Abstract
Objectives: There is evidence about a possible relationship existing between periodontal diseases and coronary heart disease. The aim of the present longitudinal study was to investigate the changes in periodontal evolution after etiological periodontal treatment, comparing a healthy control group with another having coronary heart disease. Study Design: The study included initially 55 patients of which 44 finished it. They were placed into two groups: Healthy Control Group (HCG) n =9, and Coronary Heart Disease Group (CHDG) n=35. The gingival level (GL), probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP) were measured to compare the periodontal status in both groups. The patients were examined and etiological periodontal treatment was performed and they were then examined at the end of 1 and 10 years. Statistical method: A one way-ANOVA and a MR-ANOVA were established; significance p<0.05. Results: No significant differences between both groups were detected on the first visit (p>0.5). However, at the second visit the CHDG presented a significantly higher PD (p<0.05) and PI (p<0.01). CHDG patients gradually increase PD through time and in comparison to the control group (p<0.041). CHDG patients present a significantly higher CAL loss (p<0.0385) and a significant increase in PI (p<0.0041) at the end of one year, while on the third visit no significant differences were detected in any of these indices. Likewise, a similar fact can be observed on evaluating BOP at the end of ten years causal treatment, a smaller decrease in the cardiac group was observed in regards to the initial values (p<0.001). Conclusion: Patients with coronary heart disease showed a worse evolution of periodontal indices than healthy ones, when referring to probing depth, plaque index and bleeding on probing index. Key words:Attachment loss, coronary heart disease, periodontal disease, risk factors.
Highlights
Coronary heart diseases (CHD) suppose a major health problem in today’s society in industrialized countries and they are the main cause of mortality in both men and women [1]
A similar fact can be seen on evaluating plaque index (PI) at the end of one year’s causal treatment, a small decrease in the cardiac group being observed in respect to the initial values, as opposed to the healthy control group (p
With respect to the choice of sample, it has to be underlined that the patients in the healthy control group were chosen amongst patients who consulted because of suffering some type of periodontal problem, whereas the patients in the cardiological group were selected on the basis of having a cardiac disease, and yet this group has periodontal characteristics comparable to the control group
Summary
Coronary heart diseases (CHD) suppose a major health problem in today’s society in industrialized countries and they are the main cause of mortality in both men and women [1]. The factors which predispose it must fulfil causality criterion: strength of association (relative high risk), consistency of association (demonstrated in several studies), temporal relationship (cause precedes effect), biological acceptability, experimental proof and above all, evidence of studies in humans From this point of view, the importance that periodontal diseases could have as a risk factor in CHD has been debated [2,3,4]. Offenbacher et al have gone so far as to postulate a PAS syndrome (“periodontitis-atherosclerosis syndrome”) which unites both concepts [5] In this sense it would really be important to clarify this concept from the point of view of public health, since to really establish an unmistakable relationship would imply an adequate and precocious foundation of periodontal treatment, reducing the risk of cardiovascular disease in these patients [14]. The present study has been established in which the changes in response to periodontal treatment when a cardiologically healthy control group and another which had undergone coronary diseases are compared
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