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Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Cty Hosp Gavle, Dept Periodontol, S-80187 Gavle, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.ORCID iD: 0000-0003-2335-8542
2017 (English)In: Journal of Dental Research, ISSN 0022-0345, E-ISSN 1544-0591, Vol. 96, no 7, 768-773 p.Article in journal (Refereed) Published
Abstract [en]

Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having > 10% sites with probing pocket depth > 4 mm deep and bleeding on probing at >= 20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD (n = 870) when compared with responders (23.6 vs. 15.3%, P < 0.001). When adjusting for calendar time, age, sex, educational level, smoking, and baseline values for bleeding on probing, probing pocket depth > 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS INC , 2017. Vol. 96, no 7, 768-773 p.
Keyword [en]
periodontal disease(s)/periodontitis, patient outcome, inflammation, epidemiology, oral-systemic disease(s), cardiovascular disease(s)
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-328993DOI: 10.1177/0022034517701901ISI: 000403934500009PubMedID: 28363032OAI: oai:DiVA.org:uu-328993DiVA: diva2:1139561
Available from: 2017-09-08 Created: 2017-09-08 Last updated: 2017-09-08Bibliographically approved

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Holmlund, AndersLampa, ErikLind, Lars

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