Periodontal Hastalıklar ve Covid-19 Arasındaki İlişki
Özet
Periodontal hastalıklar, dişleri destekleyen dokuları etkileyen inflamatuar hastalıklardır ve patojenik bakterilerin etkisiyle ortaya çıkar. Hastalığın risk faktörleri arasında genetik yatkınlık, yaşam tarzı faktörleri ve diyabet gibi sistemik hastalıklar bulunur. Hastalığın patogenezi, dokuların anormal immün tepkisinden kaynaklanır. Nötrofiller, inflamatuar sitokinler ve bakteriyel enzimlerin etkisiyle doku yıkımı meydana gelir.
Covid-19 virüsü, damlacık yoluyla ve doğrudan temasla kolayca bulaşarak solunum yolu enfeksiyonlarına sebep olan salgın bir hastalıktır. Virüsün kuluçka süresi diğer solunum yolu hastalığına neden olan patojenlere göre daha uzundur ve ACE2 reseptörleri aracılığıyla hücre içerisine girer. Hastalığın şiddeti, immün yanıt ve sitokin fırtınası gibi bağışıklık sisteminin gösterdiği tepkiye göre değişiklik gösterir. Diyabet, hipertansiyon ve kardiyovasküler hastalıklar gibi komorbiditeler Covid-19 enfeksiyonunun şiddetini artırabilirken, periodontal hastalıklarının da Covid-19 şiddeti ile ilişkili olabileceği düşünülmektedir. Diyabet gibi risk faktörleri hem Covid-19 hem de periodontal hastalıkların şiddetini artırabilir. Periodontal hastalıklarda artan sitokin seviyeleri Covid-19 enfeksiyonunda sitokin fırtınasına neden olarak enfeksiyonun şiddetini artırabilir. Ayrıca iyi bir ağız hijyeni sağlamak, Covid-19 enfeksiyonunu ve periodontal hastalıkları kontrol altında tutmada ve hastalıkların şiddetini azaltmada kritik rol oynar. Dolayısıyla, hem periodontal hastalıklar hem de Covid-19 enfeksiyonunun kontrolü ve tedavisi için ağız hijyeni önlemleri ve periodontal tedavi önemlidir.
Periodontal diseases are inflammatory conditions affecting the tissues that support the teeth, often arising due to the influence of pathogenic bacteria. Risk factors for the disease include genetic predisposition, lifestyle factors, and systemic diseases such as diabetes. The pathogenesis of the disease stems from abnormal immune responses in the tissues, leading to tissue destruction mediated by neutrophils, inflammatory cytokines, and bacterial enzymes.
Covid-19, on the other hand, is a pandemic disease easily transmitted through droplet and direct contact, causing respiratory tract infections. The virus has a longer incubation period compared to other respiratory pathogens and enters cells via ACE2 receptors. The severity of the disease varies depending on the immune response, including cytokine storms. Comorbidities such as diabetes, hypertension, and cardiovascular diseases can exacerbate the severity of Covid-19, and it's thought that periodontal diseases may also be associated with Covid-19 severity. Risk factors like diabetes can increase the severity of both Covid-19 and periodontal diseases. Elevated cytokine levels in periodontal diseases may exacerbate Covid-19 severity by triggering cytokine storms. Additionally, maintaining good oral hygiene plays a critical role in controlling both Covid-19 infection and periodontal diseases, helping to reduce their severity. Therefore, oral hygiene measures and periodontal treatment are crucial for the control and management of both periodontal diseases and Covid-19 infection. Understanding the relationship between these diseases and implementing appropriate treatment strategies is essential.
Referanslar
Tekin A. Tarihten günümüze epidemiler, pandemiler ve ekonomik sonuçları. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2021:330-355.
