Volume 84, Issue 4S p. S85-S105
Article

Evidence that periodontal treatment improves biomarkers and CVD outcomes

Francesco D’Aiuto

Corresponding Author

Francesco D’Aiuto

Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK

Address:

Francesco D'Aiuto

Periodontology Unit

Department of Clinical Research

UCL Eastman Dental Institute

256 Gray's Inn Road

London WC1X 8LD

E-mail: [email protected].

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Marco Orlandi

Marco Orlandi

Periodontology Unit, Department of Clinical Research, UCL Eastman Dental Institute, London, UK

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John C. Gunsolley

John C. Gunsolley

Department of Periodontics, Virginia Commonwealth University School of, Dentistry, Richmond, VA, USA

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First published: 01 April 2013
Citations: 56

The proceedings of the workshop were jointly and simultaneously published in the Journal of Clinical Periodontology and Journal of Periodontology. www.joponline.org/doi/abs/10.1902/jop.2013.134007 http://onlinelibrary.wiley.com/doi/10.1111/jcpe.12061/abstract

Abstract

Aim: The aim of this review was to critically appraise the evidence on the impact of periodontal treatment of cardiovascular diseases (CVDs) biomarkers and outcomes. Methods: A systematic search was performed in Cinhal, Cochrane, Embase and Medline for relevant articles up to July 2012. Duplicate screening and reference hand searching were performed. Data were then summarized and evidence graded in tables.

Results: The search resulted in: (a) no evidence on the effects of periodontal therapy on subclinical atherosclerosis, serum levels of CD40 ligand, serum amyloid A and monocyte chemoattractant protein-1, (b) limited evidence on the effects of periodontal therapy on arterial blood pressure, leucocyte counts, fibrinogen, tissue necrosis factor-a, sE-selectin, von Willebrand factors, d-dimers, matrix metalloproteinases, oxidative stress and CVD events, and (c) moderate evidence suggesting a negligible effect of periodontal therapy in reducing interleukin-6 and lipids levels, whilst a positive effect in reducing serum C-reactive protein levels and improving endothelial function.

Conclusions: Periodontal therapy triggers a short-term inflammatory response followed by (a) a progressive and consistent reduction of systemic inflammation and (b) an improvement in endothelial function. There is however limited evidence that these acute and chronic changes will either increase or reduce CVD burden of individuals suffering from periodontitis in the long term.