The effect of initial treatment of periodontitis on systemic markers of inflammation and cardiovascular risk: a randomized controlled trial.

Observational studies indicate that chronic periodontal disease is associated with adverse cardiovascular outcomes. The aim of this study was to determine whether initial periodontal treatment has a beneficial effect on systemic markers of inflammation and cardiovascular risk. One hundred and thirty-six adults with chronic periodontitis were allocated to either intervention or control groups in a 3-month randomized controlled intervention study. The intervention group received initial periodontal treatment, whereas the control group did not receive that treatment until after the study. Blood levels of cardiovascular risk factors, and of hematological, inflammatory, and metabolic markers, were measured at the beginning and the end of the study, and differences were calculated. Fibrinogen level was the primary outcome measure. Data for 61 persons in the intervention group and for 64 persons in the control group were available for statistical analysis. Compared with the control group, the intervention group showed a non-significant trend for a lower fibrinogen level. Significant increases in hemoglobin and hematocrit were seen after treatment, showing that initial periodontal treatment, a relatively simple and cost-effective intervention, has systemic effects.

[1]  K. Tabeta,et al.  Periodontitis-associated up-regulation of systemic inflammatory mediator level may increase the risk of coronary heart disease. , 2010 .

[2]  D. Couper,et al.  Results from the Periodontitis and Vascular Events (PAVE) Study: a pilot multicentered, randomized, controlled trial to study effects of periodontal therapy in a secondary prevention model of cardiovascular disease. , 2009, Journal of periodontology.

[3]  G. Tofler,et al.  SAA and PLTP activity in plasma of periodontal patients before and after full-mouth tooth extraction. , 2008, Oral diseases.

[4]  C. Ramsay,et al.  A review of RCTs in four medical journals to assess the use of imputation to overcome missing data in quality of life outcomes , 2008, Trials.

[5]  R. Seymour,et al.  Change in cardiovascular risk status after dental clearance , 2007, BDJ.

[6]  J. Bernimoulin,et al.  Influence of periodontal therapy on the regulation of soluble cell adhesion molecule expression in aggressive periodontitis patients. , 2007, Journal of periodontology.

[7]  Francesco D'Aiuto,et al.  Treatment of periodontitis and endothelial function. , 2007, The New England journal of medicine.

[8]  Peter Libby,et al.  The immune response in atherosclerosis: a double-edged sword , 2006, Nature Reviews Immunology.

[9]  J. Lessem,et al.  Periodontal infections cause changes in traditional and novel cardiovascular risk factors: results from a randomized controlled clinical trial. , 2006, American heart journal.

[10]  G. Tofler,et al.  Full-mouth Tooth Extraction Lowers Systemic Inflammatory and Thrombotic Markers of Cardiovascular Risk , 2006, Journal of dental research.

[11]  P. Pussinen,et al.  Dental Infections and Cardiovascular Diseases: A Review. , 2005, Journal of periodontology.

[12]  T. Kocher,et al.  Lipoprotein-associated phospholipase A2 and plasma lipids in patients with destructive periodontal disease. , 2005, Journal of clinical periodontology.

[13]  M. Brodmann,et al.  Periodontal treatment improves endothelial dysfunction in patients with severe periodontitis. , 2005, American heart journal.

[14]  H. Oflaz,et al.  Endothelial dysfunction in patients with chronic periodontitis and its improvement after initial periodontal therapy. , 2004, Journal of periodontology.

[15]  Kenneth R Feingold,et al.  Effects of infection and inflammation on lipid and lipoprotein metabolism: mechanisms and consequences to the host. , 2004, Journal of lipid research.

[16]  J. Sundvall,et al.  Periodontitis decreases the antiatherogenic potency of high density lipoprotein Published, JLR Papers in Press, September 16, 2003. DOI 10.1194/jlr.M300250-JLR200 , 2004, Journal of Lipid Research.

[17]  M. Ide,et al.  Effect of treatment of chronic periodontitis on levels of serum markers of acute-phase inflammatory and vascular responses. , 2003, Journal of clinical periodontology.

[18]  M. Nieminen,et al.  Effect of treating periodontitis on C-reactive protein levels: a pilot study , 2002, BMC infectious diseases.

[19]  F. Hoek,et al.  Lower numbers of erythrocytes and lower levels of hemoglobin in periodontitis patients compared to control subjects. , 2001, Journal of clinical periodontology.

[20]  D. Moher,et al.  The Revised CONSORT Statement for Reporting Randomized Trials: Explanation and Elaboration , 2001, Annals of Internal Medicine.

[21]  Qingbo Xu,et al.  Chronic Infections and the Risk of Carotid Atherosclerosis Prospective Results From a Large Population Study , 2001 .

[22]  R. Page,et al.  Advances in the pathogenesis of periodontitis: summary of developments, clinical implications and future directions. , 1997, Periodontology 2000.

[23]  M. Steffen,et al.  Systemic acute‐phase reactants, C‐reactive protein and haptoglobin, in adult periodontitis , 1997, Clinical and experimental immunology.

[24]  A. Clauss,et al.  Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens , 1957 .

[25]  J. Grbic,et al.  Plasma levels of tumour necrosis factor‐α in patients with chronic periodontitis and type 2 diabetes , 2007 .

[26]  J. Beck,et al.  The effects of periodontal therapy on vascular endothelial function: a pilot trial. , 2006, American heart journal.