Oral care for patients with cardiovascular disease and stroke

BACKGROUND

The authors describe how oral disease, particularly periodontal disease, may place certain patients at increased risk of developing cardiovascular disease and stroke.

RESULTS

Although the precise mechanisms of interaction are not clear, two biological mechanisms that may explain the relationship are presented. In addition, the authors describe the dental management issues that need to be understood in treating patients compromised by cardiovascular disease.

CONCLUSIONS AND CLINICAL IMPLICATIONS

The patient with cardiovascular disease may present a challenge to the dental health care provider, depending on the degree of hemodynamic compromise and the stability of his or her condition.

The periodontal-medical risk relationship

The evidence of a periodontal-medical risk warrants serious consideration. As dentists increase their knowledge about the link between periodontal disease and other systemic diseases, they will be able to prevent periodontal disease in more patients as well as develop better treatments for the disease. It is important for physicians and dentists to improve their collaboration to provide better patient care. Physician awareness of the increased risk for dental complications in certain patients will benefit their patients' overall well-being.

The relationship between periodontal disease and systemic conditions

In this year's report of the United States Surgeon General on oral health in America, two major themes evolved: 1) oral health means much more than healthy teeth, and 2) oral health is integral to general health. This article describes how oral diseases, in particular periodontal diseases, are associated with other health problems, including cardiovascular disease, diabetes mellitus, complications of pregnancies, and osteoporosis.

Dental implant outcomes in postmenopausal women undergoing hormone replacement

To determine if hormone supplementation reduces the risk of failure for osseointegration of dental implants in postmenopausal women, the treatment outcomes of 116 women older than age 50, treated with 450 endosseous dental implants, were analyzed in this retrospective study. The findings indicated that hormone replacement therapy may not be linked with improved outcomes of endosseous dental implant treatment in postmenopausal women. Smoking, however, appears to significantly increase the implant failure rate in the group observed in this study.

Outcome failures of endosseous implants from a clinical training center

In an effort to provide realistic clinical information from a "real-world" environment, the present retrospective study was undertaken to assess outcome failures after implant placement in a dental school clinical training center. A database was kept of the clinical information and was analyzed according to established parameters for implant outcomes. The demographics showed that over a period of 6 years, 80 different operators with a wide range of clinical experience had inserted 1,263 implants in a diverse patient pool of 380 individuals. Analysis of the outcomes showed a cumulative survival rate of 91.3%. The time of explantation, the type, size, and location of implants lost, and failure rates in smoking patients were also analyzed. The results indicated that the use of implants by operators with different levels of experience did not affect favorable outcomes.

A simplified method for measuring photomicrographs

An accurate technique that simplifies measurements of two- and three-dimensional specimens is presented. Photomicrographs of a microruler and of the specimens of a research project were made at the same magnification. A ruler with the exact dimensions of the photographic prints of the microruler was generated through computer graphics and printed as a transparency. After verification, the ruler was used to measure specimens directly on the photomicrographs.

Treatment planning and site development for the implant-assisted periodontal reconstruction

Implants can be used to recreate an edentulous dentition that is esthetic, comfortable, and functional by augmenting the total surface area of load carrying abutments. Traditionally, implants were placed in areas of the mouth where adequate amounts of bone were present. Today, clinicians are strategically planning and developing implant sites to optimize oral health. This article will describe methods of treatment planning and site development for the reconstruction of the implant-assisted periodontal restoration.