Bacterial Biofilms: A Role in Systemic Inflammation

It has been calculated that among individuals with chronic periodontitis, the surface area of the dento-gingival epithelium exposed to potential bacterial invasion and/or infiltration of antigenic microbial components is approximately 8 cm². Thus, it is not surprising that a breach of this epithelial barrier is a common occurrence in chronic periodontitis, and it is likely to result in systemic dissemination of microbes, antigens, and mediators of inflammation, which may constitute an independent risk factor for systemic inflammation and thus, to many systemic conditions, whose pathogenesis is based on chronic inflammation. In spite of the scientific evidence derived from many cross-sectional and cohort studies where these associations have been demonstrated, mostly between periodontitis and cardiovascular diseases, with pregnancy complications, with diabetes and with obesity, the role of bacterial serum dissemination and colonization at distant sites has not been fully proven. In this presentation we shall present available scientific evidence on the influence of periodontal treatment in the passage of periodontal pathogens derived from the subgingival biofilm into serum (bacteremia). We shall also present evidence on the colonization of these bacteria on atheroma plaques, derived from specimens collected from aortic arteries by endarterectomy and analysed by specific nested PCR against putative periodontal bacteria. With this available information, we shall try to develop possible clinical implications and directions for future research.