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

Mehtap Bilgin Çetin; Canan Önder; Kaan Orhan; Deniz Kumbasar; Muhittin Abdulkadir Serdar; Elif Ünsal

doi:10.1111/jre.12782

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

J Periodontal Res. 2020 Dec;55(6):895-904. doi: 10.1111/jre.12782. Epub 2020 Jul 9.

Authors

Mehtap Bilgin Çetin¹, Canan Önder², Kaan Orhan³, Deniz Kumbasar⁴, Muhittin Abdulkadir Serdar⁵, Elif Ünsal²

Affiliations

¹ Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
² Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
³ Department of Dento Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
⁴ Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey.
⁵ Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey.

PMID: 32648271
DOI: 10.1111/jre.12782

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.

Keywords: coronary angiography; coronary artery disease; edentulism; periodontal disease; periodontitis.

MeSH terms

Aged
Coronary Angiography
Coronary Artery Disease* / complications
Coronary Artery Disease* / diagnostic imaging
Coronary Artery Disease* / epidemiology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Mouth, Edentulous*
Periodontitis* / complications
Periodontitis* / diagnostic imaging
Periodontitis* / epidemiology
Risk Factors