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Kida M, Kokubo Y, Kosaka T, Ono T, Maeda Y, Watanabe M, Miyamoto Y, Ikebe K. Relationship between carotid intima-media thickness and periodontal disease in a Japanese urban population with and without hypertension: The Suita Study. J Clin Periodontol 2023; 50:265-275. [PMID: 36330666 DOI: 10.1111/jcpe.13740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM To investigate the association between periodontal disease and atherosclerosis and to examine whether the association is modified by hypertension status. MATERIALS AND METHODS In this cross-sectional study, 1472 Japanese individuals aged 50-79 years who underwent a medical check-up, dental examination, and carotid ultrasonography were studied. Carotid atherosclerosis was expressed as the maximum and mean carotid intima-media thickness (max-IMT, mean-IMT) and the presence of stenosis (≥75%). Periodontal status was examined by the Community Periodontal Index (CPI, codes 0-4). The participants were divided into three groups according to the periodontal status (CPI0-2, CPI3, CPI4). RESULTS A positive correlation was found between mean-IMT and periodontal disease after adjustment for cardiovascular risk factors in the entire cohort (mean-IMT in hypertensives: CPI0-2: 0.848 mm, CPI3: 0.857 mm, CPI4: 0.877 mm; normotensives: 0.782, 0.802, 0.826). In the entire cohort, the multivariable-adjusted odds ratio of stenosis based on mean-IMT significantly increased according to periodontal status in normotensives (odds ratio; CPI0-2: 1, CPI3: 1.39, CPI4: 2.53; p-value for trend = .004) but showed only marginal significant increase in hypertensives (1, 1.15, 1.55; p-value for trend = .063). No significant relationships were observed for max-IMT in all analyses. CONCLUSION We observed an association between periodontal disease and atherosclerosis in normotensive and hypertensive participants.
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Affiliation(s)
- Momoyo Kida
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Takayuki Kosaka
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takahiro Ono
- Division of Comprehensive Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yoshinobu Maeda
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Makoto Watanabe
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Yoshihiro Miyamoto
- Open Innovation Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
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Petrenya N, Hopstock LA, Holde GE, Oscarson N, Jönsson B. Relation between periodontitis and risk of cardiovascular disease: Insights from The Tromsø Study. J Periodontol 2022; 93:1353-1365. [PMID: 35621303 DOI: 10.1002/jper.22-0004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few large-scale studies have investigated the association between periodontitis and cardiovascular risk estimated by risk assessment models; moreover, this association remains unexplored in never-smokers. We aimed to examine the relationship between periodontitis and cardiovascular risk in a Norwegian general population, with a focus on never-smokers and the impact of sex and age. METHODS The present study included 2623 participants from the seventh survey of the Tromsø Study (Tromsø7, 2015-2016) aged 45-74 years and without previous myocardial infarction or stroke. Periodontitis was defined according to the 2017 AAP/EFP classification system. Participants were categorised by grade based on percentage bone loss/age as no periodontitis/grade A (low progression rate) and grade B/C (moderate-rapid progression rate). Low, medium, and high cardiovascular risk was defined based on the Norwegian risk model NORRISK 2. We used ordered logistic regression analysis to examine the association between periodontitis and cardiovascular risk, adjusting for education, toothbrushing frequency, body mass index, and diabetes. Subanalyses included stratification by sex and age (45-54, 55-64, 65-74 years) and a separate analysis of never-smokers. RESULTS Periodontitis grade B/C was associated with higher cardiovascular risk than no periodontitis/grade A (odds ratio [OR] 2.13, 95% confidence interval [CI]: 1.75-2.61). This association was significant in both men and women, all age groups, and never-smokers. However, when never-smokers were stratified by age, the association remained significant only in those aged 65-74 years (OR 3.00, 95% CI 1.50-5.99). CONCLUSION Periodontitis grade B/C was associated with higher cardiovascular risk overall, and in never-smokers aged 65-74 years. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Natalia Petrenya
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gro Eirin Holde
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.,Department of Clinical Dentistry, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nils Oscarson
- Clinic of Periodontology, The Public Dental Service, Region Västra Götaland, Skövde, Sweden
| | - Birgitta Jönsson
- The Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.,Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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The Relationship between Pulse Pressure and Periodontal Disease in Korean Populations with or without Hypertension. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12104973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims: This study evaluated the relationship between pulse pressure (PP) and periodontal disease in Korean adults with or without hypertension (classified as HTN and non-HTN, respectively). Methods: Data on 3496 adults (≥20 years) were obtained from the Korean National Health and Nutrition Examination Survey (2015). We classified those with HTN as SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or current use of anti-hypertensive medications. Results: There were a few key findings: when logistic regression analysis was applied for periodontal disease (community periodontal index score ≥ 3), the odds ratios (OR) were significantly higher in the high PP (PP > 60 mmHg) than in the normal PP (PP ≤ 60 mmHg) in the HTN group (OR, 2.131; 95% confidence interval (CI), 1.579–2.876). However, periodontal disease was not associated with high PP in the non-HTN group and was not significant (OR, 0.866; 95% CI, 0.494–1.518). Conclusions: In Korean adults, periodontal disease was positively associated with PP in the HTN group but not in the non-HTN group.
