title: The effects of periodontal therapy on vascular endothelial function: a pilot trial.
abstract: BACKGROUND
  Chronic periodontal infection is associated with an increased risk of coronary heart disease. Although the mechanism responsible for the relationship between periodontal disease and cardiovascular events is not fully understood, it is hypothesized that the chronic inflammatory burden of periodontal disease may lead to impaired functioning of the vascular endothelium.
  
  
  METHODS
  Twenty-two otherwise healthy adults with moderate to severe periodontitis who underwent complete mouth disinfection were evaluated to determine if periodontal therapy would result in improved endothelial function and a decrease in serum inflammatory markers. Subjects had measurements of periodontal disease severity, flow-mediated (endothelium-dependent), and nitroglycerin-mediated (endothelium-independent) dilation of the brachial artery, serum C-reactive protein (CRP) and interleukin 6 (IL-6), and serum total and high-density lipoprotein cholesterol levels on 2 baseline visits separated by 1 month and, again, 1 month after treatment.
  
  
  RESULTS
  There were no significant changes in clinical periodontal measures, flow-mediated dilation, nitroglycerin-mediated dilation, CRP, IL-6, total cholesterol, or high-density lipoprotein cholesterol between the repeated baseline measurements. Periodontal treatment, however, resulted in significant improvements in periodontal pocketing, flow-mediated dilation, and serum IL-6, as well as a trend toward reduction in serum CRP; there were no significant changes in nitroglycerin-mediated dilation or in cholesterol levels.
  
  
  CONCLUSIONS
  These results represent proof of concept that improvement in endothelial function, as measured by flow-mediated dilation of the brachial artery, may be possible through near-elimination of chronic oral infection and suggest that the conduct of a larger controlled trial is justified.
authors.affiliation: SciMetrika, LLC, Research Triangle Park, NC, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Elter
authors.forename: Alan L
authors.initials: AL
authors.lastname: Hinderliter
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: James D
authors.initials: JD
authors.lastname: Beck
authors.forename: Melissa
authors.initials: M
authors.lastname: Caughey
authors.forename: Nadine
authors.initials: N
authors.lastname: Brodala
authors.forename: Phoebus N
authors.initials: PN
authors.lastname: Madianos
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis*; D002784:Cholesterol / Q000097:blood*; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000188:drug therapy*; D010865:Pilot Projects; D014664:Vasodilation
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein; D002784:Cholesterol