Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
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Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2012, vol. 49, nr 1, January-March, p. 78–87

Publication type: review article

Language: Polish

Badania interwencyjne w związkach zapaleń przyzębia z wybranymi chorobami układowymi

Intervention Studies in Periodontal Medicine

Agata Kobierzycka1,, Tomasz Konopka2,

1 Wolontariat w Katedrze i Zakładzie Periodontologii Akademii Medycznej we Wrocławiu

2 Katedra i Zakład Periodontologii Akademii Medycznej we Wrocławiu

Streszczenie

Najsilniejszym dowodem zależności między domniemanym czynnikiem a chorobą jest przeprowadzenie badań interwencyjnych i wykazanie, że przez modulowanie czynnika ryzyka w następstwie leczenia dochodzi do znamiennych zmian w zapadalności na badaną chorobę. Aby w pełni usankcjonować znaczenie zapalenia przyzębia jako niezależnego czynnika ryzyka wybranych chorób ogólnych, podejmowano ten rodzaj badań nieeksperymentalnych. Celem pracy jest przedstawienie współczesnych badań nad wpływem leczenia periodontologicznego na wykładniki i występowanie chorób sercowo-naczyniowych, cukrzycy oraz wcześniactwa i/lub małej masy urodzeniowej. Niechirurgiczne leczenie przewlekłego zapalenia przyzębia powoduje znaczącą poprawę funkcji śródbłonków naczyń, a także zmniejszenie surowiczego stężenia mediatora prozapalnego związanego z procesem aterogenezy, jakim jest białko C-reaktywne. Dotychczas nie udowodniono jednak ochronnego wpływu leczenia periodontologicznego na profilaktykę incydentów sercowo-naczyniowych. Wyniki obserwacji wpływu leczenia zapalenia przyzębia na kontrolę glikemii u pacjentów z cukrzycą nie są jednoznaczne. Większość badań wskazywało, że leczenie periodontologiczne diabetyków w istotny statystycznie sposób zmniejszało stężenie glikohemoglobiny, chociaż wpływ ten jest tylko przejściowy. Z przeglądu wyników badań nad wpływem zapalenia przyzębia i jego leczenia na występowanie porodów przedwczesnych oraz ich powikłań także wynika, że są one sprzeczne. Wcześniejsze, metodologiczne gorsze badania potwierdzają te zależności, późniejsze (w większym stopniu uwzględniające czynniki zakłócające takie obserwacje) przeczą im. Niezgodności wyników badań kohortowych i interwencyjnych w interakcji między periodontopatiami a chorobami układowymi wymagają pogłębionych analiz.

Abstract

The strongest evidence of the relationship between the suspected factor and a disease is conduction of intervention studies and demonstration that, by modulating the risk factor that follows treatment, comes to significant changes in morbidity due to the studied disease. In order to fully legitimize the importance of periodontitis as an independent risk factor for selected general diseases this kind of non-experimental researches were performed. Aim of this review article is to present recent studies concerning the effects of periodontal treatment on the markers and occurrence of the cardiovascular diseases, diabetes and prematurity and/or low birth weight. Non-surgical treatment of chronic periodontitis greatly improves function of vascular endothelium and decreases serum concentration of proinflammatory mediator involved in the process of atherogenesis which is C-reactive protein. So far, it has not been proven that periodontal treatment has a protective effect on prevention of cardiovascular diseases. The results of observation of periodontal treatment effects on glycemic control of diabetic patients are unclear. Most studies have indicated that periodontal treatment of diabetics decreased in statistically significant manner the level of glycated hemoglobin, although this effect is only temporary. A review of studies that concerned effects of periodontitis and periodontal treatment on the occurrence of preterm birth and its complications also shows contradictory results. Previous, methodologically unreliable research confirmed these relationships, however further studies (greater, taking into account interfering factors such observations) deny them. Discrepancies between the results of cohort and intervention studies in periodontal medicine require further analyses.

Słowa kluczowe

zapalenie przyzębia, leczenie niechirurgiczne, choroby sercowo-naczyniowe, cukrzyca, wcześniactwo, mała masa urodzeniowa, badania interwencyjne

Key words

periodontitis, non-surgical treatment, cardiovascular diseases, diabetes, prematurity, low birth weight, intervention studies

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