Associations among tooth loss, systemic inflammation and antibody titers to periodontal pathogens in Japanese patients with cardiovascular disease

Abstract

Background and Objective It is well known that there is a strong relationship between periodontitis and cardiovascular disease (CVD). Tooth loss reflects an end‐stage condition of oral diseases, such as periodontitis. Infection with specific periodontal pathogens is known as a possible factor that influences development of CVD. The aim of this study was to assess the relationship between the number of residual teeth and systemic inflammatory conditions in patients with CVD. Material and Methods We divided 364 patients with CVD into four groups, according to the number of residual teeth: (i) ≥20 teeth; (ii) 10‐19 teeth; (iii) 1‐9 teeth; and (iv) edentulous. We recorded medical history, blood data and periodontal conditions. Serum samples were obtained and their IgG titers against three major periodontal pathogens were measured. Results Smoking rate and the prevalence of diabetes mellitus were higher in edentulous patients and in subjects with a few teeth compared with patients with many teeth. The levels of C‐reactive protein were higher in patients with 1‐9 teeth than in those with 10‐19 teeth and with ≥20 teeth. The level of Porphyromonas gingivalis IgG in the group with 10‐19 teeth was statistically higher than that in the group with ≥20 teeth. The level of P. gingivalis IgG in the edentulous group tended to be lower than that in the other groups. Conclusion The patients with 1‐9 teeth had the highest level of C‐reactive protein among the four groups, and the patients with 10‐19 teeth had the highest level of IgG to periodontal bacteria. We conclude that the number of remaining teeth may be used to estimate the severity of systemic inflammation in patients with CVD.

Definition of hypertension‐associated oral pathogens in NHANES

“…Hypotheses suggest that periodontitis acts through systemic inflammatory pathways triggered by periodontal pathogens . In fact, increasing evidence suggests that periodontal microbiota contributes to a multitude of systemic conditions, such as hyperglycemia, hypertension, and cardiovascular diseases, besides being associated with increased mortality rates . In particular, the underlying common mechanisms appear to involve low‐grade inflammation driven by periodontal microbiota …”

“…a multitude of systemic conditions, such as hyperglycemia, 6 hypertension, 7 and cardiovascular diseases, 8 besides being associated with increased mortality rates. 9 In particular, the underlying common mechanisms appear to involve low-grade inflammation driven by periodontal microbiota.…”

Periodontal disease classifications and incident coronary heart disease in the Atherosclerosis Risk in Communities study

“…41,42 There also are studies that indicate missing teeth are associated with inflammation and other systemic markers that are risk factors for CVD. 43,44 At this time we can only speculate that GI represents general inflammation, while BOP indicates that the periodontal pocket is allowing microorganisms into the systemic circulation. Thus, the PPC stages illustrate the two hypothesized biological mechanisms underlying the association between periodontal disease and CHD, a potential hyper-inflammatory trait and the effect of periodontal pathogens in the circulatory system.…”

Characteristics of prosthetic treatment needs in patients with history of myocardial infarction and in general population based on topographic and occlusomorphological classification of missing teeth

“…na podstawie badań białka C-reaktywnego oraz poziomu IgG periopatogenów (P.gingivalis, A.actinomycetemcomitans) u Japończyków dowiedli, iż u pacjentów z zaburzeniami sercowo naczyniowymi liczba zębów rezydualnych może posłużyć jako czynnik wspomagający przy oszacowaniu nasilenia ogólnoustrojowego stanu zapalnego, nie brali oni jednak pod uwagę rozmieszczenia (klasyfikacji braków) zębów a tym samym nie wskazywali konkretnych potrzeb leczenia protetycznego. 16 Utrata zębów, skutkująca kaskadą potrzeb leczenia protetycznego jest formą niepełnosprawności, czasami nieuświadomioną, a niekiedy bagatelizowaną. Zachowanie zębów jest kluczowe dla zapewnienia odpowiedniej funkcji oraz estetyki układu stomatognatycznego.…”

“…However, they did not take into account the location of missing teeth (classification of missing teeth) and thus did not indicate the specific needs of prosthetic treatment. 16 Loss of teeth, resulting in a cascade of prosthetic treatment needs, is a form of disability, sometimes ignored and underestimated. Preservation of teeth is crucial for ensuring proper functioning and aesthetics of the stomatognathic system.…”