title: Periodontitis is associated with angiographically verified coronary artery disease.
abstract: BACKGROUND
  We investigated the association of periodontitis and severity of coronary artery disease (CAD) as verified using coronary angiography.
  
  
  METHODS
  Participants were recruited among those attending coronary angiography at Helsinki University Central Hospital, Finland, in 2007 and 2008. Detailed clinical periodontal examination [number of teeth, bleeding on probing, periodontal probing depth (PPD)] and oral panoramic radiographs [alveolar bone loss (ABL), angular bone defects] were performed.
  
  
  RESULTS
  Of 506 patients, 123 (24.3%) had no significant CAD, whereas 184 (36.4%) had stable CAD and 169 (33.4%) acute coronary syndrome (ACS). Both stable CAD and ACS were associated with 8-17 missing teeth with ORs 4.33 (1.61-11.7, p = 0.020) and 5.24 (1.90-14.5, p = 0.014), and more than seven teeth with PPD ≥6 mm with ORs 2.44 (1.01-6.07, p = 0.049) and 2.75 (1.16-6.53, p = 0.022) respectively. Severe ABL was associated with ACS with an OR 5.39 (1.23-23.6, p = 0.025). Number of stenosed arteries was linearly associated with ABL (p for trend <0.001), number of missing teeth (p < 0.001), and pockets with probing depth ≥6 mm (p = 0.033).
  
  
  CONCLUSIONS
  Compared with patients with no significant stenosis, poor periodontal health including missing teeth, periodontal inflammation, and bone loss is associated with angiographically verified coronary artery narrowing in patients with stable CAD or ACS.
authors.affiliation: Institute of Dentistry, University of Helsinki, Helsinki, Finland. kare.buhlin@helsinki.fi
authors.forename: Kåre
authors.initials: K
authors.lastname: Buhlin
authors.forename: Päivi
authors.initials: P
authors.lastname: Mäntylä
authors.forename: Susanna
authors.initials: S
authors.lastname: Paju
authors.forename: Jaakko S
authors.initials: JS
authors.lastname: Peltola
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
authors.forename: Juha
authors.initials: J
authors.lastname: Sinisalo
authors.forename: Pirkko J
authors.initials: PJ
authors.lastname: Pussinen
mesh_terms: D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications / Q000453:epidemiology; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D016009:Chi-Square Distribution; D055113:Chronic Periodontitis / Q000150:complications* / Q000453:epidemiology; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D018709:Statistics, Nonparametric; D016388:Tooth Loss / Q000150:complications / Q000453:epidemiology