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.
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.
Objective Obstructive sleep apnea (OSA) and periodontitis share risk factors, such as age, obesity, stress, and cardiovascular events, which have a bidirectional cause-effect relationship through systemic inflammation. Our objective was to determine the relationship between OSA and the periodontal condition and its associated local and systemic risk factors. Material and methods This was an observational case-control study involving 60 patients. Local oral risk factors and the systemic condition of each patient were evaluated. All patients underwent polysomnography for the diagnosis of OSA. Chi-squared, one-way ANOVA, and Bonferroni’s tests were performed. Results A higher percentage of patients with periodontitis had severe OSA (66.66%); however, no statistically significant association was found between the two pathologies (p = 0.290). In terms of systemic risk factors, an association was found between arterial hypertension and severe OSA (p = 0.038), and in terms of local factors, an association was found between the use of removable prostheses and severe OSA (p = 0.0273). Conclusion In the general population, patients with periodontitis showed a higher prevalence of severe OSA. Obesity and hypothyroidism were the most prevalent systemic findings in patients with OSA and periodontitis. Arterial hypertension and osteoarthritis were found to be associated with severe OSA. The local risk factors associated with periodontitis and severe OSA were removable partial dentures and misfit resins. Clinical relevance To study the factors that can facilitate the progression of OSA and periodontitis, physicians and dentists should be advised to provide comprehensive care for patients with both pathologies.
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