ABSTRACT
Alzheimer's disease is the preeminent cause and commonest form of dementia. It is clinically characterized by a progressive descent in the cognitive function, which commences with deterioration in memory. The exact etiology and pathophysiologic mechanism of Alzheimer's disease is still not fully understood. However it is hypothesized that, neuroinflammation plays a critical role in the pathogenesis of Alzheimer's disease. Alzheimer's disease is marked by salient inflammatory features, characterized by microglial activation and escalation in the levels of pro-inflammatory cytokines in the affected regions. Studies have suggested a probable role of systemic infection conducing to inflammatory status of the central nervous system. Periodontitis is common oral infection affiliated with gram negative, anaerobic bacteria, capable of orchestrating localized and systemic infections in the subject. Periodontitis is known to elicit a "low grade systemic inflammation" by release of pro-inflammatory cytokines into systemic circulation. This review elucidates the possible role of periodontitis in exacerbating Alzheimer's disease. Periodontitis may bear the potential to affect the onset and progression of Alzheimer's disease. Periodontitis shares the two important features of Alzheimer's disease namely oxidative damage and inflammation, which are exhibited in the brain pathology of Alzheimer's disease. Periodontitis can be treated and hence it is a modifiable risk factor for Alzheimer's disease.
A doença de Alzheimer é uma proeminente causa e a forma mais comum de demência. Caracteriza-se clinicamente por uma progressiva diminuição da função cognitiva, que tem início com a deterioração da memória. A exata etiologia e o mecanismo fisiopatológico da doença de Alzheimer ainda não são totalmente compreendidos. No entanto, postula-se que a neuroinflamação desempenhe um papel crucial na patogênese da doença de Alzheimer. A doença de Alzheimer é caracterizada por importantes características inflamatórias, assinalada pela ativação microglial e escalada dos níveis de citocinas pró-inflamatórias nas regiões afetadas. Estudos têm sugerido um provável papel de infecção sistêmica imbuída de estado inflamatório do sistema nervoso central. Periodontite é uma infecção oral comum associada a germes Gram-negativos, anaeróbios, capaz de orquestrar infecções localizadas e sistêmicas no paciente. É conhecida por suscitar um "baixo grau de inflamação sistêmica" pela liberação de citocinas pró-inflamatórias na circulação sistêmica. Esta revisão elucida o possível papel da periodontite no agravamento da doença de Alzheimer e pode ter o potencial de afetar o início e a progressão da doença de Alzheimer. Periodontite partilha as duas importantes características da doença de Alzheimer: dano oxidativo e inflamação, que estão presentes na patologia do cérebro com doença de Alzheimer. Periodontite pode ser tratada e, portanto, é um fator de risco modificável para a doença de Alzheimer.
Subject(s)
Humans , Alzheimer Disease/etiology , Periodontitis/complications , Cytokines/adverse effects , Disease Progression , Inflammation/complications , Inflammation/microbiology , Risk FactorsABSTRACT
The purpose of this study was to evaluate the effectiveness of platelet rich fibrin (PRF) in periodontal regeneration in generalized aggressive periodontitis (GAgP) patients. Two patients diagnosed with GAgP were selected for this study. Baseline clinical and radiographic examination was performed and patients were treated by surgical periodontal therapy along with PRF. Post-surgical re-evaluation was carried out at regular intervals to evaluate clinical and radiographic changes. Surgical periodontal therapy accompanying the placement of PRF in angular defects of GAgP patients showed decreased probing pocket depth, increased attachment level and radiographic bone fill when baseline and 9 month follow-up data was compared. Surgical reconstructive therapy with placement of PRF in angular defects of GAgP patients can be an effective approach to enhance the periodontal regeneration.