Association between subclinical atherosclerosis and oral inflammation: A cross‐sectional study

Abstract

Background:The aim of this cross-sectional study was to investigate the association between carotid intima-media thickness (c-IMT) values and periodontal and peri-implant diseases in a sample of patients with hypertension. Methods: A total of 151 participants with presence of at least one dental implant in function for >5 years were recruited. Anthropometric measurements, 24-h ambulatory blood pressure monitoring, ultrasound assessment of carotid arteries (c-IMT and presence of plaque) were recorded and venous blood samples obtained. An oral examination was performed by calibrated examiners to ascertain prevalence and severity of periodontal and peri-implant diseases. Binomial logistic regression was performed to investigate the potential association between various measures of exposure of dental diseases and predictors of cardiovascular risk (c-IMT > 0.9 mm and presence of plaque or their combination). Results: Diagnosis of periodontitis (OR 6.71, 95% CI: 2.68-16.76, P < 0.001), cumulative mucosal/gingival inflammation (Periodontal Screening and Recording score) (OR 1.25, 95% CI:1.12-1.41, P < 0.001), and mucositis (OR 3.34, 95% CI:1.13-9.85, P < 0.05) were associated with c-IMT > 0.9 mm and/or plaque presence independent of age, sex, smoking, 24 h systolic blood pressure and body mass index differences. No statistically significant results were noted for peri-implantitis. Linear regression models confirmed a positive association of cumulative mucosal/gingival inflammation (β = 0.011, SE 0.002, P < 0.001), diagnosis of periodontitis (β = 0.114, SE 0.020, P < 0.001), and peri-implant diseases (β = 0.011, SE 0.002, P < 0.001) with increased c-IMT values. Conclusions:This study confirms a positive association between mucosal/ gingival inflammation and subclinical atherosclerosis assessed by c-IMT values and the presence of carotid plaque in patients with hypertension, independent of traditional cardiovascular risk factors. Future studies are needed to further characterize this relationship.

Association between peri-implantitis and systemic inflammation: a systematic review

“…Thus, it is reasonable to hypothesize that peri-implantitis could induce a systemic inflammatory response in a similar fashion to periodontitis ( 46 ) ( Figure 4 ). A recent report confirmed indeed that when contrasting the host response of patients with periodontitis and peri-implantitis, the former represented a greater stimulus/trigger ( 47 ). This could be explained by the disproportionate number of inflamed sites often identified in patients with periodontitis as opposed to most reports describing the host response in patients with peri-implantitis referring to the single-digit number of implants affected.…”

The Impact of Peri-Implant Diseases on the General Status of Patients with Cardiovascular Diseases: A Literature Review

“…Upon exclusion of ineligible titles and abstracts, 27 studies remained for evaluation. Finally, 23 studies were excluded for not meeting the inclusion criteria, leaving 4 studies to be included in the qualitative analysis [ 43 , 44 , 45 , 46 ] ( Figure 1 ).…”

“…Blood sampling and analysis of serum concentrations of triglycerides, total cholesterol, LDL, HDL and vitamin-D, uric acid, plateletcrit, neutrophil, hemoglobin were measured in two studies [ 43 , 44 ]. One cross-sectional study investigated the association between carotid intima–media thickness (c-IMT) values and periodontal and peri-implant diseases.…”

“…The present systematic review, unlike the previous ones [ 48 , 49 ] including studies on the risk markers of cardiovascular diseases, aimed to primarily evaluate the correlation of factors affecting peri-implant bone resorption. The periodontal parameters around natural teeth and dental implants were used in all of the included studies [ 43 , 44 , 45 , 46 ]. The included studies’ CVD group had a significantly higher prevalence of moderate to severe peri-implantitis (RBL ≥ 2 mm) [ 46 ].…”

Poor Childhood Oral Health and Carotid Intima-Media Thickness: A Systematic Review

“…This association is present in adulthood as seen by a few articles and systematic reviews on the effect of poor oral health on cardiovascular risk factors (10) (22, 23) (24). In adults, infrequent visits to the dentist, gingivitis and/or periodontal disease were all positively correlated to increased IMT, independently from regular cardiovascular risk factors, such as age, hypertension, smoking, sex, diabetes, and others (23)(24)(25). evidence that intima-media thickness is increased in adults with poorer oral health, leading to premature atherosclerosis development and increased prevalence of atherosclerotic plaques, is alarming (24).…”