Effect of Intensive Periodontal Therapy on Blood Pressure and Endothelial Microparticles in Patients With Prehypertension and Periodontitis: A Randomized Controlled Trial

Zhou, Qing; Xia, Wenhao; Ren, Jing; Yu, Bingqing; Tong, Xinzhu; Chen, Yanbin; Chen, Shan; Feng, Lei; Dai, Jing; Tao, Jun; Yang, Jiao

doi:10.1902/jop.2017.160447

Cited by 66 publications

(68 citation statements)

References 52 publications

(69 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, recent studies have shown a significant association between periodontitis and hypertension and have suggested that periodontal treatment could reduce arterial blood pressure [47,48]. In this RCT, we have reported an adjusted statistically significant reduction of systolic and diastolic blood pressure (7.8 and 7.3 mmHg, respectively), three months after effective periodontal treatment.…”

Section: Discussionsupporting

confidence: 70%

Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

Montero

López

Vidal

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Although there is evidence of positive effect of periodontal therapy on systemic inflammation, this response is highly variable among subjects. It was the aim of this clinical investigation to determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. Methods In this parallel-arm, double blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg, q.d., for three days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on hs-CRP serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipids metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. Results The ITT population consisted on 63 subjects randomly assigned to either MPT (n = 31) or IPT (n = 32) groups. At baseline, mean hs-CRP was 3.9 mg/L (standard deviation, SD = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in their cardiometabolic risk profiles were detected between groups. After 6 months, unadjusted mean hs-CRP were 2.9 mg/L (standard error, SE = 0.4) and 4.0 (SE = 0.8), respectively. Adjusting for baseline hs-CRP, sex, age, smoking status and body mass index, hs-CRP was 1.2 mg/L (95% confidence interval, [CI 0.4; 2.0]; p = 0.004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL-1β, TNF-α, HbA1c and blood pressure were observed in the IPT group at 3 months, when compared to the MPT group. Conclusion Effective periodontal treatment significantly reduced hs-CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients. Trial registration: ClinicalTrials.gov Registration Number: NCT03960216.

show abstract

Section: Discussionsupporting

confidence: 70%

Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

Montero

López

Vidal

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Some cross‐sectional studies have also been published, with inconclusive results . No experimental studies have addressed the effect of dental intervention on the time course of cognitive impairment, unlike in the field of cardiovascular disease, where intensive periodontal interventions were found to reduce arterial blood pressure levels in pre‐hypertensive patients …”

Section: Introductionmentioning

confidence: 99%

“…13,14 No experimental studies have addressed the effect of dental intervention on the time course of cognitive impairment, unlike in the field of cardiovascular disease, where intensive periodontal interventions were found to reduce arterial blood pressure levels in pre-hypertensive patients. 15 Various aetiological models have been proposed, 16 all based to date on the hypothesis that patients with chronic periodontal disease develop a higher or lower immune response according to their genotype, and that the disease is a continuous source of bacteria, viruses, bacterial lipopolysaccharides (LPS) and inflammation products such as pro-and anti-inflammatory cytokines, and C-reactive protein, among others. All of these elements may pass to the bloodstream via the periodontal pocket and, under certain circumstances, may cross the blood-brain barrier at the level of circumventricular organs and choroid plexus, 17 activating glial cells and producing local inflammation that results in neuronal destruction.…”

mentioning

confidence: 99%

Systemic inflammatory impact of periodontitis on cognitive impairment

et al. 2019

View full text Add to dashboard Cite

Objectives The role in dementia of systemic inflammation derived from periodontal disease is not fully elucidated. The objective of our study was to examine the impact of inflammation on the relationship between periodontitis and cognitive impairment. Methods We have designed a case (n = 171) and control (n = 131) study to determine the periodontal health status, grade of cognitive impairment/dementia and systemic inflammation level, the last being measured by analysis of 29 inflammatory biomarkers using multiplex techniques. Results At the time of sampling, 11 of the 29 inflammatory biomarkers were associated with cognitive impairment in patients with more severe periodontitis. However, the inflammatory response to severe periodontitis was more reduced (lower biomarker concentrations) in cases (with cognitive impairment or dementia) than in (cognitively healthy) controls, an unexpected finding. Conclusions Based on these results, we cannot confirm that systemic inflammation derived from periodontal disease plays a relevant role in the aetiology of cognitive impairment.

show abstract

“…The population of the studies varied from 40 to 125 patients depending on the article. Moreover, the types of studies were different: five randomized clinical trials, [15][16][17][18][19] one interventional prospective cohort study, 10 one clinical intervention trial, 20 and one pilot intervention study. 21 There were also different types of periodontal treatment compared.…”

Section: Description Of the Study Characteristicsmentioning

confidence: 99%

Does Periodontal Treatment Help in Arterial Hypertension Control? A Systematic Review of Literature

2020

View full text Add to dashboard Cite

Arterial hypertension and periodontal diseases are two of the pathologies with more prevalence worldwide. In the last few years, several scientific evidences have demonstrated the relationship between both diseases. Besides the etiopathogenic and causal relationship, some recent publications have pointed out that the therapeutic approach of periodontitis could have positive effects on the control of arterial hypertension.The aim of this systematic review is to determine whether there is a decrease in or better control of blood pressure after performing nonsurgical periodontal treatment in patients with periodontitis.A thorough search in PubMed, Scopus, and ISI Web of Science databases with the keywords “‘periodontal disease’ OR ‘periodontitis’ OR ‘periodontal’ AND ‘blood pressure’ OR ‘hypertension’ OR ‘arterial hypertension’” was conducted. The quality of the reported information was assessed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for systematic reviews.Eight articles were considered for this systematic review. Five of the studies showed statistically significant reduction in systolic blood pressure (SBP) values.Despite the limitations of the review, nonsurgical treatment of periodontal disease seems to reduce SBP values. Further research with larger and longer-term clinical trials are needed to demonstrate this potential positive effect.

show abstract

Effect of Intensive Periodontal Therapy on Blood Pressure and Endothelial Microparticles in Patients With Prehypertension and Periodontitis: A Randomized Controlled Trial

Abstract: To the best knowledge of the authors, the present study demonstrates for the first time that intensive periodontal intervention without any antihypertensive medication therapy may be an effective means to lower levels of BP and EMPs in patients with prehypertension with periodontitis.

Cited by 66 publications

References 52 publications

Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

Systemic inflammatory impact of periodontitis on cognitive impairment

Does Periodontal Treatment Help in Arterial Hypertension Control? A Systematic Review of Literature

Contact Info

Product

Resources

About