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

Abstract

Aim: To determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. Materials and Methods: In this parallel-arm, double-blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive either intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg every day for 3 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 high-sensitivity C-reactive protein (hs-CRP) serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipid metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. Results: The intention-to-treat population consisted of 63 subjects randomly assigned to either the MPT (n = 31) or the IPT (n = 32) group. 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 cardiometabolic risk profiles were detected between the groups. Adjusting for baseline hs-CRP, sex, age, smoking status and body mass index, hs-CRP at 6 months was 1.2 mg/L (95% CI 0.4; 2.0; P = .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 compared with 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.

Association between periodontitis and severity of COVID‐19 infection: A case–control study

“…Successful treatment of periodontitis has been shown to improve serum markers of systemic inflammation (CRP, IL-6) (D'Aiuto et al, 2013), as well as systemic metabolic control (Montero et al, 2020).…”

“…Moreover, there is evidence that periodontal treatment leads to an improvement of glycaemic control in patients with type 2 diabetes (Teeuw et al, 2010), and metabolic syndrome (Montero et al, 2020), as well as improved renal function associated with diabetes (Chambrone et al, 2013). Periodontitis treatment also improves the balance of lipids and glucose metabolism (Teeuw et al, 2014), and biomarkers associated to atherosclerosis, such as serum CRP, IL-6, fibrinogen and IL-1 β levels (D'Aiuto et al, 2013;Tonetti et al, 2007).…”

The effect of bariatric surgery on periodontal health: systematic review and meta-analyses

“…This is of particular importance due to the recognized negative effects of periodontitis that extend beyond the oral cavity and include effects on cardiovascular diseases, diabetes mellitus and liver disease [33][34][35]. Furthermore, periodontal therapy has been shown to improve parameters of systemic inflammation [36], insulin resistance [37] and arterial blood pressure [38][39][40].…”

Periodontitis and Systemic Disorder—An Overview of Relation and Novel Treatment Modalities

“…Simultaneously, elevated CRP levels aggravate the inflammatory process at the atherosclerotic plaques in patients with periodontitis. In addition, the inflamed plaques are assumed to be unstable and prone to be ruptured, with increased chances of cardiovascular events [ 26 ].…”