Bartłomiej Górski

The Association Between Dental Status and Systemic Lipid Profile and Inflammatory Mediators in Patients After Myocardial Infarction

BACKGROUND Many epidemiological studies have proven that local infection may influence the levels of systemic lipid profile and inflammatory mediators. OBJECTIVES The aim of this research was to evaluate the association between the state of the oral cavity, lipids and inflammatory mediator concentrations in Poles after acute myocardial infarction (MI). MATERIAL AND METHODS A total of 134 subjects with a mean age of 54.3 years (± 8.1) were included in the study. Sociodemographic and cardiologic variables were gathered. Subsequently, serum samples were collected for estimation of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), high-sensitivity C-reactive protein (hsCRP), fibrinogen and white blood cell counts (WBC). The periodontal parameters measured included bleeding on probing index (BoP), pocket depth (PD), clinical attachment level (CAL), the number of bleeding periodontal pockets (bPP) and the number of lost teeth. RESULTS Overall, patients shared high levels of periodontal inflammation and tissue breakdown. Multivariate analysis revealed a significant association between the serum concentration of LDL-C and bPP (standardized coefficient b = 0.3179; p = 0.0009) and PD (b = 0.3186; p = 0.0015); the level of fibrinogen and the number of lost teeth (b = 0.3669; p = 0.0013); WBC and bPP (b = 0.2726; p = 0.0035) independent of age, sex, income, education, atherosclerotic disease in the family, tobacco smoking, arterial hypertension, diabetes mellitus and BMI. No correlations were found regarding hsCRP serum concentration. CONCLUSIONS To our knowledge, this study demonstrated for the first time that local inflammatory processes in the oral cavity are positively associated with the systemic levels of LDL-C, fibrinogen and WBC in adult Poles. This may underscore relationships between periodontitis and MI as well as potentially impinge on atherosclerotic processes and MI prognosis.

The Association Between Dental Status and Risk of Acute Myocardial Infarction Among Poles: Case-control Study

BACKGROUND Results of scientific research on the effects of periodontitis on the incidence of myocardial infarction (MI) are ambiguous. OBJECTIVES The aim of this study was to investigate the association of the severity and extent of periodontitis with acute MI in Poles. MATERIAL AND METHODS This case-control study included 134 cases hospitalized with acute MI under the age of 70 years and 155 controls drawn from the general population with no MI history. Sociodemographic, cardiologic and periodontal variables were assessed. Three periodontal indicators were evaluated: (1) the severity of periodontitis classified in accordance with Page and Eke definition, (2) the extent of periodontitis determined on the basis of the percentage of sites with CAL ≥ 3 mm (Arbes Index) and (3) tooth loss (> 10 teeth). In a logistic regression model, the association of periodontal parameters with MI occurrence was evaluated after adjusting for well-known cardiovascular risk factors. RESULTS The extent of periodontitis was significantly associated with the risk of acute MI even after adjusting for age, sex, tobacco smoking, hypertension, diabetes, BMI, education and income (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.1 to 5.2; p = 0.0203). However, the severity of periodontitis was associated with MI after adjusting for age and sex (OR = 2.0; 95% CI = 1.2-3.5; p = 0.0109), but not after adjusting for the other above-mentioned risk factors. The association between the number of lost teeth and acute MI was significant after adjusting for age, sex, tobacco smoking, arterial hypertension and diabetes mellitus (OR = 2.1; 95% CI = 1.2-5.9; p = 0.0151). CONCLUSIONS This study proves the positive association between periodontitis and acute MI in Poles. This association seems to be stronger with regard to the extent rather than to the severity of periodontitis.

Early postoperative healing following guided tissue regeneration in aggressive periodontitis patients

BACKGROUND In order to regenerate periodontal tissues, necessary conditions for this process must be created during surgery, primarily by allowing uninfected adhesion of the clot to the root surface, and then its stable position in the defect. OBJECTIVES The aim of this secondary analysis was to evaluate early postoperative healing of papillary incisions and its correlations with patient-, siteand technique-related factors following guided tissue regeneration (GTR) in treatment of intrabony defects in patients with aggressive periodontitis (AgP). MATERIAL AND METHODS The analysis included the data from 25 patients and 59 treatment sites. Surgical treatment consisted of using grafts together with collagen membranes. Post-operative healing was assessed 1 week and 2 weeks after GTR using the Early Wound-Healing Index (EHI). RESULTS Early Wound-Healing Index values ranged from 1 (complete flap closure and primary healing) to 4 (incomplete flap closure, partial tissue necrosis, secondary healing). After 1 week, primary healing (EHI ≤ 3) was observed in 55 sites, and secondary healing (EHI = 4) in 4 sites. After 2 weeks, the values were 45 and 14, respectively. No correlations between EHI and patient-related factors were found. However, 1-rooted teeth, sites with thin phenotype and the presence of gingival recessions were associated with impaired healing (higher EHI recordings and secondary healing), as was analyzed in a multiple regression model. CONCLUSIONS Site-related factors may impinge on the early postoperative healing of papillary incisions succeeding GTR in AgP patients.

Status of marginal periodontal tissues in patients after myocardial infarction in Poland

Introduction. Periodontitis is associated with numerous risk factors. Many studies have proven the existing relationship between periodontitis and cardiovascular diseases. Aim. The aim of the study was to assess the state of periodontium in patients after myocardial infarction (MI), as compared to the general population. Material and methods. The study group consisted of 152 patients after MI. The control group consisted of 160 individuals. Periodontal status was assessed using the classification by Page and Eke. The interview included: gender, age, education, income level and tobacco smoking. Results. In the study group, periodontitis occurred more frequently than in the control group (84.1 vs 73.1%), including advanced periodontitis (49.7 vs 27.5%) and edentulism (11.3 vs 2.5%). In the study group, correlation was observed between prevalence of periodontitis and gender as well as age. Conclusions. The periodontal status of patients after MI is clearly worse than that of the general population and not really well-correlated with risk factors. Key words

Oral health in postmenopausal and premenopausal women after myocardial infarction in Poland: a preliminary study

Introduction Age and hormonal disorders are recognized factors impacting the periodontium and the prevalence of cardiovascular diseases, but as yet the relationship between these two conditions in postmenopausal (post-M) and premenopausal (pre-M) women in Poland has not been assessed. The aim of this study was to compare the periodontal status in women after myocardial infarction (MI) with women without MI history and to determine risk factors for periodontitis. Material and methods The study included 35 women hospitalized due to MI, average age 54.7 ± 9.4 years, and 96 women randomly drawn from the general population, average age 56.1 ± 10.0 years. All women were checked for periodontitis risk factors (education, socioeconomic status, tobacco smoking, stress), and underwent dental examination. Results The lowest number of teeth was found in post-M women after MI (median = 8), whereas pre-M women without MI history had 25 teeth. Edentulousness occurred more frequently in post-M women compared with pre-M women (12.2% vs. 0%), the same was observed for advanced periodontitis (28.4% vs. 21.1%). The severity of periodontitis was highest in the post-M subgroup (more than half demonstrated advanced periodontitis or edentulousness). The most important risk factor for periodontitis, regardless of age, was the level of education. In post-M women the second risk factor was smoking, while in pre-M women negative stress. Conclusions The status of oral health in post-M women is unsatisfactory, particularly in those affected by cardiovascular diseases. It is necessary to take preventive and educational measures targeted at these women.