Periodontal disease is an infection that, in pregnant women, can act as a risk factor for preterm delivery by increasing local and systemic inflammatory responses. Objective. To analyze the presence of periodontal disease, proinflammatory cytokines, and prostaglandin E2 (PGE2) in pregnant patients at high risk for preterm delivery. Materials and Methods. Pilot study for a case-control study. We included 46 pregnant patients (23 patients at risk of preterm delivery as cases and 23 patients without risk of preterm delivery as controls). We excluded patients who received periodontal treatment, antibiotics, or antimicrobials over the last 3 months as well as those with infections or diseases such as diabetes or hypercholesterolemia. The patients underwent a periodontal assessment, and their levels of cytokines (interleukin- [IL-] 2, IL-6, IL-10, and tumor necrosis factor- [TNF-] α) and prostaglandin E2 (PGE2) were quantified. Results. Patients with periodontal disease showed higher levels of cytokines (IL-2, IL-6, IL-10, and TNF-α) and PGE2. Patients at high risk for preterm birth showed higher IL levels compared with patients at low risk for preterm delivery. PGE2 increased with the severity of periodontal disease. PGE2 was higher in patients at low risk for preterm delivery, although this difference was not significant. Conclusion. Periodontal disease can increase the systemic inflammatory response as well as the levels of PGE2 and inflammatory cytokines in pregnant patients.

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.

Objective: The purpose of this study was to evaluate the impact of diabetes and periodontal disease in us-CRP, an inflammatory marker in patients with and without acute myocardial infarction (AMI). Subjects and methods: A case-control study was conducted in 401 subjects aged between 30 and 75 years, living in Bogotá D.C. (Colombia). Patients arriving at the emergency room of the San Ignacio University Hospital with AMI were included into the case group. The control group was defined as those subjects without AMI. The following blood tests were performed: complete blood count (CBC), glycemia, total cholesterol, triglycerides, cHDL, cLDL, and us-CRP. Patients with infections or antibiotic treatment within the last three months, who had received periodontal treatment within the six months prior to the study entry, had oral ulcerations, or less than seven teeth were excluded from the study. Periodontal disease was diagnosed based on the 1999 Armitage's classification. Results: The mean us-CRP value found in diabetic patients with severe chronic periodontitis was 5.31 mg/L (SD 6.82), and 2.38 mg/L (SD 4.42) in non-diabetic patients, being statistically significant (p = 0.000). Conclusion: Diabetes had an impact in periodontal disease and us-CRP. In patients with AMI, DM and PD considerably increased the us-CRP. Arq Bras Endocrinol Metab. 2014;58(4):362-8 Keywords Diabetes mellitus; periodontal disease; cardiovascular disease; inflammation; C-reactive protein RESUMO Objetivo: O objetivo deste estudo foi avaliar o impacto do diabetes e da doença periodontal na us-CRP, um marcador inflamatório em pacientes com ou sem infarto agudo do miocárdio (IAM). Sujeitos e métodos: Um estudo caso-controle foi conduzido em 401 sujeitos com idades entre 30 e 75 anos que moravam em Bogotá D.C. (Colômbia). Os pacientes que chegavam ao pronto--socorro do hospital universitário de San Ignacio com IAM foram incluídos no grupo caso. O grupo controle foi definido por sujeitos sem IAM. Foram feitos os seguintes exames de sangue: contagem total de eritrócitos (CTE), glicemia, colesterol total, triglicérides, cHDL, cLDL e us-CRP. Os pacientes com infecções ou em tratamento com antibióticos nos últimos três meses, que receberam tratamentos periodontal nos seis meses anteriores ao estudo, tinham úlceras orais ou menos de sete dentes foram excluídos do estudo. A classificação de Armitage de 1999 foi usada para definir a doença periodontal. Resultados: O valor médio de us-CRP observados em pacientes diabéticos com periodontite crônica grave foi 5,31 mg/L (SD 6,82) e 2,38 mg/L (SD 4,42) em pacientes não diabéticos, um valor estatisticamente significativo (p = 0,000). Conclusão: O diabetes tem um impacto na doença periodontal e na us-CRP. Em pacientes com IAM, DM e DP, a us-CRP foi consideravelmente mais alta. Arq Bras Endocrinol Metab. 2014;58(4):362-8 Descritores Diabetes

