Background Chronic periodontal infection is associated with an increased
risk of coronary heart disease. Although the mechanism responsible for
the relationship between periodontal disease and cardiovascular events
is not fully understood, it is hypothesized that the chronic
inflammatory burden of periodontal disease may lead to impaired
functioning of the vascular endothelium.
Methods Twenty-two otherwise healthy adults with moderate to severe
periodontitis who underwent complete mouth disinfection were evaluated
to determine if periodontal therapy would result in improved endothelial
function and a decrease in serum inflammatory markers. Subjects had
measurements of periodontal disease severity, flow-mediated
(endothelium-dependent), and nitroglycerin-mediated
(endothelium-independent) dilation of the brachial artery, serum
C-reactive protein (CRP) and interleukin 6 (IL-6), and serum total and
high-density lipoprotein cholesterol levels on 2 baseline visits
separated by 1 month and, again, 1 month after treatment.
Results There were no significant changes in clinical periodontal
measures, flow-mediated dilation, nitroglycerin-mediated dilation, CRP,
IL-6, total cholesterol, or high-density lipoprotein cholesterol between
the repeated baseline measurements. Periodontal treatment, however,
resulted in significant improvements in periodontal pocketing,
flow-mediated dilation, and serum IL-6, as well as a trend toward
reduction in serum CRP; there were no significant changes in
nitroglycerin-mediated dilation or in cholesterol levels.
Conclusions These results represent proof of concept that improvement in
endothelial function, as measured by flow-mediated dilation of the
brachial artery, may be possible through near-elimination of chronic
oral infection and suggest that the conduct of a larger controlled trial
is justified
