Ramirez JH, Arce R, Parra B, Bravo LE, Gutierrez SJ, Jaramillo A, Vivas J, Gonzalez V, Soto JE, Otalvaro A, Consuegra J, Contreras A. Periodontal therapy does not improve cardiovascular disease biomarkers: results of a randomized clinical trial. figshare 2014. http://dx.doi.org/10.6084/m9.figshare.1098548
The purpose of this interventional study (parallel, single blind, randomized controlled trial) was to assess the effect of periodontal therapy on biomarkers of cardiovascular disease in patients with chronic periodontitis.
Materials and methods
Subjects with chronic moderate to severe periodontitis were invited to participate in the study. Patients were randomized (stratified by gender/smoking status) to periodontal intervention therapy using the full mouth disinfection protocol (one-stage supragingival/subgingival plaque cleaning plus chlorhexidine 1%) or adult dental prophylaxis (supragingival plaque removal). Participants were monitored at baseline, 24 hours and 12 weeks after the assigned intervention. The primary outcome was the change of brachial artery endothelium-dependent flow mediated dilatation at 12-weeks post-therapy. Secondary outcomes included biochemical cardiovascular disease biomarkers (C-reactive protein, E-selectin, MPO, ICAM-1, VCAM-1, MMP-9, tPAI-1), lipid profile and white-cell count. Probing depth, clinical attachment loss, number of periodontal pockets and subgingival microbiota (determined by microbial culture and polymerase chain reaction) were used to diagnose disease severity and to evaluate the effectiveness of periodontal therapy.
Patients were randomized to dental prophylaxis (n=55) and periodontal intervention therapy (n=47). At 12 weeks of follow-up, forty-seven patients in the dental prophylaxis group and forty-one patients in the periodontal intervention therapy completed the study. Full mouth disinfection compared to dental prophylaxis group did not result in significant changes on endothelial dependent flow-mediated dilatation and cardiovascular disease biomarkers at 12 weeks post-treatment. Even though clinical periodontal and microbiological parameters were improved.
Non-surgical periodontal treatment of moderate to severe chronic periodontitis with the full mouth disinfection protocol did not improve endothelial function and other inflammatory biomarkers of cardiovascular disease.
ClinicalTrials.gov Identifier: NCT00681564