Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr;49(4):334-42.
doi: 10.1111/iej.12468. Epub 2015 Jun 11.

Apical periodontitis and incident cardiovascular events in the Baltimore Longitudinal Study of Ageing

M S Gomes  1 , F N Hugo  2 , J B Hilgert  2 , M Sant'Ana Filho  3 , D M P Padilha  2 , E M Simonsick  4 , L Ferrucci  4 , M A Reynolds  5
Affiliations

Apical periodontitis and incident cardiovascular events in the Baltimore Longitudinal Study of Ageing

M S Gomes et al. Int Endod J. 2016 Apr.

Abstract

Aim: To evaluate whether the presence of apical periodontitis (AP), root canal treatment (RCT) and endodontic burden (EB) - as the sum of AP and RCT sites - were associated with long-term risk of incident cardiovascular events (CVE), including cardiovascular-related mortality, using data on participants in the Baltimore Longitudinal Study of Ageing (BLSA).

Methodology: This retrospective cohort included 278 dentate participants in the BLSA with complete medical and dental examinations. Periodontal disease (PD) and missing teeth were recorded. The total number of AP and RCT sites was determined from panoramic radiographs. EB was calculated as the sum of AP and RCT sites. Oral inflammatory burden (OIB) was calculated combining PD and EB. The main outcome was incident CVE including angina, myocardial infarction and cardiovascular-related death. Participants were monitored for up to 44 years (mean = 17.4± 11.1 years) following dental examination. Relative risks (RRs) were calculated through Poisson regression models, estimating the relationship between AP, RCT, EB, PD, OIB and incident CVE.

Results: Mean age at baseline was 55.0 ±16.8 years and 51.4% were men. Sixty-two participants (22.3%) developed CVE. Bivariate analysis showed that PD, EB, number of teeth and OIB were associated with incident CVE. Multivariate models, adjusted for socio-demographic and medical variables, showed that age ≥60 years (RR = 3.07, 95% CI =1.68-5.62), hypertension (RR = 2.0, 95% CI = 1.16-3.46) and EB ≥3 (RR = 1.77, 95% CI = 1.04-3.02) were independently associated with incident CVE. The association between OIB and incident CVE was reduced to nonsignificance after adjustments (RR = 1.97, 95% CI = 0.83-4.70).

Conclusions: EB in midlife was an independent predictor of CVE amongst community-dwelling participants in the BLSA. Prospective studies are required to evaluate cardiovascular risk reduction with the treatment of AP.

Keywords: atherosclerosis; cardiovascular diseases; inflammation; oral-systemic diseases; risk factors.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart of the study sample.
See this image and copyright information in PMC

References

    1. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. American Heart Journal. 2007;154:830–7. - PubMed
    1. Blake GJ, Ridker PM. Inflammatory bio-markers and cardiovascular risk prediction. Journal of Internal Medicine. 2002;252:283–94. - PubMed
    1. Caplan DJ, Chasen JB, Krall EA, et al. Lesions of endodontic origin and risk of coronary heart disease. Journal of Dental Research. 2006;85:996–1000. - PMC - PubMed
    1. Cotti E, Dessi C, Piras A, et al. Association of endodontic infection with detection of an initial lesion to the cardiovascular system. Journal of Endodontics. 2011a;37:1624–9. - PubMed
    1. Cotti E, Dessi C, Piras A, Mercuro G. Can a chronic dental infection be considered a cause of cardiovascular disease? A review of the literature. International Journal of Cardiology. 2011b;148:4–10. - PubMed

Publication types

LinkOut - more resources