Effects of Periodontal Treatment on CRP and Other Cellular Markers in Blood
DOI:
https://doi.org/10.15517/ijds.2024.62839Keywords:
Periodontitis; Cardiovascular disease; Atherosclerosis; Inflammation; C-reactive protein.Abstract
Periodontitis is a chronic inflammatory disease that affects public health worldwide. It has been related to microorganisms that trigger an inflammatory response that, in turn, produces a deterioration of the teeth’s supporting tissue. In recent years, studies have shown some similarity and association between periodontitis and atherosclerotic cardiovascular disease. The serum increases in C-reactive protein (CRP), fibrinogen, alpha-1 antitrypsin, moderate increase in leukocytes, increase in sedimentation rate and Von Willebrand factor antigen make it likely that there is a relationship between periodontal disease and other systemic conditions, specifically atherosclerotic disease. This study seeks to establish if there is any relationship between these values after phase II periodontal treatment in patients with periodontitis at the Faculty of Dentistry of the University of Costa Rica. The initial values are found in a previous publication (1). In this second stage, the sample was reduced to 14 patients, of whom 57% presented metabolic compromise such as rheumatoid arthritis, arterial hypertension and diabetes mellitus, and 50% decreased PCR levels. As for the mean level of the total sample, in both stages of the study, PCR increased from 2.72 (SD: 2.25) to 5.36 (SD: 9.68). Of the patients who received periodontal treatment, 21.4% had low PCR levels (<1 mg/L), 50% medium (1-3 mg/L) and 28.6% high (>3 mg/L). There was no statistically significant difference in any of the variables analyzed for cholesterol, triglycerides and fibrinogen. Of the total number of patients in whom carotid ultrasound was performed, 52.4% were diagnosed as healthy, 33.3% had bulbar myointimal hyperplasia and 14.3% had atheromatous plaques. One of the participants died of myocardial infarction. This study does not conclude that there is a relationship between periodontal disease and cellular markers, which are also found in atheromatous disease, but it can be affirmed that there is a probability that periodontal disease contributes to affect the metabolic condition of the patient.
Downloads
References
Rojas G., Silva S. Is C Reactive Protein a Risk Indicator for Periodontal Disease? Odovtos International Journal of Dental Science. 2021; 2 (23): 171-180.
Abdulkareem A., Al-Taweel F., Al-Sharqi A.J.B., Gul S., Sha A., Chapple I. Current concepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis. Journal of Oral Microbiology, 2023; 15 (1): DOI: https://doi.org/10.1080/20002297.2023.2197779
Listgarten M.A. Pathogenesis of periodontitis. J Clin Periodontol. 1986; 13 (5): 418-30. DOI: https://doi.org/10.1111/j.1600-051X.1986.tb01485.x
Gasner N.S., Schure R.S. Periodontal Disease. In NCBI Bookshelf. 2 Treasure Island: StatPearls Publishing. 2023; 1-12.
Liccardo D., Cannavo A., Spagnuolo G., Ferrara N., Cittadini A., Rengo C., Rengo G. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int J Mol Sci. 2019; 20 (6): 1414. DOI: https://doi.org/10.3390/ijms20061414
Kinane D., Stathopoulou P., Papapanou P. Periodontal Diseases. Nat Rev dis Primers. 2017; 22 (3): 17038. DOI: https://doi.org/10.1038/nrdp.2017.38
Zardawi F., Gul S., Abdulkareem A., Sha A., Yates J. Association Between Periodontal Disease and Atherosclerotic cardiovascular Disease: revisted. Frontiers in Cardiovascular Medicine. 2021; 7: 625579. DOI: https://doi.org/10.3389/fcvm.2020.625579
Genco R. J., Borgnakke W. S. Risk factor for periodontal disease. Periodontol 2000. 2013; 62 (1): 59-94. DOI: https://doi.org/10.1111/j.1600-0757.2012.00457.x
Haffajee A. D., Socransky S. S. Relation of body mass index, periodontitis and tannerella forsythia. J Clin Periodontol. 2009; 36 (2): 89-99. DOI: https://doi.org/10.1111/j.1600-051X.2008.01356.x
Premoli G., Villareal J., González A. Proteína C reactiva y su relación con la enfermedad periodontal y la aterosclerosis [C-reactive protein and its relation to periodontal disease and atherosclerosis]. Acta Odontológica Venezolana. 2008; 46 (1): 92-93.
Cacko A., Kondracka A., Gawalko M., Glowczynska R., Filipiak K. J., Bartoszewicz Z. et al. Novel biochemical predictors of unfavorable prognosis for stable coronary disease. Medicine. 2018; 97 (37): e12372. DOI: https://doi.org/10.1097/MD.0000000000012372
Tonetti M. S., Van Dyke T. E. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP workshop on Periodontitis and Systemic Diseases. J Periodont. 2013; 84 (4): S24-9. DOI: https://doi.org/10.1902/jop.2013.1340019
Genco R., Offenbacker S., Beck J. Periodontal disease and cardiovascular disease: epidemiology and possible mechanisms. J Am Dent Assoc. 2002; (133): 14-22. DOI: https://doi.org/10.14219/jada.archive.2002.0375
Amezcua L., Springall R., Bojalil R. Proteína C reactiva: aspectos cardiovasculares de una proteína de fase aguda [C-reactive protein: cardiovascular aspects of an acute phase protein]. Arch Cardiol Mex. 2007; 77 (1): 58-66.
