Periodontal and biochemical bone metabolism assessment on a chronic oral anticoagulation population treated with dicoumarins

  1. Daniel López Lacomba 1
  2. Antonio Roa 2
  3. Maximino González Jaranay 2
  4. Gerardo Gómez Moreno 3
  5. Gerardo Moreu Burgos 2
  1. 1 Department of Haematology, Fuenlabrada Hospital, Madrid, Spain
  2. 2 Department of Periodontology, Faculty of Dentistry, University of Granada, Spain
  3. 3 Department of Special Care in Dentistry, Pharmacological Research in Dentistry Group, Faculty of Dentistry, University of Granada, Granada, Spain
Aldizkaria:
Medicina oral, patología oral y cirugía bucal. Ed. inglesa

ISSN: 1698-6946

Argitalpen urtea: 2017

Alea: 22

Zenbakia: 2

Orrialdeak: 17

Mota: Artikulua

DOI: 10.4317/MEDORAL.21567 DIALNET GOOGLE SCHOLAR lock_openSarbide irekia editor

Beste argitalpen batzuk: Medicina oral, patología oral y cirugía bucal. Ed. inglesa

Garapen Iraunkorreko Helburuak

Laburpena

The aim is to evaluate periodontal alteration and biochemical markers associated with bone turnover in chronic oral with dicoumarins anticoagulant treatment patients. 80 patients treated with oral anticoagulants were divided into 2 cohort: Group A (n=36) 6 month to 1 year with anticoagulant treatment and Group B (n=44) > 2 years with anticoagulant treatment. Clinical evaluation included: Clinical attachment level (CAL), plaque index (PI) and gingival index (GI). Analytically biochemical parameters of bone remodeling (calcium and phosphorus), formation (total acid phosphatase, alkaline phosphatase and osteocalcin) and resorption (tartrate-resistant acid phosphatase and beta-crosslaps) were evaluated. High values of PI (67-100%) especially in men and in Group B were observed. Men with anticoagulation treatment length showed an increased GI (49.167 vs 78.083) while Group B women showed a decreased GI in comparison with Group A (59.389 vs 42.120). Women presented a greater average CAL than men as well as Group B vs Group A but without statistical significance. All biochemical markers were decreased respect to values of general population. Osteocalcin in GroupB women showed a statistically significant outcome vs GroupA (p=0.004). Acid phosphatase (total and tartrate-resistant) has a slight increase in Group B women versus Group A, and Beta-crosslap showed lower values in Group A men than Group B and slightly lower in Group A women versus Group B, without statistical significance. Patients showed a slight to moderate degree of periodontal affectation, especially gingivitis related to bacterial plaque. Periodontal disorders tended to be more severe in Group B. While bone remodeling showed an overall decrease with greater affectation of bone neoformation phenomena, bone destruction tended to recover and normalize in time.

