Periodontal treatment influences risk markers for atherosclerosis in patients with severe periodontitis

Buhlin, Kåre; Hultin, Margareta; Norderyd, Ola; Persson, Lena; Pockley, A. Graham; Pussinen, Pirkko J.; Rabe, Per; Klinge, Björn; Gustafsson, Anders

doi:10.1016/j.atherosclerosis.2009.03.035

Cited by 66 publications

(65 citation statements)

References 27 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In support of a causal relationship, it has been claimed that periodontal treatment lowers C-reactive protein and low-density lipoproteins and improves endothelial function. [12][13][14][15] Such findings, addressing surrogate end points and not cardiovascular events, must be interpreted with caution, leaving an uncertainty regarding the true nature of the association between periodontal and cardiovascular disease. This knowledge gap was recently recognized by the American Heart Association in the following way …"statements that imply a causative association between periodontal disease and specific atherosclerotic vascular disease events or claim that therapeutic interventions may be useful on the basis of that assumption are unwarranted."…”

mentioning

confidence: 99%

Periodontitis Increases the Risk of a First Myocardial Infarction

et al. 2016

Self Cite

View full text Add to dashboard Cite

C ardiovascular disease is a leading mortality cause, which, despite a recent decline, still contributes to 4 million deaths per year, that is, almost half of all deaths in Europe, whereof ≈30% occurred at <65 years of age. 1It contributes to 22% of all disability-adjusted life-years lost in the European Union and a hospital discharge rate of 2400/100 000 inhabitants.2 Although traditional risk factors are behind a substantial proportion of cardiovascular disease, other factors are important.3 Chronic inflammation accelerates the progress of atherosclerosis, and inflammatory activation increases the risk for plaque rupture leading to acute coronary syndromes. 4,5 Editorial see p 549 Clinical Perspective on p 583Periodontal diseases are inflammatory conditions ranging from gingivitis to severe periodontitis, the latter with a prevalence of 9% in the western European population. 6 The prevalence is age dependent as exemplified by a survey from the United States where it increased from 11% in the age group 50 to 65 years to 20% among those >75 years. 7 The disease, which is diagnosed by clinical and radiographic examination, 8 is a chronic tissuedestructive inflammatory state, predominantly induced by Gramnegative bacteria colonizing the gingival crevice. Background-The relationship between periodontitis (PD) and cardiovascular disease is debated. PD is common in patients with cardiovascular disease. It has been postulated that PD could be causally related to the risk for cardiovascular disease, a hypothesis tested in the Periodontitis and Its Relation to Coronary Artery Disease (PAROKRANK) study. Methods and Results-Eight hundred five patients (<75 years of age) with a first myocardial infarction (MI) and 805 age-(mean 62±8), sex-(male 81%), and area-matched controls without MI underwent standardized dental examination including panoramic x-ray. The periodontal status was defined as healthy (≥80% remaining bone) or as mild-moderate (from 79% to 66%) or severe PD (<66%). Great efforts were made to collect information on possibly related confounders (≈100 variables). Statistical comparisons included the Student pairwise t test and the McNemar test in 2×2 contingency tables. Contingency tables exceeding 2×2 with ranked alternatives were tested by Wilcoxon signed rank test. Odds ratios (95% confidence intervals) were calculated by conditional logistic regression. PD was more common (43%) in patients than in controls (33%; P<0.001). There was an increased risk for MI among those with PD (odds ratio, 1.49; 95% confidence interval, 1.21-1.83), which remained significant (odds ratio, 1.28; 95% confidence interval, 1.03-1.60) after adjusting for variables that differed between patients and controls (smoking habits, diabetes mellitus, years of education, and marital status). Conclusions-In this large case-control study of PD, verified by radiographic bone loss and with a careful consideration of potential confounders, the risk of a first MI was significantly increased in patients with PD even after adjustment for confoundin...

show abstract

mentioning

confidence: 99%

Periodontitis Increases the Risk of a First Myocardial Infarction

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Periodontal therapy can reduce the levels of pro-inflammory cytokines at three months post-therapy, and thus may lower the CVD incidence. In addition, the current study concluded that periodontal therapy had minimal impact on levels of TNF-α and IL-1β [37]. The effects of periodontal intervention on serum IL-6 are not consistent.…”

Section: Effects Of Periodontal Intervention On Inflammatory Cytokinesmentioning

confidence: 68%

Is a Potential Therapeutic Strategy of Periodontal Intervention on Cardiovascular Disease, Yes or No?

Chen¹,

Zhang²,

Xu³

et al. 2017

View full text Add to dashboard Cite

Aims: Cardiovascular disease (CVD) and periodontitis are both chronic inflammatory disorders which are highly prevalent in populations. Bacteria involved in the periodontal disease have been found to be cardiovascular risk markers. Periodontal pathogens may contribute to the atheroma pathogenesis. Severe periodontitis is correlated with the prevalence of bacteraemia, and poor periodontal status is an important risk factor for CVD. However, the association is unclear. If the association is causal, the periodontal therapy will lead to an attenuation of the effects on CVD. The study aimed to study if the periodontal intervention therapy presented therapeutic effects on CVD. Methods: English language literature on periodontal intervention therapy on CVD is causal or not. The literature revealed 62 papers associated with this study to investigate the relationship between periodontitis and CVD. Results: The literature supported the idea that periodontal infections had been associated with CVD. Certain periodontal therapy is associated with bacteraemia, and the prevalence of bacteraemia may arise from periodontal therapy and poor oral hygiene practices. Periodontal therapy not only presented therapeutic effects by reducing cytokine activity and C-response protein (CRP), but also caused bacteraemia transitorily. Effective antibiotic prophylaxis pre-or post-periodontal therapy presented some beneficial effects on bacteraemia or CVD. Conclusion: Severe periodontitis causes systemic inflammation and endothelial dysfunction, and goes beyond the oral cavity. Periodontal intervention would contribute to the prevention of atherosclerosis, and antibiotic prophylaxis would be helpful to decrease bacteraemia and reduce the onset of CVD.

show abstract

“…In a study where successful periodontal treatment with pocket reduction was reported in adult periodontal patients with severe periodontitis, serum glucose, lipids and markers of systemic inflammation were not significantly altered after 3 months. At one year, HDL-C concentrations were significantly increased and LDL-C concentrations decreased with concurrent reduction in IL-18 and interferon  levels (Buhlin et al 2009). Both mechanical periodontal debridement and treatment with a nonsteroidal anti-inflammatory drug appeared to affect serum glycoprotein markers of infection and inflammation.…”

Section: Associations Of Periodontal Disease With Coronary Heart Diseasementioning

confidence: 89%

Diagnostic Value of Acute Phase Proteins in Periodontal, Psychosomatic and Cardiometabolic Diseases: Response to Treatment

Soory¹,

El-Shinnawi²

2011

Acute Phase Proteins as Early Non-Specific Biomarkers of Human and Veterinary Diseases

View full text Add to dashboard Cite

Periodontal treatment influences risk markers for atherosclerosis in patients with severe periodontitis

Cited by 66 publications

References 27 publications

Periodontitis Increases the Risk of a First Myocardial Infarction

Periodontitis Increases the Risk of a First Myocardial Infarction

Is a Potential Therapeutic Strategy of Periodontal Intervention on Cardiovascular Disease, Yes or No?

Diagnostic Value of Acute Phase Proteins in Periodontal, Psychosomatic and Cardiometabolic Diseases: Response to Treatment

Contact Info

Product

Resources

About