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Published on: May 9, 2022
Non-surgical periodontal therapy lowers serum inflammatory markers: a pilot study
Syed Akhtar Hussain Bokhari1, Ayyaz Ali Khan, Dimitris N Tatakis
1Department of Oral Health Sciences, Sheikh Zayed Federal Postgraduate Medical Institute and Hospital, Lahore, Pakistan. pdplhr@yahoo.com
Insights
Periodontal therapy significantly reduced markers of gum disease and systemic inflammation in patients with and without coronary heart disease (CHD). This suggests a potential reduction in CHD risk following dental treatment.
Area of Science:
- Cardiovascular Health
- Periodontology
- Inflammation Research
Background:
- Periodontal disease is linked to coronary heart disease (CHD).
- Inflammatory markers like C-reactive protein (CRP), fibrinogen, and white blood cell (WBC) counts are associated with CHD risk.
- This study examined the impact of periodontal therapy on these systemic inflammatory markers.
Purpose of the Study:
- To investigate the effect of non-surgical periodontal therapy on systemic inflammatory markers.
- To assess changes in CRP, fibrinogen, and WBC counts in patients with and without CHD after treatment.
- To evaluate the impact of periodontal treatment on clinical measures of periodontal disease.
Main Methods:
- Recruited patients with CHD and without CHD (NCHD) aged 40+.
- Measured periodontal disease via bleeding on probing (BOP) and probing depth (PD).
- Administered non-surgical periodontal therapy (oral hygiene, scaling, root planing) and measured inflammatory markers before and after.
Main Results:
- Significant reductions in BOP and PD observed in both CHD and NCHD groups post-therapy.
- Systemic levels of CRP, fibrinogen, and WBC counts significantly decreased (21-40%) in all subjects after treatment.
- No significant intergroup differences in clinical improvements were noted.
Conclusions:
- Non-surgical periodontal therapy effectively reduces periodontal disease indicators.
- Periodontal treatment leads to significant reductions in systemic inflammatory markers.
- These findings support further investigation into periodontal therapy for decreasing CHD risk.
Background:
Evidence suggests an association between periodontal disease and coronary heart disease (CHD). C-reactive protein (CRP), fibrinogen, and white blood cell (WBC) counts are markers of inflammation, and their systemic levels have been associated with CHD risk. This pilot study investigated the effect of non-surgical periodontal therapy on systemic levels of CRP, fibrinogen, and WBC counts in subjects with CHD or no CHD (NCHD).
Methods:
Twenty-seven angiographically defined patients with CHD and 18 subjects with NCHD aged >or=40 years were recruited for the study. Periodontal disease was measured through the clinical parameters bleeding on probing (BOP) and probing depth (PD). All subjects received non-surgical periodontal therapy that included oral hygiene instructions and subgingival scaling and root planing. Systemic levels of inflammatory markers (CRP, fibrinogen, and WBC counts) were measured prior to and 1 month after periodontal therapy.
Results:
Seventeen subjects with CHD and 11 subjects with NCHD completed the study. Subjects with CHD or NCHD experienced significant reductions in BOP (59% and 34%, respectively; P <0.05) and PD (41% and 35%, respectively; P <0.05), with non-significant intergroup differences (P >0.05). In all subjects, CRP, fibrinogen, and WBC counts were reduced significantly (21% to 40%) after periodontal therapy (P <0.05).
Conclusions:
Periodontal treatment resulted in significant decreases in BOP and PD and lowered serum inflammatory markers in patients with CHD or NCHD. This may result in a decreased risk for CHD in the treated patients. These findings will allow pursuit of a large-scale randomized intervention trial in this population.