Dental and Medical Problems
2017, vol. 54, nr 1, January-March, p. 41–47
Publication type: original article
Evaluation of non-surgical periodontal treatment in patients with a past history of myocardial infarction
Ocena niechirurgicznego leczenia periodontologicznego u pacjentów z przebytym zawałem mięśnia sercowego
1 Departmant of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Białystok, Poland
2 Private Dental Practice, Białystok, Poland
3 Department of Cardiology, Medical University of Bialystok, Białystok, Poland
Background. The cohort study revealed a relationship between chronic periodontitis and the risk of developing coronary heart disease (CHD) and myocardial infarction.
Objectives. The aim of the study was to evaluate the influence of periodontal treatment on periodontal status in patients with past history of acute myocardial infarction.
Material and Methods. The study comprised 45 patients with chronic periodontitis hospitalized due to acute myocardial infarction treated with coronary angioplasty. The patients were randomized to the group of non-surgical periodontal treatment (group 1; 25 individuals) or the group of periodontal prophylactics (group 2; 20 individuals). The following aspects were evaluated in clinical study: plaque index (PI), approximal plaque index (API), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). The study was carried out 1–2 weeks following discharge from hospital and 6, 7 and 12 months after the initial examination.
Results. High values of PI, API and BOP were observed in both groups, which indicated poor oral hygiene and a considerable percentage of inflamed pockets. Those values significantly decreased with further control examinations, yet the obtained values were still very high. No significant changes in time were observed in PD and CAL in both groups. A significant PD reduction in the examinations performed 7 and 12 moths from the baseline was detected only in the group of younger patients who underwent non-surgical periodontal treatment.
Conclusion. The patients with past history of acute myocardial infarction show an abnormal periodontal status which does not significantly change due to constant hygienic negligence despite prophylactic-therapeutic intervention.
periodontitis, cardiovascular disease, non-surgical periodontal treatment
zapalenie przyzębia, choroby układu sercowo-naczyniowego, niechirurgiczne leczenie periodontologiczne
- Baehni P, Tonetti MS. Group 1 of the European Workshop on Periodontology: Conclusions and consensus statements on periodontal health, policy and education in Europe: A call for action-consensus view 1. Consensus report of the 1st European Workshop on Periodontal Educa-tion. Eur J Dent Educ. 2010;14(Suppl 1):2–3.
- Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ. Prevalence of periodontitis in adults in the United States: 2009 and 2010. J Dent Res. 2012;91:914–920.
- De Stefano F, Anda RF, Kahn HS, Williamson DF, Russel CM. Dental disease and risk of coronary heart disease and mortality. BMJ. 1993;306:688–691.
- Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodontal disease and cardiovascular disease. J Periodontol. 1996;67:1123–1137.
- Dietrich T, Jimenez M, Krall Kaye EA, Vokonas PS, Garcia RI. Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease. Circulation 2008;117:1668–1674.
- Hyman JJ, Winn DN, Reid BC. The role cigarette smoking in the association between periodontal disease and coronary heart disease. J Periodontol. 2002;73:988–994.
- Górska R. Relationship between periodontitis and systemic disorderd. Dent Med Probl. 2009;46:379–383 [in Polish].
- Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodon-titis: A meta-analysis. Am Heart J. 2007;154:830–837.
- D’Aiuto F, Parkar M, Andreou G, Suvan J, Brett PM, Ready D, Tonetti MS. Periodontitis and systemic inflammation: Control of the local infec-tion is associated with a reduction in serum inflammatory markers. J Dent Res. 2004;83:156–160.
- Mattila K, Vesanen M, Valtonen V, Nieminen M, Palosuo T, Rasi V, Asikainen S. Effect of treating periodontitis on C-reactive protein levels: A pilot study. BMC Infect Dis. 2002;10:2–30.
- Tonetti MS, Van Dyke TE. Periodontitis and atherosclerotic cardiovascular disease: Consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol. 2013;84 (Suppl 4):24–29.
- O’Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol. 1972;43:38.
- Lange DE, Plegmann HC, Eenboom A, Promsberger A. Klinische Bewertungsverfahren zur Objektivierung der Mundhygiene. Dtsch Zahnärztl Z. 1977;32:44–47.
- Ainamo J, Bay I: Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25:229–235.
- Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF. Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol. 2003;74:1361–1367.
- Taylor GW, Burt BA, Becker MP, et al. Non-insulin dependent diabetes mellitus and alveolar bone loss progression over 2 years. J Periodontol. 1998;69:76–83.
