Cultura

Inflammation, Infection, And The Oral–Systemic Disease Connection

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Mohammad Abdulrahman Aldossari, Bader Mohammed Almotairiy, Sakhar Fahad Almuhaya, Abdullah Saeed Albaqami, Yazeed Sultan Alsabeh, Musab Jurayyad Aljurayyad, Khalid Ibrahim Alanazi
Bader Saad Al-Dobaian, Abdulhmeed Abdulmohsen Alodib, Dr. Turki Abdullah Alqarni, Abeer Kheder Albishi, Munirah Fatis Alshahrani, Bandry Abdullah Almuqbil, Amani Nasser Almfrah, Saleh Mohammed Alsaygh

Abstract

Oral health is increasingly recognized as an integral component of systemic health, with growing evidence demonstrating complex, bidirectional relationships between oral diseases and a wide range of systemic conditions. This review synthesizes current evidence on the oral–systemic health continuum, with particular emphasis on periodontal disease, cardiovascular disease, diabetes mellitus, and the oral manifestations of systemic disorders. The review highlights the diagnostic and prognostic value of oral health indicators in identifying systemic disease risk and progression.

A central focus of this review is the emerging role of Artificial Intelligence (AI) in enhancing the detection, prevention, and management of oral–systemic conditions. AI-driven technologies, including machine learning algorithms, advanced imaging analysis, predictive modeling, and digital health platforms, are increasingly applied to identify early oral signs of systemic disease, support personalized care strategies, and facilitate interdisciplinary collaboration between dental and medical professionals.

The review also explores integrated care models that align dental and medical services, emphasizing the importance of interprofessional education, policy support, and community-based initiatives in reducing health disparities and improving patient outcomes. By consolidating evidence across clinical practice, public health, education, and health systems research, this review underscores the transformative potential of AI-enabled, interdisciplinary approaches in advancing holistic, patient-centered care. Future directions for research, policy, and practice are discussed, highlighting the need for scalable, ethically guided, and evidence-based integration of oral and systemic healthcare.

Keywords : Oral health; Systemic diseases; Oral–systemic health; Periodontal disease; Cardiovascular disease; Diabetes mellitus; Artificial intelligence; Machine learning; Interdisciplinary care; Integrated healthcare; Dental–medical collaboration; Public health; Predictive modeling.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty