Infectious Dental Diseases in Patients with Coronary Artery Disease:
An Orthopantomographic Case–Control Study. JCDA • www.cdaadc.ca/jcda • February 2009, Vol. 75, No. 1 •
EVALUACIÓN DEL ESTADO PERIAPICAL Y ENDODÓNCICO
DEL PACIENTE CON CARDIOPATÍA ISQUÉMICA. ESTUDIO
TRASVERSAL COMPARANDO ENFERMOS CHD Y SANOS.
Tamaño de la muestra: 200 pacientes – 100 con CHD y 100 sanos.
Criterios de inclusión:
Pacientes diagnosticados de cardiopatía isquémica.
Criterios de exclusión? En principio, ninguno.
HOJA DE RECOGIDA DE DATOS
Nombre:…………………………………………………………………
Edad:……………….
Sexo:………………..
Raza / Etnia: ……..
Estado Civil………………………..
Profesión:………………….
Frecuencia visita al
dentista:………………………………………………………
Nivel de estudios:………………………………………………………
Tipo de cardiopatía isquémica: Angor, Infarto.
Desde cuando está diagnosticado (años desde diagnóstico)…………
Antecedentes familiares:………………………..
Fumador:………………………………
Peso:
Altura:
Indice de masa coroporal:
Tamaño de la cintura:
Ejercicio físico: 1, 2, 3 o 4 veces a la semana.
Alcohol: si / no.
Enfermedad Periodontal: s/n. Bien diagnosticada: bolsas de > 4 mm......
Hipertensión: s/n. TAS:...........
Antihipertensivos: ..................................................................................
Triglicéridos: .........
Colesterol HDL / LDL: ..........
Leucocitos:.............
Diabetes: s/n y tipo.
Insulindependiente:…………..
Antidiabéticos orales:……………………
Otras
patologías:………………………………………………………………
Tratamiento médico: ……………………………………………………
Metodología:
Ortopantomografía.
Se anota:
Número de dientes presentes.
CAO: dientes cariados + dientes ausentes + dientes obturados.
Indice de restauración: (O/CAO) x 100= (dientes obturados / CAO) x 100
Lesiones de la furcación.
Enfermedad periodontal: pérdida ósea vertical / horizontal.
Número y localización de tratamiento de conductos.
Número y localización de imágenes apicales.
Valoración de la patología periapical: PAI.
Otra patología periapical.
Hussain Bokhari SA, Khan AA, Tatakis DN, Azhar M, Hanif M, Izhar M.
Non-surgical periodontal therapy lowers serum inflammatory markers: a pilot
study. J Periodontol. 2009 Oct;80(10):1574-80.
Department of Oral Health Sciences, Sheikh Zayed Federal Postgraduate Medical Institute and Hospital,
Lahore, Pakistan. pdplhr@yahoo.com
BACKGROUND: Evidence suggests an association between periodontal disease and coronary heart
disease (CHD). C-reactive protein (CRP), fibrinogen, and white blood cell (WBC) counts are markers of
inflammation, and their systemic levels have been associated with CHD risk. This pilot study investigated
the effect of non-surgical periodontal therapy on systemic levels of CRP, fibrinogen, and WBC counts in
subjects with CHD or no CHD (NCHD). METHODS: Twenty-seven angiographically defined patients with
CHD and 18 subjects with NCHD aged >or=40 years were recruited for the study. Periodontal disease was
measured through the clinical parameters bleeding on probing (BOP) and probing depth (PD). All subjects
received non-surgical periodontal therapy that included oral hygiene instructions and subgingival scaling
and root planing. Systemic levels of inflammatory markers (CRP, fibrinogen, and WBC counts) were
measured prior to and 1 month after periodontal therapy. RESULTS: Seventeen subjects with CHD and 11
subjects with NCHD completed the study. Subjects with CHD or NCHD experienced significant reductions
in BOP (59% and 34%, respectively; P <0.05) and PD (41% and 35%, respectively; P <0.05), with nonsignificant intergroup differences (P >0.05). In all subjects, CRP, fibrinogen, and WBC counts were
reduced significantly (21% to 40%) after periodontal therapy (P <0.05). CONCLUSIONS: Periodontal
treatment resulted in significant decreases in BOP and PD and lowered serum inflammatory markers in
patients with CHD or NCHD. This may result in a decreased risk for CHD in the treated patients. These
findings will allow pursuit of a large-scale randomized intervention trial in this population.
