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Periodontal profiles in CAD.


Periodontitis and atherosclerosis have complex aetiologies, genetic and gender predispositions and may share pathogenic mechanisms as well as common risk factors. It is becoming increasingly clear that infections and chronic inflammatory condition such as periodontitis may influence the atherosclerotic process. Epidemiological associations between periodontally and cardiovascular disease have been reported. [1,2].

However, detailed analysis suggest that this relationship is weak, and that an over estimation of this association might result from insufficient compensation for lifestyle differences and common risk factors in the statistical models used to evaluate the relationship [3]. Hence, the present study was planned to evaluate periodontal conditions in CAD (Coronary Artery Disease)

Materials and methods

1030 smokers patient with CAD (diagnosed by CAG having more than 50% stenosis in one of epicardial vessel) [range 38-66 years] having cardiovascular disease attending cardiology LSL superspeciality centre PGIMS Rohtak were screened for periodontal conditions [according to previous classification[4]. i.e. mild, moderate, severe and attachment loss were measured by Williams probe],and selected for this study.

None of the participants were diabetic, alcoholic, hypertensive or suffering from any other ongoing general disease or infections.

All the statistical analysis were performed using SPSS software package (Version 11.0) and student 't' test were applied.

Result and Discussion

Attachment loss increase with advancing age in CAD patients (Table I, p<0.05). The 51.2%, 36.6%, 73% and 4.9% were normal, mild, moderate, and severe periodontitis in coronary artery disease patients.


Previous studies have indicated a correlation between periodontal disease and asymptomatic coronary heart disease (50% stenosis in at least one of the epicardial arteries). While in the present study 4.9% normal, 7.3% mild, 36.6% moderate, and 51.2% severe periodontal conditions in CAD. These result lend support to the observation that there could be relationship between periodontal and cardiovascular disease because most of these patients periodontally were compromised i.e. 88%. Lopez et al., examined the relationship between oral health parameters and CHD and found that the mean attachment loss was significantly associated with CAD and the mean pocket depth was also positively associated with CAD[6]. results of our study in contrast with previous study. Periodontal disease, tooth loss, and carotid artery plaque have been reported to possible precursors of stroke and CAD[7]. It has been also observed that total tooth loss was significantly associated with CAD after adjustment of age, sex, smoking, social class and citrus fruit consumption[8]. While in our study, in addition to smoking, alcoholic and hypertensive, other systemic disease might be common factor for CHD and periodontitis. We conclude there is paucity of data regarding the effect of oral health on cardiovascular disease related parameters more studies with larger patient population group are needed.


[1.] Slade, G.D., E.M. Ghezzi, G. Heiss, 2003. Relationship between periodontal disease and cre a c tive protein among adults in the atherosclerosis risk in community study. Arch Intern Med, 163 (10): 1172-9.

[2.] Moorison, H.I., L.F. Ellison, G.W. Taylor, 1999. Periodontal disease and the risk of fatal coronary heart and cerebrovascular disease. J Cardiovascular Risk, 6(1): 7-11.

[3.] Hujoel, P.P., 2002. Does chronic periodontitis cause coronary heart disease? J Am Dent Assoc, 133(Supl.): 31S-36S.

[4.] Nyman, S., J. Lindhe, J. Lindhe, 2000. Clinical periodontology and implant dentistry. Copenhagen Blackwell Munksgaard, 403-13.

[5.] Emingil, G., E. Buduneli, A. Alijev, A. Akilli, G. Atilla, 2000. Association between periodontal disease and acute myocardial infraction. J Periodontol.

[6.] Loesche, W.J., A. Schock, M.S. Terpening, Y.M. Chen, C. Kerr, 1998. Dominguez BL. The relationship between dental disease and cerebral vascular accident in elderly united states veterans. Ann Periodontol, 3: 161-174.

[7.] Desvarieux, M., R.T. Demmer, T. Rundek, B. Boden Albala, D.K. Jacob Jr, P.N. Papapanou, 2003. Relationship between periodontal disease, tooth loss, and ceratoid artery plaque: the oral infections and vascular disease epidemiology study. Stroke vascular disease epidemiology. Stroke, 34: 2120-5.

[8.] Lowe, G., M. Woodward, A. Rumley, C. Morrison, H. Tunstall Pedode, K. Stephen, 2003. Total tooth loss and prevalent cardiovascular disease in men and women: possible roles of citrus consumption, vitamin C and inflammatory and thrombotic variables. J Clin Epidemiology, 56: 694-700.

Corresponding Author

Dr. Balwant Rai Government Dental College, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Science, Rohtak, Haryana (INDIA) E-mail :, Mobile No: 091-9812185855

Dr. Balwant Rai, Dr. Kuldeep Singh Lallar, Dr. Simmi Kharb, Government Dental College, Pt. Bhagwat Dayal Sharma, Post Graduate Institute of Medical Science, Rohtak, Haryana (INDIA)
Table I: (mean+SD) clinical loss of attachment (in mm) in
various age group in patients (CAD patients).

Age group (in years) Attachment loss (in mm)

38-49 6.0 [+ or -] 1.3
49.1-59 6.2 [+ or -] 1.2
59.1-70 6.3 [+ or -] 1.2

p < 0.05
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Article Details
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Title Annotation:Original Article; coronary artery disease
Author:Rai, Balwant
Publication:Advances in Medical and Dental Sciences
Article Type:Report
Geographic Code:9INDI
Date:Sep 1, 2008
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