Leão TSS, Tomasi GH, Conzatti LP, Marrone LCP, Reynolds MA, Gomes MS. Oral inflammatory burden and carotid atherosclerosis among stroke patients.
J Endod 2022;
48:597-605. [PMID:
35143813 DOI:
10.1016/j.joen.2022.01.019]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 12/26/2022]
Abstract
INTRODUCTION
This study aimed to test the hypothesis that oral inflammatory burden (OIB) is independently associated with the carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA).
METHODS
This cross-sectional observational study included 240 hospital patients with the diagnosis of IS or TIA. The main exposures were apical periodontitis (AP), root canal treatment (RCT), and crestal alveolar (periodontal) bone loss (BL), and the main outcome was the CAB. Exposure and outcome variables were measured through a head and neck multidetector computed tomography angiography and CAB was dichotomized in <50% and ≥50% vessel occlusion. OIB scored as a composite measure of the endodontic and periodontal disease exposure. Hospital health records provided information on socio-demographic and medical covariates. Prevalence ratios (PR) were calculated through Poisson regression models, estimating the relationship between the oral exposures and CAB, with =5%.
RESULTS
Mean age was 62.15 ± 13.1 years, with 56.7% males. Univariate analyses showed that AP≥2 (PR=1.83,95%CI=1.05-3.17) and endodontic burden (EB) (AP &/or RCT≥2) (PR=1.98,95%CI=1.13-3.47) were associated with CAB ≥50%. Multivariate models, adjusted for socio-demographic and medical covariates, revealed that pooled periodontal and endodontic parameters (OIB= BL ≥5mm & EB ≥2) was independently associated with CAB ≥50% (PR=2.47,95%CI= 1.04-5.87).
CONCLUSION
A higher OIB was independently associated with increased levels of CAB among IS or TIA hospital patients. The combination of endodontic and periodontal parameters strengthened the observed association and should be evaluated in future studies on the relationship between oral health and cardiovascular outcomes.
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