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

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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.

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About the authors

Andrey V. Eremin

V.I. Razumovsky Saratov State Medical University

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, Saratov

Aleksandr V. Lepilin

V.I. Razumovsky Saratov State Medical University

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, Saratov

Tatiana E. Lipatova

V.I. Razumovsky Saratov State Medical University

Author for correspondence.
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, Saratov


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Supplementary files

Supplementary Files
1. Fig. Gum biopsy. Patient S., 48 years old. Diagnosis: Chronic generalized periodontitis of moderate severity. Arterial hypertension. An increase in the number of cells immunopositive to endothelin-1 is determined mainly in the vascular wall. Immunohistochemical method with antibodies to endothelin-1. ×400

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Свидетельство о регистрации СМИ № 015648 от 14.05.1999 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор). 
Свидетельство о регистрации СМИЭЛ № ФС 77 - 80635 от 15.03.2021 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).

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