Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 3, May-June, p. 505–514
Publication type: original article
Correlation between the state of periodontal tissues and selected risk factors for periodontitis and myocardial infarction
1 Department of Periodontology and Oral Diseases, Medical University of Warsaw, Poland
2 Department of Periodontology, Pomeranian Medical University, Szczecin, Poland
3 Department of Periodontology, Wroclaw Medical University, Poland
4 Department of Periodontology, Medical University of Lublin, Poland
5 Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland
Background. The current level of knowledge indicates a relationship between periodontitis and diabetes and/or cardiovascular diseases (CVD). Periodontitis can be not only a risk factor for these diseases, but also a condition modifying other primary risk factors associated with the occurrence of cardiovascular complications (lipid disorders, arterial hypertension, etc.) or diabetes.
Objectives. The aim of the study was an analysis of the correlation between the state of periodontal tissues and selected risk factors for myocardial infarction (MI) in patients after recent myocardial infarction.
Material and Methods. The study included 417 patients (92 women, 325 men) hospitalized due to recent MI. The inclusion criteria were MI history and age below 70 years. The state of periodontal tissues (plaque index, bleeding on probing, pocket depth and clinical attachment loss, CPI index) and selected risk factors for periodontitis and CVD were recorded.
Results. An analysis of the results showed no statistically significant correlation between the depth, the number, percentage of periodontal pockets and the average clinical attachment level on one hand and BMI on the other hand. Whereas a statistically significant correlation was observed between tobacco smoking and the degree of severity of periodontal diseases measured by the average pocket depth, the number and percentage of pockets above 4 mm and the average clinical attachment loss, as well as between hypertension and the state of oral hygiene and between diabetes and the number of preserved teeth and the number of pockets above 4 mm.
Conclusion. The degree of severity of periodontal disease can impact hypertension and diabetes, which could potentially influence the occurrence and course of CVD.
risk factors, periodontitis, cardiovascular diseases
- Borrell LN, Papapanou PN. Analytical epidemiology of periodontitis. J Clin Periodontol. 2005;32:132–158.
- Napora M, Ganowicz E, Górska R. Correlation between the state of periodontal tissue and selected cardiovascular parameters in patients with 2 diabetes. Centr Eur J Immunol. 2013;38:556–561.
- D’Auito F, Sabbah W, Netuveli G, Donos N, Hingorani AD, Deanfield J, Tsakos G. Association of the metabolic syndrome with severe periodontitis in a large U.S. population–based survey. J Clin Endocrinol Metab. 2008;93:3989–3994.
- Tonetti MS, Van Dyke TE. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on periodontitis and systemic diseases. J Periodontol. 2013;84:(Suppl.4)24–29.
- Amar S, Gokce N, Morgan S, Loukideli M, Van Dyke TE, Vita JA: Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler Thromb Vasc Biol. 2003;23:1245–1249.
- Dalla Vecchia CF, Susin C, Rösing CK, Oppermann RV, Albandar JM. Overweight and obesity as risk indicators for periodontitis in adults. J Periodontol. 2005;76:1721–1728.
- Tonetti MS, Claffey N. Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. J Clin Periodontol. 2005;32:(Suppl. 6)210–213.
- Tonetti MS, D’Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J. Hingorani AD, Vallance P, Deanfield J. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356:911–920.
- O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43:38–46.
- Ainamo J, Bay I. Problems and proposal for recording gingivitis and plaque. Int Dent J. 1975;25:229–235.
- Cutress TW, Ainamo J, Sardo–Infirri J. The community periodontal index of treatment needs (CPITN) procedure for population groups and individuals. Int Dent J. 1987;37:222–233.
- Eke PI, Dye BA, Wei L, Thornton–Evans G, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91:914–920.
- Konopka T, Dembowska E, Pietruska M, Dymalski P, Górska R: Periodontal status and selected parameters of oral condition of Poles aged from 65 to 74 years. Przegl Epidemiol. 2015;69:643–647.
- Persson RE, Hollender LG, Powell VL, MacEntee M, Wyatt CC, Kiyak HA, Persson GR. Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases. J Clin Periodontol. 2002;29:803–810.
- Bertoldi C, Lalla M, Pradelli JM, Cortellini P, Lucchi A, Zaffe D. Risk factors and socioeconomic condition effects on periodontal and dental health: A pilot study among adults over fifty years of age. Eur J Dent. 2013;7:336–346.
- Thornton–Evans G, Eke P, Wei L, Palmer A, Moeti R, Hutchins S, Borrell LN. Periodontitis among adults aged > 30 years – United States, 2009–2010. Morb Mort Week Rep. 2013;62:129–134.
- Zhang Q, Li Z, Wang C, Shen T, Yang Y, Chotivichien S, Wang L. Prevalence and predictors for periodontitis among adults in China, 2010. Glob Health Action 2014;8:24503.
