Rutger Persson G, Ohlsson Ola, Pettersson Thomas, Renvert Stefan
Departments of Periodontics and Oral Medicine, University of Washington, WA, Seattle, USA.
Eur Heart J. 2003 Dec;24(23):2108-15. doi: 10.1016/j.ehj.2003.10.007.
Chronic periodontitis (CP) has been associated with cardiovascular diseases. The study purposes were to identify the odds of acute myocardial infarction (AMI) and CP defined at different thresholds.
We studied 80 subjects with clinically confirmed AMI and 80 matched control subjects with no evidence of cardiovascular disease all receiving a comprehensive periodontal examination. Statistical analysis demonstrated a difference in the proportion of sites with a periodontal probing depth >/=6.0mm (2.7% for non-AMI and 12.1% for AMI group, 95% CI: -2.8 to 0.01, P<0.05) but no difference in the extent of gingival bleeding was found between groups. The odds ratio of having AMI and periodontitis varied between 9.2:1 to 14.1:1 with the greatest odds ratio if bone loss exceeded 4mm at >/=50% of the teeth (OR: 14.1:1, 95% CI: 5.5 to 28.2, P<0.0001). The odds ratio remained significant also when only non-smokers were considered (51 subjects) (OR: 7.0:1, 95% CI: 2.0 to 24.3, P<0.01).
Our findings suggest that patients who at routine dental visits demonstrate evidence of bone loss around several teeth can predictably be identified as being at risk for future AMI. Such subjects should be referred for medical and periodontal examinations and treatments.
慢性牙周炎(CP)与心血管疾病有关。本研究的目的是确定在不同阈值定义下急性心肌梗死(AMI)与CP的关联几率。
我们研究了80名临床确诊为AMI的受试者和80名匹配的无心血管疾病证据的对照受试者,所有受试者均接受了全面的牙周检查。统计分析表明,牙周探诊深度≥6.0mm的部位比例存在差异(非AMI组为2.7%,AMI组为12.1%,95%CI:-2.8至0.01,P<0.05),但两组之间牙龈出血程度无差异。患有AMI和牙周炎的比值比在9.2:1至14.1:1之间变化,如果超过50%的牙齿骨丧失超过4mm,则比值比最大(OR:14.1:1,95%CI:5.5至28.2,P<0.0001)。仅考虑非吸烟者(51名受试者)时,比值比也仍然显著(OR:7.0:1,95%CI:2.0至24.3,P<0.01)。
我们的研究结果表明,在常规牙科检查中显示出几颗牙齿周围有骨丧失迹象的患者,可以被预测为未来发生AMI的风险人群。这些受试者应被转诊进行医学和牙周检查及治疗。