title: Assessment of periodontal conditions and systemic disease in older subjects. II. Focus on cardiovascular diseases.
abstract: BACKGROUND
  Panoramic radiographs (PMX)s may provide information about systemic health conditions.
  
  
  OBJECTIVE
  i). To study clinical periodontal conditions and collect self-reported health status in a cohort of 1084 older subjects; ii). to study signs of alveolar bone loss and carotid calcification from panoramic radiographs obtained from these subjects; and iii). to study associations between study parameters.
  
  
  METHODS
  PMXs from 1064 adults aged 60-75 (mean age 67.6, SD +/- 4.7) were studied. Signs of alveolar bone loss, vertical defects, and molar furcation radiolucencies defined periodontal status. Medical health histories were obtained via self-reports. Signs of carotid calcification were identified from panoramic radiographs.
  
  
  RESULTS
  The PMX allowed assessment of 53% of the films (Seattle 64.5% and Vancouver 48.4%). A self-reported history of a stroke was reported by 8.1% of men in Seattle and 2.9% of men in Vancouver (P < 0.01). Heart attacks were reported by 12% of men in Seattle and 7.2% in Vancouver (N.S.). PMX evidence of periodontitis was found in 48.5% of the subjects, with carotid calcification in 18.6%. The intraclass correlation score for PMX findings of carotid calcification and stroke was 0.24 (95% CI: 0.10-0.35, P < 0.001). The odds ratio for PMX carotid calcification and periodontitis was 2.1 (95% CI: 1.3-3.2, P < 0.001), and for PMX carotid calcification and stroke 4.2 (95% CI: 1.9-9.1, P < 0.001). The associations disappeared when smoking was accounted for. A history of a heart attack was associated with stroke, gender, age, and PMX scores of alveolar bone loss.
  
  
  CONCLUSIONS
  PMXs may provide valuable information about both oral conditions and signs of carotid calcification, data that are consistent with self-reported health conditions. Alveolar bone loss as assessed from PMXs is associated with cardiovascular diseases.
authors.affiliation: Department of Oral Medicine, University of Washington, Seattle, WA, USA. rper@u.washington.edu
authors.forename: R E
authors.initials: RE
authors.lastname: Persson
authors.forename: L G
authors.initials: LG
authors.lastname: Hollender
authors.forename: V L
authors.initials: VL
authors.lastname: Powell
authors.forename: M
authors.initials: M
authors.lastname: MacEntee
authors.forename: C C L
authors.initials: CC
authors.lastname: Wyatt
authors.forename: H A
authors.initials: HA
authors.lastname: Kiyak
authors.forename: G R
authors.initials: GR
authors.lastname: Persson
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D002114:Calcinosis / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D005006:Ethnicity; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016014:Linear Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D011862:Radiography, Panoramic; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000453:epidemiology; D014861:Washington / Q000453:epidemiology