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Periodontal disease in patients with ischemic coronary atherosclerosis at a University Hospital. Mailing Address. PD is a serious public denfales health care problem with a differentiated distribution in sextantes to severity, age group, type of infection, co-morbidities and risk factors. Fifty-eight patients with heart disease dentales 62 patients without heart disease between the ages of 30 and 79 met the criteria to be included in the investigation.

The elevated prevalence of risk factors found, indicates that intervention strategies are required. Key words: Periodontal disease, heart diseases, periodontal index, periodontal attachment loss.

Periodontal disease is universal, representing a serious public dental health problem for both developing and industrialized countries 1,2. In Brazil, PD is the second leading public oral health issue surpassed only by tooth decay 3. Dental biofilm and calculus are important factors for sextantes onset of PD, and are highly prevalent in adults and children worldwide.

Nevertheless, the most serious manifestations present differentiated distributions that vary according to age group, type of infection, systemic problems and sextantes factors 1,2,4. While tooth decay results dentales demineralization of the teeth, PD is the result of periodontal tissue destruction caused by the action of toxic products released in the sub-gingival area by specific periodontal pathogens 5.

PD can also result from inflammatory and immunological responses caused by the presence of microorganisms and their toxic subproducts lipopolysaccharides-LPS 5.

It is important to recognize PD as an infectious disease caused by specific anaerobic bacteria, strongly suspected to be transmissible, multifactorial affecting populations and sites of risk PD is a chronic disease sextantes is usually assymptomatic 5. Recent studies 6, demonstrate that the association between oral health and atherosclerosis is consistent in different population samples and that the oral conditions precede coronary events.

In PD there is a possibility of bacteremia due to the proximity of the infectious agents with the connective tissue and dentalew vascular components.

In dehtales and advanced cases, the endotoxins for example, LPS of the microbial wall can stimulate the accumulation of plaque sxtantes to the formation sextantes thrombi and atheroma plaque 6,8, It is very possible that this physiopathological link is the conclusive explanation sextantea the association between the two conditions. Common factors sextantes cardiovascular and periodontal diseases include genetic susceptibility and important behavioral components such as dietary habits, personal hygiene and tobacco dentapes, among others.

In both cases the incidence increases with age, and occur more frequently in males, diabetics, people from lower socioeconomic and cultural classes, individuals that suffer from psychic stress and with substantial genetic predisposition sextantes, Since there are few studies regarding oral health in general and PD in particular, data relating to distribution and risk factors for these diseases are in short supply. Sextantes objective of the present investigation was to study oral conditions and requirements as well as the prevalence of PD in patients with ischemic heart disease with follow-up in a tertiary hospital, comparing the data with those obtained from a dentales of patients without heart disease.

As a comparison group, patients without ischemic heart disease from the Hepatitis Outpatient Clinic were used. In the initial stage of the study, the patients were interviewed and examined in the medical office during their regularly denrales appointment. During this first contact, data regarding oral conditions were collected and the potential participants of the periodontal investigation were identified.

The interviews and sextantrs exams for all candidates were performed by the same dental surgeon. Difficulties in recruiting patients with heart disease and a sexfantes number of 20 teeth as well dentales age matching with patients without heart disease altered the initial planning of the study sample size people per group.

At the Ischemic Cardiopathy Outpatient Clinic, patients were denhales evaluated and only 58 In the Hepatitis Outpatient Clinic, patients were evaluated of which 62 The patients between the ages of 30 and 79 and with a minimum of 20 functional teeth, were then placed in two new groups for periodontal evaluation. Even if the patients met the criteria for age and number of teeth, they were excluded if they had a previous history of bacterial endocarditis, congenital or rheumatic heart disease or HIV.

A special periodontal probe with a 0. The probing technique involves the application of a maximum edntales of 20 grams, with the instrument parallel to the debtales of the teeth, touching and moving the probe along the cervical surface with the rounded tip inserted in the gingival sulcus and probing the entire seextantes.

In sexfantes periodontal exam technique, the dentition is divided in six parts or sextants, sextantes the sextant was only examined if there were two or more teeth present that were not indicated for extraction due to tooth decay.

The CPI codes are: 0 healthy ; 1 bleeding when probed ; 2 calculus detected, but black band of the probe is visible ; 3 mm periodontal pocket and gingival margin on black band on probe ; 4 periodontal pocket 6mm or more, black band on probe sextanets visible ; X sextant excluded, less than two teeth present. Periodontal attachment loss PAL was observed in the same sextants in order to estimate the accumulated tissue destruction throughout the life of the periodontal attachment.

The cementoenamel junction CEJ is exposed or visible when there is gingival recession and is used as a denyales. This enables comparisons between the population groups without attempting to describe the extent of dentales loss in an dsntales. The PAL extent is recorded using the following codes: 0 loss of attachment of mm, CEJ is not visible and CPI value between ; 1 loss of attachment of mm, CEJ within the black band ; 2 loss of attachment of mm and Sextantes between the upper limit of the black band and the 8.

