Efect of periodontal disease and non surgical periodontal treatment on C-reactive protein. Evaluation of type 1 diabetic patients

Abstract

Objectives: The purpose of this study was to analyze how anti-infectious periodontal treatment affects C reactive protein (CRP) values in patients with type 1 diabetes, and correlate baseline CRP levels with periodontal disease severity. Study Design: A cohort of fifty three subjects with type 1 diabetes and moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate high-sensitivity C-reactive protein (hs-CRP). Group 1 was treated with scaling, root planning, and systemic administration of doxycycline. Group 2 received only scaling and root planning. Results: Hs-CRP was reduced after periodontal treatment in group 1 (-0.22 mg/l) and 2 (-0.21 mg/l ) but this reduction was not statistically significant, even in the patients with the best response to periodontal treatment. However, significant correlation appeared between hs-CRP and mean probing pocket depth (PPD) (p=0, 01) and mean clinical attachment level (CAL) (p=0,03). Conclusions: Non-surgical periodontal treatment couldn’t reduce hs-CRP values, however, it was found an association between advanced periodontitis and elevated blood hs-CRP levels in patients with type 1 diabetes. It can be speculated that periodontal disease increases production of pro-inflammatory mediators in patients with type 1 diabetes, but other producing sources of these pro-inflammatory substances may exist. Key words:Periodontal disease, periodontitis, diabetes mellitus type 1, periodontal therapy, C reactive protein.

Efficacy of systemic antibiotics in nonsurgical periodontal therapy for diabetic subjects: a systematic review and meta-analysis

“…Two of these studies investigated the effect of doxycycline 100 mg 26,27 and one study assessed the effects of the association of metronidazole 400 mg + amoxicillin 500 mg 15 . Doxycyline was the antimicrobial most commonly studied 13,23,24,[26][27][28]30,31,38,39 . However, subgroup analysis showed a modest additional benefit of 0.13 mm in PPD reduction and no further benefit in CAL gain compared with SRP alone.…”

“…Doxycyline was the antimicrobial most commonly studied. However, subgroup analysis showed a modest additional benefit of 0.13 mm in PPD reduction and no further benefit in CAL gain compared with SRP alone.…”

“…The search in the databases resulted in the identification of 164 publications, 143 of which were excluded after reviewing titles and abstracts. The complete texts of 21 publications were analysed 13,15,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] , and of these, six 32,33,[35][36][37]40 were excluded ( Figure 1).…”

The Influence of Anti-Infective Periodontal Treatment on C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Among the 24 trials, appropriate CRP data could not be abstracted from 8 trials (typically because data were presented graphically and not numerically). The corresponding and/or first authors from these 8 trials were contacted and we obtained CRP data for 4 out of 8 trials, yielding a total of 20[29,32,34–51] included trials.…”

“…Among studies with an active comparator, only 3 of 6 trials compare periodontal therapy+antibiotics to periodontal therapy alone[50,51,56] and these results show no evidence that antibiotic therapy provides stronger reductions in CRP. However, there is considerable heterogeneity between study.…”