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Observational Study
. 2022 May;48(5):597-605.
doi: 10.1016/j.joen.2022.01.019. Epub 2022 Feb 7.

Oral Inflammatory Burden and Carotid Atherosclerosis Among Stroke Patients

Thayana S S Leão  1 , Gustavo H Tomasi  2 , Lucas P Conzatti  2 , Luiz C P Marrone  2 , Mark A Reynolds  3 , Maximiliano S Gomes  4
Affiliations
Observational Study

Oral Inflammatory Burden and Carotid Atherosclerosis Among Stroke Patients

Thayana S S Leão et al. J Endod. 2022 May.

Abstract

Introduction: This study aimed to test the hypothesis that oral inflammatory burden (OIB) is independently associated with the carotid atherosclerotic burden (CAB) among individuals with ischemic stroke (IS) or transient ischemic attack (TIA).

Methods: This cross-sectional observational study included 240 hospital patients with the diagnosis of IS or TIA. The main exposures were apical periodontitis (AP), root canal treatment (RCT), and crestal alveolar (periodontal) bone loss (BL), and the main outcome was the CAB. Exposure and outcome variables were measured through a head and neck multidetector computed tomography angiography and CAB was dichotomized in <50% and ≥50% vessel occlusion. OIB scored as a composite measure of the endodontic and periodontal disease exposure. Hospital health records provided information on sociodemographic and medical covariates. Prevalence ratios (PRs) were calculated through Poisson regression models, estimating the relationship between the oral exposures and CAB, with = 5%.

Results: Mean age was 62.15 ± 13.1 years, with 56.7% men. Univariate analyses showed that AP ≥2 (PR = 1.83; 95% confidence interval [CI], 1.05-3.17) and endodontic burden (EB) (AP and/or RCT ≥ 2) (PR = 1.98; 95% CI, 1.13-3.47) were associated with CAB ≥50%. Multivariate models, adjusted for sociodemographic and medical covariates, revealed that pooled periodontal and endodontic parameters (OIB = BL ≥ 5 mm and EB ≥ 2) were independently associated with CAB ≥ 50% (PR = 2.47; 95% CI, 1.04-5.87).

Conclusion: A higher OIB was independently associated with increased levels of CAB among hospital patients with IS or TIA. The combination of endodontic and periodontal parameters strengthened the observed association and should be evaluated in future studies on the relationship between oral health and cardiovascular outcomes.

Keywords: Apical periodontitis; alveolar bone loss; cardiovascular disease; periodontal disease; risk factor.

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