Merriam-Webster. Word of The Year: Pandemic. (Accessed 16 September, 2022. https://www.merriam-webster.com/words-at-play/word-of-the-year-2020-pandemic/pandemic)
Deng J, Zhou F, Hou W, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis. Annals of the New York Academy of Science. Feb 2021;1486(1):90-111. doi:10.1111/nyas.14506
Helmy YA, Fawzy M, Elaswad A, Sobieh A, Kenney SP, Shehata AA. The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control. Journal of Clinical Medicine. Apr 24 2020;9(4)doi:10.3390/jcm9041225
Walls AC, Park YJ, Tortorici MA et al. Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein. Cell. Apr 16 2020;181(2):281-292 e6. doi:10.1016/j.cell.2020.02.058
Chan JF-W, Yuan S, Kok K-H, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. 2020;395(10223):514-523. doi:10.1016/s0140-6736(20)30154-9
Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. The New England Journal of Medicine. Mar 5 2020;382(10):970-971. doi:10.1056/NEJMc2001468
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bioscience Trends. Mar 16 2020;14(1):72-73. doi:10.5582/bst.2020.01047
Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine. 2020;8(4)doi:10.1016/s2213-2600(20)30116-8
Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International Journal of Oral Science. Feb 24 2020;12(1):8. doi:10.1038/s41368-020-0074-x
Ren YF, Rasubala L, Malmstrom H, Eliav E. Dental Care and Oral Health under the Clouds of COVID-19. JDR Clinical & Translational Research. Jul 2020;5(3):202-210. doi:10.1177/2380084420924385
Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. International Journal of Oral Science. Mar 3 2020;12(1):9. doi:10.1038/s41368-020-0075-9
Li Y, Ren B, Peng X, et al. Saliva is a non-negligible factor in the spread of COVID-19. Molecular Oral Microbiology. Aug 2020;35(4):141-145. doi:10.1111/omi.12289
Baghizadeh Fini M. Oral saliva and COVID-19. Oral Oncology. Sep 2020;108:104821. doi:10.1016/j.oraloncology.2020.104821
Badran Z, Gaudin A, Struillou X, Amador G, Soueidan A. Periodontal pockets: A potential reservoir for SARS-CoV-2? Medical Hypotheses. Oct 2020;143:109907. doi:10.1016/j.mehy.2020.109907
Antonio Nanci DDB. Structure of periodontal tissues in health and disease. Periodontology 2000. 2006;40:11-28. doi:10.1111/j.1600-0757.2005.00141.x
Kinane DF. Causation and pathogenesis of periodontal disease. Periodontology 2000. 2001;5:8-20. doi:10.1034/j.1600-0757.2001.22250102.x
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology. Jun 2018;89 Suppl 1:S159-S172. doi:10.1002/JPER.18-0006
Armitage GC, Robertson PB. The Biology, Prevention, Diagnosis and Treatment of Periodontal Diseases. The Journal of the American Dental Association. 2009;140:36S-43S. doi:10.14219/jada.archive.2009.0356
Robert J Genco WSB. Risk factors for periodontal disease. Periodontology 2000. 2013;62:59-94. doi:10.1111/j.1600-0757.2012.00457.x
Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology. Jun 2018;89 Suppl 1:S74-S84. doi:10.1002/JPER.17-0719
Newman MG, Takei H, Klokkevold PR, Carranza FA. Newman and Carranza's clinical periodontology. 13 ed. Elsevier Health Sciences; 2018.
Loos BG, Van Dyke TE. The role of inflammation and genetics in periodontal disease. Periodontol 2000. Jun 2020;83(1):26-39. doi:10.1111/prd.12297
A. E, Loos NBG. Polymorphonuclear neutrophils in periodontitis and their possible modulation as a therapeutic approach. Periodontology 2000. 2016;71:140-163.
Lang NP, Lindhe J. Clinical Periodontology and Implant Dentistry. Sixth edition ed. vol 2. John Wiley & Sons, Ltd, Chichester, West Sussex, 2015; 2015.
Lourenco TG, Heller D, Silva-Boghossian CM, Cotton SL, Paster BJ, Colombo AP. Microbial signature profiles of periodontally healthy and diseased patients. Journal of Clinical Periodontology. Nov 2014;41(11):1027-36. doi:10.1111/jcpe.12302
Socransky SS, Haffajee AD. Evidence of bacterial etiology: a historical perspective. Periodontology 2000. 1994;doi:10.1111/j.1600-0757.1994.tb00016.x
Reddy S. Essential of Clinical Periodontology and Periodontics. vol 2. Jaypee Brothers Pub.; 2008:192-201.
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. Mar 2020;579(7798):270-273. doi:10.1038/s41586-020-2012-7
Tsang HF, Chan LWC, Cho WCS, et al. An update on COVID-19 pandemic: the epidemiology, pathogenesis, prevention and treatment strategies. Expert Review of Anti-Infective Therapy. Jul 2021;19(7):877-888. doi:10.1080/14787210.2021.1863146
Ding S, Liang TJ. Is SARS-CoV-2 Also an Enteric Pathogen With Potential Fecal-Oral Transmission? A COVID-19 Virological and Clinical Review. Gastroenterology. Jul 2020;159(1):53-61. doi:10.1053/j.gastro.2020.04.052
Wei Y, Wei L, Liu Y, et al. Comprehensive estimation for the length and dispersion of COVID-19 incubation period: a systematic review and meta-analysis. Infection. Aug 2022;50(4):803-813. doi:10.1007/s15010-021-01682-x
Chan JF, Kok KH, Zhu Z, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerging Microbes & Infections. 2020;9(1):221-236. doi:10.1080/22221751.2020.1719902
