Comparative Clinical Study on Periodontal Health Status and Early Diagnosis of Periodontal Diseases Quantified through Clinical Periodontal Indices on a Group of Children and Adolescents with and without Cardiovascular Diseases

Abstract

It is well known that bacterial plaque is the main etiological factor that causes the appearance of periodontal diseases and carious disease. Periodontal diseases can affect children and adolescents and are manifested in the form of gingivitis, but also the early form of chronic periodontitis as well as aggressive marginal periodontitis associated with local or general factors. Early periodontitis is frequently undiagnosed by clinicians due to a lack of knowledge of the specific symptoms. Certain systemic diseases, such as cardiovascular diseases, can create favorable conditions for the appearance and progression of severe manifestations of periodontal disease; also, recent research highlights that individuals with periodontal disease present an increased risk of developing cardiovascular diseases. Children with congenital or acquired cardiovascular diseases are at increased risk for complications resulting from the growth of microorganisms in the oral cavity, presenting a risk of infective endocarditis. The specific aim was to highlight the existing differences between the periodontal health of children with cardiovascular diseases and that of children without these diseases. The analyzed group included 124 patients, represented by children and adolescents, aged between 7 and 17 years, who were divided into four subgroups depending on the presence or absence of cardiovascular diseases and periodontal disease. A specialized clinical examination was performed for each patient, and periodontal clinical parameters were quantified (plaque index, gingival bleeding index, gingival index, community periodontal index of treatment needs) and associated with the diagnosis of general condition. Patients diagnosed with periodontal disease underwent specialized treatment and were called to a control visit 3 months after treatment. Statistical analysis showed significant differences between subgroups with much higher values of clinical parameters for patients with cardiovascular disease. Also, the response to the treatment was better in the case of patients in the control subgroup without cardiovascular diseases. The present study highlighted the interaction of three factors in the progression of periodontal diseases: subgingival microbiota, immune system response and environmental factors.