Peculiarities of diagnostics and treatment of chronic generalized periodontitis in patients with heart rhythm disorders taking anticoagulants
https://doi.org/10.36377/ET-0082
Abstract
INTRODUCTION. A clinical examination and treatment were conducted on 104 patients with cardiac arrhythmias who were receiving anticoagulant therapy. The patients were aged between 45 and 59 years (classified as middle age according to the WHO classification) and were diagnosed with moderate chronic generalized periodontitis (53% male, 47% female).
AIM. To evaluate the effectiveness of standard therapeutic measures in the treatment of chronic generalized periodontitis in patients receiving anticoagulant therapy and to identify the specific characteristics of the disease course in this patient group.
MATERIALS AND METHODS. The study included 104 patients with cardiac arrhythmias who were receiving anticoagulant therapy and were diagnosed with moderate chronic generalized periodontitis. Standard treatment for periodontitis was administered with consideration of anticoagulant use. Clinical parameters, including gingival bleeding, periodontal status, and the effectiveness of therapeutic measures, were assessed.
CONCLUSIONS. Standard therapeutic measures for the treatment of chronic generalized periodontitis were equally effective in patients receiving and not receiving anticoagulant therapy. However, a distinguishing feature of periodontitis treatment in patients receiving anticoagulants was the persistence of high levels of gingival bleeding after the resolution of the inflammatory process in the periodontium, which was attributed to anticoagulant use. This situation often misleads clinicians, who may interpret gingival bleeding as a sign of inflammation, resulting in overdiagnosis and inflated values of corresponding indices. Standard therapeutic methods were found to be effective and sufficient for preventing the progression of pathological processes in the periodontium in this patient group.
About the Authors
M. V. LomakinaRussian Federation
Maria V. Lomakina – Postgraduate Student of the Department of Therapeutic Dentistry, E.V. Borovsky Institute of Dentistry
8c2 Trubetskaya Str., Moscow 119048
Competing Interests:
The authors report no conflict of interest.
A. G. Volkov
Russian Federation
Alexander G. Volkov – Dr. Sci. (Med.), Professor of the Department of Therapeutic Dentistry, E.V. Borovsky Institute of Dentistry
8c2 Trubetskaya Str., Moscow 119048
Competing Interests:
The authors report no conflict of interest.
V. M. Grinin
Russian Federation
Vasily M. Grinin – Dr. Sci. (Med.), Professor of the Department of Maxillofacial Surgery named after Academician N.N. Bazhanov Institute of Dentistry
8c2 Trubetskaya Str., Moscow 119048
Competing Interests:
The authors report no conflict of interest.
N. Zh. Dikopova
Russian Federation
Natalya Zh. Dikopova – Cand. Sci. (Med.), Associate Professor of the Department of Therapeutic Dentistry
8c2 Trubetskaya Str., Moscow 119048
Competing Interests:
The authors report no conflict of interest.
L. V. Abolyan
Russian Federation
Liubov V. Abolyan – Dr. Sci. (Med.), Professor of the Department of Public Health and Public Health
8c2 Trubetskaya Str., Moscow 119048
Competing Interests:
The authors report no conflict of interest.
I. A. Nikolskaya
Russian Federation
Irina A. Nikolskaya – Cand. Sci. (Med.), Professor, Department of Therapeutic Dentistry, Institute of Dentistry
1 Ostrovityanova Str., Moscow 117997
Competing Interests:
The authors report no conflict of interest.
References
1. Erema N.A., Dental care for patients receiving anticoagulant therapy in the post-myocardial infarction period [Dissertation for the degree of Candidate of Medical Sciences]. Moscow; 2013. 127 p.
2. Vieira R.W. Cardiovascular and periodontal diseases. Rev Bras Cir Cardiovasc. 2014;29(1):VII–IX. https://doi.org/10.5935/1678-9741.20140003
3. Anisimova E.N., Ryazancev N.A., Raskurajev A.A., Tanashyan M.M., Philippova M.P., Sadulaev A.H., Labzenkova M.A. The relationship of inflammatory diseases in the oral cavity and cardiovascular system. Literature review and determining the level of dental education. Parodontologiya. 2019;24(4):301–307. (In Russ.) https://doi.org/10.33925/1683-3759-2019-24-4-301-307
4. Glushhenko V.A., Irklienko E.K. Cardiovascular morbidity – one of the most vital problems of modern health care. Medicine and Health Care Organization. 2019;4(1):56–63. (In Russ.) Available at: https://ojs3.gpmu.org/index.php/medorg/article/download/559/561/ (accessed: 17.01.2025).
5. Karakov K.G., Mordasov N.A., Kasimova G.V., Ivanyuta I.V. Comparative study of complex therapy of chronic catarrhal gingivitis against the background of cardiovascular system pathology. Scientific Medical Bulletin. 2017;(1):43–50. (In Russ.).
