Periodontitis and carotid atheroma: is there a causal relationship?

Periodontal diseases are highly prevalent in the population. Several studies implicated that chronic periodontitis may affect the arterial wall inducing subclinical atherosclerosis by triggering a systemic inflammatory response. Three theories have been put forward to explain potential mechanisms involved: the theory of bacterial invasion, the cytokine theory and the autoimmunization theory. Periodontal inflammation could have a role in the initiation and progression of arterial diseases such as coronary artery disease and carotid atherosclerosis. Further clinical studies are required to investigate if there is a causal relationship of chronic periodontitis with echolucent unstable carotid plaques.