Non‐surgical periodontal therapy reduces coronary heart disease risk markers: a randomized controlled trial

Abstract

Non-surgical periodontal therapy reduces coronary heart disease risk markers: a randomized controlled trial Abstract:Aim: Periodontal disease elevates systemic inflammatory markers strongly associated with coronary heart disease (CHD) risk. The aim of this randomized controlled trial was to investigate the effect of non-surgical periodontal therapy on systemic C-reactive protein (CRP), fibrinogen and white blood cells in CHD patients. Materials and Methods: Angiographically proven CHD patients with periodontitis (n = 317) were randomized to intervention (n = 212) or control group (n = 105). Primary outcome was reduction in serum CRP levels; secondary outcomes were reductions in fibrinogen and white blood cells. Periodontal treatment included scaling, root planing and oral hygiene instructions. Periodontal and systemic parameters were assessed at baseline and at 2-month follow-up. Intentto-treat (ITT) analysis was performed. Results: Study was completed by 246 subjects (intervention group = 161; control group = 85). Significant improvements in periodontal and systemic parameters were observed in intervention group. The number of subjects with CRP > 3mg/L in intervention group decreased by 38% and in control group increased by 4%. ITT analysis gave a significant (v 2 =4.381, p = 0.036) absolute risk reduction of 12.5%. Conclusion: In CHD patients with periodontitis, non-surgical mechanical periodontal therapy significantly reduced systemic levels of C-reactive protein, fibrinogen and white blood cells.

Correlation of high-sensitivity C-reactive protein and carotid plaques with coronary artery disease in elderly patients

“…C-reactive protein (CRP), an acute-phase protein that arises rapidly and reaches high levels in plasma in response to infection or tissue injury, plays an important role in the occurrence and progress of inflammation; hence, it has attracted considerable attention. CRP activates the complement system and enhances phagocytosis to remove pathogens and damaged, necrotic or apoptotic cells (5,6). Studies have also demonstrated that CRP is an independent predictor of carotid IMT (7,8).…”

Local and systemic immune responses in gingivitis and periodontitis

“…The difference between smoking patients with periodontitis and smoking controls was not statistically significant. Christan et al [18] and Bokhari et al [51] found a significant reduction in WBC counts in venous blood after non-surgical therapy among non-smokers. Current knowledge suggests that smoking is associated with a less favorable response to periodontal therapy [50].…”

Periodontal parameters and tooth loss were associated with Creactive protein and leukocyte counts in adult population aged 50 or older

“…First, moderate to severe periodontal disease increases the level of systemic inflammatory disease; and periodontal disease has been associated with increased systemic inflammation as measured by CRP and other biomarkers. Treatment of periodontitis sufficient to reduce clinical signs of the disease also decreases the level of systemic inflammatory mediators [6,23,24]. Second, in untreated periodontitis, gramnegative bacteria may be found in periodontal pockets surrounding each diseased tooth, and also the same species have been found in atheroma [4].…”

“…In particular, studies have reported the relationship between periodontal disease and CVD based on incidence or mortality [3,4]. Continuing studies [5][6][7][8] have revealed that periodontal disease is another important risk factor for cardiovascular diseases. The host-mediated inflammatory response to periodontal pathogens and their components, release of matrix metalloproteinases, alteration in lipoprotein metabolism and poor dietary habits may contribute to the atheroma pathogenesis in patients with periodontal disease [4].…”