Association between individuals with unilateral and bilateral carotid artery calcifications and periodontal disease: a cross-sectional study.

Abstract

Background: This study investigated the association between unilateral and bilateral carotid artery calcifications (CAC) and periodontal disease severity using panoramic radiographs, and assessed the influence of systemic risk factors such as hypertension, diabetes, and smoking.

Methods: A retrospective cross-sectional study analyzed 116 radiographs from 87 females and 29 males with CAC. CAC was identified as radiopaque lesions near the C3-C4 intervertebral space. Participants were categorized into unilateral or bilateral CAC groups. Demographic data, medical histories, and periodontal parameters (plaque index, gingival index (GI), bleeding on probing, probing depth (PD), and clinical attachment loss) were recorded. Participants were classified as healthy, gingivitis, periodontitis stage I-II, or stage III-IV. Binomial logistic regression and independent samples t-tests were used.

Results: Age and gender were not significantly associated with the type of CAC (p > 0.05). Only PD showed a significant association: an increase in PD was linked to higher odds of unilateral CAC and lower odds of bilateral CAC (p < 0.05). Smoking, diabetes, and hypertension were not significantly associated with the type of CAC (p > 0.05). Unilateral CAC was linked to higher GI, PD, and stage III-IV periodontitis, while bilateral CAC was more common in stage I-II (p < 0.05).

Conclusion: The findings suggest a differential association between the severity of periodontitis and the type of CAC. Unilateral CAC may be more strongly linked to advanced periodontal inflammation, possibly reflecting an earlier, inflammation-dominant phase of atherosclerosis. Due to the cross-sectional design and use of panoramic radiographs, causal inferences cannot be drawn. Further longitudinal studies using advanced imaging techniques are needed.