title: Periodontal Therapy Effects on Nitrite Related to Oral Bacteria: A 6-Month Randomized Clinical Trial.
abstract: BACKGROUND
  Nitrite is a biologic factor relevant to oral and systemic homeostasis. Through an oral bacteria reduction process, it was suggested that periodontal therapy and chlorhexidine (CHX) rinse could affect nitrite levels, leading to negative effects, such as an increase in blood pressure. This 6-month randomized clinical trial evaluated the effects of periodontal therapeutic protocols on salivary nitrite and its relation to subgingival bacteria.
  
  
  METHODS
  One hundred patients with periodontitis were allocated randomly to debridement procedures in four weekly sections (quadrant scaling [QS]) or within 24 hours (full-mouth scaling [FMS]) in conjunction with a 60-day CHX (QS + CHX and FMS + CHX), placebo (QS + placebo and FMS + placebo), or no mouthrinse (QS + none and FMS + none) use. Real-time polymerase chain reaction determined total bacterial, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Streptococcus oralis, and Actinomyces naeslundii levels. Salivary nitrite concentration was determined with Griess reagent. Data were analyzed statistically at baseline and 3 and 6 months by analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests (P <0.05).
  
  
  RESULTS
  Nitrite concentrations did not tend to change over time. Regarding CHX use, there was a negative correlation between nitrite and total bacterial load at 6 months (FMS + CHX) and one positive correlation between P. gingivalis and nitrite at baseline (QS + CHX). Independently of rinse type, in the FMS group, nitrite correlated negatively with several microbial parameters and also with a higher percentage of deep periodontal pockets.
  
  
  CONCLUSIONS
  The relationship between nitrite and bacterial levels appears weak. Short-term scaling exhibited a greater influence on nitrite concentrations then long-term CHX use.
authors: Nucleus of Periodontal Research, Dental School, University of Taubaté, Taubaté, São Paulo, Brazil.|Dental School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Sheila C
authors: SC
authors: Cortelli
authors: Periodontal Department, Dental School, Federal University of Minas Gerais.
authors: Fernando O
authors: FO
authors: Costa
authors: Biochemistry Department, Institute of Biosciences, University of Taubaté.
authors: Edson
authors: E
authors: Rodrigues
authors: Periodontal Department, Dental School, Federal University of Minas Gerais.
authors: Luis O M
authors: LO
authors: Cota
authors: Nucleus of Periodontal Research, Dental School, University of Taubaté, Taubaté, São Paulo, Brazil.
authors: Jose R
authors: JR
authors: Cortelli
mesh_terms: D000190:Actinomyces / Q000187:drug effects; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001419:Bacteria / Q000378:metabolism*; D058491:Bacterial Load / Q000187:drug effects; D002710:Chlorhexidine / Q000627:therapeutic use; D055113:Chronic Periodontitis / Q000628:therapy*; D012534:Dental Scaling / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009573:Nitrites / Q000032:analysis*; D057747:Periodontal Debridement / Q000379:methods; D010919:Placebos; D016966:Porphyromonas gingivalis / Q000187:drug effects; D012463:Saliva / Q000737:chemistry / Q000382:microbiology*; D019533:Streptococcus oralis / Q000187:drug effects; D000070436:Tannerella forsythia / Q000187:drug effects; D048373:Treponema denticola / Q000187:drug effects
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D009573:Nitrites; D010919:Placebos; D002710:Chlorhexidine
keywords: Bacteria; nitrites; periodontal diseases; randomized controlled trial; therapeutics