Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지

Association between periodontal disease and coronary heart disease

치주질환과 관상동맥질환의 관련성에 대한 임상적 연구

  • Lee, Jun-Ho (Department of Periodontology, Chonnam National University) ;
  • Chung, Hyun-Ju (Department of Periodontology, Chonnam National University, Dental Science Research Institute, Chonnam National University) ;
  • Kim, Ju-Han (Department of Cardiovascular Medicine, Chonnam National University)
  • 이준호 (전남대학교 치과대학 치주과학교실) ;
  • 정현주 (전남대학교 치과대학 치주과학교실, 전남대학교 치과대학 치의학연구소) ;
  • 김주한 (전남대학교 의과대학 순환기내과학 교실)
  • Published : 2005.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Coronary heart disease is the leading cause of mortality in adult population. Whereas the association between periodontal disease and coronary heart disease (CHD) are controversial, recent studies reported the association between periodontal disease and acute myocardial infarction or prognosis of CHD. This study was aimed to investigate the relationship between periodontal disease and angiographically defined CHD, and acute myocardial infarction, and the prognosis of treated CHD. Patients under the age of 60 who had undergone the diagnostic coronary angiography were enrolled in this study, Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=20) without stenosis. After recording the number of missing teeth, periodontal disease status was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL), Positive CHD subjects were classified into acute myocardial infarction group (AMI), and non-AMI with angina pectoris and old myocardial infarction. Six months postoperatively, positive CHD subjects were followed and had undergone the coronary angiography again. Even though there was no significant difference in the periodontal parameters and status between positive CHD and negative CHD, some periodontal parameters, such as mean probing depth and proportion of sites with probing depth greater than 4mm or 6mm were significantly different between AMI and Non-AMI(p<0.05). There was no significant difference in the periodontal parameters according to in angiographically follow-up status. These results indicate that periodontal disease may be associated with the occurrence of acute myocardial infarction.

