Association of Apical Periodontitis with Cardiovascular Disease via Noninvasive Assessment of Endothelial Function and Subclinical Atherosclerosis

Chauhan, Nishant Kumar; Mittal, Shweta; Tewari, Sanjay; Sen, Jyotsana; Laller, Kuldip

doi:10.1016/j.joen.2019.03.003

Cited by 34 publications

(46 citation statements)

References 71 publications

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“…Recently, an experimental study conducted in rats has found an association between AP and atherosclerosis, the major contributor to ACVD [ 17 ]. Moreover, several observational studies have reported statistically significant excess risk for ACVD and cardiovascular events in patients with oral inflammation [ 18 , 19 ] including periodontal disease [ 15 ] and AP [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. AP has also been associated with poor endothelial flow reserve and early endothelial dysfunction in young adults [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study

González-Navarro

Segura-Egea

Estrugo‐Devesa

et al. 2020

JCM

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Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.

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Section: Introductionmentioning

confidence: 99%

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study

González-Navarro

Segura-Egea

Estrugo‐Devesa

et al. 2020

JCM

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“…Apical periodontitis (AP) is the inflammation and destruction of the periapical tissues as a consequence of a pulpal necrosis. It can also result from a pre-existing acute abscess or inadequate endodontic therapy (1,2). AP is a fairly frequent condition that increases with age.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Apical Periodontitis in patients with Multiple Myeloma

Sánchez¹,

Pérez-Díaz²,

Fj³

et al. 2020

Med Oral

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Background: Previous reports have been analyzed the prevalence/association of apical periodontitis (AP) with systemic diseases. The present study aims to analyze the prevalence of healthy/diseased periapex and endodontic treatments in patients with Multiple Myeloma (MM) and compare the results with those of control subjects. Material and Methods: Panoramic radiographs of 50 individuals with MM were evaluated and compared with 50 controls that were sex and age matched exactly with the diseased group. Radiographic analysis was performed by two experienced endodontists under standardized conditions. The periapical status (presence or not of AP) was assessed using the periapical index (PAI). Data included systemic health, technical quality of root fillings, total number of teeth, quality of restoration, and periapical status. Statistical evaluation of differences between groups used chi-squared tests and Fisher's exact tests. Results: The prevalence of root canal-treated teeth was 10.11% in the MM group and 12.05% in the control group (p=0.90). The average root canal-treated teeth in the test group was 2,34 and 2.48 in the control group, where the difference was statistically significant (p=0.05). AP in 1 or more teeth was found in 86 % and in 78% of the patients in the MM and the control groups, respectively. When analyzed by subject, there was no statistically significant difference in the prevalence of AP (p>0.72). Similarly there was also no statistically significant difference in the prevalence of PA (p=0.85), when analyzed by tooth, AP was found in 63.2% and 62.9% in MM and control groups. Conclusions: The presence of AP and endodontic treatment was not significantly different in individuals with MM compared with control subjects. Future studies are needed to elucidate and confirm the association between MM and AP.

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“…Furthermore, there was a significant inverse correlation observed between c-IMT and FMD (rs = -0.381, P < 0.001). This indicated an impaired FMD and greater carotid IMT in AP patients, supporting an association between endodontic infection and cardiovascular inflammatio [43] .…”

Section: Current View Of the Infectious Component Of Atherosclerosismentioning

confidence: 62%

Atherosclerosis microbiome: upcoming target for vaccine and drug development

Kozarov¹,

Progulske‐Fox²

2020

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Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in adults and is one critical area of the medical sciences. Atherosclerosis is the main underlying pathology and is characterized by chronic inflammation of the arterial walls. The current treatment modalities for CVD target hypertension, hyperlipidemia and hemostasis, and suppress inflammation without directly addressing the origin of inflammation. Thus, many individuals with multiple classic risk factors for CVD do not experience acute ischemic events. Moreover, myocardial infarction and stroke continue to occur in up to two-thirds of all patients. Because many cardiovascular events have not been explained by genetics or other risk factors, and multiple epidemiologic studies have consistently suggested an infectious component, the introduction of entirely novel approaches for diagnostics and treatment that target infections are acutely needed. These complementary novel approaches addressing additional manageable risk factors such as infections will be based on the concept of personalized medicine to control CVD and achieve longevity, while also increasing the quality of life. There are a variety of avenues that could enable such novel approaches. These focus on the discovery and characterization of the infective component of atherosclerosis, the atherosclerosis microbiome. Specifically, we provide an update of the latest developments in the oral microbiome and its relation to CVD.

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Association of Apical Periodontitis with Cardiovascular Disease via Noninvasive Assessment of Endothelial Function and Subclinical Atherosclerosis

Cited by 34 publications

References 71 publications

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study

Prevalence of Apical Periodontitis in patients with Multiple Myeloma

Atherosclerosis microbiome: upcoming target for vaccine and drug development

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