PREVALENCE AND STRUCTURE OF PERIODONTAL DISEASES IN PATIENTS WITH CORONARY ARTERY DISEASE

Abstract

Introduction. In recent decades, there has been an active discussion of the pathogenetic mechanisms of the relationship, the features of the clinical course, the improvement of methods of diagnosis and treatment of periodontal diseases in patients with coronary artery disease. The relevance of the study of this direction is due to the modern theory of atherogenesis, which considers atherosclerosis as a consequence of the immune inflammatory process associated with the presence of chronic foci of infection, in particular, in the case of periodontal diseases. Along with this, there are a number of studies that indicate that the progression of atherosclerosis can be the cause of damage to the hemomicrocirculatory system of periodontal tissues and cause persistent morpho-functional changes in the periodontium. The aim of the study. To study the prevalence and structure of the main periodontal diseases in patients with coronary artery disease. Research materials and methods. An examination of 130 patients (average age – 58,08 ± 0,72 years) who were undergoing inpatient treatment for coronary artery disease was carried out. The study included 78 (60,0%) men and 52 (40,0%) women diagnosed with coronary artery disease. Assessment of periodontal status and establishment of periodontal diagnosis was carried out according to the classification of M.F. Danylevsky (1994) based on the collection of anamnesis, clinical and index assessment of the condition of periodontal tissues and orthopantomograms. Results. During the dental examination of 130 patients who were undergoing inpatient treatment for coronary artery disease, the periodontal diseases had been revealed in 93,08 ± 2,23% of the examined patients. Chronic generalized periodontitis was most often diagnosed, which was found in 87,69 ± 2,88% of the examined. The main share in the structure of periodontal diseases in patients with coronary artery disease was chronic generalized periodontitis of the initial – I and II degrees of severity ˗ 40,0 ± 4,30 and 32,31 ± 4,10%, respectively. Chronic generalized periodontitis of the III degree was diagnosed somewhat less frequently – 15,38 ± 3,16%. The analysis of the percentage of the prevalence of clinical forms of coronary artery disease in patients with chronic generalized periodontitis established that those examined with chronic generalized periodontitis of the initial – I were more often observed angina pectoris of the II functional class (50,00 ± 6,93%) than in patients with other clinical forms of coronary artery disease (p < 0,05). No statistical difference was found in the prevalence of angina pectoris of the II, III functional classes and angina with cardiosclerosis in patients with coronary artery disease and chronic generalized periodontitis of the II degree (p > 0,05). Among patients with coronary artery disease and chronic generalized periodontitis of the III degree, angina pectoris of the II–III functional class and diffuse cardiosclerosis was most often diagnosed (45,00 ± 11,12%). Conclusions. The results of the conducted study demonstrate a high prevalence of periodontal diseases, in particular chronic generalized periodontitis, in patients with coronary artery disease. A direct correlation was established between the degree of severity of chronic generalized periodontitis and functional class of angina pectoris. Thus, with the growth of dystrophic and inflammatory changes in the periodontal tissues, along with an increase in the degree of chronic generalized periodontitis, the severity of angina pectoris also increases.