Effect of periodontal treatment on peak serum levels of inflammatory markers
Abstract
Background and objective
Some
subjects with untreated periodontitis exhibit elevated levels of
distinct inflammatory markers in serum. The aim of the study was to
assess whether nonsurgical periodontal therapy changes the levels of
these markers and lowers these peaks.
Methods
Forty
periodontally diseased subjects received nonsurgical periodontal
therapy (full-mouth scaling and root planing within 48 h) with either
adjunctive systemic amoxicillin and metronidazole (n = 19) or placebo (n
= 21). Serum samples, obtained at baseline (BL) and 3 months after
treatment (M3), were evaluated for 15 cytokines and 9 acute-phase
proteins using the Bio-Plex bead array multianalyte detection system.
For each analyte, peak values were defined as greater than the mean + 2
standard deviations (SD) of measurements found in 40 periodontally
healthy persons. Proportions were compared using Fisher’s exact test.
Results
At
M3, a significantly better primary clinical outcome (persisting pockets
of >4 mm with bleeding on probing) was obtained in patients treated
with scaling and root planing plus antibiotics compared to those
receiving placebo (3.3 ± 5.1 vs. 6.8 ± 7.8 pockets per patient, p
< 0.05). The levels of cytokines and acute-phase proteins of
periodontitis patients were usually below the mean + 2 SD threshold of
healthy persons. However, values above threshold were found in some
individuals. Eleven patients showed a peak value of one analyte, and
seven patients showed two peaks. In the remaining 12 patients, between
three and ten analytes showed peak values. Therapy greatly reduced the
number of subjects with four or more peaks (BL, 11 subjects; M3, 1
subject, p = 0.003). With regards to the reduction of peaks, no specific benefit of adjunctive antibiotics could be seen.
Conclusion
Subjects
with untreated periodontitis may show high peaks for several
inflammatory markers in serum simultaneously. Nonsurgical periodontal
treatment with or without antibiotics reduced most of these peak levels.
One-sentence summary
Nonsurgical
periodontal treatment with or without antibiotics reduced peak levels
of several inflammatory markers in serum of subjects with periodontitis.
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