Evaluation of nonsurgical periodontal therapy in chronic periodontitis patients with anemia by estimating hematological parameters and high-sensitivity C-reactive protein levels

Abstract

Background:Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high‑sensitivity C‑reactive protein (hs‑CRP) and can depress erythropoietin production leading to the development of anemia.Aim:The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia.Materials and Methods:This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy.Results:The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes associated with chronic periodontal disease.Conclusion:The present study strengthens the hypothesis that chronic periodontitis may lead to anemia and provides evidence that nonsurgical periodontal therapy can improve the anemic status and reduce levels of hs-CRP in patients with chronic periodontitis.

Evaluation of the association between the number of natural teeth and anemia among Korean adults using nationally representative data

“…The association between anemia and tooth loss may be explained by the following. In a previous study, the change in red cell parameters in participants with chronic periodontal disease may be due to hemoglobulin level chronic inflammatory changes . Similarly, the values of gingival inflammation and the hemoglobulin level were statistically significant between the periodontally healthy and periodontally diseased individuals .…”

Endodontic infections increase leukocyte and lymphocyte levels in the blood

“…Similar study in humans would not be ideal owing to the variability of samples, which could put the results into question. In addition, blood count is an extremely reliable test and has been used in several medical evaluations and scientific studies [13,18,19]. For those reasons, we found it prudent to use blood count in rats to confirm the hypothesis that infection of endodontic origin may influence systemic health.…”

“…The blood count is a highly reliable test and has been used for blood evaluation in several studies [13,18,19]. It is possible to evaluate several blood parameters such as the levels of erythrocytes, leukocytes, neutrophils, and lymphocytes.…”

Características de la enfermedad periodontal en pacientes anémicos y no anémicos

“…incrementa los valores sanguíneos de elementos figurados (eritrocitos + hemoglobina) en dichos pacientes. 1,13,24 Rodak B et al, 25 establecieron en su estudio que el número de eritrocitos y hemoglobina son significativamente bajos en pacientes que padecen periodontitis en comparación a los sanos. Kolte et al 26 también establecen una relación positiva a la disminución del recuento eritrocitario y la progresión de la enfermedad periodontal.…”

“…La enfermedad periodontal es un proceso inflamatorio del periodonto de protección e inserción, producida por cerca de 400 patógenos específicos que provocan tanto una destrucción a nivel del ligamento periodontal como del hueso alveolar, y en consecuencia produce una bolsa periodontal o recesión de la encía. [1][2] Las bacterias gramnegativas y sus productos, como los lipopolisacáridos acceden por el epitelio del surco, el cual se encuentra inflamado y ulcerado, e ingresan a la circulación. [3][4][5][6][7] En efecto, crean una leve inflamación sistémica, que se manifiesta en los cambios de los componentes de la sangre.…”