Systemic inflammatory response to non-surgical treatment in hypertensive patients with periodontal infection

Abstract

Hypertension is associated with chronic inflammation in the tissues and organs that are involved in the regulation of arterial pressure, such as kidneys and blood vessels. Periodontal disease affects systemic inflammatory markers, leading to endothelial dysfunction, atherosclerotic plaque instability, dyslipidaemia, and insulin resistance. These conditions can also cause an increase in the blood pressure. Nonsurgical periodontal therapies, such as scaling and root planning, can affect systemic markers of inflammation. We evaluated the effect of scaling and root planning on serum levels of inflammation biomarkers in hypertensive patients. The sample consisted of 19 hypertensive patients with Periodontitis. The patients underwent laboratory tests that included glycaemia, cholesterol, triglycerides and blood count. Blood pressure was measured before periodontal therapy, and the second blood pressure recording was obtained at the re-evaluation appointment. Quantification of peripheral blood cytokines was performed using the Milliplex Inflammation Human Cytokine kit (Interleukin 1-β, Interleukin-4, Interleukin-6, Interleukin-8, Interleukin-10, Interleukin-12 P70, Interleukin-17A, vascular endothelial growth factor and tumor necrosis factor-alpha). All cytokine levels decreased from the initial examination to reassessment. Cytokines that reflected a statistically significant difference included Interleukin-1β and endothelial vascular growth factor ( P = .04 and P = .004). Hypertensive patients with periodontitis undergoing non-surgical periodontal treatment exhibited a decrease in proinflammatory cytokine levels. Non-surgical periodontal treatment decreases the levels of systemic proinflammatory cytokines in controlled hypertensive patients.

The Effect of Non-surgical Periodontal Treatment on Patients With Combined Refractory Arterial Hypertension and Stage Iii, Grade B Periodontitis: A Preliminary Prospective Clinical Study

“…Studies that evaluated the effect of NSPT on systemic BP are controversial [22, 25-28, 48, 49, 56]. Some studies have demonstrated a BP improvement after NSPT [25][26][27], whereas other studies did not show such improvements [28,48,49,56]. In the present study, in the analysis of systemic BP variables, no significant reductions were observed after NSPT at 90 and 180 days compared to baseline.…”

“…Of importance, 5 out 12 interventional studies confirmed a reduction in blood pressure levels following periodontal therapy, ranging from 3 to 12.5 mmHg of SBP and from 0 to 10 mmHg of DBP [24]. These findings parallel observation made by previous studies showing that patients subjected to non-surgical periodontal treatment (NSPT) showed improved periodontal clinical parameters and reduced plasma levels of inflammatory markers [25][26][27][28]. Vidal et al (2011) found that periodontitis is a risk indicator for hypertensive patients, and there are indications that systemic inflammation is associated with both conditions [29].…”

“…Good periodontal health may be associated with better BP control during antihypertensive treatment [38]. The effects of NSPT in hypertensive individuals have been reported in a few studies [26][27][28]39]. In our study, the NSPT of individuals with RAH proved to be beneficial during the 90 and 180-day evaluations.…”

“…Since there is still limited evidence suggesting that successful NSPT can improve systemic BP post-treatment in RAH patients [25][26][27], we hypothesize that NSPT in RAH patients would enhance the control of BP and a reduction in the plasma levels of systemic inflammatory markers. Therefore, the objective of this study was to clinically evaluate the effect of NSPT on clinical periodontal parameters, systemic BP and the plasma levels of systemic inflammation markers in patients with RAH and stage III, grade B periodontitis.…”

Title Effect of Non-surgical Periodontal Therapy (NSPT) on the Systemic Inflammatory Markers (IL-6 and IL-8) in β-Thalassemia Patients with Gingivitis

“…In a study by Konopka, Pietrzak and Brzezińska-Błaszczyk, (32), the levels of GCF IL-8 in patients with periodontal inflammatory diseases, reduced from the range of 7.4 to 96.1pg/ml to 2.7 ± 20.3 pg/ml at 4 weeks of intervention and was significantly lower than at baseline (p-value <0.001). Escobar Arregocés et al, (33) evaluated the systemic pro-inflammatory markers levels in hypertensive patients with periodontal conditions. Although the result of their study shows reduced levels of IL-6 (from 0.31 ± 0.18pm/ml to 0.24 ± 0.13pg/ml) and IL-8 (from 9.17 ± 1.05pg/ml to 7.79 ± 0.62pg/ml) but not statistically significant.…”