- Offenbacher S, Beck JD, Moss K, et al. Results from the Periodontitis and Vascular Events (PAVE) study: A pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. J Periodontol. 2009;80:190–201.
- Pruszczyk P, Ciurzyński M, Opolski G, et al. Common dental-cardio position for dealing anticoagulation in patients undergoing dental pro-cedures. Kardiol Pol. 2016;74:87–98.
- De Oliveira C, Watt R, Hammer M. Tooth brushing, inflammation, and risk of cardiovascular disease: Results from Scottish Health Survey. BMJ. 2010;340:2451.
- Tonetti MS, D’Aiuto F, Nibali L, et al. Treatment of periodontitis and endothelial function. N Engl J Med. 2007;356:911–920.
- Piconi S, Trabattoni D, Luraghi C, et al. Treatment of periodontal disease results in improvements in endothelial dysfunction and reduction of the carotid intima-media thickness. FASEB J. 2009;23:1196–1204.
- Beck JD, Eke P, Lin D. Associations between IgG antibody to oral organisms and carotid intima-medial thickness in community-dwelling adults. Atheroscler. 2005;183:342–348.
- Desvarieux M, Demmer RT, Rundek T. Relationship between periodontal disease, tooth loss, and carotid artery plaque. The oral infections and vascular disease epidemiology study (INVEST). Stroke 2003;34:2120–2125.
- Górska R. Sprawozdanie z niezależnego panelu ekspertów na temat związku chorób przyzębia z chorobami ogólnoustrojowymi. Kardiol Pol. 2009;67:708–710 [in Polish].
- Geismar K, Stoltze K, Sigurd B, Gyntelberg F, Holmstrup P. Periodontal disease and coronary heart disease. J Periodontol. 2006;77:1547–1554.
- D’Aiuto F, Orlandi M, Gunsolley JC. Evidence that periodontal treatment improves biomarkers and ACVD outcomes. J Clin Periodontol. 2013;40(Suppl 14):85–105.
- Sanz I, Alonso B, Carasol M, Herrera D, Sanz M. Nonsurgical treatment of periodontitis. J Evid Base Dent Pract. 2012;1:76–86.
- Meissner G, Kocher T. Calculus-detection technologies and their clinical application. Periodontol. 2000;2011:55, 189–204.
- Jepsen S, Deschner J, Braun A, Schwarz F, Eberhard J. Calculus removal and the prevention of its formation. Periodontol. 2000;2011, 55:167–188.
- Suvan JE. Effectiveness of mechanical nonsurgical pocket therapy. Periodontol. 2000;2005, 37:48–71.
- Cobb CM. Non-surgical pocket therapy: Mechanical. Ann Periodontol. 1996;1:443–490.
- Van Der Weijden GA, Timmerman MF. A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol. 2002;29(Suppl 3):55–71.
- Adriaens PA, Adriaens LM. Effects of nonsurgical periodontal therapy on hard and soft tissues. Periodontol. 2000;2004, 36:121–145.
- Chapple IL, Van Der Weijden F, Doerfer C, et al. Primary prevention of periodontitis: Managing gingivitis. J Clin Periodontol. 2015;42 (Suppl 16):71–76.
- Johansson LA, Oster B, Hamp SE. Evaluation of cause related periodontal therapy and compliance with maintenance care recommendations. J Clin Periodontol. 1984;11:689–699.
- Kay EJ, Locker D. Is dental health education effective? A systematic review of current evidence. Comm Dent Oral Epidemiol. 1996;24:231–235.
- Schüz B, Sniehotta FF, Wiedemann A, Seemann R. Adherence to a daily flossing regimen in university students: Effects of planning when, where, how and what to do in the face of barriers. J Clin Periodontol. 2006;33:612– 619.
- Miller WR, Rollnick S. Motivational interviewing: Preparing people for chance. 2nd ed. New York, Guilford, 2002.
- Clarkson JE, Young L, Ramsay CR, Bonner BC, Bonetti D. How to influence patient oral hygiene behavior effectively. J Dent Res. 2009;88:933–937.
- Jönsson B, Ohrn K, Oscarson N, Lindberg P. The effectiveness of an individually tailored oral health educational program on oral hygiene behavior in patients with periodontal disease: A blinded randomized-controlled clinical trial (one-year follow-up). J Clin Periodontol. 2009;36:1025–1034.