Periodontitis and Atherosclerosis

Poor oral health has been related to cardiovascular diseases. Specifically, periodontitis has been implicated in the pathogenesis of atherosclerosis. The objective of a study by Pinho et al was to evaluate the relationship between the degree of carotid atherosclerosis and severity of periodontitis in a patient cohort. The study involved 50 adult patients who received carotid duplex scans in a cerebral hemodynamics lab. Ultrasound protocol included measurement of carotid intima-media thickness (IMT), which is a marker of atherosclerosis, and characterization of any atherosclerotic plaques in the cervical common and internal carotid arteries. Patients were divided into 2 main groups: the test group had IMT ≥ 1 mm or the presence of any carotid atherosclerotic plaque, and the control group had IMT < 1 mm and absence of atherosclerotic plaques. Periodontal evaluation was performed in all the teeth and characterized according to the clinical attachment level, as follows: between one mm and 2 mm was classified as slight, 3 mm and 4 mm as moderate, and ≥ 5 mm as severe. The control group included 15 subjects (30%), while the test group included 35 (70%) subjects. The study found that the most common diagnosis was severe periodontitis (40%); moderate and slight periodontitis were also frequent occurrences (32% and 28%, respectively). In the control group, 53.3% had slight, 33.3% had moderate, and 13.3% had severe periodontitis. In the test group, those percentages were respectively 22.2%, 44.4%, and 33.3%. Patients with atheroma plaque had the highest percentage of severe periodontitis (70.6%). More severe periodontitis was related to atherosclerosis (P = .007). The study concluded that there was an association between periodontitis severity and carotid atherosclerosis, suggesting that periodontal disease might be a risk indicator for atherosclerotic disease.
(Source: Morado Pinho M, et al. “Periodontitis and Athero­sclerosis: An Observational Study.” Journal of Periodontal Research; doi: 10.1111/jre.12026, 2012 John Wiley & Sons A/S)

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