CORRELATION BETWEEN CARDIOVASCULAR DISEASES AND PERIODONTITIS - A RETROSPECTIVE STUDY
DOI:
https://doi.org/10.61841/4pq4jt66Keywords:
Cardiovascular disease; Hypertension; Myocardial Infarction; PeriodontitisAbstract
Periodontitis is a chronic inflammatory disease caused by bacterial colonization, which results in destruction of the tissues between the tooth surface and gingiva, loss of connective tissue attachment, erosion of alveolar bone, and tooth loss. There is much evidence stating that prevalent periodontitis is associated with increased coronary heart disease risk. Thus there is a need to evaluate the extent to which the strength of this association has been established. The aim of this study was to evaluate the correlation between cardiovascular diseases and periodontitis. A retrospective study was conducted using the patient records from a private dental college from June 2019 - March 2020. The study population included the case records of cardiovascular disease patients, selected by non-probability purposive sampling. Data was collected and then subjected to statistical analysis. Microsoft Excel 2016 (Microsoft office 10) data spreadsheet was used to collect data and later exported to SPSS IBM (version 20.0). Descriptive statistics and chi square test were employed with a level of significance set at p<0.05. The prevalence of periodontitis among cardiovascular patients was 81.47%. Among patients with CVD, 78.06% of hypertension patients, 3.41% of MI patients and 0.22% patients with other cardiac diseases had periodontitis. Within the limits of this study, there was a significant correlation between CVD and periodontitis (p=0.000), with a higher prevalence among hypertension patients. Patients with periodontitis are at an increased risk for cardiovascular diseases. The systemic inflammatory or immune response to periodontal infection may increase cardiovascular risk. Thus proper oral hygiene practices are important in maintaining overall health
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References
1. Li Y, Lee S, Hujoel P, Su M, Zhang W, Kim J, et al. Prevalence and severity of gingivitis in American
adults. Am J Dent. 2010 Feb;23(1):9–13.
2. Zheng Y. Genetic risks of periodontal disease [Internet]. Available from:
http://dx.doi.org/10.5353/th_b5801679
3. Ostberg AL, Halling A, Lindblad U. Gender differences in knowledge, attitude, behavior and perceived
oral health among adolescents. Acta Odontol Scand. 1999 Aug;57(4):231–6.
4. AlJehani YA. Risk factors of periodontal disease: review of the literature. Int J Dent. 2014 May
20;2014:182513.
5. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann
Periodontol. 1999 Dec;4(1):1–6.
6. Salvi GE, Lawrence HP, Offenbacher S, Beck JD. Influence of risk factors on the pathogenesis of
periodontitis. Periodontol 2000. 1997 Jun;14:173–201.
7. Seymour RA, Steele JG. Is there a link between periodontal disease and coronary heart disease?
[Internet]. Vol. 184, British Dental Journal. 1998. p. 33–8. Available from:
http://dx.doi.org/10.1038/sj.bdj.4809536
8. Armitage GC. Periodontology/Oral Medicine: Periodontal infections and cardiovascular disease-how
strong is the association? [Internet]. Vol. 6, Oral Diseases. 2008. p. 335–50. Available from:
http://dx.doi.org/10.1111/j.1601-0825.2000.tb00126.x
9. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, De Nardin E. Periodontal Infections Contribute
to Elevated Systemic C-Reactive Protein Level [Internet]. Vol. 72, Journal of Periodontology. 2001. p.
