title: Effects of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a controlled clinical trial.
abstract: BACKGROUND
  The systemic inflammation in both metabolic syndrome (MetS) and periodontitis is a common denominator of the association of these conditions with higher risk of atherosclerosis. The current study investigates whether periodontal therapy may reduce systemic inflammation in patients with MetS and reduce cardiovascular risk.
  
  
  METHODS
  A parallel-arm, double-blind, randomized clinical trial of 1-year duration in patients with MetS and periodontitis was conducted. Participants were randomized to an experimental treatment group (ETG) (n = 82) that received plaque control and root planing plus amoxicillin and metronidazole or to a control treatment group (CTG) (n = 83) that received plaque control instructions, supragingival scaling, and two placebos. Risk factors for cardiovascular disease were recorded; serum lipoprotein cholesterol, glucose, body mass index (BMI), C-reactive protein (CRP) and fibrinogen concentrations, and clinical periodontal parameters were assessed at baseline and every 3 months until 12 months after therapy. The primary and secondary outcomes were changes in CRP and fibrinogen levels, respectively.
  
  
  RESULTS
  The baseline patients' characteristics of both groups were similar. No significant changes in lifestyle factors, frequency of hypertension, BMI, serum lipoprotein cholesterol, and glucose levels were observed during the study period. The periodontal parameters significantly improved in both groups 3 months after therapy (P = 0.0001) and remained lower than baseline up to 12 months. The improvement of periodontal status was significantly greater in the ETG (P = 0.0001). A multiple linear regression analysis, controlled for sex, smoking, hypertension, and extent of periodontitis, demonstrated that CRP levels decreased with time and that this reduction was significant at 9 (P = 0.024) and 12 (P = 0.001) months in both groups, without difference between the groups. Fibrinogen levels significantly decreased in the ETG at 6 and 12 months but not in the CTG.
  
  
  CONCLUSIONS
  Reduction of periodontal inflammation either with root planing and systemic antibiotics or with plaque control and subgingival scaling significantly reduces CRP levels after 9 months in patients with MetS.
authors: Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile. nlopez@interactiva.cl
authors: Néstor J
authors: NJ
authors: López
authors: Antonio
authors: A
authors: Quintero
authors: Patricia A
authors: PA
authors: Casanova
authors: Carola I
authors: CI
authors: Ibieta
authors: Vibeke
authors: V
authors: Baelum
authors: Rodrigo
authors: R
authors: López
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D002784:Cholesterol / Q000097:blood; D003773:Dental Plaque / Q000517:prevention & control; D012534:Dental Scaling; D004311:Double-Blind Method; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000097:blood; D010518:Periodontitis / Q000097:blood / Q000628:therapy*; D010919:Placebos; D012307:Risk Factors; D016745:Root Planing
chemical_list: D000900:Anti-Bacterial Agents; D015415:Biomarkers; D001786:Blood Glucose; D008074:Lipoproteins; D010919:Placebos; C030104:lipoprotein cholesterol; D008795:Metronidazole; D000658:Amoxicillin; D005340:Fibrinogen; D002097:C-Reactive Protein; D002784:Cholesterol