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    The Impact of Periodontal Diseases on Alzheimer's Disease: A Literature Review
    (Düzce Üniversitesi, 2024) Ozturk, Ayla
    Mounting evidence supports the link between Alzheimer's disease (AD), a neurodegenerative disease of the brain, and periodontitis, an inflammatory disease caused by bacteria attached to the tooth surface. It known that inflammation plays a vital role in the pathogenesis of both diseases with totally different clinical symptoms. Periodontitis can be defined as a low-grade systemic disease, considering that the level of pro-inflammatory cytokines and C-Reaktif protein in the systemic circulation is increased. Inflammation is also one of the important features of AD and forms the basis of the hypothesis that periodontitis may be a risk factor for AD. In inflammation theory, it has been suggested that the peripheral inflammatory process triggers amyloid plaque accumulation. Periodontitis can affect cognitive functions through various mechanisms. The mechanisms proposed in the literature are: a) Direct invasion of microorganism into the brain, b) Toxic products of the periodontal pathogens can reach the brain and have a toxic effect, c) the increase in subclinical doses of pro-inflammatory molecules in the systemic circulation during the host response to periodontitis and the long-term exposure of the brain to these molecules due to the chronic nature of periodontitis. Consistent with these theories, one of the major periodontal pathogens, Porphyromonas. gingivalis, has been detected in AD brains and cerebrospinal fluid. When administered orally to mice, P. gingivalis travels to the brain and induces neuroinflammation, amyloid plaque formation, and neurofibrillary tangles, which are pathological hallmarks of AD. The virulence factor of this pathogen, gingipain, has been shown to be elevated in the brain tissue of people with AD. Interestingly, the use of gingipain inhibitors, a P. gingivalis proteinase, in mice alleviates infection, decreases Amyloid beta 42 (A?42) peptide accumulation and neuroinflammation. The purpose of this review is to evaluate the link between periodontitis and AD and present the latest evidence explaining the relationship between both diseases.