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Review

Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review

by
Adelina S. Plachokova
1,*,
Jolijn Gjaltema
1,
Eliza R. C. Hagens
1,
Zahra Hashemi
1,
Tim B. A. Knüppe
1,
Thomas J. M. Kootstra
1,
Anita Visser
1,2 and
Bastiaan R. Bloem
3
1
Department of Dentistry, Radboud University Medical Center, 6525 EX Nijmegen, The Netherlands
2
Department of Gerodontology, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
3
Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Department of Neurology, Centre of Expertise for Parkinson and Movement Disorders, 6525 GA Nijmegen, The Netherlands
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2024, 25(8), 4504; https://doi.org/10.3390/ijms25084504
Submission received: 27 February 2024 / Revised: 15 April 2024 / Accepted: 17 April 2024 / Published: 19 April 2024
(This article belongs to the Special Issue Neuroinflammation in the Pathogenesis of Alzheimer's Disease and Related Dementias)
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Abstract

The aim of this comprehensive review is to summarize recent literature on associations between periodontitis and neurodegenerative diseases, explore the bidirectionality and provide insights into the plausible pathogenesis. For this purpose, systematic reviews and meta-analyses from PubMed, Medline and EMBASE were considered. Out of 33 retrieved papers, 6 articles complying with the inclusion criteria were selected and discussed. Additional relevant papers for bidirectionality and pathogenesis were included. Results show an association between periodontitis and Alzheimer’s disease, with odds ratios of 3 to 5. A bidirectional relationship is suspected. For Parkinson’s disease (PD), current evidence for an association appears to be weak, although poor oral health and PD seem to be correlated. A huge knowledge gap was identified. The plausible mechanistic link for the association between periodontitis and neurodegenerative diseases is the interplay between periodontal inflammation and neuroinflammation. Three pathways are hypothesized in the literature, i.e., humoral, neuronal and cellular, with a clear role of periodontal pathogens, such as Porphyromonas gingivalis. Age, gender, race, smoking, alcohol intake, nutrition, physical activity, socioeconomic status, stress, medical comorbidities and genetics were identified as common risk factors for periodontitis and neurodegenerative diseases. Future research with main emphasis on the collaboration between neurologists and dentists is encouraged.
Keywords: periodontitis; neurodegenerative diseases; Alzheimer’s disease; Parkinson’s disease; neuroinflammation; risk factor periodontitis; neurodegenerative diseases; Alzheimer’s disease; Parkinson’s disease; neuroinflammation; risk factor

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MDPI and ACS Style

Plachokova, A.S.; Gjaltema, J.; Hagens, E.R.C.; Hashemi, Z.; Knüppe, T.B.A.; Kootstra, T.J.M.; Visser, A.; Bloem, B.R. Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review. Int. J. Mol. Sci. 2024, 25, 4504. https://doi.org/10.3390/ijms25084504

AMA Style

Plachokova AS, Gjaltema J, Hagens ERC, Hashemi Z, Knüppe TBA, Kootstra TJM, Visser A, Bloem BR. Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review. International Journal of Molecular Sciences. 2024; 25(8):4504. https://doi.org/10.3390/ijms25084504

Chicago/Turabian Style

Plachokova, Adelina S., Jolijn Gjaltema, Eliza R. C. Hagens, Zahra Hashemi, Tim B. A. Knüppe, Thomas J. M. Kootstra, Anita Visser, and Bastiaan R. Bloem. 2024. "Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review" International Journal of Molecular Sciences 25, no. 8: 4504. https://doi.org/10.3390/ijms25084504

APA Style

Plachokova, A. S., Gjaltema, J., Hagens, E. R. C., Hashemi, Z., Knüppe, T. B. A., Kootstra, T. J. M., Visser, A., & Bloem, B. R. (2024). Periodontitis: A Plausible Modifiable Risk Factor for Neurodegenerative Diseases? A Comprehensive Review. International Journal of Molecular Sciences, 25(8), 4504. https://doi.org/10.3390/ijms25084504

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