1221–7. Available from: http://dx.doi.org/10.1902/jop.2000.72.9.1221
10. Baelum V, Fejerskov O, Karring T. Oral hygiene, gingivitis and periodontal breakdown in adult
Tanzanians [Internet]. Vol. 21, Journal of Periodontal Research. 1986. p. 221–32. Available from:
http://dx.doi.org/10.1111/j.1600-0765.1986.tb01454.x
11. Genco R, Offenbacher S, Beck J. Periodontal disease and cardiovascular disease [Internet]. Vol. 133,
The Journal of the American Dental Association. 2002. p. 14S – 22S. Available from:
http://dx.doi.org/10.14219/jada.archive.2002.0375
12. Kinane DF. Periodontal Diseases’ Contributions to Cardiovascular Disease: An Overview of Potential
Mechanisms [Internet]. Vol. 3, Annals of Periodontology. 1998. p. 142–50. Available from:
http://dx.doi.org/10.1902/annals.1998.3.1.142
13. Chaitanya NC, Muthukrishnan A, Babu DBG, Kumari CS, Lakshmi MA, Palat G, et al. Role of
Vitamin E and Vitamin A in Oral Mucositis Induced by Cancer Chemo/Radiotherapy- A Meta-analysis. J
Clin Diagn Res. 2017 May;11(5):ZE06–9.
14. Subashri A, Uma Maheshwari TN. Knowledge and attitude of oral hygiene practice among dental
students [Internet]. Vol. 9, Research Journal of Pharmacy and Technology. 2016. p. 1840. Available
from: http://dx.doi.org/10.5958/0974-360x.2016.00375.9
15. Steele JC, Clark HJ, Hong CHL, Jurge S, Muthukrishnan A, Ross Kerr A, et al. World Workshop on
Oral Medicine VI: an international validation study of clinical competencies for advanced training in oral
medicine [Internet]. Vol. 120, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2015. p.
143–51.e7. Available from: http://dx.doi.org/10.1016/j.oooo.2014.12.026
16. Subha M, Arvind M. Role of Magnetic Resonance Imaging in Evaluation of Trigeminal Neuralgia with
its Anatomical Correlation [Internet]. Vol. 12, Biomedical and Pharmacology Journal. 2019. p. 289–96.
Available from: http://dx.doi.org/10.13005/bpj/1640
17. Muthukrishnan A, Kumar LB. Actinic cheilosis: early intervention prevents malignant transformation
[Internet]. BMJ Case Reports. 2017. p. bcr2016218654. Available from: http://dx.doi.org/10.1136/bcr-
2016-218654
18. Choudhury P. Vanishing Roots: First Case Report of Idiopathic Multiple Cervico–Apical External Root
Resorption [Internet]. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH. 2015. Available
from: http://dx.doi.org/10.7860/jcdr/2015/11698.5668
19. Warnakulasuriya S, Muthukrishnan A. Oral health consequences of smokeless tobacco use [Internet].
Vol. 148, Indian Journal of Medical Research. 2018. p. 35. Available from:
http://dx.doi.org/10.4103/ijmr.ijmr_1793_17
20. Patil SR, Maragathavalli G, Araki K, Al-Zoubi IA, Sghaireen MG, Gudipaneni RK, et al. Three-Rooted
Mandibular First Molars in a Saudi Arabian Population: A CBCT Study [Internet]. Vol. 18, Pesquisa
Brasileira em Odontopediatria e Clínica Integrada. 2018. p. e4133. Available from:
http://dx.doi.org/10.4034/pboci.2018.181.87
21. Rohini S, Jayanth Kumar V. Incidence of dental caries and pericoronitis associated with impacted
mandibular third molar-A radiographic study [Internet]. Vol. 10, Research Journal of Pharmacy and
Technology. 2017. p. 1081. Available from: http://dx.doi.org/10.5958/0974-360x.2017.00196.2
22. Venugopal A, Maheswari TNU. Expression of matrix metalloproteinase-9 in oral potentially malignant
disorders: A systematic review [Internet]. Vol. 20, Journal of Oral and Maxillofacial Pathology. 2016. p.
474. Available from: http://dx.doi.org/10.4103/0973-029x.190951
23. Maheswari TNU, Venugopal A, Sureshbabu N, Ramani P. Salivary micro RNA as a potential
biomarker in oral potentially malignant disorders: A systematic review [Internet]. Vol. 30, Tzu Chi
Medical Journal. 2018. p. 55. Available from: http://dx.doi.org/10.4103/tcmj.tcmj_114_17
24. Misra SR, Shankar YU, Rastogi V, Maragathavalli G. Metastatic hepatocellular carcinoma in the
maxilla and mandible, an extremely rare presentation. Contemp Clin Dent. 2015 Mar;6(Suppl 1):S117–
21.
