Geerts Sabine O, Legrand Victor, Charpentier Joseph, Albert Adelin, Rompen Eric H
Department of Periodontology-Dental Surgery, University of Liege, Liège, Belgium.
J Periodontol. 2004 Sep;75(9):1274-80. doi: 10.1902/jop.2004.75.9.1274.
There is increasing evidence that chronic infections, such as periodontal diseases, could play a role in the initiation and development of coronary artery disease (CAD). The present study was intended to test for a possible association between presence and severity of periodontitis and coronary artery disease in a Belgian population.
A total of 108 CAD patients (mean age 59.2 +/- 11 years) and 62 presumably healthy controls (mean age 57.7 +/- 9 years) were enrolled in the study. Probing depth, periodontal pocket bleeding index (PPBI), plaque index, furcation involvements, and tooth mobility were evaluated to compare periodontal health in both groups. The subjects were also ranked according to a novel index of periodontitis severity, the periodontal index for risk of infectiousness (PIRI), aimed at quantifying the risk of release of proinflammatory mediators from the periodontal sites.
Periodontitis was significantly more frequent in CAD patients than in controls (CAD patients: 91%; controls: 66%). The mean number of pockets was 18 +/- 17.1 in cardiac patients versus 7.6 +/- 12.7 in controls (P < 0.0001), despite the fact that the mean number of missing teeth was significantly greater in cases than in controls (14 +/- 7.1 versus 9 +/- 5.2; P < 0.0001). Furthermore, proportions of mobile teeth, bleeding sites, periodontal pockets, and involved furcations were significantly higher in CAD patients than in controls. In addition, the extent of the periodontal disease present was also greater in cases than in controls. A logistic model, adjusted for known cardiovascular risk factors, showed a strong association between CAD and periodontitis (odds ratio [OR] = 6.5). Moreover, there was a significant dose-response relationship between increasing scores of the periodontal risk of infectiousness and the presence of CAD (adjusted OR = 1.3 per PIRI unit).
In the present study, periodontitis was revealed to be a significant risk factor for CAD after adjusting for other confounding factors, with the level of association increasing with the individual extent of the periodontal lesions.
越来越多的证据表明，慢性感染，如牙周疾病，可能在冠状动脉疾病（CAD）的发生和发展中起作用。本研究旨在检测比利时人群中牙周炎的存在和严重程度与冠状动脉疾病之间可能存在的关联。
本研究共纳入108例CAD患者（平均年龄59.2±11岁）和62例健康对照者（平均年龄57.7±9岁）。评估探诊深度、牙周袋出血指数（PPBI）、菌斑指数、根分叉病变和牙齿松动度，以比较两组的牙周健康状况。还根据一种新的牙周炎严重程度指数——感染风险牙周指数（PIRI）对受试者进行排名，该指数旨在量化牙周部位促炎介质释放的风险。
CAD患者中牙周炎的发生率显著高于对照组（CAD患者：91%；对照组：66%）。心脏病患者的牙周袋平均数量为18±17.1个，而对照组为7.6±12.7个（P<0.0001），尽管病例组缺失牙的平均数量显著多于对照组（14±7.1颗对9±5.2颗；P<0.0001）。此外，CAD患者中牙齿松动、出血部位、牙周袋和根分叉病变的比例显著高于对照组。此外，病例组牙周疾病的程度也高于对照组。在对已知心血管危险因素进行校正的逻辑模型中，显示CAD与牙周炎之间存在强关联（比值比[OR]=6.5）。此外，感染风险牙周指数得分增加与CAD的存在之间存在显著的剂量反应关系（校正OR=每PIRI单位1.3）。
在本研究中，在调整其他混杂因素后，牙周炎被揭示为CAD的一个重要危险因素，且关联程度随牙周病变的个体程度增加而增加。
