Die Beziehung zwischen Parodontitis und koronarer Herzerkrankung

Summary Results of research carried out over of the last years point to the fact that infections have an impact on the pathogenesis of arteriosclerosis. The aim of this study is to demonstrate the potential correlation between coronary-angiographically secured CHD and periodontitis. 617 patients, who had visited the Clinic for Internal Medicine / Cardiology at the Philipps University of Marburg for a heart catheter examination, were voluntarily submitted for a periodontical-dental examination. Before the catheter examination, anamnestic as well as periodontical parameters were raised. According to the catheter examination the patients had been split into a test group of cardiac patients CHD+ (n=175) and a control group, the non-cardiac patients CHD- (n=442). Both groups were compared with regards to the results of the dental-periodontal examination. The average age of patients without cardiac disease was 53.0 years and the age of cardiac patients was 65.0 years. There was a larger proportion of male (n=451, 73.1%) compared to female (n=166, 26.9%) patients within the whole group. 127 (20.6%) of the test subjects were agomphious, of which n=102 belonged to the control group and n=25 on the test group. Therefore cardiac patients are significantly more often agomphious (p=0,015). With a number of 316 probands (51.2%) being smokers, they outweighed the number of non-smokers, from which we can also conclude that there are significant group differences with regards to their smoking behaviour (p=0,005). Smokers are considerably higher represented within the cardiac patient group. It can also be ascertained that the level of formal education notably (p=0,042) correlates to heart disease. No significant connection with regards to CHD could be ascertained solely from the level of alcohol consumption, oral hygiene, the differentiation whether periodontal treatments were carried out or not and the periodontal BOP index (bleeding on probing). It can be pointed out that the periodontal indices (probe graduation, probe graduation mesial-distal, gingival recession, gingival recession mesial-distal, attachment level mesial-distal, bleeding on probing and plaque index) show substantially worse median values in cardiac patients in comparison to patients free from heart disease. For all periodontal indices, except bleeding on probing, the Mann-Whitney-U-Test shows more pronounced differences in most cases for both CHD groups (PD: p=0,000; PD mesial-distal: p=0,003; GR: p=0,000; GR mesial-distal: p=0,000; AL mesial-distal: p=0,000; PI: p=0,017). CHD + patients have higher values for these six periodontal clinical dimensions. As the age (p=0,000) correlates significantly to the CHD group differences, an examination regarding the significance of the periodontical indices was carried out adjusted by the influencing factor of the patient s age. Thereby four out of six significances investigated by means of the Mann-Whitney-U-Test remained. Therefore probing depths, probing depths mesial-distal, gingival recession mesial-distal and attachment levels mesial-distal were irrespective or robust compared with the logistically carried out age adjustment. Following the test of the CHD groups with regards to the differences of the classified probing depths, 19.9 % (n=68) of the average PD-values of > 3.5 mm were found, compared to 10% (n=15) found in the CHD-negative group. This difference is statistically highly significant (p=0,007). Based on the currently available data an indication with regards to a connection between periodontal illness and coronary heart disease arises.