Document Type : Original Article(s)
Authors
1 Associate Dean & Professor, Department of Oral Medicine and Radiology Manipal College of Dental Sciences Mangalore Manipal Academy of Higher Education Karnataka, India, 575001
2 Senior Lecturer, Department of Oral Medicine and Radiology Srinivas Institute of Dental Sciences Mukka. India
3 Associate Professor, Department of Oral Medicine and Radiology Manipal College of Dental Sciences, Mangalore Manipal Academy of Higher Education Manipal, Karnataka, India,576104
4 Associate Professor Department of Oral Medicine and Radiology Manipal College of Dental Sciences Mangalore Manipal Academy of Higher Education India,575001
Abstract
Background: Various mechanisms suggest that periodontal pathogens and inflammatory processes contribute to systemic pathogenic processes such as atherosclerosis. This study investigated the possibility of a correlation between the presence of incidentally found calcifications along the course of the internal carotid artery (ICA) and tooth loss and periodontal status.
Methods: A retrospective CBCT analysis was performed on 110 patients. CBCT scans obtained as a part of the dental examinations were analyzed for missing teeth and evidence of any calcification along the ICA course. The mean age, gender, and the total number of missing teeth for all scans revealing calcifications were evaluated.
Results: The study sample consisted of 110 scans, with the cohort’s mean age (SD) of 50.01 (±11.6) and gender distribution of 53.4% females and 43.6% males. A total of 17% of the scans exhibited the presence of calcification. A comparison of missing teeth between the two groups revealed that the group with calcification exhibited more missing teeth, which was statistically significant with a p-value of 0.01. Comparison of the apical lesions between the two groups revealed that apical lesion was higher in the group with calcification and was statistically significant with a p-value of 0.011.
Conclusions: The greater the number of missing teeth, the higher the chances of calcifications being detected along the course of the ICA.
Keywords
- Wei R, Curtin LR, Arias E, Anderson RN. US decennial life tables for 1999–2001: Methodology of the United States life tables. National vital statistics reports. 2008; 57(4): 1984-89.
- Guyer B, Freedman MA, Strobino DM, Sondik EJ. Annual summary of vital statistics: trends in the health of Americans during the 20th century. Pediatrics. 2000; 106(6): 1307-17.
- Marcus SE, Drury TF, Brown LJ, Zion GR. Tooth retention and tooth loss in the permanent dentition of adults: United States, 1988–1991. J Dent Res. 1996; 75(2_suppl): 684-95.
- Nazliel HE, Hersek N, Ozbek M, Karaagaoglu E. Oral health status in a group of the elderly population residing at home. Gerodontology. 2012; 29(2): e761-7.
- Krustrup U, Erik Petersen P. Periodontal conditions in 35–44 and 65–74-year-old adults in Denmark. Acta Odontologica Scandinavica. 2006; 64(2): 65-73.
- Hirota S, Imakita M, Kohri K, Ito A, Morii E, Adachi S, Kim HM, Kitamura Y, Yutani CH, Nomura S. Expression of osteopontin messenger RNA by macrophages in atherosclerotic plaques. A possible association with calcification. The American journal of pathology. 1993; 143(4): 1003.
- Woodcock Jr RJ, Goldstein JH, Kallmes DF, Cloft HJ, Phillips CD. Angiographic correlation of CT calcification in the carotid siphon. American journal of neuroradiology. 1999; 20(3): 495-9.
- Prabhakaran S, Singh R, Zhou X, Ramas R, Sacco RL, Rundek T. Presence of calcified carotid plaque predicts vascular events: the Northern Manhattan Study. Atherosclerosis. 2007; 195(1): e197-201.
- Heiland M, Pohlenz P, Blessmann M, Habermann CR, Oesterhelweg L, Begemann PC, Schmidgunst C, Blake FA, Püschel K, Schmelzle R, Schulze D. Cervical soft tissue imaging using a mobile CBCT scanner with a flat panel detector in comparison with corresponding CT and MRI data sets. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007; 104(6): 814-20.
