Slavova Velislava, Nyagolova Atanaska
Department of Periodontology and Dental Implantology, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR.
Cureus. 2025 Jun 11;17(6):e85794. doi: 10.7759/cureus.85794. eCollection 2025 Jun.
Introduction Peri-implant mucositis and peri-implantitis are driven by the same periodontal pathogens implicated in atherosclerosis. Whether peri-implant infection influences coronary artery disease is uncertain. We compared subgingival microbial profiles and coronary stenosis in patients with dental implants versus dentate controls undergoing coronary angiography. Methods In this prospective cross-sectional study (December 6, 2021, to January 24, 2024), we enrolled 88 men (45-64 years) referred for elective or emergency coronary arteriography at a tertiary center. Thirty-seven patients with at least one implant (Group 1) and 51 dentate patients (Group 2) underwent standardized periodontal examination, subgingival sampling for real-time polymerase chain reaction quantification of and red-complex species (), and assessment of systemic risk factors. Coronary stenosis was graded angiographically and summarized by vessel-specific percent narrowing and the SYNTAX I score. Group differences were analyzed with Mann-Whitney U, χ², or Fisher's exact tests (α = 0.05). Results The cohorts were similar in body mass index, lipid profile, diabetes prevalence, and hypertension control. Implant carriers were older (median 60 vs. 55 years, p = 0.001) and more often received statins (75.7% vs. 54.9%, p = 0.046). Median counts of (210 × 10³ vs. 100 × 10³ genomes) and (32 × 10³ vs. 31 × 10³ genomes) were higher in Group 1, whereas total bacterial load was greater in Group 2 (p = 0.026). Implant carriers exhibited more severe stenosis of the circumflex (80% vs. 20%, p = 0.006) and right coronary arteries (75% vs. 20%, p = 0.025); SYNTAX I scores did not differ. Conclusions Peri-implant inflammatory disease was associated with higher concentrations of virulent red-complex bacteria and with marked stenosis of the circumflex and right coronary arteries, independent of traditional cardiovascular risk factors. Routine periodontal surveillance and early management of peri-implant mucositis may represent adjunctive strategies to mitigate coronary artery disease progression in implant recipients.
种植体周围黏膜炎和种植体周围炎是由与动脉粥样硬化相关的相同牙周病原体引起的。种植体周围感染是否会影响冠状动脉疾病尚不确定。我们比较了接受冠状动脉造影的牙种植体患者与有牙对照者的龈下微生物谱和冠状动脉狭窄情况。
在这项前瞻性横断面研究（2021年12月6日至2024年1月24日）中，我们纳入了88名年龄在45至64岁之间、在三级中心接受择期或急诊冠状动脉造影的男性。37名至少有一颗种植体的患者（第1组）和51名有牙患者（第2组）接受了标准化牙周检查、龈下采样以进行实时聚合酶链反应定量检测 和红色复合体菌种（），并评估全身危险因素。冠状动脉狭窄通过血管造影进行分级，并通过血管特异性狭窄百分比和SYNTAX I评分进行总结。组间差异采用Mann-Whitney U检验、χ²检验或Fisher精确检验（α = 0.05）。
两组在体重指数、血脂谱、糖尿病患病率和高血压控制方面相似。种植体携带者年龄较大（中位数60岁对55岁，p = 0.001），且更常接受他汀类药物治疗（75.7%对54.9%，p = 0.046）。第1组中 （210×10³对100×10³基因组）和 （32×10³对31×10³基因组）的中位数计数较高，而第2组的总细菌负荷更大（p = 0.026）。种植体携带者的回旋支（80%对20%，p = 0.006）和右冠状动脉（75%对20%，p = 0.025）表现出更严重的狭窄；SYNTAX I评分无差异。
种植体周围炎症性疾病与毒性红色复合体细菌的较高浓度以及回旋支和右冠状动脉的明显狭窄相关，独立于传统心血管危险因素。对种植体周围黏膜炎进行常规牙周监测和早期管理可能是减轻种植体接受者冠状动脉疾病进展的辅助策略。
