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The advent of the inflammation paradigm in coronary pathogenesis stimulated research in chronic infections caused by a variety of micro-organisms\u2014such as Chlamydia pneumoniae, Helicobacter pylori, and cytomegalovirus\u2014as well as dental pathogens, since these chronic infections are thought to be involved in the etiopathogenesis of CVD by releasing cytokines and other pro-inflammatory mediators ( e.g., C-reactive protein [CRP], tumor necrosis factor [TNF-\u03b1]) that may initiate a cascade of biochemical reactions and cause endothelial damage and facilitate cholesterol plaque attachment. Yet, due to the multi-factorial nature of dental infection and CVD, confirming a causal association is difficult, and the published results are conflicting. The main deficit in the majority of these studies has been the inadequate control of numerous confounding factors, leading to an overestimation and the imprecise measurement of the predictor or overadjustment of the confounding variables, resulting in underestimation of the risks. A meta-analysis of prospective and retrospective follow-up studies has shown that periodontal disease may increase the risk of CVD by approximately 20% (95% confidence interval [CI], 1.08\u20131.32). Similarly, the reported risk ratio between periodontal disease and stroke is even stronger, varying from 2.85 (CI 1.78\u20134.56) to 1.74 (CI 1.08\u20132.81). The association between peripheral vascular disease and oral health parameters has been explored in only two studies, and the resultant relative risks among individuals with periodontitis were 1.41 (CI 1.12\u20131.77) and 2.27 (CI 1.32\u20133.90), respectively. Overall, it appears that periodontal disease may indeed contribute to the pathogenesis of cardiovascular disease, although the statistical effect size is small. <\/jats:p>","DOI":"10.1177\/154411130401500606","type":"journal-article","created":{"date-parts":[[2009,1,9]],"date-time":"2009-01-09T00:40:32Z","timestamp":1231461632000},"page":"403-413","source":"Crossref","is-referenced-by-count":290,"title":["O<scp>ral<\/scp> H<scp>ealth<\/scp>, A<scp>therosclerosis<\/scp>, <scp>and<\/scp> C<scp>ardiovascular<\/scp> D<scp>isease<\/scp>"],"prefix":"10.1177","volume":"15","author":[{"given":"Jukka H.","family":"Meurman","sequence":"first","affiliation":[{"name":"Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, PB 41, FIN-00014 Helsinki, Finland;"},{"name":"Faculty of Odontology, Complutense University, Ciudad Universitaria, E-28040 Madrid, Spain; and"},{"name":"Boston University Goldman School of Dental Medicine and"},{"name":"Harvard School of Public Health, Boston, MA 02215-1204, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Sanz","sequence":"additional","affiliation":[{"name":"Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, PB 41, FIN-00014 Helsinki, Finland;"},{"name":"Faculty of Odontology, Complutense University, Ciudad Universitaria, E-28040 Madrid, Spain; and"},{"name":"Boston University Goldman School of Dental Medicine and"},{"name":"Harvard School of Public Health, Boston, MA 02215-1204, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sok-Ja","family":"Janket","sequence":"additional","affiliation":[{"name":"Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, PB 41, FIN-00014 Helsinki, Finland;"},{"name":"Faculty of Odontology, Complutense University, Ciudad Universitaria, E-28040 Madrid, Spain; and"},{"name":"Boston University Goldman School of Dental Medicine and"},{"name":"Harvard School of Public Health, Boston, MA 02215-1204, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2004,11,1]]},"reference":[{"key":"bibr-AHA-2003","unstructured":"AHA (2003). 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