- Hashimoto K, Kawashima S, Kameoka S, Akiyama Y, Honjoya T, Ejima K, Sawada K. Comparison of image validity between cone beam computed tomography for dental use and multidetector row helical computed tomography. Dentomaxillofacial Radiology. 2007; 36(8): 465-71.
- Ravon NA, Hollender LG, Mcdonald V, Persson GR. Signs of carotid calcification from dental panoramic radiographs are in agreement with Doppler sonography results. Journal of clinical periodontology. 2003; 30(12): 1084-90.
- Damaskos S, Tsiklakis K, Syriopoulos K, der Stelt PV. Extra-and intra-cranial arterial calcifications in adults depicted as incidental findings on cone beam CT images. Acta Odontologica Scandinavica. 2015; 73(3): 202-9.
- Aarabi G, Heydecke G, Seedorf U. Roles of oral infections in the pathomechanism of atherosclerosis. International Journal of Molecular Sciences. 2018; 19(7): 1978.
- National Institute of Dental, Craniofacial Research (US). Oral health in America: a report of the Surgeon General. US Public Health Service, Department of Health and Human Services; 2000.
- Persson RE, Hollender LG, Powell VL, MacEntee M, Wyatt CC, Kiyak HA, Persson GR. Assessment of periodontal conditions and systemic disease in older subjects: II. Focus on cardiovascular diseases. Journal of clinical periodontology. 2002; 29(9): 803-10.
- Schenkein HA, Papapanou PN, Genco R, Sanz M. Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontology 2000. 2020; 83(1): 90-106.
- Rahimi A, Hadavi MM. Relationship between periodontitis and cardiovascular disease. ARYA Atherosclerosis Journal. 2020; 16(6): 306.
- Higashi Y, Goto C, Hidaka T, Soga J, Nakamura S, Fujii Y, Hata T, Idei N, Fujimura N, Chayama K, Kihara Y. Oral infection-inflammatory pathway, periodontitis, is a risk factor for endothelial dysfunction in patients with coronary artery disease. Atherosclerosis. 2009; 206(2): 604-10.
- Minn YK, Suk SH, Park H, Cheong JS, Yang H, Lee S, Do SY, Kang JS. Tooth loss is associated with brain white matter change and silent infarction among adults without dementia and stroke. Journal of Korean medical science. 2013; 28(6): 929-33.
- Teeuw WJ, Slot DE, Susanto H, Gerdes VE, Abbas F, D'Aiuto F, Kastelein JJ, Loos BG. Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta‐analysis. Journal of clinical periodontology. 2014; 41(1): 70-9.
- Tada S, Ikebe K, Kamide K, Gondo Y, Inomata C, Takeshita H, Matsuda KI, Kitamura M, Murakami S, Kabayama M, Oguro R. Relationship between atherosclerosis and occlusal support of natural teeth with mediating effect of atheroprotective nutrients: From the SONIC study. PLoS One. 2017; 12(8): e0182563.
- Genco R, Offenbacher S, Beck J. Periodontal disease and cardiovascular disease: epidemiology and possible mechanisms. The Journal of the American Dental Association.2002; 133: 14S-22S.
- Asai K, Yamori M, Yamazaki T, Yamaguchi A, Takahashi K, Sekine A, Kosugi S, Matsuda F, Nakayama T, Bessho K, Nagahama Study Group. Tooth loss and atherosclerosis: the Nagahama Study. Journal of Dental Research. 2015; 94(3_suppl): 52S-8S.
- da Silveira HL, Damaskos S, Arús NA, Tsiklakis K, Berkhout EW. The presence of calcifications along the course of internal carotid artery in Greek and Brazilian populations: a comparative and retrospective cone beam CT data analysis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2016; 121(1): 81-90.
- Scarfe WC, Farman AG. Soft tissue calcifications in the neck: Maxillofacial CBCT presentation and significance. AADMRT Currents. 2010; 2(2): 3-15.
- Liljestrand JM, Havulinna AS, Paju S, Männistö S, Salomaa V, Pussinen PJ. Missing teeth predict incident cardiovascular events, diabetes, and death. Journal of dental research. 2015; 94(8): 1055-62.