1.- Correlacionar el estado periapical (PAI con panorex) con los niveles de
hs-CRP, IL-6, TNFa, leucocitos, fibrinógeno en enfermos con CHD.
2.- Correlacionar el estado periapical (PAI con panorex) con los niveles de
hs-CRP, IL-6, TNFa, leucocitos, fibrinógeno en población general.
3.- Estudio comparativo CHD y en sanos.
Clin Oral Investig.
2007 Jun;11(2):171-4. Epub 2007 Mar 13.
Necessity of surgical dental foci treatment
transplantation and heart valve replacement.
prior
to
organ
Rustemeyer J, Bremerich A.
Department of Cranio-Maxillofacial Surgery, Klinikum Bremen Mitte, 28177 Bremen, Germany.
janrustem@t-online.de
Diagnosis and surgical treatment of septic foci (e.g., apical or marginal and profound periodontitis, cysts,
unrestorable teeth, or abscesses) in patients awaiting organ transplants and heart valve replacement
(HVR) have become a recommended, yet controversial standard procedure. This study aims to evaluate
the numerical extent of the required oral surgical procedures removing septic foci in these patients. Data of
204 patients (115 males/89 females) of the Department of Oral- and Maxillofacial Surgery with an average
age of 58 years were evaluated in terms of necessary oral surgical procedures before HVR or kidney (K),
heart (H), or liver (L) transplant (T) and were compared with data from patients not undergoing
transplantation or HVR, who were referred for other reasons such as oral surgery. The number of tooth
extractions or apicoectomies per patient averaged two to five for each of the four patient groups (KT, 0-7
affected teeth; HT, 0-5; LT, 1-5; and HVR, 1-10). Treatment of periodontitis was necessary in 64% of
patients. A total of 70% of patients required oral surgical procedures before HT, LT, and HVR, while 84%
needed before KT. Removal of oral septic foci is necessary to avoid jeopardizing the success of
transplantations. With regard to the surprisingly high need for surgical treatment in this patient population,
assessment of these patients by the appropriate specialist and continuation with a follow-up program is still
highly recommended
Valorar las necesidades de tratamiento quirúrgico dental (apicectomías,
exodoncias…) previo al transplante de órganos.
Clin Transplant. 2009 Mar;23(2):213-9. Epub 2009 Dec 16.
The influence of chronic periodontitis on serum TNF-alpha, IL-6 and
hs-CRP concentrations, and function of graft and survival of kidney
transplant recipients.
Blach A, Franek E, Witula A, Kolonko A, Chudek J, Drugacz J, Wiecek A.
Department of Internal Diseases and Rheumatology, Silesian University School of Medicine, Katowice,
Poland.
OBJECTIVE: The aim of the study is to analyze whether chronic periodontitis (CP) influences serum tumor
necrosis factor (TNF)-alpha, interleukin (IL)-6, and high-sensitivity C-reactive protein (hs-CRP)
concentrations in renal transplant recipients and patients or graft survival. BACKGROUND: CP is
associated both with higher serum concentrations of cytokines and CRP and high cardiovascular risk.
METHODS: One hundred and seventeen patients with a transplanted kidney (Tx) were divided according
to the Community Periodontal Index of Treatment Needs (CPITN) into two subgroups: TxP+: severe CP
(CPITN 3-4) and TxP-: no or moderate CP (CPITN 0-2). The control group (C) consisted of 36 subjects
with no kidney disease and with no or moderate CP (CPITN 0-2). RESULTS: hs-CRP concentration was
higher in TxP+ than in TxP- patients [2.0 mg/L (0.7-4.4) vs. 0.9 mg/L (0.3-1.9), p = 0.006]. There were no
differences in serum TNF-alpha and IL-6 between TxP+ and TxP-. Significant positive correlation between
CPITN score and hs-CRP concentration was found both in Tx and C. The hazard ratio of death was 7.17
(1.4-76.4) for TxP+ patients. CP status did not increase the risk of graft loss or doubling of serum
creatinine. CONCLUSIONS: Severe CP is associated with increased serum hs-CRP concentration in
patients after kidney transplantation. Severe periodontitis seems to increase the risk of patients' death after
kidney transplantation.
Correlacionar el estado periapical (PAI con panorex) de enfermos
transplantados con los niveles de hs-CRP, IL-6 y TNFa.