BACKGROUND Periodontal diseases are among the most common worldwide. The connections and mechanisms between periodontitis and systemic diseases have been and are being intensively researched and have developed into an independent field of research: periodontal medicine. Peripheral arterial occlusive disease (PAD) and periodontitis are closely related to each other, so that a number of risk factors for both diseases can be classified as modulating or aggravating. The aim of this study, on which this dissertation is based, is to investigate the prevalence of periodontal disease in patients with PAD and the influence of periodontal therapy on clinical periodontal parameters. METHODOLOGY Data from 409 screened patients with PAVK, stage II and III after Fontaine, and at least one natural tooth were used to determine the prevalence of periodontal disease. Periodontal disease was classified according to the Periodontal Basic Examination (PGU). For the study on the influence on periodontal parameters, 90 patients were randomized according to strict inclusion and exclusion criteria to 30 patients each in three groups. One group underwent non – surgical periodontal therapy using adjuvant systemic antibiotics (PT1), the second group underwent non-surgical periodontal therapy without antibiotics (PT2) and the third group was left untreated for a period of 3 months and presented the control (CG). Clinical, microbiological and immunological parameters were collected at baseline, after 3 months and after 12 months. RESULTS Prevalence: 296 male and 113 female volunteers between 39 and 89 years of age (mean age 63) were tested for PGU, DMFT and number of natural teeth. Mean PGU was 3.1, PGU 0 was found in 1, PGU 1 in 0, PGU 2 in 115, PGU 3 in 64 and PGU 4 in 219 probands. The mean DMFT value was 22.8 and the mean number of natural teeth including third molars and dental implants was 16.7. Influence of periodontal therapy: 319 subjects from the screening group could not be considered due to dental, systemic or other exclusion criteria. PT1 subjects achieved significantly better clinical, microbiological and immunological scores than PT2 and CG. PT2, on the other hand, also achieved significantly better clinical results than CG. No adverse effects of the therapy were observed. No significant changes were observed in CG over a period of up to 3 months. SUMMARY We were able to show that periodontitis is a highly prevalent disease in patients with PAVK, stage II and III after Fontaine. Comparative studies of the general population are not possible in Austria due to a lack of epidemiological studies. However, the comparison with neighbouring European countries shows that the prevalence is well above the average and that the DMFT is increased and the number of natural teeth is highly reduced. Treatment with adjuvant antibiotics showed a significant improvement in the values obtained and partly coincides with expected results from comparative studies. Microbiological data showed that only with the use of systemic antibiosis, changes of periodontal - pathogenic bacteria with determination via Polymerase Chain Reaction (PCR) methods could be shown. The influence of periodontal treatment in patients with PAD on the vascular level remains the subject of research.
PREVALENCE OF PERIODONTITIS AND IMPACT OF PERIODONTAL TREATMENT IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASES
Arefnia, B. (Author). 2020
Student thesis: Doctoral thesis