Relationship of periodontitis and edentulism to angiographically diagnosed coronary artery disease: A cross‐sectional study

Abstract

Objective: The objective of the study is to examine the connection between oral status and the extent of coronary artery disease (CAD), which is diagnosed by angiography. Background: Periodontitis and tooth loss have been linked to atherosclerosis and CAD in previous studies. However, no distinct connection was revealed due to the diversity of the results and the variety of diagnostic methods. To provide a more consistent data pool and stronger evidence, there is a need for studies with standard measurements and diagnostic criteria. Methods: 309 patients, who consulted to Ankara University, Faculty of Medicine, Department of Cardiology and had coronary angiography, were enrolled to this study. Individuals were grouped based on their coronary angiography results, as CAD (+) (n = 233) and CAD (−) (n = 76). Studied parameters included cardiovascular risk factors, plaque index (PI), remaining teeth count, bleeding on probing (BOP), and probing pocket depth (PPD). Periapical radiographs were taken from teeth with ≥4 mm PPD. Oral status was categorized as periodontally healthy subjects/patients with gingivitis (Group 1), patients with periodontitis (Group 2), and edentulous subjects (Group 3). Results: PI (P < 0.001), PPD (P = 0.001), BOP (P = 0.004), the number of patients with less than 10 teeth (P = 0.014), and edentulism (P = 0.009) were significantly higher in CAD (+) patients, who were mostly older (P < 0.001) and male (P < 0.001). Multivariate logistic regression analysis revealed that Group 2 (odds ratio = 2.48, 95% confidence interval = 1.24-4.95, P = 0.010) and Group 3 (odds ratio = 2.01, 95% confidence interval = 1.14-5.17, P = 0.040) were highly associated with CAD. Two and three stenosed vessels were significantly higher in Groups 2 and 3 compared to Group 1 (P = 0.003). Conclusions: It was found that both edentulism and periodontitis were related to CAD.

Association of Systemic Sclerosis and Periodontitis with Vitamin D Levels

“…In agreement, a recent report [55] has evidenced that CRP was strictly correlated with PT, even after adjusting for some potential confounders [55][56][57]. For these reasons, during SSc, PT can lead to a negative systemic inflammatory stimulus and a relative augmented risk of endothelial dysfunction and focal ischemic injuries that, associated with SSc, may determine, in the heart tissues, myocytes apoptosis and fibroblasts replacement, with a final, irreversible myocardial fibrosis [56].…”

Systemic Multimorbidity Clusters in People with Periodontitis

“…Previous studies mainly focused on the association between periodontitis and only 1 of the systemic conditions, such as cardiovascular disease (Larvin et al 2021a), hypertension (Czesnikiewicz-Guzik et al 2019), diabetes (Winning et al 2017), and COVID-19 outcomes (Larvin et al 2020; Larvin, Wilmott, et al 2021). Some studies demonstrated that periodontitis is coprevalent with several systemic conditions, such as obesity, diabetes, and cardiovascular disease, but these were predefined at study inclusion (Kang et al 2019; Bilgin Çetin et al 2020; Takeda et al 2021). Through use of hypergraph analysis as a data-driven technique, our study has identified some common systemic multimorbidity clusters in people with periodontitis and the most influential single diseases to multimorbid presentation.…”

Assessment of Lipid Metabolism in Patients With Coronary Artery Disease and Generalized Periodontitis

“…Literature data indicate the close relationship of GP with cardiovascular diseases including coronary artery disease (CAD) [2,12,14,16,17,18,19]. CAD is a disease that combines angina, myocardial infarction, cardiosclerosis etc., and occurs due to narrowing of the coronary vessel lumen, often with subsequent thrombosis, which leads to insufficient oxygen supply to the heart muscle [11].…”

“…It has been suggested that GP may contribute to dysfunction and damage of blood vessels, including coronary arteries [2]. From this perspective, GP can act as an independent risk factor for CAD, along with common factors such as hypertension, diabetes, dyslipidemia, obesity, smoking, and others [1,12,14,23].…”

“…From this perspective, GP can act as an independent risk factor for CAD, along with common factors such as hypertension, diabetes, dyslipidemia, obesity, smoking, and others [1,12,14,23]. The pathogenesis of atherosclerosis due to GP is primarily associated with the presence of pathogenic anaerobic microorganisms in periodontal pockets, endotoxins which provoke the body's immune response with the subsequent development of systemic infl ammation, production of C-reactive protein and proinfl ammatory cytokines (IL-6, TNF-a) [2,5,8]. These cytokines are involved in atherogenesis, activate the processes of functional and structural impairment of the endothelium in the arterial walls (endothelial dysfunction), which subsequently leads to the formation of atherosclerotic plaques [12,15].…”