Optimization of protocols of management of patients with generalized periodontitis at the background of cardiovascular disease

Abstract

Many researchers have proven the relationship between periodontal disease and somatic pathology. Analysis of the data obtained from 348 patients showed that patients under the age of 49 were most often diagnosed with various forms of gingivitis — 36.3–51.65 % and generalized periodontitis (GP) I–II degree — 48.35–59.42 %. However, in patients aged 50–69 years, GP was the predominant disease and accounted for 93.2 %, with 56.03 % of patients having concomitant cardiovascular disease (CVD). Our studies showed that despite the significant prevalence of periodontal disease in patients with CVD, they did not systema-tically visit dentists for treatment. Our studies demonstrated a significant role of autoimmune processes in the formation and progression of chronic generalized periodontal disease in patients with concomitant comorbid conditions, in particular with cardiovascular disease. The data obtained by us demonstrated that one of the important autoantigens that determine the forms of syste-mic inflammatory response and progression of local and systemic endothelial dysfunction in GP with CVD is heat shock proteins. Taking this into consideration, a new differentiated approach to the treatment of GP in CVD was developed based on a new concept of pathogenesis. Pathogenetic therapy of GP in CVD is based on the simultaneous treatment of diseases (including the regenerative method of therapy) taking into account the severity of pathological processes that have an aggravating course. Interdisciplinary integration of dentists and cardiologists will optimize management protocols considering the presence and severity of somatic pathology and, therefore, will improve the quality of GP treatment in conditions of comorbidity.