Periodontitis and carotid calcifications on panoramic radiographs in relation to carotid atherosclerosis on ultrasound

OBJECTIVES: To investigate periodontitis combined with carotid artery calcifications on panoramic radiographs in relation to carotid ultrasound findings of atherosclerotic disease among participants in the Malmö Offspring Dental Study. METHODS: In this population-based, cross-sectional cohort study, 410 participants (mean age 53.0±7.8 years) were examined by carotid ultrasound, panoramic and intraoral radiography. The panoramic radiographs were assessed for presence and shape of carotid artery calcifications and marginal bone loss, indicating current or past periodontitis. Groups with and without periodontitis stage III-IV and/or carotid artery calcifications were analyzed for associations to findings of three carotid ultrasound characteristics: total plaque area, number of plaques, and lumen reduction. Adjustments for covariates were performed. RESULTS: Participants with combined periodontitis and carotid artery calcifications (all shapes) had significantly greater total plaque area, number of plaques, and lumen reduction (P < 0.001). The findings for vessel-outlining shape combined with periodontitis was more severe but non-significant. Participants with combined findings had 13.7-times higher probability of having plaques on ultrasound, whereas those with carotid artery calcifications alone had 7.65-times higher probability than participants with no carotid artery calcifications or periodontitis (P < 0.001). CONCLUSIONS: Participants with periodontitis and carotid artery calcifications had more ultrasound findings, indicating more advanced atherosclerotic disease. Dentists should consider recommending patients with these findings to seek medical attention for cardiovascular risk factor evaluation and prevention. ADVANCES IN KNOWLEDGE: This study explore that participants with periodontitis combined with carotid artery calcification on panoramic radiographs have more advanced signs of atherosclerotic disease on ultrasound than participants with carotid artery calcifications but without periodontitis.