Periodontal disease is a chronic inflammatory disorder of the tissues surrounding the teeth, with evidence of systemic effects. Some studies showed the benefit of periodontal therapy on blood pressure (BP), but the impact of periodontitis on BP control is unknown. We retrospectively analyzed cross-sectional, nationally representative data from treated hypertensive adults aged ≥30 years with and without periodontitis. BP was examined as both continuous (mm Hg) and categorical (treatment goal achievement status according to guidelines: at goal and above goal) variable according to the presence or absence of periodontitis and its clinical parameters (probing depth, clinical attachment loss, and disease severity [mild, moderate, and severe]). Systolic BP means and odds ratios for uncontrolled BP according to the presence and severity of periodontitis were calculated using progressively adjusted models. Among treated hypertensive adults, mean systolic BP was about 2.3 to 3 mm Hg higher in the presence of periodontitis ( P <0.0001). Periodontitis was associated with unsuccessful antihypertensive treatment after multiple adjustments, with higher odds by disease severity. A good periodontal health is associated with better systolic BP profile during antihypertensive therapy by about 2.3 to 3 mm Hg and with lower odds of antihypertensive treatment failure. Dedicated studies are needed to test the impact of periodontal therapy on BP and the long-term effects on cardiovascular outcomes of this complementary approach to systemic health.

Aim Periodontitis is a relapsing–remitting disease. Compared with bleeding on probing (BoP), expression of disease activity, periodontal inflamed surface area (PISA), incorporates chronic disease parameters. We tested the association of PISA and BoP with blood pressure (BP) in NHANES III. Materials and methods A total of 8,614 subjects (≥30 years) with complete periodontal and BP examinations were enrolled. PISA was derived from periodontal probing depth and BoP. The association of PISA and BoP with high/uncontrolled BP was examined by multiple‐adjusted models. Inflammatory markers were tested as possible mediators. A machine learning (ML) approach was used to define the relative importance of PISA and BoP and estimate the power of BP status prediction. Results Compared to no inflammation, severe PISA and BoP were associated with 43% (p < .001) and 32% (p = .006) higher odds of high/uncontrolled BP (≥130/80 mmHg), and with higher systolic BP by ≈4 (p < .001) and 5 (p < .001) mmHg, respectively. Inflammatory markers appeared to mediate this association with various extents, without threshold effect. BoP predicted high/uncontrolled BP more efficiently than PISA using ML. Conclusion PISA and BoP describe the association of periodontal inflammation and hypertension with subtle differences. The contribution of local inflammation to the global inflammatory burden might explain the observed findings.

BackgroundThe aim of this case series/control study is to investigate the presence of the Advanced Glycation End products (AGEs) and oxidative stress in periimplantitis.The study group was composed of five dental implants, failed within 6 months after implantation, taken from 5 subjects (3 M/2 F) aged between 43–57 years and stored in isotonic liquid before freezing at -80°C, according to literature. All the implants had been placed using traditional submerged technique. The whole saliva was also collected using Salimetrics device and stored at -80°C, to assess molecular analysis. Two age-matched control groups were examined: they consisted of 5 subjects encountering dental extraction for chronic periodontal disease (2 M/3 F) and 5 healthy subjects (3 M/2 F) who needed extraction for dental trauma. Their whole saliva was collected with the same method. The implants and the tooth of control groups were processed to assess Western Blotting for identification of AGEs. The case/control whole saliva was used to perform ThioBarbituric Acid Reactive Substances (TBARS) for oxidative stress evaluation.FindingsThe Western Blotting analysis on periimplantitis and periodontal disease tissues showed marked increase of AGEs when compared to healthy control tissues. Also TBARS assay of whole saliva confirmed the expectations, showing higher oxidative stress levels in periimplantitis and periodontitis groups than in healthy group.ConclusionsWith the limitation of the sample size, these results showed that oxidative stress could be involved in the aetiology of periimplantitis. This hypothesis could lead to new therapeutic strategies in periimplantitis, using antioxidant approach in addition to conventional treatments.