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Chronic periodontitis is a marker for cardiovascular disease (CVD). [21] Mechanisms associated with cardiovascular risk are that chronic periodontitis increases inflammatory mediator levels and this may contribute to the onset of CVD, while treatment of chronic periodontitis reduces systemic levels of inflammatory mediators. [22]
Periodontitis is very common, and is widely regarded as the second most common dental disease worldwide, after dental decay, and in the United States has a prevalence of 30–50% of the population, but only about 10% have severe forms. Chronic periodontitis affects about 750 million people or about 10.8% of the world population as of 2010. [86]
Consequently, a new classification was developed at the International Workshop for a Classification of Periodontal Diseases and Conditions in 1999. This covered in much more detail the full range of periodontal diseases. "Adult periodontitis" was reclassified "chronic periodontitis" and "early-onset periodontitis" to "aggressive periodontitis". [1]
Periapical periodontitis; Other names: Apical periodontitis, periradicular periodontitis: Periapical dental radiograph showing chronic periapical periodontitis on the root of the left maxillary second premolar. Note large restoration present in the tooth, which will have undergone pulpal necrosis at some point before the development of this lesion.
PGE2 upregulates bone resorption by osteoclasts and their levels are higher in patients with periodontal disease than in healthy individuals. [2] Bisphosphonate; Sub antimicrobial doxycycline [3] Sub antimicrobial doxycycline is 20 mg doxycycline (Periostat) approved and indicated as an adjunct to SRP in the treatment of chronic periodontitis.
[1] [2] At least 16 systemic diseases have been linked to periodontitis. These systemic diseases are associated with periodontal disease because they generally contribute to either a decreased host resistance to infections or dysfunction in the connective tissue of the gums , increasing patient susceptibility to inflammation-induced destruction.