The effect of nonsurgical periodontal treatment on serum and saliva chitotriosidase activities in patients with periodontitis and coronary artery disease

Abstract

BackgroundPlasma chitotriosidase activity, which is a marker of macrophage activation, has been reported to increase in inflammatory conditions and atherosclerosis. Chronic periodontitis has likely an important role in the development of coronary artery disease. In this study, we aimed to analyze the effect of chronic periodontitis on salivary and plasma chitotriosidase activities in patients with or without coronary atherosclerosis.MethodsFifty subjects were divided into four groups as controls (n=13), periodontitis (n=11), coronary artery disease (n=13), and periodontitis + coronary artery disease (n=13). Plasma and saliva chitotriosidase activities were measured by a fluorimetric method in all groups before the nonsurgical treatment of periodontitis and 5 weeks posttreatment in periodontitis groups.ResultsSalivary chitotriosidase activity was decreased after nonsurgical periodontal treatment in patients having periodontitis with or without coronary atherosclerosis. However, plasma activities remained unchanged.ConclusionAlthough this study has some limitations like small sample size and short study duration, it can suggest that salivary chitotriosidase can have the potential to be used as a very useful and practical marker to evaluate the success of the periodontal treatment and/or host response.Key findingSalivary chitotriosidase can be used as a marker for the evaluation of the success of the periodontal treatment and/or host response.

Periodontal treatment on patients with cardiovascular disease: Systematic review and meta-analysis

“…The periodontal treatment performed in the studies reviewed consisted of mechanical debridement (n=390) ( 18 - 27 ) in all cases, complemented by oral hygiene instruction (OHI) in most of them ( 19 , 20 , 23 ). In other clinical trial periodontal pockets were reduced using a diamond bur (n=24) ( 22 ), and in another, antibiotic therapy was used in some cases depending on the intensity of the treatment applied (n=24) ( 18 ).…”

“…The criteria defining cardiovascular pathology differed from study to study. In some cases, patients with previous histories of cardiovascular events (n=94) ( 20 , 21 ) were included, in others, patients with obstruction over 50% or over 70% in at least one artery (n=43) ( 22 , 23 ), or both (n=477) ( 18 , 19 , 24 - 26 ). In one article, subjects had been diagnosed with coronary artery pathology, although this was not specified in detail (n=20) ( 27 ).…”

“…One work evaluated salivary and plasma chitotriosidase (enzyme produce by activated macrophages) and salivary proteins ( 22 ). After periodontal treatment, a significant reduction in the salivary enzyme was observed (n=24), put not in plasma or in the salivary proteins evaluated.…”

“…Also a meta-analysis was performed to analyze the mean differences of leukocytes between studies. Two studies ( 22 , 30 ) evaluated values of leukocytes before and after the administration of Oral hygiene instructions + Supragingival scaling + Root scaling and planning in the treatment group (n= 70) Vs. Oral hygiene instructions in the control group (n=60).…”

“…Nor was periodontal treatment seen to reduce plasma chitotriosidase or salivary proteins, although salivary chitotriosidase levels were reduced ( p =0.005) ( 22 ). Improvements in periodontal status could be associated with the reestablishment of some salivary parameters, which do not extend to systemic improvement.…”