Association between subclinical atherosclerosis and oral inflammation: A cross-sectional study

J Periodontol. 2023 Apr;94(4):477-486. doi: 10.1002/JPER.22-0026. Epub 2022 Nov 14.

Abstract

Background: The aim of this cross-sectional study was to investigate the association between carotid intima-media thickness (c-IMT) values and periodontal and peri-implant diseases in a sample of patients with hypertension.

Methods: A total of 151 participants with presence of at least one dental implant in function for >5 years were recruited. Anthropometric measurements, 24-h ambulatory blood pressure monitoring, ultrasound assessment of carotid arteries (c-IMT and presence of plaque) were recorded and venous blood samples obtained. An oral examination was performed by calibrated examiners to ascertain prevalence and severity of periodontal and peri-implant diseases. Binomial logistic regression was performed to investigate the potential association between various measures of exposure of dental diseases and predictors of cardiovascular risk (c-IMT > 0.9 mm and presence of plaque or their combination).

Results: Diagnosis of periodontitis (OR 6.71, 95% CI: 2.68-16.76, P < 0.001), cumulative mucosal/gingival inflammation (Periodontal Screening and Recording score) (OR 1.25, 95% CI:1.12-1.41, P < 0.001), and mucositis (OR 3.34, 95% CI:1.13-9.85, P < 0.05) were associated with c-IMT > 0.9 mm and/or plaque presence independent of age, sex, smoking, 24 h systolic blood pressure and body mass index differences. No statistically significant results were noted for peri-implantitis. Linear regression models confirmed a positive association of cumulative mucosal/gingival inflammation (β = 0.011, SE 0.002, P < 0.001), diagnosis of periodontitis (β = 0.114, SE 0.020, P < 0.001), and peri-implant diseases (β = 0.011, SE 0.002, P < 0.001) with increased c-IMT values.

Conclusions: This study confirms a positive association between mucosal/gingival inflammation and subclinical atherosclerosis assessed by c-IMT values and the presence of carotid plaque in patients with hypertension, independent of traditional cardiovascular risk factors. Future studies are needed to further characterize this relationship.

Keywords: atherosclerosis; cardiovascular diseases; hypertension; peri-implantitis; periodontitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis*
  • Blood Pressure Monitoring, Ambulatory
  • Carotid Intima-Media Thickness
  • Cross-Sectional Studies
  • Gingivitis* / complications
  • Humans
  • Hypertension* / complications
  • Inflammation
  • Mucositis*
  • Peri-Implantitis*
  • Periodontitis* / complications
  • Risk Factors