Roth G., Johnson C., Abajobir A., Abd-Allah F., Abera S. F., Abyu G., Ahmed M. et al. Global, regional and national burden of cardiovascular diseases for 10 causes 1999 to 2015. J Am Coll Cardio. 2017; 70 (1): 1-25. DOI: https://doi.org/10.1016/j.jacc.2017.04.052
Offenbacker S., Beck J.D. A perspective on the potential cardioprotective benefits of periodontal therapy. Am Heart J. 2005; 6 (149): 950-954 DOI: https://doi.org/10.1016/j.ahj.2005.01.046
Slots J. Focal infection of periodontal origin. Periodontol 2000. 2019; 1 (79): 233-235 DOI: https://doi.org/10.1111/prd.12258
Lao W., Araya H. Periodontal disease in Costa Rica year 2017. Odontología Vital. 2018; 29: 59-68.
Sánchez L. Enfermedades cardiovasculares son la primera causa de muerte en Costa Rica [Cardiovascular diseases are the leading cause of death in Costa Rica]. El Delfino. 2020 (20 set.). https://delfino.cr/2020/09/enfermedades-cardiovasculares-son-la-primera-causa-de-muerte-en-costa-rica
Leng Y., Hu Q., Ling Q., Yao X., Liu M., Chen J., Yan Z., Dai Q. Periodontal disease is associated with the risk of cardiovascular disease independent of sex: a meta-analysis. Front. Cardiovascular. Med. 2023; (10): 1114927. DOI: https://doi.org/10.3389/fcvm.2023.1114927
Machado V., Botelho J. Serum C-reactive protein and periodontitis: a systematic review and metaanalysis. Frontiers in Immunology. 2021; 1: 706432. DOI: https://doi.org/10.3389/fimmu.2021.706432
Ngamduk S., Mallawaarachchi I., Dunipace E., Chuang L. H., Jafri S., Shah N. et al. Association Between Periodontal Disease and Cardiovascular Disease (from the NHANES). American Journal of Cardiology. 2022; 1 (178): 163-168. DOI: https://doi.org/10.1016/j.amjcard.2022.05.028
Tajer D., Charask A. Género y enfermedad cardiovascular. Rev. Argentina de Cardiología [Gender and cardiovascular disease]. 2013; 81 (4): 295 DOI: https://doi.org/10.7775/rac.v81.i4.2908
Goff D.C. Jr., Lloyd-Jones D. M., Bennett G., Coady S., D’Agostino R., Gibbons R. et al. ACC/AHA Guideline on the assessment of cardiovascular risk: a report to the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am College Cardiology. 2014; 63 (25PtB): 2935-2959. DOI: https://doi.org/10.1016/j.jacc.2013.11.005
Haghgoo J. M., Gholami L., Taherpour O., Ebrahimi S. The evaluation of the effects of non-surgical periodontal treatment on blood parameters of hematocrit, RBCS, hemoglobin, CRP (C-reactive protein) and LDL/ULDL among patients with chronic periodontitis. Annals of Dental Specialty. 2018; 6 (2).
Freitas C., Luz de Aquino A., Costa de Lima K., da Fonte A. Proteína C reactiva ultrasensible en pacientes con y sin periodontitis crónica severa generalizada [Ultra-sensitive C-reactive protein in patients with and without severe chronic generalized periodontitis]. Av Periodon Implantol. 2009; 21 (3): 145-155. DOI: https://doi.org/10.4321/S1699-65852009000300004
Freitas C.O., Gomes-Filho I.S., Naves R.C., Nogueira G.R., Cruz S.S., Santos C.A. et al. Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis. J Appl Oral Sci, October. 2010; 20 (1): 1-8. DOI: https://doi.org/10.1590/S1678-77572012000100002
Ebersole J.L., Machen R.L., Steffen M.J., Willmann D.E., et al. Sistemic acute-phase reactants, C reactive protein and haptoglobin in adult periodontitis. Clin Exp Inmunol 1997; 107 (2): 347-52. DOI: https://doi.org/10.1111/j.1365-2249.1997.270-ce1162.x
Slade G.D., Offenbacher S., Beck J.D., Heiss G., Pankow J.S. et al. Acute-phase inflamatory response to periodontal disease in the US population. J Dent Res. 2000; 79 (1): 49-57. DOI: https://doi.org/10.1177/00220345000790010701
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Gisella Rojas González
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:
BY: credit must be given to the creator.
NC: Only noncommercial uses of the work are permitted.
SA: Adaptations must be shared under the same terms.
