title: Periodontal disease, tooth loss and coronary heart disease assessed by coronary angiography: a cross-sectional observational study.
abstract: OBJECTIVE
  To evaluate the association between periodontal disease, tooth loss and coronary heart disease (CHD). There is still controversy about the relationship between periodontal disease and tooth loss with vessel obstruction assessed using coronary angiography.
  
  
  METHODS
  This cross-sectional study included 195 patients that underwent coronary angiography and presented with at least six teeth. Patients were classified into three categories of coronary obstruction severity: absence; one or more vessels with ≤ 50% obstruction; and one or more vessels with ≥ 50% obstruction. The extent of coronary obstruction was dichotomized into 0 and ≥ 1 affected vessels. A periodontist blinded to patient CHD status conducted a full mouth examination to determine mean clinical attachment loss, mean periodontal probing depth and tooth loss. Multiple logistic regression models were applied adjusting for age, gender, hypertension, smoking, body mass index, low-density lipoprotein cholesterol and C-reactive protein.
  
  
  RESULTS
  Most patients were males (62.1%) older than 60 years (50.8%), and 61% of them had CHD. Mean periodontal probing depth, clinical attachment loss and tooth loss were 2.64 ± 0.72 mm, 4.40 ± 1.31 mm and 12.50 ± 6.98 teeth respectively. In the multivariable models, tooth loss was significantly associated with a higher chance of having at least one obstructed vessel (odds ratio = 1.04; 95% confidence interval 1.01-1.09) and with vessel obstruction ≥ 50% (odds ratio = 1.06; 95% confidence interval 1.01-1.11). No significant associations were found between periodontal variables and vessel obstruction.
  
  
  CONCLUSIONS
  Tooth loss was found to be a risk indicator for CHD.
authors.affiliation: Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: S M
authors.initials: SM
authors.lastname: Zanella
authors.affiliation: Periodontology, Faculty of Dentistry, São Leopoldo Mandic University, Campinas, Brazil.
authors.forename: S S
authors.initials: SS
authors.lastname: Pereira
authors.affiliation: Institute of Cardiology of Porto Alegre, Porto Alegre, Brazil.
authors.forename: J N
authors.initials: JN
authors.lastname: Barbisan
authors.affiliation: Institute of Cardiology of Porto Alegre, Porto Alegre, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Vieira
authors.affiliation: Periodontology, Faculty of Dentistry, São Leopoldo Mandic University, Campinas, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Saba-Chujfi
authors.affiliation: Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: A N
authors.initials: AN
authors.lastname: Haas
authors.affiliation: Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: C K
authors.initials: CK
authors.lastname: Rösing
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D017622:Periodontal Attachment Loss; D010510:Periodontal Diseases; D012307:Risk Factors; D012907:Smoking; D016388:Tooth Loss
keywords: coronary angiography; coronary disease; periodontal disease; tooth loss