Radiographic measures of chronic periodontitis and carotid artery plaque

Steven P. Engebretson, Ira B. Lamster, Mitchell S V Elkind, Tatjana Rundek, Neill J. Serman, Ryan T. Demmer, Ralph L Sacco, Panos N. Papapanou, Moïse Desvarieux

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.

Original languageEnglish
Pages (from-to)561-566
Number of pages6
JournalStroke
Volume36
Issue number3
DOIs
StatePublished - Mar 1 2005
Externally publishedYes

Fingerprint

Chronic Periodontitis
Carotid Stenosis
Alveolar Bone Loss
Atherosclerosis
Bone and Bones
Mouth Diseases
Logistic Models
Stroke
Hypertension
Carotid Artery Diseases
Vascular Diseases
LDL Cholesterol
HDL Cholesterol
Epidemiology
Smoking
Odds Ratio
Infection

Keywords

  • Alveolar bone loss
  • Carotid stenosis
  • Periodonitis
  • Radiography, panoramic
  • Ultrasonography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Engebretson, S. P., Lamster, I. B., Elkind, M. S. V., Rundek, T., Serman, N. J., Demmer, R. T., ... Desvarieux, M. (2005). Radiographic measures of chronic periodontitis and carotid artery plaque. Stroke, 36(3), 561-566. https://doi.org/10.1161/01.STR.0000155734.34652.6c

Radiographic measures of chronic periodontitis and carotid artery plaque. / Engebretson, Steven P.; Lamster, Ira B.; Elkind, Mitchell S V; Rundek, Tatjana; Serman, Neill J.; Demmer, Ryan T.; Sacco, Ralph L; Papapanou, Panos N.; Desvarieux, Moïse.

In: Stroke, Vol. 36, No. 3, 01.03.2005, p. 561-566.

Research output: Contribution to journalArticle

Engebretson, SP, Lamster, IB, Elkind, MSV, Rundek, T, Serman, NJ, Demmer, RT, Sacco, RL, Papapanou, PN & Desvarieux, M 2005, 'Radiographic measures of chronic periodontitis and carotid artery plaque', Stroke, vol. 36, no. 3, pp. 561-566. https://doi.org/10.1161/01.STR.0000155734.34652.6c
Engebretson SP, Lamster IB, Elkind MSV, Rundek T, Serman NJ, Demmer RT et al. Radiographic measures of chronic periodontitis and carotid artery plaque. Stroke. 2005 Mar 1;36(3):561-566. https://doi.org/10.1161/01.STR.0000155734.34652.6c
Engebretson, Steven P. ; Lamster, Ira B. ; Elkind, Mitchell S V ; Rundek, Tatjana ; Serman, Neill J. ; Demmer, Ryan T. ; Sacco, Ralph L ; Papapanou, Panos N. ; Desvarieux, Moïse. / Radiographic measures of chronic periodontitis and carotid artery plaque. In: Stroke. 2005 ; Vol. 36, No. 3. pp. 561-566.
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abstract = "Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50{\%} [severe] versus <50{\%} bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.",
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AU - Lamster, Ira B.

AU - Elkind, Mitchell S V

AU - Rundek, Tatjana

AU - Serman, Neill J.

AU - Demmer, Ryan T.

AU - Sacco, Ralph L

AU - Papapanou, Panos N.

AU - Desvarieux, Moïse

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N2 - Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.

AB - Background and Purpose-Chronic periodontitis (CP) is associated with stroke and subclinical atherosclerosis, but clinical measurement of CP can be time consuming and invasive. The purpose of this study was to determine whether radiographically assessed CP is associated with nonstenotic carotid artery plaque as an ultrasound measure of subclinical atherosclerosis. Methods-Panoramic oral radiographs were obtained from 203 stroke-free subjects ages 54 to 94 during the baseline examination of the Oral Infections and Vascular Disease Epidemiology Study (INVEST). CP exposure among dentate subjects was defined either categorically (periodontal bone loss ≥50% [severe] versus <50% bone loss) or via tertile formation (for dose-response investigation), with edentulous subjects categorized separately. In all subjects, high-resolution B-mode carotid ultrasound was performed. Carotid plaque thickness (CPT) and prevalence (present/absent) were recorded. Covariates included age, sex, smoking, diabetes, hypertension, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein cholesterol. Results-Among dentate subjects with severe periodontal bone loss, mean CPT was significantly greater (1.20±1.00 mm versus 0.73±0.89 mm; P=0.003). CPT increased with more severe bone loss (upper versus lower tertile bone loss; P=0.049; adjusted for age, sex, and hypertension). This apparent dose-response effect was more evident among never-smokers. In a fully adjusted multivariate logistic regression model, severe periodontal bone loss was associated with a nearly 4-fold increase in risk for the presence of carotid artery plaque (adjusted odds ratio, 3.64; CI, 1.37 to 9.65). Conclusions-Severe periodontal bone loss is associated independently with carotid atherosclerosis. Panoramic oral radiographs may thus provide an efficient means to assess CP in studies of atherosclerosis risk.

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KW - Radiography, panoramic

KW - Ultrasonography

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