Relaciones clínicas, histológicas y microbiológicas entre la aterosclerosis y la periodontitis crónica

• Autores: Deborah Violant Holz
• Directores de la Tesis: Antonio Santos Alemany (dir. tes.), Josep Clotet (dir. tes.)
• Lectura: En la Universitat Internacional de Catalunya ( España ) en 2010
• Idioma: español
• Tribunal Calificador de la Tesis: Miquel Cortada Colomer (presid.), Núria Casals Farré (secret.), Gernot Wimmer (voc.), Clemente Barriuso Vargas (voc.), José Javier Echeverría García (voc.)
• Materias:
  • Ciencias médicas
    • Cirugía
      • Ortodoncia-estomatología
• Enlaces
  • Tesis en acceso abierto en: TDX
• Resumen

  • Background and Objective: A relationship between some systemic diseases and periodontitis has been described. Several studies have reported a link between periodontal disease and atherosclerosis. This study aimed (i) to support the link between the two diseases by evaluating the statistically significant simultaneous detection of five putative periodontopathogens (A.actynomicetemcomitans, P.intermedia, T.forsythia, F.nucleatum and P.gingivalis) in periodontal pockets and carotid atheromatous plaques, and (ii) to analyze the risk factors associated to atherosclerosis and/or periodontitis in the study population.Materials and Methods: A complete periodontal and medical examination was conducted on 31 patients scheduled for carotid endarterectomy. Subgingival samples and atheromatous plaques were microbiologically analyzed using nested polimerase chain reaction to improve the bacterial threshold detection level in atheroma. Histological analysis of atheromatous plaques was also performed.Results: All subgingival and atheroma samples were positive to at least one of the five target periodontopathogens. P.gingivalis, T.forsythia and F.nucleatum established a statistically significant relationship between the concomitant presence of bacteria in atheroma and periodontal pockets. A strong link was demonstrated between increased glucose serum levels and the presence of P.intermedia in atheroma. High lymphocytes serum levels were also strongly related to the detection of the five target periodotopathogens in atheroma. Conclusion: The concomitant presence of P.gingivalis, F.nucleatum, and T.forsythia in the subgingival plaque and atheroma samples suggests that these bacteria might play an important role in the development of atherosclerosis. Serum glucose levels could be responsible for the colonization of periodontopathogens in atheromatous plaques and the progression of cardiovascular disease. Atherosclerosis and periodontitis might be strongly linked by a direct and an indirect pathogenic pathway.