BackgroundThe purpose of this study was to determine if the US-CRP values associated with periodontal disease are risk markers for Acute Myocardial Infarction (AMI) and to determine if the US-CRP levels associated with recent AMI are higher in patients with Periodontal disease.MethodsIn order to meet the goal of the study, a case control study design was conducted. The analysis sample consisted of 401 adults (30 - 75 years old), living in Bogota D.C., Colombia, from the Hospital Universitario San Ignacio, the Faculty of Dentistry at the Pontificia Universidad Javeriana, and the Fundacion Cardio Infantil. Patients with current infections, antibiotic use in the last 3 months, periodontal treatment at least six months before the baseline of this study, mouth ulcerations caused by any type of prosthesis, candidiasis, stomatitis, or less than 7 teeth in mouth were excluded. Periodontal examination for the case group and the control group was conducted by three previously calibrated examiners. Periodontal disease was diagnosed by the presence of bleeding on probing and attachment loss. The Chronic Periodontitis diagnosis was confirmed with these clinical signs, according to the 1999 Armitage classification. The assessment of the US-CRP was performed using the IMMULITE method containing one monoclonal and one polyclonal anti-CRP antibody. This method provides a measurement range of 0.1 - 500 mg/L. Statistical analysis of variables was performed with OR and confidence intervals. A multivariate analysis was performed to determine the association between the US-CRP increase, periodontal disease and acute myocardial infarction, adjusting for smoking and other confounding factors identified in the analysis.ResultsThe study population was constituted by 401 patients, 56.1% (225) males, with a mean age of 52.6. When groups were compared it was observed that, in those patients with AMI and chronic severe or moderate periodontitis, 24.2% had HDL-C values lower than 40 mg/dl, 78.8% had LDL-C values higher than 100 mg/dl, 55.2% had triglycerides over 150 mg/dl, and US–CRP over 2 mg/L in 53.3%.ConclusionsPeriodontal disease (moderate, severe, and chronic periodontal disease) may increase the risk of Acute Myocardial Infarction (AMI) by increasing the US-CRP levels.

RESUMEN. Antecedentes: existe evidencia clínica y experimental que la proteína C reactiva (PCR) es un marcador de inflamación sistémica asociado a periodontitis crónica, siendo esta enfermedad la principal causa de edentulismo. Objetivo: identificar microorganismos periodontopatógenos presentes en pacientes edéntulos y en pacientes con periodontitis moderada/avanzada y establecer su relación con la proteína C reactiva ultrasensible (PCR-us). Métodos: estudio de corte transversal en 61 pacientes mayores de 30 años divididos en dos grupos: con periodontitis crónica y edéntulos, A cada paciente se le tomo una muestra de saliva y del dorso de la lengua para identificación microbiológica de microorganismos y muestra sérica para evaluación de PCR-us. La asociación microorganismo, PCR-us, grupo paciente. Resultados: PCR-us mostró un valor máximo de 1,12 mg/l en el grupo de edéntulos sin ninguna diferencia estadísticamente significativa con el grupo de periodontitis crónica (p=0,29); sin embargo, valores mayores de PCR-us se observaron en pacientes con microorganismos como Candida albicans, Porphiromona gingivalis, Actinomyces naeslundii (A. naeslundii), Capnocytophaga sp, Streptococcus intermedius (S. intermedius), y Bacteroides thetaiotaomicron. Conclusión: De acuerdo con los resultados de este estudio, no hay diferencia en PCR-us entre pacientes edéntulos y aquellos con enfermedad periodontal. Se encontraron periodontopatógenos en edéntulos principalmente Capnocytophaga sp, A. naeslundii y S. intermedius, tanto en lengua como en saliva. ABSTRACT. Background: There is clinical and experimental evidence that the C-reactive protein (CRP) is a marker of systemic inflammation associated with chronic periodontitis, being this oral disease the main cause of edentulism, and sharing in some cases, some microorganisms. Purpose: To identify periodontal pathogens in edentulous and moderate/severe periodontitis subjects, and stablish its association with us-CRP. Methods: Cross sectional study in 61 patients older than 30 years old, divided in two groups: The edentulous group and the other with chronic periodontitis. A sample of saliva and tongue dorsum surface was collected for microbiological identification, and serum us-CRP levels were also evaluated. An association between the microorganisms and the us-CRP in each group of patients was investigated. Results: us-CRP showed a maximum level of 1.12 mg/l in the edentulous group with no statistically significant difference when was compared with the periodontitis group. However, the presence of microorganisms such as Candida albicans, Porphiromona gingivalis, Actinomyces naeslundii (A. naeslundii), Capnocytophaga sp, Streptococcus intermedius (S. intermedius), and Bacteroides thetaiotaomicron was associated to a slight increase in the serum us-CRP levels. Conclusion: According to the results of this study, there´s no difference in us-CPR between edentulous patients and those with periodontal disease. We found periodontopathogens in edentulous mainly Capnocytophaga sp, A. naeslundii, and S. intermedius in tongue and saliva.