Microcirculatory and clinical and morphological features of the oral mucosa in patients with atherosclerosis and periodontal diseases: a systematic review

Microcirculation disorders are considered as one of the key pathogenetic links of inflammatory periodontal diseases and systemic cardiovascular pathology. In recent years, atherosclerosis has increasingly been interpreted as a chronic inflammatory disease accompanied by endothelial dysfunction and microvascular changes, which can have a significant impact on the condition of oral tissues. This systematic review is aimed at summarizing data on the microcirculatory and clinico-morphological features of the oral mucosa in patients with atherosclerosis and associated cardiovascular and metabolic disorders. The literature search was performed in accordance with the recommendations of PRISMA 2020 and included an analysis of publications in Russian and English. The review includes original clinical studies that evaluated the state of microcirculation using laser Doppler flowmetry, ultrasound Dopplerography, videocapillaroscopy, and standard periodontal indexes. The results of the analyzed studies indicate that inflammatory periodontal diseases are accompanied by pronounced microcirculatory disorders, manifested by a decrease in tissue blood flow, increased vascular tone and structural restructuring of the capillary network. The presence of atherosclerosis and high cardiovascular risk factors exacerbates these changes even with comparable clinical severity of periodontitis. The identified microcirculatory disorders reflect the common pathogenetic mechanisms of chronic inflammation and endothelial dysfunction, which emphasizes the need for an interdisciplinary approach to the diagnosis and treatment of patients with combined dental and cardiovascular pathology.