Improving Endothelial Function With Periodontal Disease Therapy

Dentistry Today


Endothelial dysfunction is only one part of the process that can lead to cardiovascular events. Studies show that periodontal bacteria are associated with an increased  thickness of the carotid intimamedia. While there is no causal relationship between periodontal disease and systemic health, there appears to be more evidence that an association fully exists. This study of 120 patients with severe periodontal disease evaluated the effects of scaling, root planing, antibiotic therapy, and extraction on endothelial dysfunction and biomarkers such as C-reactive protein (CRP) when compared with a control group. Patients were randomly separated based on risk factors such as smoking, systemic disease, and diabetes mellitus. After treatment, follow-up visits were scheduled at days 1, 7, 30, 60, and 180. Noted were the elevated levels of CRP at baseline, an indication of the severity of the chronic inflammation having systemic impact. The intensive periodontal treatment caused a short-term increase in systemic inflammation and endothelial dysfunction, immediately followed by improvements in periodontal health and endo-thelial function beginning at 2 months post-therapy and lasting through 6 months. Endothelial improvements correlated with improvement in periodontal disease state. Treatment of the control group with supragingival scaling and polishing did not improve either the disease state or systemic condition. This study confirms that periodontitis increases the risk for systemic inflammation and that intervention with aggressive therapy of scaling, root planing, antibiotic therapy, and extraction where necessary improve endothelial dysfunction and may also improve the prognosis of patients with existing atherosclerosis. 

(Source: Colgate White Papers, Volume 2, Number 2, 2007)