Insights into Hypertension: Microbial Load, Salivary Cytokine Levels and Salivary Flow in Edentulous Patients With Complete Dentures: a Case-Control Study
Goncalves Pizziolo, P.; Clemente, L. M.; Ribeiro, A. B.; Oliveira, V. d. C.; Macedo, A. P.; Salgado, H. C.; Fazan, R.; Watanabe, E.; Silva-Lovato, C. H.; Ribeiro, A. B.
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BACKGROUNDTooth loss has been established as a correlate with an increased risk of cardiovascular disease (CVD) and hypertension. However, the influence of complete denture usage on hypertension remains inadequately explored in scientific literature. METHODSThis case-control study evaluated the microbial load of the biofilm of dentures and the palate, salivary levels of cytokines (IL-2, IL-4, IL-6, IL-10, TNF-, IFN-{gamma}, and IL-17) and Salivary Flow (SF) of healthy (CG), controlled hypertensives (G1), underreported hypertensives (G2) and uncontrolled hypertensives (G3). The sample was characterized by sociodemographic data, clinical information, systolic (SBP), and Diastolic Blood Pressure (DBP). The microbial load of Candida spp., Staphylococcus spp., enterobacteria, and mutans group streptococci was evaluated by quantifying colony-forming unit (CFU), SF of unstimulated saliva by mL per minute, and salivary cytokines by flow cytometry. RESULTS80 patients were evaluated (66{+/-}7.2 years). The time of edentulism was longer in G3 and positively associated with SBP. The CFU of mutans group streptococci on the denture was higher in G3 and showed a negative association with smoking habit, and this had a positive association with salivary cytokines (IL-4, IL-2, IL-17, IFN-{gamma}), diabetes, and CVD. Patients in group G3, who only use upper dentures, had significantly higher SBP (p=0.024) and levels of IL-2 (p=0.024). CONCLUSIONSTime of edentulism may play a role in hypertension. Smoking habits modulated microbiota and interleukins, especially in diabetic and CVD patients. Furthermore, non-functional dentures had an association with hypertensive patients not controlled by medication, reflected in an increase in SBP and IL-2.
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