Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis

Freitas, Camila Oliveira Teixeira de; Filho, Isaac Suzart Gomes; Naves, Roberta Catapano; Nogueira-Filho, Getulio; Cruz, Simone Seixas da; Santos, Carlos Antônio de Souza Teles; Dunningham, Leonardo; Miranda, Lituania Fialho de; Barbosa, Monica Dourado

doi:10.1590/s1678-77572012000100002

Cited by 62 publications

(64 citation statements)

References 20 publications

(39 reference statements)

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“…A second meta-analysis of intervention trials reported similar estimates with a mean overall difference in CRP serum levels after therapy of 0.2 mg/l (95% CI, -0.15-0.55) (Ioannidou et al 2006). The most recent meta-analysis including four clinical trials reported a 0.23 mg/l reduction in CRP levels (-0.231; p < 0.0001) (Freitas et al 2012). Two additional trials performed in individuals with periodontitis and other co-morbidities including diabetes (Sun et al 2011, Chen et al 2012) confirmed the potential antiinflammatory effect of periodontal therapy also in these populations.…”

Section: Acute-phase Proteinsmentioning

confidence: 74%

“…After reviewing all clinical trials, authors agreed to perform metaanalysis only on markers where sufficient data were available (Table 1). One biomarker had been recently extensively reviewed and more than one systematic review with metaanalysis had been already published (Ioannidou et al 2006, Paraskevas et al 2008, Freitas et al 2012. We therefore did not include it in a meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

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Evidence that periodontal treatment improves biomarkers and CVD outcomes

D’Aiuto

Orlandi

Gunsolley

2013

Journal of Periodontology

127

137

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Evidence that periodontal treatment improves biomarkers and CVD outcomes D'Aiuto F, Orlandi M, Gunsolley JC. Evidence that periodontal treatment improves biomarkers and CVD outcomes. AbstractAim: The aim of this review was to critically appraise the evidence on the impact of periodontal treatment of cardiovascular diseases (CVDs) biomarkers and outcomes. Methods: A systematic search was performed in Cinhal, Cochrane, Embase and Medline for relevant articles up to July 2012. Duplicate screening and reference hand searching were performed. Data were then summarized and evidence graded in tables. Results: The search resulted in: (a) no evidence on the effects of periodontal therapy on subclinical atherosclerosis, serum levels of CD40 ligand, serum amyloid A and monocyte chemoattractant protein-1, (b) limited evidence on the effects of periodontal therapy on arterial blood pressure, leucocyte counts, fibrinogen, tissue necrosis factor-a, sE-selectin, von Willebrand factors, d-dimers, matrix metalloproteinases, oxidative stress and CVD events, and (c) moderate evidence suggesting a negligible effect of periodontal therapy in reducing interleukin-6 and lipids levels, whilst a positive effect in reducing serum C-reactive protein levels and improving endothelial function. Conclusions: Periodontal therapy triggers a short-term inflammatory response followed by (a) a progressive and consistent reduction of systemic inflammation and (b) an improvement in endothelial function. There is however limited evidence that these acute and chronic changes will either increase or reduce CVD burden of individuals suffering from periodontitis in the long term.

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Section: Acute-phase Proteinsmentioning

confidence: 74%

Section: Methodsmentioning

confidence: 99%

Evidence that periodontal treatment improves biomarkers and CVD outcomes

D’Aiuto

Orlandi

Gunsolley

2013

Journal of Periodontology

127

137

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“…From the first category, many treatment studies show an effect on CRP levels in favor of periodontal treatment. Teixeira de Freitas et al 40 have concluded from a metaanalysis that nonsurgical periodontal treatment can exert a reductive effect on the serum levels of CRP. These authors propose that the time of measuring CRP and the type and the extent of periodontal treatment can influence the results of the studies dramatically.…”

Section: Discussionmentioning

confidence: 99%

Effect of Nonsurgical Periodontal Treatment on C-Reactive Protein Levels in Maintenance Hemodialysis Patients

et al. 2013

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Objective: C-reactive protein (CRP) has been implicated as a possible mediator of the association between periodontitis and several systemic diseases. This study evaluated the impact of nonsurgical periodontal treatment on the serum levels of CRP in chronic kidney disease (CKD) patients on hemodialysis. Methods: A total of 77 CKD patients on hemodialysis were included in this study. At baseline, periodontal examination was assessed for all the patients, and chronic periodontitis was defined through clinical attachment level and probing pocket depth, according to the American Association of Periodontology. Nonsurgical periodontal treatment was performed and serum levels of CRP were evaluated at baseline and 8 weeks after periodontal treatment. Results: Periodontal treatment resulted in significant reductions in CRP levels (p < 0.001). The difference between pre-and posttreatment CRP concentrations did not show any significant relationship with the severity of periodontitis. Conclusions: Periodontitis is an important source of systemic inflammation in CKD patients. Nonsurgical periodontal treatment can effectively reduce the serum level of CRP in these patients.

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“…Interestingly data collected in 2000 showed no statistical differences in the levels of C-reactive protein between groups, while the evaluation of the current oral condition reported the presence of periodontal infection being double in the control group (50%) that of the study group (24%). Levels of C-reactive protein have been widely used in research to monitor effectiveness of periodontal therapy, [3][4] and they are also used in the medical field as a risk indicator for MI. 5 The time of the MI occurrence was not reported.…”

mentioning

confidence: 99%