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Wechselwirkungen zwischen Parodontitis und systemischen Erkrankungen

Relationship between periodontitis and systemic diseases

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Die Parodontitis ist eine biofilminduzierte entzündliche Erkrankung des Zahnhalteapparats mit hoher und zunehmender Prävalenz in der deutschen Bevölkerung. In den letzten Jahren mehren sich Hinweise auf systemische Auswirkungen der parodontalen Infektion, insbesondere in Bezug auf Diabetes und Atherosklerose. Zwischen Parodontitis und Diabetes besteht offenbar eine bidirektionale Beziehung. Hierbei begünstigt der Diabetes die Entstehung, die Progression und den Schweregrad einer Parodontitis. Die parodontale Infektion erschwert die glykämische Einstellung des Diabetes, erhöht das Risiko Diabetes-assoziierter Komplikationen und vermutlich dessen Entstehung. Dies bedeutet, dass die Therapie parodontaler Infektionen integraler Bestandteil des Diabetesmanagements werden sollte, wohingegen die Sicherstellung einer adäquaten glykämischen Kontrolle wesentlicher Bestandteil einer erfolgreichen Parodontaltherapie ist. Parodontale Infektionen gelten darüber hinaus als ein unabhängiger Risikofaktor für Atherosklerose und deren klinische Folgen wie zerebro- und kardiovaskuläre Erkrankungen. Die positive Assoziation ist zwar nur moderat ausgeprägt, aber bemerkenswert konsistent. Durch Parodontitistherapie kann ein positiver Effekt auf subklinische Marker der Atherosklerose erzielt werden.

Abstract

Periodontitis is a biofilm-induced inflammatory disease affecting the periodontium with a high and even increasing prevalence in the German population. During recent years, there is emerging evidence for systemic effects of a periodontal infection, in particular in relation to diabetes and atherosclerosis. There is a bi-directional relationship between periodontitis and diabetes. Diabetes promotes the occurrence, the progression, and the severity of periodontitis. The periodontal infection complicates the glycemic control in diabetes, increases the risk of diabetes-associated complications and possibly even of its onset. As a consequence, the treatment of periodontal infections should become an integral part of the management of diabetes, whereas glycemic control is a prerequisite for successful periodontal therapy. Periodontal infections are considered as independent risk factor for atherosclerosis and their clinical sequelae, e.g., cerebro- and cardiovascular diseases. The positive association is only moderate, however remarkably consistent. Periodontal therapy can result in positive effects on subclinical markers of atherosclerosis.

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Danksagung

Die Autoren danken der Deutschen Forschungsgemeinschaft (DFG) und der Medizinischen Fakultät der Universität Bonn für die Förderung der Klinischen Forschergruppe 208 „Ursachen und Folgen von Parodontopathien“.

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  1. Poliklinik für Parodontologie, Zahnerhaltung und Präventive Zahnheilkunde, Rheinische Friedrich-Wilhelms-Universität Bonn, Welschnonnenstr. 17, 53111, Bonn, Deutschland

    S. Jepsen, M. Kebschull & J. Deschner

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  1. S. Jepsen
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Correspondence to S. Jepsen.

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Jepsen, S., Kebschull, M. & Deschner, J. Wechselwirkungen zwischen Parodontitis und systemischen Erkrankungen. Bundesgesundheitsbl. 54, 1089–1096 (2011). https://doi.org/10.1007/s00103-011-1348-4

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