- D’Aiuto F, Parkar M, Nibali L, Suvan J, Lessem J, Tonetti MS. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: Results from a randomized controlled clinical trial. Am Heart J. 2006;151:977–984.
- Górski B, Nargiełło E, Opolski G, Ganowicz E, Górska R. Correlation between tooth loss and an increased risk of myocardial infarction in adult Polish population below 70 years of age – a case–control study. Nowa Stomatol. 2016;21:1,30–39.
- Desvarieux M, Demmer RT, Jacobs Jr DR, Rundek T, Boden–Albala B, Sacco RL, Papapanou PN. Periodontal bacteria and hypertension: The Oral Infections and Vascular Disease Epidemiology Study (INVEST). J Hypertens. 2010;28:1413–1421.
- Schillinger T, Kluger W, Exner M, Mlekusch W, Sabeti S, Amighi J, Wagner O, Minar E, Schillinger M. Dental and periodontal status and risk for progression of carotid atherosclerosis: The inflammation and carotid artery risk for atherosclerosis study dental substudy. Stroke. 2006;37:2271–2276.
- Holmlund A, Holm G, Lind L. Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects. J Periodontol. 2006;77:1173–1178.
- Kongstad J, Hvidtfeld UA, Grønbaek M, Stoltze K, Holmstrup P. The relationship between body mass index and periodontitis in the Copenhagen City Heart Study. J Periodontol. 2009;80:1246–1253.
- Ylöstalo P, Suominen–Taipale L, Reunanen A, Knuuttila M. Association between body weight and periodontal infection. J Clin Periodontol. 2008;35:297–304.
- Al–Zahrani MS, Bissada NF, Borawskit EA. Obesity and periodontal disease in young, middle–aged, and older adults. J Periodontol. 2003;74:610–615.
- Chaffee B, Weston SJ. Association between chronic periodontal disease and obesity: A systematic review and meta–analysis. J Periodontol. 2010;81:1708–1724.
- Hyman JJ, Winn DN, Reid BC. The role of cigarette smoking in the association between periodontal disease and coronary heart disease. J Periodontol. 2002;73:988–994.
- Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D, Diaz R, Rashed W, Freeman R, Jiang L, Zhang X, Yusuf S. INTERHEART Study Investigators: Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: A case–control study. Lancet. 2006;368:647–658.
- Parish S, Collins R, Peto R, Youngman L, Barton J, Jayne K, Clarke R, Appleby P, Lyon V, Cederholm–Williams S, Marshall J, Sleight P. Cigarette smoking, tar yields, and non–fatal myocardial infarction: 14,000 cases and 32,000 controls in the United Kingdom. The International Studies of Infarct Survival (ISIS) Collaborators. BMJ. 1995;311:471–477.
- Rudziński R, Banach J, Safranow K, Jakubowska K, Olszewska M, Dembowska E, Drożdzik A, Mazurek–Mochol M, Chlubek D: Nicotine, its major metabolites and selected assessment of exposure to tobacco smoke of patients with chronic periodontitis. Dent Med Probl. 2011;48:355–363 (in Polish).
- Wożakowska–Kapłon B, Włosowicz M, Gorczyca–Michta I, Górska R. Oral health status and the occurrence and clinical course of myocardial infarction in hospital phase: a case–control study. Cardiol J. 2013;20:370–377.
- Taylor GW, Burt BA, Becker MP, Genco RJ, Shlossman M. Glycemic control and alveolar bone loss progression in type 2 diabetes. Ann Periodontol. 1998;3:30–39.
- Kannel WB, Dawber TR, Kagan A, Revotskie N, Stokes J. Factors of risk in the development of coronary heart disease– six year follow–up experience. The Framingham Study. Ann Intern Med. 1961;55:33–50.
- McGee D, Cooper R, Liao Y, Durazo–Arvizu R. Patterns of comorbidity and mortality risk in blacks and whites. Ann Epidemiol. 1996;6:381–385.
- Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L. INTERHEART Study Investigators: Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): A case–control study. Lancet. 2004;364:937–952.
- Kosiborod M, Rathore SS, Inzucchi SE, Masoudi FA, Wang Y, Havranek EP, Krumholz HM. Admission glucose and mortality in elderly patients hospitalized with acute myocardial infarction: Implications for patients with and without recognized diabetes. Circulation. 2005;111:3078–3086.
- Gerstein HC, Islam S, Anand S. Dysglycemia and the risk of acute myocardial infarction in multiple ethnic groups: An analysis of 15,780 patients from the INTERHEART study. Diabetol. 2010;12:2509–2517.
- Paizan MLM, Vilela–Martin JF. Is there an association between periodontitis and hypertension? Curr Cardiol Rev. 2014;10:355–361.
- Cześnikiewicz–Guzik M. Chronic oral infections as a risk factor of atherosclerosis and arterial hypertension. Czynniki Ryzyka. 2009;3:52.