title: Experimental gingivitis induces systemic inflammatory markers in young healthy individuals: a single-subject interventional study.
abstract: OBJECTIVE
  We here investigated whether experimental gingivitis enhances systemic markers of inflammation which are also known as surrogate markers of atherosclerotic plaque development.
  
  
  BACKGROUND
  Gingivitis is a low-level oral infection induced by bacterial deposits with a high prevalence within Western populations. A potential link between the more severe oral disease periodontitis and cardiovascular disease has already been shown.
  
  
  METHODS
  37 non-smoking young volunteers with no inflammatory disease or any cardiovascular risk factors participated in this single-subject interventional study with an intra-individual control. Intentionally experimental oral inflammation was induced by the interruption of oral hygiene for 21 days, followed by a 21-days resolving phase after reinitiation of oral hygiene. Primary outcome measures at baseline, day 21 and 42 were concentrations of hsCRP, IL-6, and MCP-1, as well as adhesion capacity and oxLDL uptake of isolated blood monocytes.
  
  
  RESULTS
  The partial cessation of oral hygiene procedures was followed by the significant increase of gingival bleeding (34.0%, P<0.0001). This local inflammation was associated with a systemic increase in hsCRP (0.24 mg/L, P = 0.038), IL-6 (12.52 ng/L, P = 0.0002) and MCP-1 (9.10 ng/l, P = 0.124) in peripheral blood samples between baseline and day 21, which decreased at day 42. Monocytes showed an enhanced adherence to endothelial cells and increased foam cell formation after oxLDL uptake (P<0.050) at day 21 of gingivitis.
  
  
  CONCLUSIONS
  Bacterial-induced gingival low-level inflammation induced a systemic increase in inflammatory markers. Dental hygiene almost completely reversed this experimental inflammatory process, suggesting that appropriate dental prophylaxis may also limit systemic markers of inflammation in subjects with natural gingivitis. International Clinical Trials Register Platform of the World Health Organization, registry number: DRKS00003366, URL: http://apps.who.int/trialsearch/Default.aspx.
authors: Department of Prosthetic Dentistry and Biomaterials Science, Hannover Medical School, Hannover, Germany. eberhard.joerg@mh-hannover.de
authors: Jörg
authors: J
authors: Eberhard
authors: Karsten
authors: K
authors: Grote
authors: Maren
authors: M
authors: Luchtefeld
authors: Wieland
authors: W
authors: Heuer
authors: Harald
authors: H
authors: Schuett
authors: Dimitar
authors: D
authors: Divchev
authors: Ralph
authors: R
authors: Scherer
authors: Ruth
authors: R
authors: Schmitz-Streit
authors: Daniela
authors: D
authors: Langfeldt
authors: Nico
authors: N
authors: Stumpp
authors: Ingmar
authors: I
authors: Staufenbiel
authors: Bernhard
authors: B
authors: Schieffer
authors: Meike
authors: M
authors: Stiesch
mesh_terms: D000328:Adult; D001483:Base Sequence; D015415:Biomarkers / Q000097:blood*; D002478:Cells, Cultured; D017931:DNA Primers; D003773:Dental Plaque / Q000382:microbiology; D005260:Female; D005891:Gingivitis / Q000097:blood / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology*; D008297:Male; D016133:Polymerase Chain Reaction; D012016:Reference Values; D055815:Young Adult
chemical_list: D015415:Biomarkers; D017931:DNA Primers