Erreferentzia bibliografikoak

  • De Andrés-Nogales, F, Oyagüez, I, Betegón-Nicolás, L, Canal-Fontcuberta, C, Soto-Álvarez, J. (2015). Status of oral anticoagulant treatment in patients with nonvalvular atrial fibrillation in Spain. REACT-AF Study. Rev Clin Esp. 215. 73-82
  • Stenova, E, Steno, B, Killinger, Z, Baqi, L, Payer, J. (2011). Effect of long-term oral anticoagulant therapy on bone mineral density and bone turnover markers: a prospective 12 month study. Bratisl Lek Listy. 112. 71
  • Rajgopal, R, Bear, M, Butcher, MK, Shaughnessy, SG. (2008). The effects of heparin and low molecular weight heparins on bone. Thromb Res. 122. 293
  • Spanakis, EK, Sellmeyer, DE. (2014). Nonuremic calciphylaxis precipitated by teriparatide [rhPTH(1-34)] therapy in the setting of chronic warfarin and glucocorticoid treatment. Osteoporos Int. 25. 1411
  • Schulze-Späte, U, Turner, R, Wang, Y, Chao, R, Schulze, PC, Phipps, K. (2015). Relationship of Bone Metabolism Biomarkers and Periodontal Disease: The Osteoporotic Fractures in Men (MrOS) Study. J Clin Endocrinol Metab. 100. 2425
  • Rodríguez-Cabrera, MA, Barona-Dorado, C, Leco-Berrocal, I, Gómez-Moreno, G, Martínez-González, JM. (2011). Extractions without eliminating anticoagulant treatment: a literature review. Med Oral Patol Oral Cir Bucal. 16. 800
  • Sánchez-Palomino, P, Sánchez-Cobo, P, Rodríguez-Archilla, A, González-Jaranay, M, Moreu, G, Calvo-Guirado, JL. (2015). Dental extraction in patients receiving dual antiplatelet therapy. Med Oral Patol Oral Cir Bucal. 20. 616
  • Li, Q, Hao, S, Fang, J, Xie, J, Kong, XH, Yang, JX. (2015). Effect of non-surgical periodontal treatment on glycemic control of patients with diabetes: a meta-analysis of randomized controlled trials. Trials. 16. 291
  • Sfyroeras, GS, Roussas, N, Saleptsis, VG, Argyriou, C, Giannoukas, AD. (2012). Association between periodontal disease and stroke. J Vasc Surg. 55. 1178
  • Humphrey, LL, Fu, R, Buckley, DI, Freeman, M, Helfand, M. (2008). Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. J Gen Intern Med. 23. 2079
  • Taberner, DA, Poller, L, Thomson, JM, Darby, KV. (1989). Effect of international sensitivity index (ISI) of thromboplastins on precision of international normalised ratios (INR). J Clin Pathol. 42. 92
  • Pita Fernández, S. (1996). Determinación del tama-o muestral. Cad Aten Primaria. 3. 138
  • O'Leary, TJ, Drake, RB, Naylor, JE. (1972). The plaque control record. J Periodontol. 43. 38
  • Ainamo, J, Bay, I. (1975). Problems and proposals for recording gingivitis and plaque. Int Dent J. 25. 229
  • Huber, F, Traber, L, Roth, HJ, Heckel, V, Schmidt-Gayk, H. (2003). Markers of bone resorption--measurement in serum, plasma or urine?. Clin Lab. 49. 203
  • Eyre, DR, Paz, MA, Gallop, PM. (1984). Cross-linking in collagen and elastin. Annu Rev Biochem. 53. 717
  • Rey-Sanchez, P, Lavado-Garcia, JM, Canal-Macias, ML, Rodriguez-Dominguez, MT, Bote-Mohedano, JL, Pedrera-Zamorano, JD. (2011). Ultrasound bone mass in patients undergoing chronic therapy with oral anticoagulants. J Bone Miner Metab. 29. 546
  • Oliva Berini, E, Galán Alvarez, P, Pacheco Onrubia, AM. (2008). [Comparison of quality and hemorragic risk of oral anticoagulant therapy using acenocoumarol versus warfarin]. Med Clin (Barc). 131. 96
  • Barrios, V, Escobar, C, Prieto, L, Lobos, JM, Polo, J, Vargas, D. (2015). Control of Anticoagulation With Warfarin or Acenocoumarol in Spain. Do They Differ?. Rev Esp Cardiol (Engl Ed). 68. 1181
  • Meurman, JH, Qvarnström, M, Janket, SJ, Nuutinen, P. (2003). Oral health and health behavior in patients referred for open-heart surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 95. 300
  • Padrón, N, Limeres, J, Tomás, I, Diz Dios, P. (2003). Oral health and health behavior in patients under anticoagulation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 96. 519
  • Mielnik-Błaszczak, M. (1999). Evaluation of dentition status and oral hygiene in Polish children and adolescents with congenital haemorrhagic diatheses. Int J Paediatr Dent. 9. 99-103
  • Bullón, P, Chandler, L, Segura Egea, JJ, Pérez Cano, R, Martínez Sahuquillo, A. (2007). Osteocalcin in serum, saliva and gingival crevicular fluid: their relation with periodontal treatment outcome in postmenopausal women. Med Oral Patol Oral Cir Bucal. 12. 193
  • Bullón, P, Goberna, B, Guerrero, JM, Segura, JJ, Pérez-Cano, R, Martínez-Sahuquillo, A. (2005). Serum, saliva, and gingival crevicular fluid osteocalcin: Their relation to periodontal status and bone mineral density in postmenopausal women. J Periodontol. 76. 513
  • Sheiham, A, Netuveli, GS. (2002). Periodontal diseases in Europe. Periodontol 2000. 29. 104
  • Burt, B. (2005). Research, Science and Therapy Committee of the American Academy of Periodontology. Position paper: epidemiology of periodontal diseases. J Periodontol. 76. 1406
  • Bravo, M, Cortés, J, Casals, E, Llena, C, Almerich-Silla, JM, Cuenca, E. (2009). Basic oral health goals for Spain 2015/2020. Int Dent J. 59. 78-82
  • Albandar, JM, Rams, TE. (2002). Global epidemiology of periodontal diseases: an overview. Periodontol 2000. 29. 7-10