4.5 Review

Viruses, periodontitis, and comorbidities

Journal

PERIODONTOLOGY 2000
Volume 89, Issue 1, Pages 190-206

Publisher

WILEY
DOI: 10.1111/prd.12435

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Studies have shown a connection between periodontal diseases and systemic conditions, suggesting that these oral diseases may contribute to the development of systemic diseases. The bacterial infection and inflammation caused by periodontal diseases are believed to play a role in the pathogenesis of these systemic conditions. Furthermore, viruses in the oral cavity might also have a similar impact in connecting periodontal diseases and systemic conditions.
Seminal studies published in the 1990s and 2000s explored connections between periodontal diseases and systemic conditions, revealing potential contributions of periodontal diseases in the initiation or worsening of systemic conditions. The resulting field of periodontal medicine led to the publication of studies indicating that periodontal diseases can influence the risk of systemic conditions, including adverse pregnancy outcomes, cardiovascular and respiratory diseases, as well as Alzheimer disease and cancers. In general, these studies hypothesized that the periodontal bacterial insult and/or the associated proinflammatory cascade could contribute to the pathogenesis of these systemic diseases. While investigations of the biological basis of the connections between periodontal diseases and systemic conditions generally emphasized the bacteriome, it is also biologically plausible, under an analogous hypothesis, that other types of organisms may have a similar role. Human viruses would be logical suspects in this role, given their ubiquity in the oral cavity, association with periodontal diseases, and ability to elicit strong inflammatory response, compromise immune responses, and synergize with bacteria in favor of a more pathogenic microbial consortium. In this review, the current knowledge of the role of viruses in connecting periodontal diseases and systemic conditions is examined. We will also delve into the mechanistic basis for such connections and highlight the importance of those relationships in the management and treatment of patients.

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