Parodontitis und Herzerkrankung mit dem Schwerpunkt auf den Schweregrad der koronaren Herzerkrankung

A possible connection between periodontitis and coronary heart disease (CHD) has been discussed in the literature for a long time. The existing studies on this subject show divergent results. The existence of a CHD had not been objectivised by means of an invasive diagnosis in any of the previous studies. The aim of this study was to demonstrate a potential connection between periodontal disease and the degrees of severity of a CHD confirmed by means of coronary angiography, and of other types of heart disease. 617 probands were admitted as in-patients to the Clinic for Cardiology for diagnosis by coronary angiography using a left heart catheter and underwent a pre-operative dental-periodontological examination. Significant periodontological parameters were recorded. Once the result of the catheter examination and the anamnestic data had been evaluated, the patients were divided into a test group according to the degree of severity of the CHD (exclusion CHD, 1-vessel coronary artery disease/2-vessel coronary artery disease, 3-vessel coronary artery disease, coronary arteriosclerosis), acute infarct, condition after infarct, condition after ACB-OP, condition after PCI and suspected myocarditis/DCM and into a control group with the patients of good coronary health (CHD-). The test and control groups were contrasted with regard to the results of the dental-periodontal examination, with adjustment being made to conventional moderators (sex, age, education, BMI, nicotine and alcohol consumption). Features of blood pressure and metabolism were also evaluated for connections with the cardiological diseases and periodontological indices. When evaluating the results, the tentative hypothesis that heart diseases are associated with a significant deterioration in periodontal health (measured by the periodontal indices) was confirmed. The evidence of this connection was strongest in the case of myocarditis/DCM. Significant data running counter to the hypothetical tendency was not found in any of the evaluations. When comparing the degrees of severity of a CHD to the effect of the meaningful periodontal indices of probing depth and attachment level, it was not possible to demonstrate a substantial difference. It can therefore be concluded that a greater intensity of a CHD is not associated with a significant, even greater deterioration of periodontal health. On the basis of the data available to date, there are discreet indications of a possible connection between a periodontal disease and CHD and other types of heart disease. The quantitative extent of this correlation must be defined in more detail. Further clarification is required as to whether the correlation between periodontitis and atherosclerosis is merely an epiphenomenon or whether periodontal diseases actually play a causal role in the development of atherosclerosis. Prospective intervention studies to confirm a causal relationship would be desirable.