Nitya Krishna N, Doshi Dolar, Kulkarni Suhas, Reddy Madupu Padma, Srilatha Adepu, Satyanarayana Dantala
Oral Health Prev Dent. 2020 Jul 4;18(3):511-519. doi: 10.3290/j.ohpd.a44036.
Atherosclerosis is a devastating disease worldwide since it is the most frequent cause of myocardial infarction, stroke, renal failure, peripheral vascular disease and perhaps dementia. There is a well-documented evidence supporting the association between clinical/subclinical atherosclerosis and periodontitis. Carotid intima media wall thickness (CIMT) is a histopathologically validated marker of atherosclerosis. This study's purpose was to assess periodontal status based on carotid artery intima media thickness.
A cross-sectional study was carried out among subjects who visited the Care Hospital, Nampally Hyderabad for CIMT test. Oral hygiene status was evaluated using Simplified Oral Hygiene Index and periodontal health status was measured using modified World Health Organization (WHO) Oral Health Assessment form, 1997. The data was analysed using Statistical Package for Social Sciences (SPSS) version 21.0. The proportions and mean scores were compared using chi-square test, Mann-Whitney U test and analysis of variance (ANOVA). Logistic regression analysis determined the relationship between periodontitis, as an independent variable and other variables with CIMT. P < 0.05 was considered statistically significant.
A total of 600 individuals were classified based on CIMT thickness ≤ 1 mm (292; 48.6%) and CIMT > 1 mm (308; 51.3%) according to variables. Significantly higher mean scores were observed for all oral parameters among subjects with CIMT > 1 mm aged > 45 years and among males (p ≤ 0.05*). Logistic regression analysis showed that increasing age group, ie,> 45 years (OR 3.5), males (OR 2.02), university education (OR 2.99), no history of previous dental visit (OR 3.71); and visit ≥ 1 year (OR 0.76) and previous history of tobacco (OR 1.13) and alcohol use (OR 1.65), poor OHI-S (OR 8.00), Community Periodontal Index (CPI) with Code 3, 4 (OR 4.41) and loss of attachment (LOA) with Code 2 (OR 3.05) and Code 3 (OR 5.80) had significantly higher odds among individuals with subjects with CIMT > 1 mm compared to their counterparts (p ≤ 0.05*).
The results of the study concluded that periodontal disease and poor oral hygiene were more severe among the subjects with CIMT > 1 mm. To halt the progression of increasing CIMT, preventive oral health programmes need to be integrated in the cardiac setting with established dental referral which can bring out positive health behaviours.
动脉粥样硬化是一种在全球范围内具有毁灭性的疾病,因为它是心肌梗死、中风、肾衰竭、外周血管疾病甚至可能是痴呆症的最常见病因。有充分的证据支持临床/亚临床动脉粥样硬化与牙周炎之间的关联。颈动脉内膜中层厚度(CIMT)是经组织病理学验证的动脉粥样硬化标志物。本研究的目的是基于颈动脉内膜中层厚度评估牙周状况。
对前往海得拉巴楠帕利关怀医院进行CIMT检测的受试者开展了一项横断面研究。使用简化口腔卫生指数评估口腔卫生状况,并使用1997年修改后的世界卫生组织(WHO)口腔健康评估表测量牙周健康状况。使用社会科学统计软件包(SPSS)21.0版对数据进行分析。使用卡方检验、曼-惠特尼U检验和方差分析(ANOVA)比较比例和平均得分。逻辑回归分析确定作为自变量的牙周炎与其他变量与CIMT之间的关系。P < 0.05被认为具有统计学意义。
根据变量,共600名个体根据CIMT厚度≤1 mm(292名;48.6%)和CIMT>1 mm(308名;51.3%)进行分类。在CIMT>1 mm且年龄>45岁的受试者以及男性中,所有口腔参数的平均得分均显著更高(p≤0.05*)。逻辑回归分析表明,年龄组增加,即>45岁(比值比3.5)、男性(比值比2.02)、大学学历(比值比2.99)、无既往牙科就诊史(比值比3.71);就诊≥1年(比值比0.76)以及既往吸烟史(比值比1.13)和饮酒史(比值比1.65)、OHI-S差(比值比8.00)、社区牙周指数(CPI)为3、4级(比值比4.41)以及附着丧失(LOA)为2级(比值比3.05)和3级(比值比5.80)的个体,与CIMT≤1 mm的个体相比,CIMT>1 mm的个体出现这些情况的几率显著更高(p≤0.05*)。
研究结果得出结论,CIMT>1 mm的受试者中牙周疾病和口腔卫生状况较差更为严重。为阻止CIMT不断增加的进展,需要在心脏疾病防治过程中整合预防性口腔健康计划,并建立牙科转诊机制,这可以带来积极的健康行为。