title: Acute-phase response following full-mouth versus quadrant non-surgical periodontal treatment: A randomized clinical trial.
abstract: OBJECTIVE
  A moderate acute-phase response occurs 24-h following full-mouth non-surgical treatment (FM-SRP). The aim of this study was to compare acute-phase (24-h) and medium-term (3 months) inflammation after quadrant scaling (Q-SRP) versus FM-SRP.
  
  
  METHODS
  Thirty-eight periodontitis-affected subjects were randomly allocated to FM-SRP or Q-SRP after a baseline visit. Periodontal and anthropometric parameters were collected at baseline and 3 months. Serum samples were drawn at baseline, 1, 7, and 90 days after treatment. High-sensitivity assays of inflammation and endothelial assays were performed.
  
  
  RESULTS
  FM-SRP produced a greater acute-phase response after 24 h [threefold increase in C-reactive protein (CRP), twofold increase in interleukin (IL-6), and a slight increase in tumour necrosis factor]. No differences in systemic biomarkers were noted between groups at any later follow-ups. Both periodontal treatments produced a comparable improvement in clinical periodontal parameters with no between-group differences. Treatment time was positively associated with the relative 24-h increase in CRP (R = 0.5, p < 0.001) and IL-6 (R = 0.5, p = 0.002), while the number of deeper (>6 mm) pockets predicted only the relative increase in IL-6 (R = 0.4, p < 0.05).
  
  
  CONCLUSIONS
  FM-SRP triggers a moderate acute-phase response of 24 h duration compared to Q-SRP. Further research is needed to assess the eventual impact of such findings on the risk of vascular events is advocated. (ClinicalTrials.gov NCT01857804).
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Filippo
authors: http://orcid.org/0000-0001-8780-7306
authors: F
authors: Graziani
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Silvia
authors: S
authors: Cei
authors: Periodontology Unit, UCL Eastman Dental Institute, London, UK.
authors: Marco
authors: M
authors: Orlandi
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Stefano
authors: S
authors: Gennai
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Mario
authors: M
authors: Gabriele
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Natalia
authors: N
authors: Filice
authors: Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
authors: Marco
authors: M
authors: Nisi
authors: Periodontology Unit, UCL Eastman Dental Institute, London, UK.
authors: Francesco
authors: F
authors: D'Aiuto
mesh_terms: D000210:Acute-Phase Reaction / Q000209:etiology* / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D012534:Dental Scaling / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications / Q000628:therapy*; D011379:Prognosis; D016745:Root Planing / Q000009:adverse effects* / Q000379:methods
chemical_list: D015415:Biomarkers
keywords: C-reactive protein; full mouth; interleukin-6; quadrant; scaling and root planing