Effects of periodontal treatment on inflammation and oxidative stress markers in patients with metabolic syndrome.

BACKGROUND AND OBJECTIVE: Metabolic syndrome (MetS) is a combination of risk factors (e.g. impaired glucose tolerance, hypertension, and dyslipidaemia) that significantly contribute to the development of cardiovascular diseases. The aim of the study was to compare the effects of nonsurgical periodontal treatment (NSPT) on inflammatory and oxidative stress markers in individuals with MetS and systemically healthy (SH) who were chronic periodontitis (CP). MATERIAL AND METHODS: A total of 50 patients with chronic periodontitis (25 with MetS and 25 SH) were included. Clinical periodontal measurements were recorded, and serum and whole-saliva samples were collected from all patients at baseline, and 3 and 6 mo following NSPT. The levels of fasting plasma glucose, glycated haemoglobin (HbA1c), triglyceride (TRG), total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were analysed. The levels of high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6 and IL-10 were determined using ELISA kits, and total oxidant status (TOS), total antioxidant capacity (TAC) and oxidative stress index (OSI) levels were measured. RESULTS: After NSPT, significant and similar improvements of all periodontal parameters were observed in both groups compared with baseline measurements. There were decreases in the levels of serum hs-CRP and IL-6, whereas increases in serum IL-10 were found in both groups, at all time points. Serum TOS and OSI showed no significant change in either group at any time point. Compared with the SH group, serum TAC levels were higher in the MetS group at baseline but lower at the 3-mo time-point. There was no difference in TAC levels between the groups at 6 mo. Saliva IL-6 was higher in the MetS group than the SH group at all time points. The levels of IL-6 and OSI in saliva decreased following NSPT in both groups, whereas salivary TAC concentrations increased. In the MetS group, TRG and HbA1c levels decreased significantly at 3 mo. CONCLUSION: NSPT decreased oxidative stress and the inflammatory status of patients with MetS and chronic periodontitis. Although similar periodontal improvements were achieved in both groups, the decreases in levels of hs-CRP and IL-6 in the MetS group did not reach the levels in the SH group. Based on these results, NSPT could be more effective in the control of systemic inflammation in patients with MetS in the short-term.

Comparison of bone mineral density in the jaws of patients with and without chronic periodontitis.

OBJECTIVES: Although several studies have addressed the relationship between systemic bone mineral status and the severity of periodontitis, there is little knowledge of the relationship between periodontal disease and locally detected bone mineral density. The aim of this study was to compare the mandibular bone mineral density of patients with chronic periodontitis with that of periodontally healthy subjects. METHODS: 48 systemically healthy subjects were included in the study and underwent a periodontal examination to determine their status. 24 subjects were periodontally healthy and the other 24 had moderate or severe chronic periodontitis. The mandibular bone mineral density of the subjects was determined by dual energy X-ray absorptiometry. The region of interest on the body of the mandible was independently determined on the dual energy absorptiometry radiographs, and a computer calculated the bone mineral density of these regions. RESULTS: The mandibular bone mineral density of the subjects with periodontitis was significantly lower than that of the periodontally healthy subjects (p < 0.01). There were significant negative correlations between the mandibular bone mineral density values and parameters related to the amount of periodontal destruction. CONCLUSIONS: Low bone mineral density in the jaw may be associated with chronic periodontitis.