Effects of Periodontal Treatment on Markers of Systemic Inflammation

OBJECTIVES: To evaluate changes in markers of inflammation (MI) after periodontal treatment (PT) in patients with cardiovascular disease (CVD) risk.

METHODS: One hundred and twelve patients with hyperlipidaemia and at least 2 traditional markers of CVD risk (hypertension, diabetes, obesity, smoking), and marginal periodontitis (&ge4 sites with pocket depth &ge4mm and concomitant loss of attachment &ge3mm) were randomized to a treatment group (TG) or to a control group (CG). The TG received plaque control, scaling, root planning and metronidazole plus amoxicillin for 7 days. The CG received plaque control, supragingival scaling and a placebo for 7 days. Periodontal clinical parameters, serum C-reactive protein (CRP high-sensitivity assay), fibrinogen, glucose, and cholesterol levels, eritrosedimentation rate (ESR) and white blood cells count were assessed prior to, and 3 months after PT. Student-t, and chi-square tests were used to analyze differences intra-group and between groups, and logistic regression analyses to identify variables associated with higher levels of MSI.

RESULTS: After PT, clinical periodontal parameters significantly decreased in both groups (P=0.001), but the improvement was significantly higher in the TG (P=0.001). After PT, mean CRP level decreased from 5.00&plusmn3.26 to 4.40&plusmn3.72 mg/l (P=0.26) in the TG, and increased from 3.89&plusmn2.99 to 4.80&plusmn8.93 mg/l (P=0.38) in the CG. No significant differences of CRP levels between the TG and the CG before and after PT were found. Fibrinogen, ESR and white cells showed no significant changes after PT. None of the variables studied was associated with higher CRP levels post-therapy in the TG. In the CG higher CRP levels were associated with body mass index (P=0.006, OR 5.3, 95%CI 1.61 to 17.48). CONCLUSIONS: Three months after PT, CRP levels tended to decrease, although the reduction was not statistically significant. FONDECYT, Project Grant 1061070.