Periodontitis as a risk factor for cardiovascular disease: the role of anti-phosphorylcholine and anti-cardiolipin antibodies.

Available evidence does allow an interpretation of periodontitis as being a risk factor for atherosclerosis and coronary heart disease. There is now a convincing body of evidence that mechanism of atherosclerosis has a major inflammatory component and it is much more than the simple accumulation of lipids on the vascular walls. Studies have shown that certain other mild bacterial infections consist a major risk factor for stroke in young and middle aged patients. Several possible mechanisms could explain the observed association between infection and infraction. The evidence supports the premise that periodontitis leads to systemic exposure to oral bacteria and that the resulting production of inflammatory mediators is capable of initiating or supporting mechanisms associated to development of atherosclerosis and coronary heart disease. Studies in patients with pathologic concentrations of anti-cardiolipin and anti-phosphorylcholine antibodies demonstrated increased pocket depth and attachment loss, compared to patients with normal levels of the above antibodies. These antibodies could be associated to increased risk for stroke and atherosclerosis in patients with periodontitis. As we become more familiar to the association between periodontitis and cardiovascular disease it is likely that in the future periodontal disease may be added to the list of the factors which are used to assess patients' risk profile for coronary heart disease and stroke.