Peripheral arterial disease associated with caries and periodontal disease.
BACKGROUND
Peripheral arterial disease (PAD) is an important cardiovascular disorder of the peripheral arteries. Chronic infections, such as periodontitis, may play an important role in the etiology and pathophysiology of PAD and other cardiovascular conditions. Recently, Streptococcus mutans has been found with high frequency in atheromatous plaques. The aim of this study is to evaluate the possible clinical and microbiologic association between PAD and periodontitis and dental caries.


METHODS
Thirty patients with PAD and 30 control individuals were selected. PAD and its severity were established by the use of the ankle-brachial index (ABI). Clinical attachment loss (AL); probing depth; decayed, missing, and filled teeth (DMFT) index; and C-reactive protein (CRP) levels were evaluated. The presence of bacterial DNA from Streptococcus mutans, Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Treponema denticola, and Aggregatibacter actinomycetemcomitans was identified by polymerase chain reaction in subgingival biofilm and serum.


RESULTS
Patients with ≥30% AL ≥ 4 mm had six-fold increased risk of having PAD (odds ratio = 8.18; 95% confidence interval = 1.21 to 35.23; P = 0.031). There was statistical difference in the CRP (P = 0.0413) and DMFT index (P = 0.0002), with elevated number of missing teeth (P = 0.0459) in the PAD group compared with the control group. There were no significant differences in the frequency of bacteria in serum and subgingival plaque.


CONCLUSIONS
There was a positive relationship between periodontitis based on AL and PAD determined by the ABI (odds ratio = 8.18).
Oral Medicine Department, The Master's Degree in Dental Science Program with specialization in Advanced Education General Dentistry, San Luis Potosí University, San Luis Potosí, Mexico.
Uriel
U
Soto-Barreras
Javier O
JO
Olvera-Rubio
Juan P
JP
Loyola-Rodriguez
Juan F
JF
Reyes-Macias
Rita E
RE
Martinez-Martinez
Nuria
N
Patiño-Marin
Gabriel A
GA
Martinez-Castañon
Celia
C
Aradillas-Garcia
James W
JW
Little
D000328:Adult; D055109:Ankle Brachial Index; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004245:DMF Index; D003731:Dental Caries / Q000150:complications*; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017622:Periodontal Attachment Loss / Q000150:complications; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications* / Q000382:microbiology; D058729:Peripheral Arterial Disease / Q000150:complications*; D016388:Tooth Loss / Q000150:complications*
D002097:C-Reactive Protein