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  Can gum disease lead to Alzheimer's? Study says it just might
  For most, implants beat dentures, but at a price The New York Times
 
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If you needed another reason to brush and floss, maybe this will help. Researchers at New York University have found that gum disease may increase the risk of cognitive dysfunction associated with Alzheimer's disease. This NYU study provides fresh evidence that gum inflammation is associated with inflammation
in the brain. The research team, led by Dr. Angela Kamer, assistant professor of periodontology and implant dentistry, studied 20 years of data from Denmark that support the hypothesis of a link between periodontal disease and Alzheimer's. More

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Review Article
Periodontitis and risk for atherosclerosis: an update on intervention trials
Maurizio S. Tonetti 1
1 European Research Group on Periodontology (ERGOPERIO), Berne, Switzerland
Correspondence to Address : Maurizio S. Tonetti
European Research Group on Periodontology (ERGOPERIO) Berne Switzerland

Conflict of interest and source of funding statement
This paper has been presented at the New York Academy of Science, the 2008 Annual Meeting of the German Society of Periodontology and at symposia organized at the IADR-PEF meeting in London and at the FDI World Dental Congress in Stockholm Sweden in September 2008. These symposia were funded by Johnson & Johnson. The author received a speaking engagement fee and a fee for the preparation of this manuscript from Johnson & Johnson Ltd.

Copyright © 2009 John Wiley & Sons A/S

KEYWORDS
atherosclerosis • causality • controlled clinical trials • periodontitis • review

Tonetti MS. Periodontitis and risk for atherosclerosis: an update on intervention trials. J Clin Periodontol 2009; 36 (Suppl. 10): 15–19. doi: 10.1111/j.1600-051X.2009.01417.x.

 
Review Article

Aims: Periodontitis has been associated with an increased risk of cardiovascular events. The nature of the association is unclear because both periodontitis and cardiovascular disease (CVD) share a host of risk factors. Intervention trials are critical to explore the relationship. If the association were causal, successful periodontal therapy will lead to an attenuation of the effect – CVD.

Material and Methods: The paper reviewed the design and the results of intervention trials aimed at improving systemic inflammation, endothelial dysfunction, carotid atherosclerosis and cardiovascular events.

Results: Early systematic reviews and a definitive controlled clinical trial indicate that intensive periodontal therapy results in a decrease in systemic inflammation and an improvement of endothelial dysfunction in systemically healthy subjects. A pilot trial has indicated the feasibility to assess the impact of periodontal therapy on carotid atherosclerosis in a primary cardiac prevention design.

Conclusions: Efforts to test causality in the relationship between periodontitis and CVD are ongoing.
Evidence to date is consistent with the notion that severe generalized periodontitis causes systemic inflammation and endothelial dysfunction. Periodontitis has effects that go beyond the oral cavity and its treatment and prevention may contribute to the prevention of atherosclerosis.

 
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Accepted for publication 4 April 2009