Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study.

Beatriz González-Navarro,Xavier Pintó-Sala,Mari Carmen Jiménez-Sánchez,Enric Jane-Salas,Albert Estrugo-Devesa,Juan José Segura-Egea,José López-López,Daniel Cabanillas-Balsera

doi:10.3390/jcm9103205

Abstract

Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.

Highlights

Apical periodontitis (AP) is the inflammatory response of periapical tissues caused by the leakage of polymicrobial and antigenic content of the root canal system through the apical foramen [1]
metabolic syndrome (MetS) increases the risk of atherosclerotic cardiovascular disease (ACVD), a pathology of multifactorial origin caused by the accumulation of lipids in arterial walls [14]
The total oral inflammatory burden was associated with MetS, but no significant association was found between AP and MetS

Summary

Introduction

Apical periodontitis (AP) is the inflammatory response of periapical tissues caused by the leakage of polymicrobial and antigenic content of the root canal system through the apical foramen [1]. AP affects 34% to 61% of people [2,3], and is especially associated with root-filled teeth (RFT) [4,5]. MetS increases the risk of atherosclerotic cardiovascular disease (ACVD), a pathology of multifactorial origin caused by the accumulation of lipids in arterial walls [14]. ACVD is associated with a high incidence of coronary artery disease, atherothrombotic accidents, and cardiovascular events such as myocardial infarction, cardiomyopathy, arrhythmias, stroke, and cardiac arrest [15]. These cardiovascular events make ACVD the leading cause of death in Europe, the United States, and most of Asia [16]

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