Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.
J Periodontol. 2021 Dec;92(12):1730-1737. doi: 10.1002/JPER.20-0758. Epub 2021 Mar 27.
Periodontitis is suggested to be associated with a risk of cardiovascular events. Using periodontal treatment recorded in Swedish national registries as a surrogate marker, we aimed to investigate whether periodontitis was associated with a first myocardial infarction.
This nationwide case-control study, with data from national registries, involved 51,880 individuals with a first myocardial infarction in 2011 to 2013 (index date) and 246,978 controls matched 5:1 for age, gender, and geographic area. Periodontal treatment in the 3 years preceding the index date was classified as (1) no dental treatment, (2) no periodontal treatment, (3) one or more supragingival curettages, or (4) one or more treatments with scaling/root planing and/or periodontal surgery. Annual frequencies of treatment with scaling/root planing and/or periodontal surgery were also calculated. In all analyses, conditional logistic regression analyses estimated ORs for myocardial infarction with 95% CIs, adjusted for matched variables, income, education, and diabetes.
Although fewer cases than controls received treatment with scaling/root planing and/or periodontal surgery (19.2% versus 19.8%, P < 0.001), annual frequencies for cases were higher. We found no association of scaling/root planing and/or periodontal surgery with a first myocardial infarction (OR = 1.02; 95% CI: 1.00, 1.05). We did observe a non-significant trend, however, between risk of a first myocardial infarction and a high frequency of scaling/root planing and/or periodontal surgery (OR 1.14; 95% CI: 1.00, 1.29).
In the contemporary Swedish nationwide setting, no association between a first myocardial infarction and periodontitis, assessed as periodontal treatment, was found.
牙周炎与心血管事件风险相关。本研究使用瑞典国家登记处记录的牙周治疗作为替代标志物，旨在探究牙周炎是否与首次心肌梗死相关。
本项全国范围内的病例对照研究基于国家登记处的数据，纳入了 2011 年至 2013 年期间（索引日期）首次发生心肌梗死的 51880 例患者和 246978 例年龄、性别和地理区域匹配的 5:1 对照者。在索引日期前的 3 年内，牙周治疗分为（1）无牙科治疗、（2）无牙周治疗、（3）一次或多次龈上刮治、（4）一次或多次牙周刮治/根面平整术和/或牙周手术。还计算了每年接受牙周刮治/根面平整术和/或牙周手术治疗的频率。在所有分析中，条件逻辑回归分析估计了心肌梗死的 OR 值及其 95%CI，调整了匹配变量、收入、教育程度和糖尿病。
尽管接受牙周刮治/根面平整术和/或牙周手术治疗的病例少于对照者（19.2%比 19.8%，P < 0.001），但病例的年治疗频率更高。我们未发现牙周刮治/根面平整术和/或牙周手术与首次心肌梗死相关（OR = 1.02；95%CI：1.00，1.05）。然而，我们观察到首次心肌梗死风险与牙周刮治/根面平整术和/或牙周手术高频率之间存在非显著趋势（OR 1.14；95%CI：1.00，1.29）。
在当代瑞典全国范围内，未发现首次心肌梗死与牙周炎（通过牙周治疗评估）之间存在关联。
