Introduction: Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. Material and Methods: English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. Results: While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. Conclusions: Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD.

中文翻译：

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龈下感染控制对患有心血管疾病的牙周炎患者的系统性影响：叙述性回顾

简介：牙周炎是一种感染性炎症，是持续性全身炎症的一个关键因素，与动脉粥样硬化性心血管疾病 (CVD) 密切相关，而动脉粥样硬化性心血管疾病是发达国家的主要死亡原因。使用龈下机械器械治疗牙周炎，使用或不使用辅助抗菌剂可减少微生物负担和局部炎症，同时还可能为牙周炎和心血管疾病患者带来全身益处。本综述探讨了龈下器械使用或不使用抗菌产品对牙周炎和 CVD 患者的系统影响，并探讨了牙周炎和 CVD 之间复杂的致病相互作用。材料和方法：在英语数据库（PubMed MEDLINE 和 Cochrane 图书馆）中检索评估非手术牙周治疗对伴或不伴 CVD 牙周炎患者效果的研究。结果：虽然牙周治疗能否降低患有牙周炎的 CVD 患者的死亡率和发病率相关结果的能力仍不确定，但一些研究表明炎症标志物和血细胞计数有所减少。与全口递送相比，多次短期递送的龈下机械器械产生不良反应的风险较低，特别是全身炎症，这使其成为 CVD 患者的首选。结论：理想情况下采用基于象限的治疗方法进行龈下机械器械净化牙周袋，有可能减少局部和全身炎症，同时对患有牙周炎和并发 CVD 的患者产生最小的不良影响。