La ortopantomografía como método diagnóstico para la detección precoz de accidentes cerebrovasculares
Introduction. Cardiovascular diseases are the leading cause of death and have a high morbidity rate. The prevalence of stroke in our country is 1.7%. The detection and prevention of risk factors, as well as early diagnosis of entities such as atheroma plaques are important factors for better treatme...
| Autor: | |
|---|---|
| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Universidad de Valladolid |
| Repositorio: | UVaDOC. Repositorio Documental de la Universidad de Valladolid |
| OAI Identifier: | oai:uvadoc.uva.es:10324/71393 |
| Acceso en línea: | https://doi.org/10.35376/10324/71393 https://uvadoc.uva.es/handle/10324/71393 |
| Access Level: | acceso abierto |
| Palabra clave: | Odontología Orthopantomography Ortopantomografia Atheroma Plaque Placa de ateroma Stroke Infarto Periodontal Disease Enfermedad periodontal 32 Ciencias Médicas |
| Sumario: | Introduction. Cardiovascular diseases are the leading cause of death and have a high morbidity rate. The prevalence of stroke in our country is 1.7%. The detection and prevention of risk factors, as well as early diagnosis of entities such as atheroma plaques are important factors for better treatment of this entity. Carotid arteriosclerosis is related to 20-30% of cerebral infarctions and cardiovascular risk factors. Orthopantomography is an extraoral radiographic test in which we can visualize the entire orofacial region. In the cervical area C3-C4 we can sometimes observe structures that may correspond to Atheroma Plaques (AP). Objectives. To evaluate the frequency of the presence of calcified atheroma plaques in orthopantomographies. To analyze the association between atheroma plaques and cardiovascular risk factors. Material and methods. Orthopantomographies of 1254 patients over 18 years of age from Clínica Arlanza, Lerma, Burgos, were examined from 2017 to 2021. Patients' medical data were obtained from reports provided by their primary care physicians. The patients' medical data were obtained through reports provided by their primary care physicians. All radiographs were captured using the same orthopantograph (Planmeca ProOne®), with parameters of 68 kV, 7 mA and 10 seconds exposure, and were performed by a single operator. The radiographic images were processed and visualized using Romexis® software. Statistical analysis was performed using SPSS Statistics® version 25. To describe the results of the categorical variables, frequencies (percentage) were used. Contingency tables were constructed and the chi-square test was applied. The measure of statistical power used was the Relative Risk (RR), and they were presented with their respective 95% Confidence Intervals (CI). Results. A prevalence of 6.2% was observed for orthopantomographies (OPG) with atheroma plaques. The distribution by gender was similar. The Relative Risk (RR) with the different risk factors was: - Previous cardiovascular event: RR 3.168, 95% CI 1.749-5.739, p = 0.001. - Diabetes mellitus: RR 1.94, 95% CI 0.881-4.284, p = 0.13. - Arterial hypertension: RR 2.293, 95% CI 1.374-3.825, p = 0.001. - Dyslipidemia: RR 2.831, 95% CI 1.555-5.155, p = 0.003. - Smoking: RR 0.885, 95% CI 0.500-1.568, p = 0.176. The risk of finding calcified lesions in patients with periodontal disease increased as periodontal disease worsened: - Healthy patients vs. patients with less than 30% bone loss: RR 0.434, 95% CI 0.181-1.041, p = 0.053 (not statistically significant). - Healthy patients vs. patients with between 30% and 60% bone loss: RR 0.177, 95% CI 0.075-0.418, p <0.05 (statistically significant). - Healthy patients vs. patients with more than 60% bone loss: RR 0.121, 95% CI 0.041-0.355, p <0.05 (statistically significant). Patients with calcifications in their OPGs had a lower mean number of teeth (20.9 teeth) compared to patients without calcifications (24 teeth), and this result was statistically significant, t(1077) = -3.125, p<0.05. Conclusions Although orthopantomography cannot be considered a definitive diagnostic method for detecting atheroma plaques, it can be an effective screening tool. Dentists can play a significant role as referrers for cardiovascular specialists. A stronger correlation between radiographic images and actual cardiovascular risk needs to be established. In addition, a number of variables related to the general health and oral health of patients should be analyzed. It is crucial that dental professionals be trained and protocolize their performance with these patients in order to refer them. This interdisciplinary collaboration can improve patient care and contribute to the prevention and early detection of cardiovascular health problems. |
|---|