Periodontitis as a risk factor of coronary heart diseases?

Zaremba M, Górska R, Suwalski P, Czerniuk MR, Kowalski J


Background: Unstable atherosclerotic plaque is a dangerous clinical state, possibly leading to acute coronary deficiency resulting in cardiac infarction. Inflammatory factor’s role in creating pathological lesions in the endothelium of coronary vessels is frequently raised. This state may be caused by bacteria able to initiate clot formation in blood vessel and destabilizing atherosclerotic plaque already present. Source of these pathogens are chronic inflammatory processes occurring in organism, among them periodontal disease as one of more frequent. Aim of the work was to evaluate incidence of selected anaerobic bacteria in subgingival plaque and in atherosclerotic plaque in patients treated surgically because of coronary vessels’ obliteration.

Methods: Study was performed on 20 individuals with chronic periodontitis. Subgingival plaque was collected from periodontal pockets deeper than 5 mm DNA test was used for marking eight pathogens responsible for periodontal tissues destruction. In the same patients, as well as in 10 edentulous individuals material from atherosclerotic plaque was collected during by-pass implantation procedure, and identical DNA testing occurred.

Results: In 13 of 20 patients pathogens most frequent in severe chronic periodontitis were found in coronary vessels. In 10 cases those bacteria were also present in atherosclerotic plaque. Pathogens linked with periodontal disease were also found in 7 of 10 edentulous individuals. Most frequently marked bacteria were: Porphyromonas gingivalis and Treponema denticola.

Conclusions: It seems that advancement of periodontal disease does not have influence on bacteria permeability to coronary vessels. Important is the presence of active inflammatory process expressed by significantly higher bleeding index in patients with marked bacteria in atherosclerotic plaque.

Key words: dental plaque, atherosclerosis.