Systemic inflammation following non-surgical and surgical periodontal therapy.
OBJECTIVE
To describe the kinetics of serum inflammatory markers after a course of treatment comprising surgical and non-surgical treatment of chronic periodontitis (CP).


METHODS
Fourteen CP cases received full-mouth non-surgical treatment and, after 6 months, at least two surgical sessions. Blood samples were collected at various time-points after treatment. Blood markers of systemic inflammation/coagulation including leucocyte counts, C-reactive protein (CRP), serum amyloid-A (SAA) and D-dimers and renal function (cystatin C) were determined using high-sensitivity assays.


RESULTS
Periodontal treatment resulted in substantial reductions of the number of pockets, gingival bleeding and plaque at 3 and 6 months after non-surgical therapy (p<0.001). Surgical therapy led to an additional reduction of periodontal pockets (p<0.01). Marked increases in the serum levels of CRP and SAA were noted 24 h after non-surgical therapy (p<0.01) and periodontal surgeries (p<0.05). D-dimer levels increased drastically 24 h after non-surgical therapy (p<0.05). The drastic increase of CRP after non-surgical therapy was greater than both the surgical therapy sessions (p<0.05).


CONCLUSIONS
Patients undergoing periodontal treatment experience perturbations of systemic inflammation of a greater magnitude after non-surgical than surgical periodontal therapy.
Graziani
Filippo
F
Department of Surgery, Unit of Dentistry and Oral Surgery, University of Pisa, Pisa, Italy. f.graziani@med.unipi.it
Cei
Silvia
S
Tonetti
Maurizio
M
Paolantonio
Michele
M
Serio
Rossella
R
Sammartino
Gilberto
G
Gabriele
Mario
M
D'Aiuto
Francesco
F
D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000097:blood / Q000601:surgery / Q000628:therapy*; D015331:Cohort Studies; D055316:Cystatin C / Q000097:blood; D003773:Dental Plaque / Q000517:prevention & control; D012534:Dental Scaling; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery / Q000628:therapy; D005889:Gingival Recession / Q000601:surgery / Q000628:therapy; D006801:Humans; D007249:Inflammation; D018836:Inflammation Mediators / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery / Q000628:therapy; D010514:Periodontal Pocket / Q000601:surgery / Q000628:therapy; D016745:Root Planing; D000685:Serum Amyloid A Protein / Q000032:analysis; D013997:Time Factors
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D005338:Fibrin Fibrinogen Degradation Products; D018836:Inflammation Mediators; D000685:Serum Amyloid A Protein; C036309:fibrin fragment D; D002097:C-Reactive Protein