Keywords

References

  1. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S, Periodontal disease and cardia-vascular disease. J Periodontol 1996;67:1123-1137
  2. Thoden van Velzen SK, Abraham-Inpijn SKL, Moorer WR. Plaque and systemic disease: a reappraisal of the focal infection concept. J Clin Periodontol 1984;11:209-220 https://doi.org/10.1111/j.1600-051X.1984.tb02211.x
  3. Page RC. The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 1998;3:108-120 https://doi.org/10.1902/annals.1998.3.1.108
  4. Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic diseases caused by oral infection. Clin Microbiol Rev 2000;13:547-558 https://doi.org/10.1128/CMR.13.4.547-558.2000
  5. Kinane DF. Periodontal diseases contributions to cardiovascular disease: an overview of potential mechanisms. Ann Periodontol 1998;3:142-150 https://doi.org/10.1902/annals.1998.3.1.142
  6. Beck J, Offenbacher S. Oral health and systemic disease: periodontitis and cardiovascular disease. J Dent Education 1998;62:859-870
  7. Beck J, Offenbacher S, Williams R, Gibbs P, Garcia R. Periodontitis: a risk factor for coronary heart disease? Ann Periodontol 1998;3:127-141 https://doi.org/10.1902/annals.1998.3.1.127
  8. Offenbacher S, Madianos P, Champagne C, Southerland J, Paquette D, William R, Slade G, Beck J. Periodontitis - atherosclerosis syndrome: An expanded model of pathogenesis. J Periodont Res 1999;34:346-352 https://doi.org/10.1111/j.1600-0765.1999.tb02264.x
  9. DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. Br Med J 1993;306:688-691 https://doi.org/10.1136/bmj.306.6879.688
  10. Loesche W, Schook A, Terpenning M, Chen Y, Dominguez L, Grossman N. assessing the relationship between dental disease and coronary heart disease in elderly US veterans. J Am Dent Assoc 1998;129:301-311
  11. Malthaner S, Moore S, Mill M, Saad R, Sabatini R, Takacs V, McMahan C, Oates 1. Investigation of the association between angiographically defined coronary artery disease and periodontal disease. J Periodontol 2002;73:1169-1176 https://doi.org/10.1902/jop.2002.73.10.1169
  12. Hujoel P, Drangsholt M, Spiekerman C, Derouen T. Examining the link between coronary heart disease and the elimination of chronic dental infections. J Am Dent Assoc 2001;132:883-889
  13. Hujoel P, Drangsholt M, Spiekerman C, Derouen T. Pre-existing cardiovascular disease and periodontitis: a follow-up study. J Dent Res 2002;81:186-191 https://doi.org/10.1177/154405910208100309
  14. Mattila KJ, Nieminen MS, Valtonen W, Rasi VP, Kesaniemi YA, Syrjala SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. Br Med J 1989;298:779-781 https://doi.org/10.1136/bmj.298.6676.779
  15. Emingil G, Buduneli E, Aliyev A, Akilli A, Atilla G. Association between periodontal disease and acute myocardial infarction. J Periodontol 2000;71:1882-1886 https://doi.org/10.1902/jop.2000.71.12.1882
  16. Mattila K, Valtonen V, Nieminen M, Huttunen J. Dental infection and the risk of new coronary events: prospective study of patients with documented coronary artery disease. Clin Infec Dis 1995;20:588-592 https://doi.org/10.1093/clinids/20.3.588
  17. Joshipura K, Rimm E, Douglass C, Trichopoulos C, Ascherio A, Willett W. Poor oral health and coronary heart disease. J Dent Res 1996;9:1631-1636
  18. Han SH, Kim KH, Yang SM, Chung HJ, Choi YS, Han SB, Chung CP, Rhyu IC. Mechanism by which periodontitis may contribute to atherosclerosis. J Kor Acad Periodontol 2002;32:837-846
  19. 정하나, 정현주, 김옥수, 김영준, 김주한, 고정태. 한국인에서 치주질환과 관상동맥질환의 관련성에 대한 염증표지자와 IL-1 유전자 다변성의 영향. 대한치주과학회지 2004;34:607-622
  20. Bazile A, Bissada N, Nair R, Siegel B. Periodontal assessment of patients undergoing angioplasty for treatment of coronary artery disease. J Periodontol 2002;73:631-636 https://doi.org/10.1902/jop.2002.73.6.631
  21. Bergstrom J, Donner W, Eliasson S, Rasmanis G, Skoldin H. Myocardial infarction and periodontal disease. J Dent Res 1998;77:990
  22. Zambon J, Grossi S, Machtei E, Ho A, Dunford R, Genco R. Cigarette smoking increases the risk for subgingival infection with periodontal pathogens. J Periodontol 1996;67:1050-1054 https://doi.org/10.1902/jop.1996.67.10s.1050
  23. Castelli W, Garrison R, Dawber T, McNamara P, Feinleib M, Kannel W. The filter cigarette and coronary heart disease: the framingham story. Lancet 1981;2:109-113 https://doi.org/10.1016/S0140-6736(02)93231-9
  24. Kuller L, Velentgas P, Barzily J, Beauchamp N, O'leary D, Savage P, Diabetes mellitus: subclinical cardiovascular disease and the risk of incident cardiovascular disease and all-cause mortality. Arterioscler Thromb Vasc Biol 2000;20:823-829 https://doi.org/10.1161/01.ATV.20.3.823
  25. Grossi S, Skrepcinski F, De Caro T, Zambon J, Cummins D, Denco R. Response to periodontal therapy in diabetics and smokers. J Periodontol 1996;67: 1094-1102 https://doi.org/10.1902/jop.1996.67.10s.1094
  26. Feldman R, Bravacos J, Rose C. Association between smoking different tobacco products and periodontal indexes. J Periodontol 1983; 54:481-487 https://doi.org/10.1902/jop.1983.54.8.481
  27. Williams R, Jeffcoat M, Kaplan M, Goldhaber P, Johnson H, Wechter W. Flurbiprofen: A potent inhibitor of alveolar bone resorption in beagles. Science 1985;227:640-642 https://doi.org/10.1126/science.3969553