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Gwon JG, Choi J, Kim SH, Kim SH, Ryu JJ, Cho DH, Song IS. Risk of acute and chronic coronary syndrome in a population with periodontitis: A cohort study. Oral Dis 2021; 28 Suppl 2:2522-2529. [PMID: 33660304 DOI: 10.1111/odi.13816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/08/2021] [Accepted: 02/20/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To investigate the role of periodontitis in the risk of acute and chronic coronary syndrome with compounding factors, including sociodemographic factors and medication use. METHODS This retrospective cohort study used nationwide, population-based data from the Korean National Health Insurance Service-Health Screening Cohort database (514,866 individuals, 40-79 years). Propensity score matching was used for analysis. Information of subjects for 12 years was included. Socioeconomic and clinical factors were recorded and analysed. RESULTS The periodontitis group had a greater risk of overall acute coronary syndrome (hazard ratio [95% confidence interval] =1.25 [1.15, 1.35], p < .001) and non-fatal acute coronary syndrome (1.26 [1.16, 1.37], p < .001). The hazard ratio for chronic coronary syndrome was higher in patients with periodontitis (1.35 [1.25, 1.46], p < .001). The cumulative incidence of both acute and chronic coronary syndrome gradually increased, and the hazard ratios reached 1.25 and 1.35 at the 12-year follow-up, respectively. Subgroup analysis revealed that periodontitis had a significantly greater link with acute coronary syndrome incidence in males, younger adults, smokers and subjects without hypertension (p < .01) and with chronic coronary syndrome incidence in smokers, subjects without hypertension and subjects without dyslipidaemia (p < .05). CONCLUSIONS Periodontitis is associated with an increased risk of acute and chronic coronary syndrome.
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Affiliation(s)
- Jun Gyo Gwon
- Department of Transplantation Vascular Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jimi Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Seung-Hyun Kim
- Department of Medical Humanities, Korea University College of Medicine, Seoul, Korea
| | - Soo-Ho Kim
- Department of Dentistry, Chungnam National University Hospital, Daejeon, Korea
| | - Jae-Jun Ryu
- Department of Dentistry, Korea University Anam Hospital, Seoul, Korea
| | - Dong-Hyuk Cho
- Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - In-Seok Song
- Department of Dentistry, Korea University Anam Hospital, Seoul, Korea
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Haukka A, Heikkinen AM, Haukka J, Kaila M. Oral health indices predict individualised recall interval. Clin Exp Dent Res 2020; 6:585-595. [PMID: 32776480 PMCID: PMC7745075 DOI: 10.1002/cre2.319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 01/22/2023] Open
Abstract
Objectives The individualised recall interval (IRI) is part of the oral health examination. This observational, register‐based study aimed to explore how oral health indices DMFT (decayed, missing, filled teeth), DT (decayed teeth), CPI (Community Periodontal Index, maximum value of individual was used) and number of teeth are associated with IRI for adults. Methods Oral health examination includes an assessment of all oral tissues, diagnosis, a treatment plan and assessment and a determination of the interval before the next assessment. It is called the IRI. This cross‐sectional study population included 42,533 adults (age range 18–89 years), who had visited for an oral health examination during 2009, provided by the Helsinki City Social Services and Health Care. The recall interval was categorised into an ordinal scale (0–12, 13–24, 25–36 and 37–60 months) and was modelled using a proportional odds model. ORs less than one indicated a shorter recall interval. Results Recall interval categories in the study population were 0–12 months (n = 4,569; 11%), 13–24 months (n = 23,732; 56%), 25–36 months (n = 12,049; 28%), and 37–60 months (n = 2,183; 5%). The results of statistical models clearly showed an association between the length of recall intervals and oral health indices. In all models, higher values of DMFT, DT and CPI indicated a shorter recall interval. The number of teeth were not so relevant. The association was not influenced when different combinations of other predictors (age, gender, socioeconomic status, chronic diseases) were included in the model. The severity of periodontitis predicted a short recall interval, for example, in the Model 1, CPI maximum value 4 was OR = 0.35 (95% confidence interval 0.31–0.40). Conclusions The oral health indices showed a clear association with the length of the IRI. Poor oral health reduced IRI. The indices provide information about the amount of oral health prevention required and are useful to health organisations.
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Affiliation(s)
- Anna Haukka
- Dental Care, Health Services, The Social Services and Health care, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Jari Haukka
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Minna Kaila
- Public Health Medicine, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Tseng CW, Lu KC, Huang CJ. Therapeutic potentials of oral health instructions in periodontitis patients with diabetes mellitus: Glycemic control and beyond. J Dent Sci 2019; 15:118-119. [PMID: 32257012 PMCID: PMC7109507 DOI: 10.1016/j.jds.2019.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 11/22/2019] [Indexed: 12/03/2022] Open
Affiliation(s)
- Chih-Wei Tseng
- Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Ching Lu
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Jen Huang
- Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Integrative Research Center for Critical Care, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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