Periodontitis deteriorates peripheral arterial disease in Japanese population via enhanced systemic inflammation

Abstract

Peripheral arterial disease (PAD) is a common manifestation of arterial stenosis of the extremity that reduces arterial flow. While patients with periodontitis are at a high risk of PAD, little causal information has been provided to date. To clarify the relationship, we conducted this cross-sectional study. The oral condition of patients with or without PAD, who attended Tokyo Medical and Dental University Hospital, was evaluated. Blood examinations and dental clinical measurements, including number of teeth, probing pocket depth (PPD), bleeding on probing (BOP) and clinical attachment level (CAL) were performed. Chi-square test was performed to compare gender, smoker rate, prevalence of DM, hypertension and dyslipidemia and edentulous rate. Wilcoxon test was used to compare bacterial counts and anti-bacterial antibodies and Student's t test was used to compare the other numerical values. The subjects were patients with (n = 34) or without (n = 956) PAD. We revealed that the PAD patients had more missing teeth (17.5 ± 11.0), a higher rate of edentulism (18%), and higher serum inflammatory factor levels than non-PAD patients (10.9 ± 8.7, 5%, respectively). On the other hand, there was no significant difference between hypertension, dyslipidemia, smoking status, HbA1c, bacterial antibody titers, and bacterial counts between the groups. In conclusion, we clarified that PAD patients had decreased tooth number and worsened oral and periodontal condition with enhanced systemic inflammation.

Periodontal condition in Japanese coronary heart disease patients: A comparison between coronary and non‐coronary heart diseases

“…We have already showed data of some cardiovascular diseases such as arrhythmia 21 and peripheral artery disease. 22 Some cardiovascular diseases in non-CHD groups might have an association with periodontal disease.…”

The risk of periodontitis for peripheral vascular disease: a systematic review and meta-analysis

“…Sixty-one studies were excluded when reviewing full text. Ultimately, 25 studies were included based on the inclusion and exclusion criteria (Ahn et al, 2016;Aoyama et al, 2017;Beck et al, 2001;Bloemenkamp et al, 2002;Çalapkorur et al, 2017;Carallo et al, 2010;Chen et al, 2008;Engebretson et al, 2005;Hayashida et al, 2013;Hung et al, 2003;Jung et al, 2014;Kure et al, 2018;Leivadaros et al, 2005;Lopez-Jornet et al, 2012;Mendez et al, 1998;Persson et al, 2002;Pinho et al, 2013;Ravon et al, 2003;Ramesh et al, 2013;Schillinger et al, 2006;Soder et al, 2005;Soto-Barreras et al, 2013;Wozakowska-Kaplon, 2013;Yu et al, 2014).…”

“…The characteristics of the including studies.Study (author, year) Adjusted, or matched factorsAoyama et al, 2017 Age, gender, smoking, hypertension, dyslipidemia and HbA1c levelsÇalapkorur et al, 2017 Age, gender, diabetes, hypertension and BMI Ahn et al, 2016 Age, gender, education level, tooth loss, smoking, drinking, central obesity…”

Introductory Chapter: The Importance of Gingival Treatment and Prevention

“…Subsequently, the endothelial tissues might be affected by this elevation, which in turn will cause peripheral artery disease [19] and lead to a significant increase in cardiovascular illnesses [20]. This conclusion is found to be more prominent if the loss of periodontal attachment is more than 4 mm in at least 30% of six different sites in the oral cavity [21]. On the other hand, the proper treatment of periodontitis can improve endothelial function and may prevent the incidence of cardiovascular diseases [22] and other systemic disorders as well [23].…”