Association Between the Severity of Periodontal Disease and Carotid Artery Pulsatility Index in Patients with Type 2 Diabetes Mellitus

Background/Objectives: Periodontal disease is a major comorbidity of diabetes mellitus, and there is a bidirectional relationship between these two chronic inflammatory conditions. Although emerging studies have suggested that periodontal disease is associated with both macrovascular and microvascular complications of diabetes, its relationship with functional vascular parameters has not been sufficiently clarified. This study aimed to investigate the association between periodontal disease severity and vascular dysfunction, as assessed by the pulsatility index of the common carotid artery (CCA-PI), in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: In this cross-sectional study, 60 patients with T2DM attending both diabetic complication and dental clinics were enrolled. Periodontal parameters, including probing pocket depth (PD), attachment level (AL), bleeding on probing, and periodontal inflamed surface area (PISA), were assessed. Vascular parameters were evaluated using carotid ultrasonography, with particular focus on CCA-PI. Associations between periodontal variables and vascular parameters were analyzed using Spearman’s rank correlation coefficients and multiple linear regression analyses. Results: The proportion of sites with PD ≥ 4 mm and AL ≥ 4 mm was positively correlated with CCA-PI. In multivariate regression analyses, only PD ≥ 4 mm remained associated with CCA-PI after adjustment for age, sex, BMI, and HbA1c. Conclusions: Although causality cannot be inferred from this cross-sectional study, greater periodontal disease severity, particularly the extent of periodontal pocketing, was associated with increased CCA-PI in patients with T2DM.