Figure 1.

Mechanisms of periodontal systemic connections. Periodontitis, a chronic inflammatory condition affecting tooth-supporting structures and resulting from altered host-biofilm interactions, generates periodontal pockets that harbor oral anaerobic bacteria and viruses. These can be released systemically through the highly vascularized pocket granulation tissue or through aspiration via the oropharynx in those at risk and during therapeutic interventions. Circulatory release of proinflammatory cytokines, bacteria, and their byproducts may be associated with bacteremia, circulating leukocyte priming, low-grade inflammation, and ectopic deposition in distant organs. Similarly, aspirated anaerobic bacteria can colonize the lungs and lead to aspiration pneumonia.