Use of orthodontic treatment protocols in patients with chronic periodontitis and arterial hypertension
- Authors: Eremin A.V.1, Lepilin A.V.1, Lipatova T.E.1
-
Affiliations:
- V.I. Razumovsky Saratov State Medical University
- Issue: Vol 25, No 3 (2021)
- Pages: 233-239
- Section: Clinical Investigation
- URL: https://rjdentistry.com/1728-2802/article/view/70736
- DOI: https://doi.org/10.17816/1728-2802-2021-25-3-233-239
Cite item
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
Full Text

About the authors
Andrey V. Eremin
V.I. Razumovsky Saratov State Medical University
Email: pr-ereminav@yandex.ru
ORCID iD: 0000-0002-0457-3303
SPIN-code: 7561-0020
ResearcherId: AAJ-6804-2021
MD, Cand. Sci. (Med.), assistant professor
Russian Federation, 112, Bolshaya Kazachya str., 410012, SaratovAleksandr V. Lepilin
V.I. Razumovsky Saratov State Medical University
Email: lepilins@mail.ru
ORCID iD: 0000-0001-6940-5178
SPIN-code: 4293-9439
Scopus Author ID: 6603785447
ResearcherId: B-5281-2017
MD, Dr. Sci. (Med.), Professor
Russian Federation, 112, Bolshaya Kazachya str., 410012, SaratovTatiana E. Lipatova
V.I. Razumovsky Saratov State Medical University
Author for correspondence.
Email: lipatova.t@inbox.ru
ORCID iD: 0000-0002-7401-9930
SPIN-code: 2483-3578
Scopus Author ID: 36892031000
ResearcherId: A-6675-2017
MD, Dr. Sci. (Med.), assistant professor
Russian Federation, 112, Bolshaya Kazachya str., 410012, SaratovReferences
- Tsimbalistov AV, Lobanovskaya AA, Mikhailova ES. Diagnostics of intolerance of structural dental materials in the clinic of orthopedic dentistry. Dental South. 2012;(2):30–32. (In Russ).
- Hannah VE, O’Donnell L, Robertson D, Ramage G. Denture Stomatitis: Causes, Cures and Prevention. Prim Dent J. 2017;6(4):46–51. doi: 10.1308/205016817822230175
- Pravdivtsev VA, Shashmurina VR, Kirillov SK, et al. Pathological processes initiated by metal-ceramic dentures. Russian journal of dentistry. 2013;3:30–34. (In Russ).
- Boitsov SA, Shalnova SA, Deev AD. Mortality from cardiovascular diseases in the Russian Federation and possible mechanisms of its change. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018;8:98–103. (In Russ).
- Eremin AV, Lipatova TE, Lepilin AV, Eremin VI. Assessment of cardiovascular risk factors in patients with chronic periodontitis. Saratovskiy nauchno-meditsinskiy zhurnal. 2020;145–49. (In Russ).
- Leong XF, Ng CY, Badiah B, Das S. Association between hypertension and periodontitis: possible mechanisms. Scientific World Journal. 2014;2014:237.
- Sanz M, Marco Del Castillo A, Jepsen S, et al. Periodontitis and cardiovascular diseases: Consensus report. J Clin Periodontol. 2020;47(3):268–288. doi: 10.1111/jcpe.13189
- Khimji AK, Rockey DC. Endothelin-biology and disease. Cell Signal. 2010;22(11):1615–1625. doi: 10.1016/j.cellsig.2010.05.002
- Guo F, Carter DE, Leask A. Mechanical tension increases CCN2/CTGF expression and proliferation in gingival fibroblasts via a TGFbeta-dependent mechanism. PLoS One. 2011;6(5):e19756. doi: 10.1371/journal.pone.0019756
- Khalid W, Varghese SS, Sankari M, Jayakumar ND. Comparison of Serum Levels of Endothelin-1 in Chronic Periodontitis Patients Before and After Treatment. J Clin Diagn Res. 2017;11(4):ZC78–ZC81. doi: 10.7860/JCDR/2017/24518.9698
- Li X, Tse HF, Jin LJ. Novel endothelial biomarkers: implications for periodontal disease and CVD. J Dent Res. 2011;90(9):1062–1069. doi: 10.1177/0022034510397194
- Costa ED, Rezende BA, Cortes SF, Lemos VS. Neuronal Nitric Oxide Synthase in Vascular Physiology and Diseases. Front Physiol. 2016;7:206. doi: 10.3389/fphys.2016.00206
- Shu X, Keller TCt, Begandt D, et al. Endothelial nitric oxide synthase in the microcirculation. Cell Mol Life Sci. 2015;72(23):4561–4575. doi: 10.1007/s00018-015-2021-0
- Hussain QA, McKay IJ, Gonzales-Marin C, Allaker RP. Regulation of adrenomedullin and nitric oxide production by periodontal bacteria. J Periodontal Res. 2015;50(5):650–657. doi: 10.1111/jre.12246
- Batista AC, Silva TA, Chun JH, Lara VS. Nitric oxide synthesis and severity of human periodontal disease. Oral Dis. 2002;8(5):254–260. doi: 10.1034/j.1601-0825.2002.02852.x
- Reher VG, Zenobio EG, Costa FO, et al. Nitric oxide levels in saliva increase with severity of chronic periodontitis. J Oral Sci. 2007;49(4):271–276. doi: 10.2334/josnusd.49.271
- Lappin DF, Kjeldsen M, Sander L, Kinane DF. Inducible nitric oxide synthase expression in periodontitis. J Periodontal Res. 2000;35(6):369–373. doi: 10.1034/j.1600-0765.2000.035006369.x
- Aurer A, Aleksic J, Ivic-Kardum M, et al. Nitric oxide synthesis is decreased in periodontitis. J Clin Periodontol. 2001;28(6):565–568. doi: 10.1034/j.1600-051x.2001.028006565.x
- Reiter RJ, Tan DX, Fuentes-Broto L. Melatonin: a multitasking molecule. Prog Brain Res. 2010;181:127–151. doi: 10.1016/S0079-6123(08)81008-4
- Srinath R, Acharya AB, Thakur SL. Salivary and gingival crevicular fluid melatonin in periodontal health and disease. J Periodontol. 2010;81(2):277–283. doi: 10.1902/jop.2009.090327
- Park KH, Kang JW, Lee EM, et al. Melatonin promotes osteoblastic differentiation through the BMP/ERK/Wnt signaling pathways. J Pineal Res. 2011;51(2):187–194. doi: 10.1111/j.1600-079X.2011.00875.x
Supplementary files
