Hindawi Publishing Corporation Journal of Oral Diseases Volume 2013, Article ID 243736, 9 pages http://dx.doi.org/10.1155/2013/243736 Clinical Study Clinically Classified Periodontitis and Its Association in Patients with Preexisting Coronary Heart Disease Nikolaos A. Chrysanthakopoulos 1,2 and Panagiotis A. Chrysanthakopoulos 3 1 Maxillofacial and Oral Surgery, 401-General Military Hospital of Athens 138, Mesogeion Avenue & Katehaki, 115 25 Athens, Greece 2 Department of Pathological Anatomy, Medical School, University of Athens, 75 M. Asias Street, 115 27 Athens, Greece 3 417-General Military Hospital of Athens-NIMTS, 10-12 M. Petraki Street, 115 21 Athens, Greece Correspondence should be addressed to Nikolaos A. Chrysanthakopoulos; nikolaos c@hotmail.com Received 21 March 2013; Accepted 27 May 2013 Academic Editor: Atsushi Saito Copyright © 2013 N. A. Chrysanthakopoulos and P. A. Chrysanthakopoulos. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te aim of this retrospective study was to investigate possible associations between clinically classifed periodontitis as determined by assessing its severity and diagnosed coronary heart disease in outpatients referred to a specialist clinic for neurosurgery treatment. A total of 2,912 individuals were clinically examined for periodontal disease experience by using probing pocket depth (PPD) and clinical attachment loss (CAL). Socioeconomic, oral health behaviour, and general health related information was collected by using a self-administered questionnaire. Statistical analysis of the questionnaire items was performed by using multivariate logistic regression analysis model. Te results showed that the occurrence of hypertension (OR = 2.42, 95% CI = 1.52– 3.84), smoking (OR = 1.97, 95% CI = 1.25–3.11), classifed periodontitis (OR = 1.79, 95% CI = 1.15–2.77), and the high level of serum C-reactive protein (OR = 1.74, 95% CI = 1.05–2.89) were signifcantly associated with the presence of coronary heart disease. Tese observations strengthen the role of some of the traditional causative risk factors for coronary heart disease while a signifcant association was recorded between diagnosed coronary heart disease and clinically classifed periodontitis which is considered as a risk factor for coronary heart disease. 1. Introduction Cardiovascular diseases (CVD) and in particular coronary heart disease (CHD) represent a severe health condition and the main cause of mortality nowadays in industrialized societies. CHD is a multifactorial pathological condition and occurs as a result of genetic, environmental, and behavioral risk factors [1] while chronic infammation has been impli- cated etiologically in CVD and CHD [2]. Te genetic factors include age, gender, hypertension, diabetes mellitus, marked obesity, lipid metabolism, fbrinogen levels, and platelet P1 polymorphism [3–5]. Te environmental and behavioral risk factors include diet, physical inactivity, stress, cigarette smoking, excessive alcohol consumption, socioeconomic sta- tus, chronic infections, use of nonsteroid anti-infammatory drugs, and possible endothelial cell injury [4–7]. However, a signifcant proportion of CHD is not explained by the traditional risk factors [8]. Periodontitis is a complex chronic infammatory disease, resulting in a loss of connective tissue and bone support of the teeth [9]. Previous studies have linked several risk factors to periodontitis including diabetes mellitus, smoking, age, gen- der, low socioeconomic status [10], dyslipidemias, and exces- sive alcohol consumption [9, 11], whereas the genetic basis of chronic periodontitis has been suggested by other investiga- tions [12, 13]. In addition, periodontitis was associated with elevations of several markers of chronic infammation [14], and because of evidence implicating chronic infammation in the etiology of CHD, an etiologic relationship between periodontitis and CHD has been hypothesized [15]. Signifcant associations between periodontitis and CHD have been reported in previous case-control and cohort