25. Chaitanya NC, Muthukrishnan A, Krishnaprasad CMS, Sanjuprasanna G, Pillay P, Mounika B. An
Insight and Update on the Analgesic Properties of Vitamin C. J Pharm Bioallied Sci. 2018 Jul;10(3):119–
25.
26. Dharman S, Muthukrishnan A. Oral mucous membrane pemphigoid – Two case reports with varied
clinical presentation [Internet]. Vol. 20, Journal of Indian Society of Periodontology. 2016. p. 630.
Available from: http://dx.doi.org/10.4103/jisp.jisp_155_16
27. Muthukrishnan A, Kumar LB, Ramalingam G. Medication-related osteonecrosis of the jaw: a dentist’s
nightmare [Internet]. BMJ Case Reports. 2016. p. bcr2016214626. Available from:
http://dx.doi.org/10.1136/bcr-2016-214626
28. Ketabi M, Meybodi F, Asgari M. The association between periodontal disease parameters and severity
of atherosclerosis [Internet]. Vol. 13, Dental Research Journal. 2016. p. 250. Available from:
http://dx.doi.org/10.4103/1735-3327.182185
29. Heaton B, Applebaum KM, Rothman KJ, Brooks DR, Heeren T, Dietrich T, et al. The influence of
prevalent cohort bias in the association between periodontal disease progression and incident coronary
heart disease [Internet]. Vol. 24, Annals of Epidemiology. 2014. p. 741–6. Available from:
http://dx.doi.org/10.1016/j.annepidem.2014.07.006
30. Hyvärinen K, Mäntylä P, Buhlin K, Paju S, Nieminen MS, Sinisalo J, et al. A common periodontal
pathogen has an adverse association with both acute and stable coronary artery disease [Internet]. Vol.
223, Atherosclerosis. 2012. p. 478–84. Available from:
http://dx.doi.org/10.1016/j.atherosclerosis.2012.05.021
31. Frisk F, Hakeberg M, Ahlqwist M, Bengtsson C. Endodontic variables and coronary heart disease
[Internet]. Vol. 61, Acta Odontologica Scandinavica. 2003. p. 257–62. Available from:
http://dx.doi.org/10.1080/00016350310005510
32. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal
Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association?
[Internet]. Vol. 125, Circulation. 2012. p. 2520–44. Available from:
http://dx.doi.org/10.1161/cir.0b013e31825719f3
33. Kodovazenitis G, Pitsavos C, Papadimitriou L, Vrotsos IA, Stefanadis C, Madianos PN. Association
between periodontitis and acute myocardial infarction: a case-control study of a nondiabetic population
[Internet]. Vol. 49, Journal of Periodontal Research. 2014. p. 246–52. Available from:
http://dx.doi.org/10.1111/jre.12101
34. Farhat Yaasmeen Sadique Basha , Rajeshkumar S , Lakshmi T ,Anti-inflammatory activity of Myristica
fragrans extract . Int. J. Res. Pharm. Sci., 2019 ;10(4), 3118-3120 DOI:
https://doi.org/10.26452/ijrps.v10i4.1607
35. Marfil-Álvarez R, Mesa F, Arrebola-Moreno A, Ramírez-Hernández JA, Magán-Fernández A, O’Valle
F, et al. Acute Myocardial Infarct Size Is Related to Periodontitis Extent and Severity [Internet]. Vol. 93,
Journal of Dental Research. 2014. p. 993–8. Available from:
http://dx.doi.org/10.1177/0022034514548223
36. Holmlund A, Lind L. Number of Teeth Is Related to Atherosclerotic Plaque in the Carotid Arteries in
an Elderly Population [Internet]. Vol. 83, Journal of Periodontology. 2012. p. 287–91. Available from:
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