Use of orthodontic treatment protocols in patients with chronic periodontitis and arterial hypertension

Abstract

BACKGROUND: The wide prevalence and mutual influence of periodontitis and arterial hypertension determine the importance of choosing a rational approach to denture prosthetics in this patients.

AIM: The study was to choose a rational tactics of dental prosthetics in patients with chronic periodontitis and arterial hypertension based on a clinical and instrumental assessment of the periodontal condition and morphofunctional characteristics of neuroendocrine gum cells.

MATERIALS AND METHODS: The results of the examination of 120 patients with periodontitis and hypertension are presented, of which 90 patients had denture defects, 30 patients — intact dentition. Clinical examination, immunohistochemical, and morphometric studies were performed. 90 patients underwent prosthetics of dentition defects, of which: 32 patients were fitted with metal dentures, 30-metal-ceramic dentures, 28 patients were fitted with thermoplastic resin removable partial dentures.

RESULTS: Periodontitis in patients with hypertension is characterized by more significant changes in the expression of endothelin-1-, melatonin- and endothelial NO-synthase-like cells of gum, than periodontitis in patients without somatic pathology. After periodontal treatment, the use of metal-ceramic dentures and thermoplastic resin removable partial dentures by a year-long persistent remission of periodontitis in 85.7–86.7% of patients is accompanied. Remission is achieved against the background of satisfactory hygiene indicators and restoring the neurotransmitter balance of the oral cavity. After a year of metal dentures, 43.7% of patients report an exacerbation of periodontitis, which by poor hygiene and local neuroendocrine imbalance is facilitated.

CONCLUSION: The use of metal-ceramic dentures and thermoplastic resin removable partial dentures is the preferred option for prosthetics of dentition defects in patients with periodontitis and hypertension.

Keywords

periodontitis / arterial hypertension / dental prosthetics

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