6. Skirdenko Y.P., Nikolaev N.A., Livzan M.A., Ershov A.V. Anticoagulant therapy for atrial fibrillation in real practice: Problems and prospects. Annals of the Russian Academy of Medical Sciences. 2019;74(2):98–107. (In Russ.) https://doi.org/10.15690/vramn1116
7. Aoyama N., Suzuki J.-I., Kobayashi N., Hanatani T., Ashigaki N., Yoshida A. et al. Detrimental effects of specific Periodontopathic bacterial infection on tachyarrhythmia compared to Bradyarrhythmia. BMC Cardiovasc Disord. 2017;17:267. https://doi.org/10.1186/s12872-017-0703-2
8. Holm-Pedersen P., Avlund K., Morse D.E., Stoltze K., Katz R.V., Viitanen M., Winblad B. Dental caries, periodontal disease, and cardiac arrhythmias in community-dwelling older persons aged 80 and older: is there a link? J Am Geriatr Soc. 2005;53(3):430–437. https://doi.org/10.1111/j.1532-5415.2005.53160.x
9. Yu G., Yu Y., Li Y.N., Shu R. Effect of periodontitis on susceptibility to atrial fibrillation in an animal model. J Electrocardiol. 2010;43(4):359–366. https://doi.org/10.1016/j.jelectrocard.2009.12.002
10. Grudianov A.I., Tkacheva O.N., Avraamova T.V., Khvatova N.T. Interrelations of inflammatory periodontal disease and cardiovascular pathology. Stomatologiya. 2015;94(3):50–55. (In Russ.) https://doi.org/10.17116/stomat201594350-55
11. Kaigorodov V.A. Management of dental patients receiving anticoagulation therapy. Perm Medical Journal. 2016;33(3):115–119. Available at: https://permmedjournal.ru/PMJ/article/view/5679 (accessed: 17.01.2025).
12. Alwithanani N. Periodontal diseases and heart diseases: A systemic review. J Pharm Bioallied Sci. 2023;15(Suppl 1):S72–S78. https://doi.org/10.4103/jpbs.jpbs_517_22
13. Zolotovskaya I.A., Davydkin I.L., Duplyakov D.V., Limareva L.V., Sustretov A.S. The influence of anticoagulant therapy on oxygenation of erythrocyte membranes in correlation with the parameters of microcirculation in patients with atrial fibrillation. Cardiology: News, Opinions, Training. 2018;(1):82–90. (In Russ.) https://doi.org/10.24411/2309-1908-2018-00004
14. Ionin V.A., Bliznuk O.I., Baranova E.I., Shlyakhto E.V. Anticoagulant therapy in patients with non-valvular atrial fibrillation in real clinical practice: in appropriate dose reductions. Rational Pharmacotherapy in Cardiology. 2021;17(2):206–211. (In Russ.) https://doi.org/10.20996/1819-6446-2021-03-04
15. Linchak R.M., Ovchinnikov Yu.V., Kuzovlev A.N. Prevalence and analysis of antithrombotic therapy during atrial fibrillation in Russia. Vestnik SurGU. Meditsina. 2021;17(2):206–211. https://doi.org/10.34822/2304-9448-2019-4-14-20
16. Kropacheva E.S., Krivosheeva E.N., Panchenko E.P. Rivaroxaban in patients with atrial fibrillation: from research to real practice (based on REGistry of Long-term AnTithrombotic TherApy-2 (REGATA)). Atherothrombosis. 2021;(1):68-88. (In Russ.) https://doi.org/10.21518/2307-1109-2021-1-68-88
17. Moiseev S.V. Clinical trials of rivaroxaban in patients with atrial fibrillation in context of evidence-based medicine. Klinicheskaya Farmakologiya i Terapiya. 2016;25(4):4–10. (In Russ.)
18. Napalkov D.A., Sokolova A.A., Gabitova M.A., Uddin L.N. Anticoagulant therapy in difficult patients with atrial fibrillation: when the risks of embolism and bleeding are comparable. Rational Pharmacotherapy in Cardiology. 2018;14(5):785–789. (In Russ.) https://doi.org/10.20996/1819-6446-2018-14-5-785-789
19. de Andrade N.K., Motta R.H.L., Bergamaschi C.C., Oliveira L.B., Guimarães C.C., Araújo J.O., Lopes L.C. Bleeding risk in patients using oral anticoagulants undergoing surgical procedures in dentistry: a systematic review and meta-analysis. Front Pharmacol. 2019;10:866. https://doi.org/10.3389/fphar.2019.00866
20. Kaplovitch E., Dounaevskaia V. Treatment in the dental practice of the patient receiving anticoagulation therapy. J Am Dent Assoc. 2019;150(7):602–608. https://doi.org/10.1016/j.adaj.2019.02.011
Review
For citations:
Lomakina M.V., Volkov A.G., Grinin V.M., Dikopova N.Zh., Abolyan L.V., Nikolskaya I.A. Peculiarities of diagnostics and treatment of chronic generalized periodontitis in patients with heart rhythm disorders taking anticoagulants. Endodontics Today. 2025;23(2):304-311. https://doi.org/10.36377/ET-0082