Індексна оцінка стану тканин пародонта у хворих з атеросклерозом

Abstract

The purpose of the study was to assess the condition of periodontal tissues using periodontal indices in patients with generalized periodontitis on the background of atherosclerosis. Materials and methods. In the course of the dental study, we examined 232 patients (202 – patients with generalized periodontitis on the background of atherosclerosis (main group), and 30 patients with generalized periodontitis without somatic diseases (control group), aged 45-65 years, with a percentage ratio of men to women 65.5% and 34.5%, respectively. To establish the diagnosis (generalized periodontitis) the classification of periodontal tissue diseases edited by Danilevsky M. F. was used. Index assessment of periodontal tissue was determined using: papillary-marginal-alveolar index (Massler M., 1949, modified by Parma), periodontal index (Russel A. L., 1956), gingiva bleeding index (Muhlemann H. R., Mazor A. S., 1958, Cowell I., 1975). The loss of epithelial attachment was measured with a graduated probe and expressed in millimetres: the condition of the furcation of multi-rooted teeth was assessed in the horizontal direction by the method of Hemp, in the vertical – by the method of Tarnow-Fletcher. To study the degree and nature of resorption of the interalveolar septa of the bone of the alveolar processes, X-ray examination was performed using panoramic radiography and evaluated according to the Fuch X-ray index (Rtg). Results and discussion. Analysis of data from the modern literature shows that cardiovascular pathology can be considered as a risk factor for periodontal disease. On the other hand, there is convincing evidence that periodontal disease, in particular, its etiological factor – periodontal pathogens, directly affects the occurrence of changes in the cardiovascular system. This relationship is also evidenced by some epidemiological studies. According to Tonetti M. S., the connection between atherosclerosis and periodontal pathology is confirmed by the presence of common risk factors, in particular, generalized periodontitis induces systemic inflammation, which leads to the development of endothelial dysfunction, which is considered the basis of the pathogenesis of atherosclerosis. It was found that in patients with generalized periodontitis on the background of atherosclerosis, the average value of the papillary-marginal-alveolar index was 53.23±2.87%, p <0.05, and the Muellemann-Cowell index (gingiva bleeding index) was 2.53±0.25 points, p >0.05, which was by 1.2 times higher than the values in patients with generalized periodontitis without somatic diseases (44.27±2.57% and 2.10±0.29 points, respectively). In the main group, the values of periodontal indices and loss of epithelial attachment were by 1.3 times higher than the values in the comparison group (2.78±0.13 points, and 3.48±0.22 mm, against 2.06±0.09 points, 2.09±0.12 and 2.69±0.19 mm, p <0.05). In this case, the average value of Rtg – recession index of the gums in patients with atherosclerosis did not differ from those in persons without somatic diseases of the comparison group (1.36±0.12 points and 1.43±0.12 points, respectively, p >0.05). Conclusion. Thus, our results indicate a progressive course of generalized periodontitis in patients with atherosclerosis