title: Association among oral health, apical periodontitis, CD14 polymorphisms, and coronary heart disease in middle-aged adults.
abstract: BACKGROUND
  There is evidence to suggest that an association exists between oral infections and coronary heart disease (CHD). Subjects presenting lesions of endodontic origin (LEOs) or pulpal inflammation had an increased risk of developing CHD. However, findings concerning systemic manifestations of apical periodontitis (AP) remain controversial. An association between CD14 gene polymorphisms and atherosclerosis-associated diseases has been shown, but there are no data regarding an association between CD14 polymorphism and AP. This study evaluated associations between clinical oral health status, CD14 polymorphisms, and CHD.
  
  
  METHODS
  A case-controlled clinical trial was designed to compare middle-aged adults with acute myocardial infarction or unstable angina (n = 51) within 12 months of the acute event defined as first manifestation with healthy controls (n = 49). Participants were matched for age, sex, and socioeconomic status. Indicators of oral disease and compliance were evaluated. CD14 polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction.
  
  
  RESULTS
  CHD subjects had a higher prevalence of oral diseases and lower compliance to oral preventive strategies than healthy controls. Multivariate analysis showed a positive association between missing teeth (odds ratio [OR] = 1.37; 95% confidence interval [CI], 1.02-1.85), the number of LEOs (OR = 4.37; 95% CI, 1.69-11.28), chronic periodontitis (OR = 5.87; 95% CI, 1.17-29.4), and CHD. No statistically significant association emerged between the CD14 C(-260)T and the CD14 C(-159)T polymorphism, endodontic or periodontal disease, and CHD.
  
  
  CONCLUSIONS
  Chronic oral diseases may increase the risk of CHD and may be an unconventional risk factor for CHD.
authors.affiliation: Department of Surgical Sciences, University of Turin, Turin, Italy. damiano.pasqualini@unito.it
authors.forename: Damiano
authors.initials: D
authors.lastname: Pasqualini
authors.forename: Loredana
authors.initials: L
authors.lastname: Bergandi
authors.forename: Luigi
authors.initials: L
authors.lastname: Palumbo
authors.forename: Alberto
authors.initials: A
authors.lastname: Borraccino
authors.forename: Valentina
authors.initials: V
authors.lastname: Dambra
authors.forename: Mario
authors.initials: M
authors.lastname: Alovisi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Migliaretti
authors.forename: Gaetana
authors.initials: G
authors.lastname: Ferraro
authors.forename: Dario
authors.initials: D
authors.lastname: Ghigo
authors.forename: Serena
authors.initials: S
authors.lastname: Bergerone
authors.forename: Nicola
authors.initials: N
authors.lastname: Scotti
authors.forename: Mario
authors.initials: M
authors.lastname: Aimetti
authors.forename: Elio
authors.initials: E
authors.lastname: Berutti
mesh_terms: D000789:Angina, Unstable / Q000150:complications; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000150:complications; D003327:Coronary Disease / Q000150:complications* / Q000235:genetics; D003596:Cytosine; D004245:DMF Index; D003729:Dental Care; D003731:Dental Caries / Q000150:complications; D003788:Dental Pulp Diseases / Q000150:complications; D005260:Female; D006801:Humans; D018950:Lipopolysaccharide Receptors / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D009909:Oral Health; D009910:Oral Hygiene; D010483:Periapical Diseases / Q000150:complications; D010485:Periapical Periodontitis / Q000150:complications*; D011110:Polymorphism, Genetic / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length / Q000235:genetics; D012307:Risk Factors; D012907:Smoking; D012923:Social Class; D013941:Thymine; D016388:Tooth Loss / Q000150:complications
chemical_list: D018950:Lipopolysaccharide Receptors; D003596:Cytosine; D013941:Thymine