ABSTRACT
PURPOSE: To evaluate the role of improvement in inflammatory oxidative stress by periodontal therapy (NSPT) in chronic kidney disease (CKD) subjects. METHODS: 50 stable subjects of CKD (stage III-IV) and having chronic periodontitis were enrolled for the present study. Group A (control group) subjects who did not receive NSPT and Group B (test group) subjects who received NSPT. Oral hygiene instructions were given to both groups, malondialdehyde (MDA) in gingival crevicular fluid (GCF) and serum, albumin creatinine ratio (ACR), urine protein creatinine ratio (UPCR), pocket depth (PD), clinical attachment loss (CAL), plaque index (PI), gingival index (GI), Interleukin 1-beta (IL-1ß), high sensitivity C-reactive protein (hs-CRP) in serum were assessed at baseline and 6 months. RESULTS: There was a significant difference observed in PD, CAL, PI, GI and MDA-GCF, hs-CRP, IL-1ß in serum following NSPT in the test group compared to the control group at 6 months follow up. Within the limitations of the study, the results revealed that NSPT can be used as an effective method to reduce inflammatory oxidative stress in CKD subjects and improve renal health. Further well-designed longitudinal trials with larger sample size and longer follow ups are needed. CLINICAL SIGNIFICANCE: The non-surgical periodontal intervention showed statistically significant improvement on oxidative and inflammatory stress markers in gingival crevicular fluid and serum in subjects suffering from chronic kidney disease which suggests that periodontal treatment may be beneficial for these subjects.
Subject(s)
Chronic Periodontitis , Renal Insufficiency, Chronic , Humans , C-Reactive Protein/analysis , C-Reactive Protein/therapeutic use , Creatinine/therapeutic use , Chronic Periodontitis/therapy , Gingival Crevicular Fluid/chemistry , Renal Insufficiency, Chronic/therapy , Oxidative Stress , Periodontal Attachment Loss/drug therapyABSTRACT
OBJECTIVE: The objective of the study was to assess the effect of non-surgical periodontal therapy (NSPT) on the levels of anti-inflammatory cytokine interleukin 10 (IL-10) in serum, gingival crevicular fluid (GCF), and saliva of chronic periodontitis patients. METHODS: A comprehensive search was made on PubMed, Embase, and Scopus databases from Jan 2000 to Sep 2020. Three focused questions were addressed: Do GCF, serum, saliva and IL-10 levels change significantly after NSPT? Randomized and Non-Randomized clinical trials were included in the study. Results of the meta-analysis are expressed as standardized mean differences and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RESULTS: A total of 709 studies were retrieved and 17 met the inclusion criteria for systematic review, whereas subgroup meta-analysis was performed on seven studies (GCF-5, serum-2). All studies included had low risk of bias. IL-10levelin GCF showed an increase at 3 months after NSPT with subsequent decrease at 6 months. However, increased serum IL-10 level at 6 months was seen after therapy. CONCLUSION: Within the limitations, there is moderate evidence that NSPT significantly alters the IL-10 levels in body fluids. IL-10 levels increased in GCF at 3 months whereas decrease was seen at 6 months. Increased IL-10 levels were seen in serum at 6 months.
