Periodontitis is an oral disease that is not limited to local tissue destruction. Escalating evidence over 20 years of research suggests there are various inflammatory pathways that link periodontitis to systemic damage. These etiological mechanisms are all metastatic in nature, and include the following:
• Metastatic spread of gram negative bacteria that gain access to the vasculature as a result of breach of the compromised epithelial lining of periodontal pockets;
• Metastatic injury from the effects of the circulating toxins of periodontal pathogens; and
• Metastatic inflammation caused by the immunologic response to the pathogens and their toxins.
Indeed, infection within the periodontium may be the site of origin for vasculature dissemination of a number of virulent pathogenic bacteria to distant sites throughout the body. This increases the burden of systemic inflammation implicated in a number of chronic disease states.
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