Wu C, Zheng M. Single-cell RNA expression profiling shows that ACE2, the putative receptor of COVID-2019, has significant expression in nasal and mouth tissue, and is co-expressed with TMPRSS2 and not co-expressed with SLC6A19 in the tissues. Research Square. 2020;doi:10.21203/rs.3.rs-16992/v1
Santos CF, Morandini AC, Dionisio TJ, et al. Functional Local Renin-Angiotensin System in Human and Rat Periodontal Tissue. PLoS One. 2015;10(8):e0134601. doi:10.1371/journal.pone.0134601
Paces J, Strizova Z, Smrz D, Cerny J. COVID-19 and the immune system. Physiological Research. Jul 16 2020;69(3):379-388. doi:10.33549/physiolres.934492
Biying Hu, ShaoyingHuang, LianghongYin. The cytokine storm and COVID-19. Journal of Medical Virology. 2021;93(1):250-256. doi:10.1002/jmv.26232
Qing Ye, Bili Wang, Mao J. The pathogenesis and treatment of the `Cytokine Storm' in COVID-19. Journal of Infection. 2020;80(6):607-613. doi:10.1016/j.jinf.2020.03.037
Snijder EJ, van der Meer Y, Zevenhoven-Dobbe J, et al. Ultrastructure and origin of membrane vesicles associated with the severe acute respiratory syndrome coronavirus replication complex. Journal of Virology. Jun 2006;80(12):5927-40. doi:10.1128/JVI.02501-05
Li J, Huang DQ, Zou B, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. Journal of Medical Virology. Mar 2021;93(3):1449-1458. doi:10.1002/jmv.26424
Chu DK, Akl EA, Duda S, et al. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. The Lancet. 2020;395(10242):1973-1987. doi:10.1016/s0140-6736(20)31142-9
Cheng VC, Wong SC, Chuang VW, et al. The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection. Jul 2020;81(1):107-114. doi:10.1016/j.jinf.2020.04.024
Ciotti M, Ciccozzi M, Pieri M, Bernardini S. The COVID-19 pandemic: viral variants and vaccine efficacy. Critical Reviews in Clinical Laboratory Sciences. Jan 2022;59(1):66-75. doi:10.1080/10408363.2021.1979462
Pachetti M, Marini B, Benedetti F, et al. Emerging SARS-CoV-2 mutation hot spots include a novel RNA-dependent-RNA polymerase variant. Journal of Translational Medicine. Apr 22 2020;18(1):179. doi:10.1186/s12967-020-02344-6
Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S, Ciccozzi M. The 2019‐new coronavirus epidemic: Evidence for virus evolution. Journal of Medical Virology. 2020;92(4):455-459. doi:10.1002/jmv.25688
Warabi Y, Tobisawa S, Kawazoe T, et al. Effects of oral care on prolonged viral shedding in coronavirus disease 2019 (COVID-19). Special Care in Dentist. Sep 2020;40(5):470-474. doi:10.1111/scd.12498
Gomes SC, Fachin S, da Fonseca JG, et al. Dental biofilm of symptomatic COVID-19 patients harbours SARS-CoV-2. Journal of Clinical Periodontology. Jul 2021;48(7):880-885. doi:10.1111/jcpe.13471
Botros N, Iyer P, Ojcius DM. Is there an association between oral health and severity of COVID-19 complications? Biomedical Journal. Aug 2020;43(4):325-327. doi:10.1016/j.bj.2020.05.016
Pitones-Rubio V, Chavez-Cortez EG, Hurtado-Camarena A, Gonzalez-Rascon A, Serafin-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Medical Hypotheses. Nov 2020;144:109969. doi:10.1016/j.mehy.2020.109969
Marouf N, Cai W, Said KN, et al. Association between periodontitis and severity of COVID-19 infection: A case-control study. Journal of Clinical Periodontology. Apr 2021;48(4):483-491. doi:10.1111/jcpe.13435
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506. doi:10.1016/s0140-6736(20)30183-5
Gong J, Dong H, Xia QS, et al. Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19: a retrospective study. BMC Infectious Diseases. Dec 21 2020;20(1):963. doi:10.1186/s12879-020-05681-5
Wang M, Zhu Q, Fu J, Liu L, Xiao M, Du Y. Differences of inflammatory and non-inflammatory indicators in Coronavirus disease-19 (COVID-19) with different severity. Infect, Genetics and Evolution. Nov 2020;85:104511. doi:10.1016/j.meegid.2020.104511
Tjendra Y, Al Mana AF, Espejo AP, et al. Predicting Disease Severity and Outcome in COVID-19 Patients: A Review of Multiple Biomarkers. Archives of Pathology & Laboratory Medicine. Dec 1 2020;144(12):1465-1474. doi:10.5858/arpa.2020-0471-SA
Yang Y, Shen C, Li J, et al. Plasma IP-10 and MCP-3 levels are highly associated with disease severity and predict the progression of COVID-19. Journal of Allergy and Clinical Immunology. Jul 2020;146(1):119-127 e4. doi:10.1016/j.jaci.2020.04.027
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395(10229):1054-1062. doi:10.1016/s0140-6736(20)30566-3
Ranganath Muniyappa, Sriram Gubbi. COVID-19 pandemic, coronaviruses, and diabetes mellitus. American Journal Physiol Endocrinology and Metabolism. 2020;doi:10.1152/ajpendo.00124.2020
Weina Guo, Mingyue Li, Yalan Dong, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metababolism Research and Reviews. 2020;doi:10.1002/dmrr.3319
Lertpimonchai A, Rattanasiri S, Arj-Ong Vallibhakara S et al. A. The association between oral hygiene and periodontitis: a systematic review and meta-analysis. International Dental Journal. Dec 2017;67(6):332-343. doi:10.1111/idj.12317
Sampson V. Oral hygiene risk factor. BRITISH DENTAL JOURNAL. 2020;228
