The Association Between Periodontal Disease, Cerebrovascular Events, and Neurodegenerative Diseases

Yıl 2025, Cilt: 5 Sayı: 2, 213 - 229, 28.08.2025

Yasemin Çiçek , Sıla Çağrı İşler

Öz

Periodontitis is a chronic inflammatory disease characterized by the destruction of the supporting tissues of the teeth. Key features include clinical attachment loss, periodontal pocket formation, bleeding on probing, and bone loss detectable via radiographs. Stroke is a vascular condition that causes damage to the central nervous system, while Alzheimer’s disease is a neurodegenerative disorder marked by the accumulation of amyloid-beta plaques and neurofibrillary tangles in brain regions responsible for learning and memory, ultimately leading to dementia. Parkinson’s disease is a progressive neurodegenerative disorder characterized by motor symptoms such as tremors, muscle stiffness, bradykinesia, and involuntary movements. Periodontal inflammation induces the host immune response, leading to the release of pro-inflammatory cytokines and an increase in systemic inflammatory markers. These cytokines, along with periodontopathogens, can cross the blood–brain barrier and trigger neuroinflammation. Chronic neuroinflammation activates microglia, resulting in central nervous system damage and contributing to neurodegeneration. Periodontitis has thus been associated with the onset and progression of stroke, Alzheimer’s disease, and Parkinson’s disease. This review aims to evaluate the relationship between periodontal disease and cerebrovascular as well as neurodegenerative disorders. A bidirectional relationship between periodontitis and these conditions has been observed. In patients with stroke, Alzheimer's disease, and Parkinson's disease, declines in physical and cognitive functions often complicates the ability to maintain proper oral hygiene, thereby increasing the risk of periodontal disease and tooth loss. Evidence suggests that periodontal treatment may improve clinical outcomes in these populations. Regular attendance at dental maintenance therapy sessions and maintaining good oral hygiene are therefore critically important for reducing systemic inflammation and preserving periodontal health.

Anahtar Kelimeler

Periodontitis , Cerebrovascular events , Alzheimer’s disease , Parkinson’s disease

Periodontal Hastalıklarla Serebrovasküler Olaylar ve Nörodejeneratif Hastalıklar Arasındaki İlişki

Öz

Periodontitis, dişleri destekleyen dokuların yıkımıyla karakterize olan kronik bir inflamatuar hastalıktır. Periodontitisin temel özellikleri arasında klinik ataşman kaybı, periodontal cep oluşumu, sondlamada kanama ve radyografik olarak tespit edilebilen kemik kaybı yer alır. İnme, merkezi sinir sisteminde hasara yol açan vasküler bir durumdur. Alzheimer hastalığı ise öğrenme ve bellekten sorumlu beyin bölgelerinde amiloid-beta plaklarının ve nörofibriler yumakların birikimi ile karakterize edilen ve demansa yol açan nörodejeneratif bir hastalıktır. Parkinson hastalığı ise titreme, kas sertliği, bradikinezi ve istemsiz hareketler gibi motor semptomlarla karakterize, ilerleyici bir nörodejeneratif bozukluktur. Periodontal inflamasyon, bağışıklık sistemini tetikleyerek pro-inflamatuar sitokinlerin salınımına ve sistemik inflamatuar belirteçlerin artışına yol açar. Bu sitokinler ve periodontopatojenler, kan-beyin bariyerini geçerek nöroinflamasyonu başlatabilir. Kronik nöroinflamasyon, mikroglia aktivasyonunu tetikleyerek merkezi sinir sisteminde hasara ve nörodejenerasyona neden olur. Bu bağlamda, periodontitis; inme, Alzheimer hastalığı ve Parkinson hastalığının başlangıcı ve ilerlemesi ile ilişkilendirilmiştir. Bu derleme, periodontal hastalık ile serebrovasküler olaylar ve nörodejeneratif hastalıklar arasındaki bağlantıyı değerlendirmeyi amaçlamaktadır. Periodontitis ile bu hastalıklar arasında çift yönlü bir ilişki olduğu gözlemlenmiştir. İnme, Alzheimer hastalığı ve Parkinson hastalığı olan bireylerde fiziksel ve bilişsel işlevlerdeki azalma, ağız hijyenini sağlamayı zorlaştırmakta, periodontal hastalık riskini ve diş kaybını artırmaktadır. Kanıtlar, periodontal tedavinin bu hastalıkların klinik seyrini iyileştirebileceğini göstermektedir. Bu nedenle, düzenli dental idame tedavilerine katılım ve optimal plak kontrolü, sistemik inflamasyonu azaltmak ve periodontal sağlığı korumak için kritik öneme sahiptir.

Anahtar Kelimeler

Periodontitis , Serebrovasküler olaylar , Alzheimer hastalığı , Parkinson hastalığı

Kaynakça

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