Introduction: Dentists often are the first to identify symptomatic manifestations of various diseases of internal organs when treating inflammatory diseases of the periodontium, caries and its complications. Oral pathology or a random test of clinical laboratory parameters with establishment of deviations in them can refer us to the disease. If dentists neglect and underestimate the problem, complications can arise in the treatment of these patients.
Aim: The aim of this article is to evaluate the type of oral pathology in patients with cardiovascular diseases.
Materials and Methods: Our study was carried out among 40 patients with cardiovascular diseases. The patients were treated at St. Marina University Hospital and had outpatient monitoring at St. Marina Diagnostic and Consultative Center, Varna. The following methods were used: documentary, clinical dental examination; DMFT; PPD; PBI and CAL; radiographic examinations, electric pulp test; palpation and percussion tests.
Results: All patients were with proven and treated cardiovascular diseases. The mean age of examined patients was 53.26 ± 16.22 years (mean ± SD). Their gender distribution was as follows: 53% (21) men and 47.50% women (19). The average DMFT was 14.38, 80% of the patients lacked an average of 8.74 ± 1.75 teeth, 5% had total dentures, 15% partial dentures, and 5% were totally edentulous and without any prosthetics. We established values for PPD 3.74 ± 0.46 mm, and in 15 patients ≥ 5 mm, and for PBI - 2.15 ± 0.25. Apical periodontitis was found in 33% of the patients.
Conclusion: The presence of significant oral pathology in patients with cardiovascular diseases indicates that they are immunocompromised and are at greater risk of inflammation due to their underlying disease, therefore prevention and treatment of dental infections are essential for improving their general somatic health.
Ц. Цветанов. Дентално лечение при медицински компрометирани пациенти, 2017, 134, 978-619-713-443-8
Berlin-Broner Y, Febbraio M, Levin L. Association between apical periodontitis and cardiovascular diseases: a systematic review of the literature. Int Endod J 2017; 50: 847–859.
Berlin-Broner Y., Febbraio М, Levin L. Apical periodontitis and atherosclerosis: is there a link? Review of the literature and potential mechanism of linkage. Quintessence Int, 48 (2017), pp 527-534
Boneu, B., Abbal, M., Plante J. et al. Factor-VIII complex and endothelial damage. Lancet. 1, 1430, 1975
Caplan DJ. Chronic apical periodontitis is more common in subjects with coronary artery disease. J Evid Based Dent Pract 2014; 14: 149–50.
De Angelis F., Basili S., Giovanni F. et al. Influence of the oral status on cardiovascular diseases in an older Italian population. International Journal of Immunopathology and Pharmacology, 2018; 31:1-7
Gröndahl HG. and S. Huumonen. Radiographic manifestations of periapical inflammatory lesions. Endod Topics, 8 (2004), pp. 55-67
Khalighinejad N, Aminoshariae MR, Aminoshariae A et al. Association between systemic diseases and apical periodontitis. J Endod 2016; 42: 1427–1434.
Mattila K.J., Nieminen M.S., Valtonen V.V. et al. Association between dental health and acute myocardial infarction. Br. Med. J. 298, 779-781, 1989
Messing M., Chaves de Souza L., Cavalla F. et al. Investigating Potential Correlations between Endodontic Pathology and Cardiovascular Diseases Using Epidemiological and Genetic Approaches. J of Endodontics 2019; 45 (2):104-110
Rose LF, Genco RJ, Cohen DW et al. Periodontal medicine. Hamilton, Ontario BC: Deckeer Inc. Z; 73-78
Ross R. The pathogenesis of atherosclerosis - an update. New Engl. J. Med. 314, 488-500, 1986
Sanchez P, Everett B, Ajwani S et al. Oral Healthcare and Cardiovascular Disease. A Scoping Review of Current Strategies and Implications for Nurses. The J of Cardiovascular Nursing: 2017: 5/6; 32 (3); E10-E20
Sanz М. and Tonett М. (2019). Periodontitis: clinical decision tree for staging and grading” in New classification of periodontal and peri-implant diseases. European Federation of Periodontology
Wu T, Trevisan M, Genco RJ et al. Examination of relation between periodontal health status and cardiovascular risk factors: Total and HD lipoprotein, cholesterol, CRР and plasma fibrinogen. Am J Epidemiol 2000; 151; 273-82
Zanella SM., Pereira SS, Barbisan JN. Periodontal disease, tooth loss and coronary heart disease assessed by coronary angiography: a cross‐sectional observational study. J of Periodontal Research 2016, 51 (2): 221-227