Utjecaj oralnog zdravlja na zdravlje mozga

master's thesis

• Title (english): The impact of oral health on brain health
• Author: Izidora Pavetić
• Mentor: Arijana Lovrenčić-Huzjan (mentor)
• Granter: University of Zagreb; School of Dental Medicine; Zagreb
• Defense date and country: 2024, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Dental Medicine

Abstract

Istraživanja sve više povezuju parodontitis s moždanom patologijom Alzheimerove bolesti i moždanog udara, dovodeći do razvitka ideje o liječenju parodontitisa kao metodi prevencije navedenih bolesti. Parodontitis je kronična upala zubnog parodonta multifaktorijalne etiologije povezana s disbiotičkim bakterijskim biofilmom. Ovakvo stanje usne šupljine dovodi do povišene razine sistemskih tjelesnih medijatora upale. Proinflamatorni citokini dovode do povećane propusnosti krvno-moždane barijere i neuroinflamacije. Neuroinflamacija je moždano stanje za koje se misli da se nalazi u podlozi demencija i dovodi do degeneracije neurona i njihovih sinapsi. Prisutnost bakterija parodontitisa i njihovih toksina u moždanom parenhimu pronađena je u post mortem analizi oboljelih od Alzheimerove bolesti. Također, stanje sistemne tjelesne upale dokazano dovodi do oštećenja endotela krvnih žila i ubrzavanja nastanka aterosklerotičnih promjena. Navedene promjene zahvaćaju i krvne žile moždane cirkulacije, povećavajući direktno, ali i indirektno rizik za nastanak moždanog udara. Dostupni podaci još uvijek ne mogu sa sigurnošću potvrditi uzročnu povezanost između parodontitisa i moždane patologije. Nejasnim ostaje točan trenutak ulaska bakterija u mozak (s obzirom na to da bi to mogla biti karakteristika poodmaklih stadija Alzheimerove bolesti), ali i točan način na koji štetno djeluju pojedini upalni citokini. Također, jasno je da oboljele nerijetko karakterizira manjak manualne koordinacije dovodeći do lošije oralne higijene i rezultirajući gingivitisom, a dugoročno i parodontitisom. Potrebna su dodatna randomizirana kontrolirana istraživanja s jasnim dijagnostičkim kriterijima. Kako je sistemna tjelesna upala dokazano povezana s aterosklerozom i moždanom patologijom, liječenje parodontitisa kao bolesti s velikom prevalencijom trebalo bi biti od zdravstvenog interesa u svrhu smanjenja sistemne tjelesne upale.

Abstract (english)

Research is increasingly linking periodontal disease with the brain pathology of Alzheimer's disease and stroke, leading to the development of the idea of periodontal treatment as a method of preventing these diseases. Periodontal disease is a chronic inflammation of the dental periodontium with a multifactorial etiology, associated with dysbiotic bacterial biofilm. This condition in the oral cavity leads to elevated levels of systemic mediators of inflammation. Pro-inflammatory cytokines lead to increased permeability of the blood-brain barrier and neuroinflammation. Neuroinflammation is a brain condition thought to underlie dementia leading to the degeneration of neurons and their synapses. The presence of periodontal bacteria and their toxins in the brain parenchyma was found in post mortem analyses of Alzheimer's disease patients. Additionally, a state of systemic inflammation has been proven to lead to endothelial damage of blood vessels and acceleration of atherosclerotic changes. These changes also affect the blood vessels of cerebral circulation, both directly and indirectly increasing the risk of stroke. Available data still cannot confirm with certainty a causal relationship between periodontitis and brain pathology. The exact moment of bacterial entry into the brain remains unclear (as this could be a characteristic of advanced stages of Alzheimer's disease), as well as the exact way in which certain inflammatory cytokines act harmfully. Also, it is evident that affected individuals are often characterized by a lack of manual coordination leading to poor oral hygiene resulting in gingivitis and, in the long term, periodontitis. Further randomized controlled trials with clear diagnostic criteria are required. As systemic inflammation is proven to be associated with atherosclerosis and brain pathology, treating periodontitis as a high prevalence disease should be of public health interest to reduce systemic inflammation.

• Keywords: parodontitis; Alzheimerova bolest; moždani udar; kronična upala
• Keywords (english): Periodontal Disease; Alzheimer's Disease; Stroke; Chronic Inflammation
• Language: croatian
• URN:NBN: urn:nbn:hr:127:730092
• Study programme: Title: Integrated undergraduate and graduate university study of Dental Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor dentalne medicine (doktor dentalne medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-07-06 08:56:53