Association between chronic apical periodontitis and coronary artery disease

J Endod. 2014 Feb;40(2):164-7. doi: 10.1016/j.joen.2013.10.026. Epub 2013 Nov 25.


Introduction: Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease.

Methods: This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software.

Results: The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease.

Conclusions: In these study patients, chronic apical periodontitis was independently associated with coronary artery disease.

Keywords: Chronic periodontitis; coronary artery disease; periapical periodontitis.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Blood Glucose / analysis
  • Blood Pressure / physiology
  • Body Mass Index
  • Cholesterol / blood
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cholesterol, VLDL / blood
  • Chronic Disease
  • Coronary Angiography / methods
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / diagnostic imaging
  • Cross-Sectional Studies
  • Diabetes Complications
  • Educational Status
  • Female
  • Humans
  • Hypertension / complications
  • Male
  • Marital Status
  • Middle Aged
  • Periapical Periodontitis / complications*
  • Periapical Periodontitis / diagnostic imaging
  • Radiography, Bitewing / methods
  • Risk Factors
  • Triglycerides / blood


  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Cholesterol, VLDL
  • Triglycerides
  • Cholesterol