD) is the most frequent cause of dementia in older adults and a major global health issue for geriatric patients, leading to progressive cognitive impairment and behavioral problems. Periodontitis is a common oral infection considered a “low-grade systemic disease” causing the secretion of proinflammatory cytokines and elevation of C-reactive protein (CRP). The aim of the current review is to investigate the pathophysiology and possible association between periodontitis and AD according to released evidence.
Methods: The data were collected using literature retrieved using relevant keywords and MeSH terms in MEDLINE, PMC, Scopus, Google Scholar, and ProQuest. After full-text screening and quality assessment, a total of 17 articles were included in the final report.
Results: Alzheimer's disease is a complex neurodegenerative disorder associated with aging with several etiologies for its onset and progression. The development of extracellular amyloid plaques and intraneuronal neurofibrillary tangles is this disorder's most notable identifying feature (NFTs). Tau, a protein connected to microtubules, is found in hyperphosphorylated forms in NFTs. Reactive astrocytes and activated microglial cells are closely related to A-P plaques. The formation of A-P in the cerebral microvasculature is a result of inflammation. Pro-inflammatory cytokines, reactive oxygen and nitrogen species, and nitrogen may all contribute to neuroinflammation. These elements play a crucial role in the activation of microglia and the promotion of NFT formation. Spirochete plaques or masses resemble senile AD plaques in the brain. The tissue-invasive periodontal pathogens that cause periodontitis include Aa, Pg, Pi, Tf, and Fn. Spirochetes were found in 93.7 percent of AD cases and 33.3 percent of controls.
Conclusion: AD and periodontitis exhibit the same chronicity-related characteristics, with inflammation as their common denominator. Periodontitis has risk factors in common with disorders linked to cognitive impairment. The methodical management of geriatric patients requires constant coordination between the dentist and the neurosurgeon