Evidence that periodontal treatment improves biomarkers and CVD outcomes

Abstract

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.

Periodontal Disease and its Association with Angiographically Verified Coronary Artery Disease

“…Nekoliko je autora istraživalo je li potrebna rigorozna preventivna i parodontološka njega kako bi se smanjio kardiovaskularni rizik (26), popravili nalazi biomarkera i ishodi CVD-a (27) te utječe li parodontološka terapija pozitivno na smanjenje razine serumskoga C-reaktivnog proteina i na poboljšanje funkcije endotela (27,28). Prema tome, pravodobna dijagnoza parodontitisa u populaciji te ciljana terapija i održavanje, trebali bi biti najvažniji u smanjenju opasnosti od CHD-a.…”

“…Several authors have examined the possibility that rigorous preventive and periodontal care is needed to reduce the cardiovascular risk (26) as well as to improve biomarkers and CVD outcomes (27) and that periodontal therapy has a positive effect in reducing serum C-reactive protein levels and improving the endothelial function (27,28). Therefore, the diagnosis of periodontitis in population and its treatment and maintenance should be of utmost importance in order to reduce the risk for CHD.…”

Periodontal associations in cardiovascular diseases: The latest evidence and understanding

“…14 It is not unusual for patients to have a transient increase in systemic inflammatory mediators and a decrease in endothelial function following non-surgical periodontal treatment within a period of 1 month. 12 However, following this period, these levels will progressively decrease, showing a reduction in basal CRP levels by 6 months. 12 A meta-analysis done in 2012 of four most recent clinical intervention trials reports a 0.23 mg/L reduction (p < 0.0001) in CRP levels of patients with periodontitis 2-6 months post-periodontal therapy.…”

“…12 However, following this period, these levels will progressively decrease, showing a reduction in basal CRP levels by 6 months. 12 A meta-analysis done in 2012 of four most recent clinical intervention trials reports a 0.23 mg/L reduction (p < 0.0001) in CRP levels of patients with periodontitis 2-6 months post-periodontal therapy. 15 Furthermore, patients diagnosed with CVD showed a considerable reduction of CRP from 2.7 AE 1.9 to 1.8 AE 0.9 mg/L (p < 0.05) 6 months postperiodontal therapy.…”

“…CRP remains to be the established marker of CVD risk. 3,12,13 In absence of systemic inflammation, high sensitivity CRP level of 1 mg/L indicates a lower risk of CVD, while a level of 3 mg/L indicates an approximate doubling in CVD risk. 14 It is not unusual for patients to have a transient increase in systemic inflammatory mediators and a decrease in endothelial function following non-surgical periodontal treatment within a period of 1 month.…”