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Article: Treatment of periodontitis and endothelial function

TitleTreatment of periodontitis and endothelial function
Authors
Issue Date2007
Citation
New England Journal of Medicine, 2007, v. 356, n. 9, p. 911-920 How to Cite?
AbstractBackground: Systemic inflammation may impair vascular function, and epidemiologic data suggest a possible link between periodontitis and cardiovascular disease. Methods: We randomly assigned 120 patients with severe periodontitis to community-based periodontal care (59 patients) or intensive periodontal treatment (61). Endothelial function, as assessed by measurement of the diameter of the brachial artery during flow (flow-mediated dilatation), and inflammatory biomarkers and markers of coagulation and endothelial activation were evaluated before treatment and 1, 7, 30, 60, and 180 days after treatment. Results: Twenty-four hours after treatment, flow-mediated dilatation was significantly lower in the intensive-treatment group than in the control-treatment group (absolute difference, 1.4%; 95% confidence interval [CI], 0.5 to 2.3; P=0.002), and levels of C-reactive protein, interleukin-6, and the endothelial-activation markers soluble E-selectin and von Willebrand factor were significantly higher (P<0.05 for all comparisons). However, flow-mediated dilatation was greater and the plasma levels of soluble E-selectin were lower in the intensive-treatment group than in the control-treatment group 60 days after therapy (absolute difference in flow-mediated dilatation, 0.9%; 95% CI, 0.1 to 1.7; P=0.02) and 180 days after therapy (difference, 2.0%; 95% CI, 1.2 to 2.8; P<0.001). The degree of improvement was associated with improvement in measures of periodontal disease (r=0.29 by Spearman rank correlation, P=0.003). There were no serious adverse effects in either of the two groups, and no cardiovascular events occurred. Conclusions: Intensive periodontal treatment resulted in acute, short-term systemic inflammation and endothelial dysfunction. However, 6 months after therapy, the benefits in oral health were associated with improvement in endothelial function. Copyright © 2007 Massachusetts Medical Society.
Persistent Identifierhttp://hdl.handle.net/10722/230774
ISSN
2015 Impact Factor: 59.558
2015 SCImago Journal Rankings: 14.619

 

DC FieldValueLanguage
dc.contributor.authorTonetti, Maurizio S.-
dc.contributor.authorD&apos;Aiuto, Francesco-
dc.contributor.authorNibali, Luigi-
dc.contributor.authorDonald, Ann-
dc.contributor.authorStorry, Clare-
dc.contributor.authorParkar, Mohamed-
dc.contributor.authorSuvan, Jean-
dc.contributor.authorHingorani, Aroon D.-
dc.contributor.authorVallance, Patrick-
dc.contributor.authorDeanfield, John-
dc.date.accessioned2016-09-01T06:06:46Z-
dc.date.available2016-09-01T06:06:46Z-
dc.date.issued2007-
dc.identifier.citationNew England Journal of Medicine, 2007, v. 356, n. 9, p. 911-920-
dc.identifier.issn0028-4793-
dc.identifier.urihttp://hdl.handle.net/10722/230774-
dc.description.abstractBackground: Systemic inflammation may impair vascular function, and epidemiologic data suggest a possible link between periodontitis and cardiovascular disease. Methods: We randomly assigned 120 patients with severe periodontitis to community-based periodontal care (59 patients) or intensive periodontal treatment (61). Endothelial function, as assessed by measurement of the diameter of the brachial artery during flow (flow-mediated dilatation), and inflammatory biomarkers and markers of coagulation and endothelial activation were evaluated before treatment and 1, 7, 30, 60, and 180 days after treatment. Results: Twenty-four hours after treatment, flow-mediated dilatation was significantly lower in the intensive-treatment group than in the control-treatment group (absolute difference, 1.4%; 95% confidence interval [CI], 0.5 to 2.3; P=0.002), and levels of C-reactive protein, interleukin-6, and the endothelial-activation markers soluble E-selectin and von Willebrand factor were significantly higher (P<0.05 for all comparisons). However, flow-mediated dilatation was greater and the plasma levels of soluble E-selectin were lower in the intensive-treatment group than in the control-treatment group 60 days after therapy (absolute difference in flow-mediated dilatation, 0.9%; 95% CI, 0.1 to 1.7; P=0.02) and 180 days after therapy (difference, 2.0%; 95% CI, 1.2 to 2.8; P<0.001). The degree of improvement was associated with improvement in measures of periodontal disease (r=0.29 by Spearman rank correlation, P=0.003). There were no serious adverse effects in either of the two groups, and no cardiovascular events occurred. Conclusions: Intensive periodontal treatment resulted in acute, short-term systemic inflammation and endothelial dysfunction. However, 6 months after therapy, the benefits in oral health were associated with improvement in endothelial function. Copyright © 2007 Massachusetts Medical Society.-
dc.languageeng-
dc.relation.ispartofNew England Journal of Medicine-
dc.titleTreatment of periodontitis and endothelial function-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1056/NEJMoa063186-
dc.identifier.pmid17329698-
dc.identifier.scopuseid_2-s2.0-33847346939-
dc.identifier.volume356-
dc.identifier.issue9-
dc.identifier.spage911-
dc.identifier.epage920-
dc.identifier.eissn1533-4406-

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