Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis

The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events. OBJECTIVE: The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis. MATERIAL AND METHODS: A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis. RESULTS: The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311). CONCLUSIONS: The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein.

Avaliação dos níveis de lipídeos séricos HDL e lDL em pacientes periodontais / Evaluattion of HDL and LDL serum levels in patients with periodontal disease

Estudos apontam uma possível associação entre a existência de bolsas periodontais e níveis lipídicos no plasma.Estes achados são consistentes com as evidências emergentes sobre a relação entre as várias condições orais e a saúde sistêmica. Esta pesquisa realizou uma análise transversal comparando os níveis de lipoproteína de alta densidade(HDL) e lipoproteína de baixa densidade (LDL) em pacientes periodontais. Realizou-se exame clínico periodontal em 124 pacientes, de ambos os sexos, com faixa etária entre 30 e 60 anos. No momento do exame periodontal as amostras de sangue foram coletadas e encaminhadas imediatamente para exames laboratoriais do LDL e HDL. A análise da razão de prevalência constatou relação estatisticamente significante entre os níveis elevados de colesterol total e de LDL e a baixa escolaridade assim como a faixa etária mais elevada. Verificou uma prevalência maior de indivíduos com altos níveis de colesterol e LDL, porém isto não foi estatisticamente significante. Portanto,dentro das limitações do presente estudo pode-se concluir que, na população estudada, o perfil lipídico dos indivíduos não está associado ao diagnóstico de periodontite.

Studies show a strong association between the presence of periodontal pockets and plasma’s lipid levels. Thesefindings are consistent with the emerging evidence on the relationship between the various oral conditions and systemic health. This research aims to carry out an analysis comparing HDL and LDL cholesterol levels in patients with and without periodontal disease. There was clinical periodontal examination on 124 patients of both sexes, aged between 30 and 60 years. When the examination is collected samples of blood which were immediately referred for laboratory tests of LDL and HDL in the same laboratory. There was no statistically significant association between periodontitis and high lipid levels. Therefore, within the limitations of this study may conclude that in the population studied the lipid profile of individuals is not linked to the diagnosis of periodontitis.