For both indexes the worst condition observed was registered; however this does not exclude the presence dentalea less serious conditions at other sites of the sextants sextanges. The information was entered into the Program EpiInfo 6.

In the situations in which the reduced sample size inhibited denfales use of the chi-square test, the Fisher exact test was used. In all situations, the sextqntes significance limit adopted was equal to 0. In the initial stage patients were examined between April 15 and September 19,of which had heart disease and did sextantea. Of the patients with heart disease, The average and median ages were The results relative to the number of teeth revealed that people On the whole, Of the patients without heart disease, The ages of the males ranged from 21 to 61 years and for the females between 17 and The average and median ages were fentales and 40 respectively and The results of tooth counts were substantially different from those observed in the heart disease group.

Ten people 6. On the whole, 56 In sextantws to dental treatment requirements, Among the patients without heart disease, 58 In the periodontal fentales of the 58 patients with heart disease, 48 Ages ranged between 33 and 75 for the men and between 38 and 70 for the women. The median age for men was 53 years and for women The average age for both genders was 53 years.

All required periodontal treatment, Based on the CPI, four 1. Eighty sextants In reference to lack of periodontal treatment, Therefore, three 5. Based on the accumulated tissue destruction throughout the life of the periodontal attachment, measured by loss of attachment, 21 dentales 6. The categories "no loss of attachment" and "loss of attachment of mm" were combined as these stages are not indicative of tooth loss and included sextants All categories for loss of attachment of 6 mm and dentalss were grouped together as these stages are indicative of tooth loss and included sextants Among the 62 patients without heart disease submitted to the periodontal investigation, 46 Ages ranged from dentales to 61 for the males and from 30 to 60 for the females.

The average and median ages for the men were 40 and 39 years and for the women 37 and 35 years, respectively. It was observed that 51 Based on the CPI Tab. Based on the number of people requiring periodontal treatment Tab. Based on the accumulated tissue sextantes throughout the life of the periodontal attachment, sextants Loss of sextsntes greater than 8 mm sextantex not observed in this group of patients. All categories for loss of attachment of 6 mm or dentales were grouped together as these stages are indicative of tooth loss and included 28 sextants 7.

In order to make the two groups more compatible in relation to age, the periodontal health conditions in the patients between 30 sextantes 59 years for both groups were analyzed Tab. It was verified that the worst periodontal conditions CPI score of 4 were more frequently seen in the patients with heart disease when compared to the others dentales respective values of These patients also had consistently higher percentages The elevated percentages of edentulous individuals and those with limited functions due eextantes the low number of teeth are proof of the lack of adequate dental care sextantea some point in their lives.

Sextantea fact is also proven by the elevated number of individuals that required health care, particularly in regard to prostheses, periodontal treatment and oral cancer prevention.

Thus, the greater severity of PD in patients with heart disease suggests that systemic factors could be simultaneously involved in the origin dentales the two diseases. However, age distribution discrepancies greatly limits result comparison when evaluating the two groups, particularly regarding the periodontal investigation, since PD is time dependent.

Nevertheless, even when evaluated in dentales same age group, the two groups remained distinct regarding periodontal health. The evaluation dentalrs general oral health conditions demonstrated that both groups required large percentages of dental treatments in all specialties. PD was very dentsles in the two study groups but much more severe in the patients with ischemic coronary atherosclerosis.

Although not mentioned in the text, there was also a high prevalence sexrantes risk factors for PD, indicating the need to implement oral health care strategies that include preventative and educational measures for large population groups, early periodontal care and directed at groups with higher risks to develop PD smokers, low socioeconomic and cultural classes, those with difficulty to modify inadequate habits of dental biofilm removal, people infected with HIV, diabetics, people with psychomotor deficiencies and ischemic dentles.

In conclusion, the creation of methods to better orient patients regarding oral health care is essential. At the HCFMRP-USP clinic, diagnostic procedures and systematic treatment of periodontal diseases have been implemented, with emphasis placed on high risk groups, making quick and effective oral health care viable for those who need it.

The results of this study indicate the need to conduct new studies with larger samples and adequate age matching to accurately establish real oral health conditions in general population groups that receive care in clinics seztantes as the one used in this study.

They also indicate the requirement of Dentsles Dental Care to be expanded to include preventive and rehabilitation care for age groups above 15 years of age. Potential Conflict of Interest. No potential conflict of interest relevant to this esxtantes was reported.

Natural history of periodontal disease in man. Rapid, moderate and no loss of attachment in Sri-Lankan tea laborers 14 to 46 years of age. J Clin Periodontol ; 13 dentales : Papapanou PN.

Periodontal diseases: epidemiology.

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2 Editora Sextante reviews. A free inside look at Close (Esc). Editora Sextante Logo . Dental Assistant salaries ($28k) · Engineering jobs. devidamente registrado no Conselho Federal de Odontologia (CFO) e Rede Credenciada de Odontologia S2: Segmento/ Sextante intermediário superior. Os resultados mostraram que, para os sextantes posteriores esquerdos e Motives of the entrance and dropout of undergraduate dental students from a public.