title: A bidirectional relationship of oral-systemic responses: observations of systemic host responses in patients after full-mouth extractions.
abstract: OBJECTIVE
  This investigation tested the hypothesis that systemic inflammatory responses would be attenuated by minimizing the oral microbial burden in patients with moderate to severe periodontitis.
  
  
  METHODS
  Patients (n = 73) scheduled for full-mouth extractions were categorized as case type I/II (gingivitis/mild periodontitis) or case type III/IV (moderate/severe periodontitis). Serum levels of acute phase proteins (APPs) and immunoglobulin G (IgG) antibody were assessed at baseline and through 1 year after extraction.
  
  
  RESULTS
  At baseline, the levels of multiple APPs (e.g., fibrinogen, C-reactive protein) and antibodies to periodontal pathogens were significantly higher with case type III/IV vs I/II. These differences were sustained 12 months after extractions for most APPs.
  
  
  CONCLUSIONS
  The results demonstrated that removal of disease by full-mouth extraction of teeth altered the overall burden of challenge to the host. Continued elevation in various APPs in the III/IV group suggested a potential underlying constitutive difference in systemic response characteristics of this population.
authors.affiliation: Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, Lexington, KY, USA; Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA. Electronic address: llcunn2@email.uky.edu.
authors.forename: L L
authors.initials: LL
authors.lastname: Cunningham
authors.affiliation: Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Novak
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Louisville School of Dentistry, Louisville, KY, USA.
authors.forename: M
authors.initials: M
authors.lastname: Madsen
authors.affiliation: Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, KY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Abadi
authors.affiliation: Center for Oral Health Research, College of Dentistry, University of Kentucky, Lexington, KY, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Ebersole
mesh_terms: D000209:Acute-Phase Proteins / Q000378:metabolism; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*; D014081:Tooth Extraction
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; D007074:Immunoglobulin G