Effect of Preoperative Periodontal Treatment on Postoperative Infection and Mortality After Aortic and Mitral Valve Surgery

NCT07626801 | Completed

• 1 other identifier: 2025/168
• Study Type: observational
• Target: 200
• Locations: 1 country
• Sites: 1

Brief Summary

This retrospective observational study aims to evaluate the effect of preoperative periodontal treatment on postoperative infection and mortality in patients undergoing aortic and mitral valve surgery. Patient records between 2015 and 2024 analyzed. Demographic, clinical, and and radiographic findings, evaluated. Postoperative outcomes such as infection, antibiotic use, length of hospital and intensive care unit stay, and mortality assessed. The findings of this study may contribute to understanding the role of periodontal health in improving postoperative outcomes in cardiac surgery patients.

Conditions

Periodontitis; Heart Valve Disease; Postoperative Infection; Cardiovascular Disease

Keywords

Preoperative Periodontal Treatment; Cardiac Valve Surgery; Periodontal Disease; Postoperative Infection; Retrospective Study

Outcome Measures

Primary Outcomes (5)

• Radiographic Alveolar Bone Loss Percentage Assessed on Panoramic Radiographs

  Radiographic periodontal bone loss have been assessed on panoramic radiographs by measuring the percentage of alveolar bone loss relative to root length. Bone loss severity will be categorized according to the extent of radiographic alveolar bone loss. Higher percentages indicate greater periodontal destruction and more severe periodontal disease.

  Preoperative assessment (baseline)

• Periodontal disease diagnosis (presence and severity)

  Periodontal disease diagnosed based on radiographic findings and classified according to established periodontal disease criteria (e.g., mild, moderate, or severe periodontitis).

  Preoperative assessment (baseline)

• DMFT index (Decayed, Missing, Filled Teeth score)

  The DMFT index calculated from radiographic and clinical records to quantify cumulative dental caries experience in each patient.

  Preoperative assessment (baseline)

• Postoperative infection-related clinical outcomes (fever duration)

  The number of days with postoperative fever (≥37.5°C) recorded from patient medical records and used as an indicator of postoperative infection.

  Measured within the first 7 postoperative days following cardiac surgery.

• Length of postoperative hospital stay (days)

  The duration of hospitalization has been recorded in days from the date of cardiac surgery until hospital discharge and compared according to preoperative oral and periodontal status.

  From the date of cardiac surgery until hospital discharge, assessed up to 30 days postoperatively.

Secondary Outcomes (4)

• Duration of intensive care unit (ICU) stay (days)

  From admission to the intensive care unit following cardiac surgery until ICU discharge, assessed up to 30 days postoperatively.

• Time to initiation of oral feeding (days)

  From the date of cardiac surgery until initiation of oral feeding, assessed up to 30 days postoperatively.

• Postoperative C-Reactive Protein (CRP) Level

  Measured within the first 7 postoperative days following cardiac surgery.

• Postoperative White Blood Cell (WBC) Count

  Measured within the first 7 postoperative days following cardiac surgery.

Study Arms (2)

Elective Surgery Patients

This cohort includes patients who underwent elective aortic or mitral valve surgery and had complete medical and dental records available. All patients received standard preoperative evaluation, and those with documented periodontal treatment within 15 days prior to surgery were included.

Emergency Surgery Patients

This cohort consists of patients who underwent emergency aortic or mitral valve surgery. Due to the urgent nature of the procedure, preoperative periodontal assessment and treatment not have been consistently performed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This retrospective study population consists of adult patients who underwent cardiac valve surgery and had available preoperative panoramic radiographs and complete clinical records. The study aims to evaluate the association between oral health status (DMFT index and radiographic periodontal condition) and postoperative clinical outcomes.

You may qualify if:

• Adult patients (≥18 years) who underwent cardiac valve surgery
• Availability of preoperative panoramic radiographs
• Complete medical and dental records, including DMFT index and systemic clinical parameters
• Patients with documented postoperative clinical follow-up data

You may not qualify if:

• Patients under 18 years of age
• Patients with incomplete or missing medical or radiographic records
• Patients with a history of systemic conditions severely affecting bone metabolism (e.g., advanced malignancy, metabolic bone disease)
• Patients who received recent periodontal treatment prior to radiographic assessment
• Poor-quality radiographs that do not allow accurate evaluation

Sponsors & Collaborators

• Istanbul University - Cerrahpasa: lead

Study Sites (1)

Bakirköy Dr. Sadi Konuk Education and Research Hospital

Istanbul, Bakirköy, 34147, Turkey (Türkiye)

Location

Related Publications (6)

• Nakano K, Nemoto H, Nomura R, Inaba H, Yoshioka H, Taniguchi K, Amano A, Ooshima T. Detection of oral bacteria in cardiovascular specimens. Oral Microbiol Immunol. 2009 Feb;24(1):64-8. doi: 10.1111/j.1399-302X.2008.00479.x.

  PMID: 19121072 RESULT

• Sfyroeras GS, Roussas N, Saleptsis VG, Argyriou C, Giannoukas AD. Association between periodontal disease and stroke. J Vasc Surg. 2012 Apr;55(4):1178-84. doi: 10.1016/j.jvs.2011.10.008. Epub 2012 Jan 14.

  PMID: 22244863 RESULT

• Saengtipbovorn S, Taneepanichskul S. Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes. BMC Oral Health. 2014 Jun 16;14:72. doi: 10.1186/1472-6831-14-72.

  PMID: 24934646 RESULT

• Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Jul 11;70(2):252-289. doi: 10.1016/j.jacc.2017.03.011. Epub 2017 Mar 15. No abstract available.

  PMID: 28315732 RESULT

• Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015 Jan;15(1):30-44. doi: 10.1038/nri3785.

  PMID: 25534621 RESULT

• Bagyi K, Haczku A, Marton I, Szabo J, Gaspar A, Andrasi M, Varga I, Toth J, Klekner A. Role of pathogenic oral flora in postoperative pneumonia following brain surgery. BMC Infect Dis. 2009 Jun 29;9:104. doi: 10.1186/1471-2334-9-104.

  PMID: 19563632 RESULT

MeSH Terms

Conditions

Periodontitis; Heart Valve Diseases; Cardiovascular Diseases; Periodontal Diseases

Condition Hierarchy (Ancestors)

Mouth Diseases; Stomatognathic Diseases; Heart Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: May 19, 2026
• First Posted: June 4, 2026
• Study Start: January 1, 2015
• Primary Completion: December 1, 2024
• Study Completion: May 1, 2025
• Last Updated: June 4, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, ANALYTIC CODE

Locations

TU (1)