Systemic diseases and

1
? ? ? ? ?
Systemic diseases and oral cavity ???????????
?????? ?????? ?????
07-31211012755
yukkwa_at_kmu.edu.tw
2
? ? ? ?

• Relationships between
• chronic oral infectious
• diseases systemic
• diseases

2. Systemic diseases manifested in oral
cavity
3
????
References
1. ??? ???????????? Happy Teeth 2000?9?15?
p.5-10 2. Okuda K Ebihara Y. Relationships
between chronic oral infectious diseases
systemic diseases. Bull Tokyo Dent Coll
199839165-74 3. Scannapieco FA. Role of oral
bacteria in respiratory infection. J Periodontol
199970793-802 4. Sakane T et al Behcets
disease. New Eng Med J 19993411284-91 5.
Kaohsiung Medical University, Oral Pathology
Department 6. OBrien SJ Dean M. In search of
AIDS-resistance genes. Sci Am 199717744-53 7.
Mann JM Tarantola DJM. Improving HIV therapy.
Sci Am 199827964-67 8. Regezi JA et al. Oral
Kaposis sarcoma Biopsy accessions as an
indication of declining incidence. Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 200294399 9.
Sharquie KE. et al. Oral pathergy test in
Behcet's disease. Br J Dermatol 2002168-9 10.
Crispian Scully Handbook of oral disease
diagnosis management Chapter 4, p.148-9 11.
Cawson RA et al. Oral Disease 3rd edition,
p.14.14 12. Jin LJ et al. Are periodontal
diseases risk factors for certain systemic
disorders- what matters to medical practitioners?
Hong Kong Med J 2003931-7 13. Chen YK et al.
Intra-oral HIV-associated Burkitts lymphoma with
mandible involvement a case report. Oral Oncol
2005 41 249-52
4
Subtopics
bacteria
5
1. Oral bacteria causing bacterial
endocarditis
Ref 2
6
2. Relationships of periodontobacteria
and cardiovascular diseases
? ? ? ? ? ? ? ? ? ? ? ? ? ?
Ref 1
7
3. Pathogens for bacterial pneumonia in
oral cavity (epidemiological view)
Ref 3
8
3. Pathogens for bacterial pneumonia in
oral cavity (pathway)
Silent aspiration
Colonization
Ref 2
9
3. Pathogens for bacterial pneumonia in
oral cavity (cytokine)
(???)
Ref 3
10
3. Pathogens for bacterial pneumonia in
oral cavity (four mechanisms)
Mechanism (1)
(Respiratory pathogen)
H. influenzae
(Enzyme)
Protease
P. gingivalis
(Dental pathogen)
1. Mucosal surface receptor alteration by
protease
2. Aspiration into lung
Ref 3
11
3. Pathogens for bacterial pneumonia in
oral cavity (four mechanisms)
Mechanism (2)
2. Salivary pellicle
P. gingivalis
degradation by protease
H. influenzae
1. Salivary pellicle prevents respiratory
pathogen adhere to mucosal surface
3. Respiratory pathogen adhere to mucosal surface
Ref 3
12
3. Pathogens for bacterial pneumonia in
oral cavity (four mechanisms)
Mechanism (3)
H. influenzae
P. gingivalis
1. Salivary pellicle
Mucous layer
degradation by protease
2. Exposure of adhesion receptor for
respiratory pathogen
Salivary pellicle
Ref 3
13
3. Pathogens for bacterial pneumonia in
oral cavity (four mechanisms)
Mechanism (4)
Ref 3
14
4. Oral chronic infectious diseases cause
secondary diseases
Refs 2, 5
15
4. Oral chronic infectious diseases cause
secondary diseases
16
4. Oral chronic infectious diseases cause
secondary diseases
Metabolic injury by oral bacterial toxin
Coronary heart disease Abnormal pregnancy
outcome Persistent pyrexia Idiopathic trigeminal
neuralgia Atypical facial pain Acute myocardial
infarction
17
4. Oral chronic infectious diseases cause
secondary diseases
18
4. Oral chronic infectious diseases cause
secondary diseases - Bechets disease
Criteria recurrent oral ulceration
2 others findings
Ref 4
19
4. Oral chronic infectious diseases cause
secondary diseases
Pricking a sterile needle into the patients
forearm or lower lip. The results are judged to
be positive when the puncture causes an aseptic
erythematous nodule or pustule that is more than
2mm in diameter at 24 to 48 hours. At the
reaction site there is initially an accumulation
of neutrphils, followed by the accumulation of
mononuclear cells
Ref 9
20
4. Oral chronic infectious diseases cause
secondary diseases
Ref 9
21
4. Oral chronic infectious diseases cause
secondary diseases
Oral ulcer
Genital ulcer
A horizontal layer of inflammatory cells
Hypopyon
Erythema nodosum
Ref 4
22
4. Oral chronic infectious diseases cause
secondary diseases Crohns disease
Labial swelling fissuring
Ulceration
Cobblesing stone mucosa
Mucosal tag
Ref 4
23
5. Heat shock proteins producing by oral
bacteria may induce dermal diseases
Dermatitis
Ref 2
24
6. Gingivitis pathogens cause pregnancy
disorders
Ref 2
25
6. Gingivitis pathogens cause pregnancy
disorders
Ref 1
26
7. Periodontitis and diabetic mellitus
Ref 1
27
Periodontal infection systemic
conditions - potential linkage possible
pathogenic mechanisms
Ref 12
28
Systemic diseases manifested in oral cavity
Ref 5
29
Ref 6
30
Ref 5
31
Other Host cell
Infected other host cells
Integration
Integrase
Nucleus
HIV RNA
Nucleus
HIV mRNA
Protease
Reverse- transcriptase
Cytoplasm
Caspid
Uncoating
Cytoplasm
Ref 5
32
Ref 5
33
Ref 7
34
Ref 10
35
Ref 11
36
Oral Kaposis sarcoma Biopsy accessions as an
indication of declining incidence
203
Oral KS cases/year N 203
Due to highly active antiretroviral therapy in
1995
No. of cases
0
2002
1981
1997
1991
Twenty-year incidence of KS at the University of
California San Francisco
Ref 8
37
Hairy leukoplakia
Our Collected Case
Oral candidiasis
Ref 5
38
Our Collected Case Burkitts lymphoma
Refs 5, 13
39
Our Collected Case Burkitts lymphoma
CD-20
c-myc
Ki-67
p53
Oral Oncol Extra 200541249-52.
Refs 5, 13
40
Ref 5
41
Ref 5
42
Ref 5
43
Summaries
Knowing

• Relationships between
• chronic oral infectious
• diseases systemic
• diseases

2. Systemic diseases manifested in oral
cavity - AIDS, TB
44
? ?