Abgesichertes Wissen zur Assoziation der Parodontitis mit Frühgeburt, Herzkreislauferkrankung und Diabetes mellitus

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Dissertation

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BACKGROUND: There is a rapid growth in evidence with regard to a possible link between periodontal disease and several systemic diseases. Periodontal disease is postulated to be the major reason of tooth loss in adults; inflammation is one of its components. Inflammatory processes are also involved in preterm/premature birth, diabetes mellitus as well as cardiovascular disease (CVD). METHODS: On the basis of a systematic literature research (until December 2007) and a study evaluation according to current evidence criteria, the task was to reliably examine if the accumulated common occurrence of periodontal disease and preterm birth, diabetes mellitus or cardiovascular disease is a simple coincidence or a causal relation. RESULTS: Periodontal disease is highly prevalent and affects at least 20 % of the worldwide population. The most important risk factor for periodontal disease as well as for CVD (and diabetes mellitus) is age. Periodontal disease frequently occurs in patients with preterm birth, diabetes mellitus or CVD. But it is definitely not a proven cause of these diseases. Periodontal treatment in pregnancy does not reduce the incidence of preterm birth. Periodontal treatment does not improve the glycaemic control and has no clinically important benefit for patients with diabetes. The treatment of periodontal disease has no influence on the occurrence and severity of cardiovascular events. CONCLUSION: The effects of periodontal treatment on tooth loss as well as the impact on preterm birth, diabetes mellitus or cardiovascular disease have to be analysed reliably. Experts agree that future studies should aim at important clinical endpoints. Large multicentre randomised controlled trials (RCTs) are needed to investigate whether the treatment of periodontal disease has an effect on preterm birth, diabetes mellitus or cardiovascular disease. Clinical decisions for periodontal treatment need reliable evidence-based investigations and results.

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Medizinische Fakultät

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DFG Project uulm

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Standard (Fassung vom 01.10.2008)

Keywords

CVD, Herzkreislauferkrankung, Preterm birth, Diabetes mellitus, Frühgeburt, Parodontitis, Schwangerschaft, Cardiovascular diseases, Periodontal diseases, Premature birth, DDC 610 / Medicine & health