title: Severe chronic periodontitis is associated with endothelial and microvascular dysfunctions: a pilot study.
abstract: BACKGROUND
  Periodontitis is an inflammatory chronic disease that has been implicated as a risk factor for cardiovascular disease (CVD). Endothelium has a central role in CVD pathogenesis, and chronic inflammation can make it dysfunctional, contributing to CVD emergence. Thus, the aim of this study is to investigate the existence of an association between severe chronic periodontitis (CP) and nailfold microvascular, gingival microvascular, and endothelial functions.
  
  
  METHODS
  Twenty-three patients were included, 13 with severe periodontitis (median age, 46 years; interquartile range, 9.5 years) and 10 healthy control patients (median age, 35.5 years; interquartile range, 12.5 years). Clinical and laboratorial variables were gathered, and patients were examined by the following: 1) nailfold videocapillaroscopy to assess functional capillary density (FCD), capillary diameters, red blood cell velocity at rest (RBCV) and after 1-minute arterial occlusion (RBCVmax), and time taken to reach RBCVmax (TRBCVmax); 2) side-stream dark-field imaging to determine gingival capillary density (GCD); and 3) venous occlusion plethysmography to assess endothelium-dependent (% Hyper) and endothelium-independent vasodilatation (% Nitro).
  
  
  RESULTS
  Patients with CP have smaller values for FCD, RBCV, RBCVmax, and % Hyper and higher values for TRBCVmax and GCD compared with controls (P <0.05). There were significant correlations between periodontal parameters with FCD, RBCV, RBCVmax, TRBCVmax, GCD, and % Hyper. There was also a negative correlation between FCD and GCD (r = -0.7; P <0.01). Associations between periodontitis and FCD, RBCVmax, TRBCVmax, GCD, and % Hyper remained significant after adjustments for age and systolic blood pressure.
  
  
  CONCLUSIONS
  Severe CP was directly associated with endothelial and microvascular dysfunctions.
authors.affiliation: Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Lira-Junior
authors.forename: Carlos Marcelo
authors.initials: CM
authors.lastname: Figueredo
authors.forename: Eliete
authors.initials: E
authors.lastname: Bouskela
authors.forename: Ricardo Guimarães
authors.initials: RG
authors.lastname: Fischer
mesh_terms: D000328:Adult; D000367:Age Factors; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D055113:Chronic Periodontitis / Q000150:complications*; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000473:pathology*; D004912:Erythrocytes / Q000502:physiology; D005260:Female; D005881:Gingiva / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D008297:Male; D020678:Microscopic Angioscopy / Q000379:methods; D018715:Microscopy, Video; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D009262:Nails / Q000098:blood supply; D010865:Pilot Projects; D010991:Plethysmography / Q000379:methods; D014652:Vascular Diseases / Q000150:complications*; D014664:Vasodilation / Q000502:physiology; D014741:Video Recording / Q000379:methods
keywords: Capillaries; cardiovascular diseases; microcirculation; periodontitis; vasodilation