- Mattila KJ, Nieminen MS, Valtonen VV, Rasi VP, Kesäniemi YA, Syrjälä SL, Jungell PS, Isoluoma M, Hietaniemi K, Jokinen MJ. Association between dental health and acute myocardial infarction. British medical journal. 1989; 298(6676): 779-81.
- Mattila KJ, Valtonen VV, Nieminen M, Huttunen JK. Dental infection and the risk of new coronary events: prospective study of patients with documented coronary artery disease. Clinical Infectious Diseases. 1995; 20(3): 588-92.
- DeStefano F, Anda RF, Kahn HS, Williamson DF, Russell CM. Dental disease and risk of coronary heart disease and mortality. British Medical Journal. 1993; 306(6879): 688-91.
- Loesche WJ, Schork A, Terpenning MS, Chen YM, Dominguez BL, Grossman N. Assessing the relationship between dental disease and coronary heart disease in elderly US veterans. The Journal of the American Dental Association. 1998; 129(3): 301-11.
- Desvarieux M, Demmer RT, Rundek T, Boden-Albala B, Jacobs Jr DR, Papapanou PN, Sacco RL. Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke. 2003; 34(9): 2120-5.
- Wiener RC, Sambamoorthi U. Cross-sectional association between the number of missing teeth and cardiovascular disease among adults aged 50 or older: BRFSS 2010. International journal of vascular medicine. 2014; 2014.
- Joshipura KJ, Hung HC, Rimm EB, Willett WC, Ascherio A. Periodontal disease, tooth loss, and incidence of ischemic stroke. Stroke. 2003; 34(1): 47-52.
- Choe H, Kim YH, Park JW, Kim SY, Lee SY, Jee SH. Tooth loss, hypertension and risk for stroke in a Korean population. Atherosclerosis 2009; 203: 550-6.
- Houshmand M, Holtfreter B, Berg MH, Schwahn C, Meisel P, Biffar R, Kindler S, Kocher T. Refining definitions of periodontal disease and caries for prediction models of incident tooth loss. Journal of clinical periodontology. 2012; 39(7): 635-44.
- Oluwagbemigun K, Dietrich T, Pischon N, Bergmann M, Boeing H. Association between number of teeth and chronic systemic diseases: a cohort study followed for 13 years. PLoS One. 2015; 10(5): e0123879.
- Beck JD, Offenbacher S, Williams R, Gibbs P, Garcia R. Periodontitis: a risk factor for coronary heart disease? Annals of periodontology. 1998; 3(1): 127-41.
- Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clinical oral implants research. 2012; 23(11): 1261-8.
- Allison MA, Criqui MH, Wright CM. Patterns and risk factors for systemic calcified atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology. 2004; 24(2): 331-6.
- Petersen J, Glaßl EM, Nasseri P, Crismani A, Luger AK, Schoenherr E, Bertl K, Glodny B. The association of chronic apical periodontitis and endodontic therapy with atherosclerosis. Clinical oral investigations. 2014; 18(7): 1813-23.
- Demmer RT, Kocher T, Schwahn C, Völzke H, Jacobs Jr DR, Desvarieux M. Refining exposure definitions for studies of periodontal disease and systemic disease associations. Community dentistry and oral epidemiology. 2008; 36(6): 493-502.
- Rennenberg RJ, Kessels AG, Schurgers LJ, Van Engelshoven JM, De Leeuw PW, Kroon AA. Vascular calcifications as a marker of increased cardiovascular risk: a meta-analysis. Vascular health and risk management. 2009; 5:
- Bos D, van der Rijk MJ, Geeraedts TE, Hofman A, Krestin GP, Witteman JC, van der Lugt A, Ikram MA, Vernooij MW. Intracranial carotid artery atherosclerosis: prevalence and risk factors in the general population. Stroke. 2012; 43(7): 1878-84.
- Asai K, Yamori M, Yamazaki T, Yamaguchi A, Takahashi K, Sekine A, Kosugi S, Matsuda F, Nakayama T, Bessho K, Nagahama Study Group. Tooth loss and atherosclerosis: the Nagahama Study. Journal of Dental Research. 2015; 94(3_suppl): 52S-8S.