Étude du profil clinique et microbiologique des maladies parodontales chez les patients présentant une maladie cardiovasculaire

Abstract

Introduction:In recent years, more and more studies have enabled the reintroduction of the association "oral infections and general diseases". Thus, periodontitis could present risks in many circumstances, among others, cardiovascular diseases, especially ischemic, synonymous with atherosclerosis. Problematic :From the pioneers, Mackenzie and Millard, Mackenzie, Syrjänen, Matilla, and DeStefano, studies have continually poured in from all over the world, reaching the same conclusion that proves the regularity of the alliance. But what about the situation in Algeria? It is to answer this question that we have chosen to address this study with the main objectiveof describing the clinical and microbiological status of periodontal disease in patients with cardiovascular disease. Materials / Methods: This was a cross-sectional descriptive study, with an analytical aim ,over a period of three years (October 1, 2015 until October 31, 2018), in the periodontology service of university hospital center of Tlemcen, in patients meeting our criteria for inclusion. Consultation trays, sterile paper cones (for bacterial samples) were used. hsCRP (high sensitive C-reactive protein ) micro-index of the inflammatory process, in which periodontal disease takes place, and at the same time an indicator of cardiovascular risk, represented the biological parameter of our study. It was carried out by nephelemetry from blood samples. Results / Discussion:75 patients were recruited. The mean age was 48.64 ± 1 years. The sex-ratio was 1.12.30,7% of our patients had a high sensibility C-reactive protein(hsCRP) ≤ 1 mg / l, with a low cardiovascular risk, compared to 34.7% for a hsCRP between 1 -3 mg / l, or greater than 3 mg / l, characterizing a moderate, severe cardiovascular risk. hsCRP was linearly proportional to gingival index (GI), pocket depth, loss of attachment confirmed by Pearson's linear correlation coefficient r(0.8, 0.5, 0.6) attesting to the strength of the association. The bacterial species identified by conventional PCR (Polymerase Chain Reaction) most associated with high cardiovascular risk were: Treponema denticola (Td), Tannerella forsythia (Tf), Porphyromonas gingivalis (Pg), Aggregatibacter actionomycetemcomitans (Aac), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), Parvimonas micra (Pm),et le complexe Pg-Td-Tf.New generation sequencing (NGS) revealed the presence of more than 17638, 14454, 10058 bacterial species. Conclusion:The results obtained by our study highlight the potential role that periodontitis could maintain in the crescendo increase of cardiovascular risk. The implementation of a program to promote oral health, and therefore periodontal health, which is decidedly inseparable from cardiovascular health, must prevail in our prevention strategies