Pathogenetic features of generalized periodontitis course in patients with chronic disorder of cerebral circulation
AIM. To reveal disorders of basic defense systems of the oral cavity in chronic generalized periodontitis of moderate severity in patients with chronic cerebral ischemia. METHODS. 52 patients with chronic generalized periodontitis of moderate severity were observed: 24 people without concomitant diseases and 28 patients with chronic generalized periodontitis in association with cerebral vessels atherosclerosis. The comparison group (control) consisted of 12 persons without somatic diseases at the age of 35-40 years with an intact periodontium. Levels of homocysteine and autoantibodies against heat shock proteins (HSP-70) in blood plasma and oral fluid were determined by enzyme immunoassay method. RESULTS. In chronic generalized periodontitis of moderate severity, high levels of antibodies to HSP-70 in saliva, 1.6 times exceeding the normal values, were revealed. These changes are more pronounced in patients with chronic generalized periodontitis and cerebral vessels atherosclerosis. Similar changes were observed in blood values in patients with chronic generalized periodontitis, in whom levels of antibodies to HSP-70 were 1.3 times higher than the «normal» value, and 1.9 times higher in combination of periodontitis with chronic cerebral ischemia. In patients with chronic generalized periodontitis of moderate severity combined with atherosclerotic vascular disease, in contrast to patients with only chronic generalized periodontitis, there was a more significant increase in homocysteine levels in the blood and saliva. CONCLUSION. The findings confirm the importance of determining homocysteine levels in the blood in chronic generalized periodontitis, particularly when it is combined with atherosclerotic vascular disease.