Use of orthodontic treatment protocols in patients with chronic periodontitis and arterial hypertension

Abstract

BACKGROUND: The wide prevalence and mutual influence of periodontitis and arterial hypertension determine the importance of choosing a rational approach to denture prosthetics in this patients. AIM: The study was to choose a rational tactics of dental prosthetics in patients with chronic periodontitis and arterial hypertension based on a clinical and instrumental assessment of the periodontal condition and morphofunctional characteristics of neuroendocrine gum cells. MATERIALS AND METHODS: The results of the examination of 120 patients with periodontitis and hypertension are presented, of which 90 patients had denture defects, 30 patients intact dentition. Clinical examination, immunohistochemical, and morphometric studies were performed. 90 patients underwent prosthetics of dentition defects, of which: 32 patients were fitted with metal dentures, 30-metal-ceramic dentures, 28 patients were fitted with thermoplastic resin removable partial dentures. RESULTS: Periodontitis in patients with hypertension is characterized by more significant changes in the expression of endothelin-1-, melatonin- and endothelial NO-synthase-like cells of gum, than periodontitis in patients without somatic pathology. After periodontal treatment, the use of metal-ceramic dentures and thermoplastic resin removable partial dentures by a year-long persistent remission of periodontitis in 85.786.7% of patients is accompanied. Remission is achieved against the background of satisfactory hygiene indicators and restoring the neurotransmitter balance of the oral cavity. After a year of metal dentures, 43.7% of patients report an exacerbation of periodontitis, which by poor hygiene and local neuroendocrine imbalance is facilitated. CONCLUSION: The use of metal-ceramic dentures and thermoplastic resin removable partial dentures is the preferred option for prosthetics of dentition defects in patients with periodontitis and hypertension.