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Moderate elevation of serum C-reactive protein (CRP) is a risk factor for cardiovascular disease among apparently healthy individuals, although factors that create this inflammatory response in the absence of systemic illness have not been clarified. This study aimed to: (1) evaluate associations among periodontal disease, established risk factors...
Contexts in source publication
Context 1
... prevalence of edentulism was 9.6% (95% CI = 8.6-10.6%), and, among dentate people, the prevalence of extensive periodontal pocketing (> 10% of sites having pockets of 4+ mm) was of sites) compared with that in the group having no pockets, and there was a two-fold difference in prevalence of elevated CRP (Table 1-all persons). The mean and prevalence values for the group with intermediate extent of periodontal pockets (from 1 to 10% of sites) were very similar to those in the group with no pockets. ...
Context 2
... stratified analysis, the association between age- standardized CRP levels and extent of periodontal pockets generally persisted, although the magnitude of the association varied among strata (Table 1). For example, there were larger differences in CRP levels between periodontal pocket groups in males (four-fold difference in prevalence) compared with females (two-thirds difference in prevalence). ...
Context 3
... the parameter estimate for the 1 to 10% group was close to zero, indicating virtually no increase for the group with intermediate periodontal disease. These results are consistent with the apparent threshold effect of periodontal disease observed in the age-standardized findings ( Table 1). The parameter estimate of 0.14 for the group with most extensive periodontal disease was midway between the estimates for bronchitis and arthritis, indicating that the effect of severe pocketing on CRP levels was of a magnitude comparable with that of those two conditions. ...
Context 4
... effect of extensive periodontal pocketing was similar, in magnitude, to the effects observed when only age was adjusted for. That is, the greater age-adjusted prevalence of CRP > 10 mg/L for people with extensive pocketing, as reported in Table 1, was equivalent to an odds ratio of 2.24 relative to people with no pocketing (data not reported). This was only marginally greater than the multivariate-adjusted odds ratio of 1.83 observed in Table 3. ...
Context 5
... large sample size and broad scope of variables available for analysis in this study are additional strengths, permitting periodontal-CRP associations to be estimated with good statistical precision, even after stratification for other competing determinants of CRP, such as chronic bronchitis, which themselves have relatively low prevalence. A novel finding was that oral conditions had their strongest association with CRP levels in population subgroups that did not have systemic diseases (Table 1). The cross-sectional design of NHANES III constitutes the major weakness of this study for the purpose of drawing causal inferences. ...
Similar publications
Background:
The current retrospective cross-sectional study investigated 5-18 years treatment outcomes in subjects who did not complete a recommended course of periodontal therapy.
Methods:
Sixty-five subjects who voluntarily discontinued therapy were recalled. Subject's demographic data and dental history since discontinuation of periodontal tr...
Citations
... Periodontitis, as well as any other disease, is capable of promoting an inflammatory crisis, which causes an increase in PCR levels (29). ...
Periodontitis is a chronic inflammatory disease that affects public health worldwide. It has been related to microorganisms that trigger an inflammatory response that, in turn, produces a deterioration of the teeth’s supporting tissue. In recent years, studies have shown some similarity and association between periodontitis and atherosclerotic cardiovascular disease. The serum increases in C-reactive protein (CRP), fibrinogen, alpha-1 antitrypsin, moderate increase in leukocytes, increase in sedimentation rate and Von Willebrand factor antigen make it likely that there is a relationship between periodontal disease and other systemic conditions, specifically atherosclerotic disease. This study seeks to establish if there is any relationship between these values after phase II periodontal treatment in patients with periodontitis at the Faculty of Dentistry of the University of Costa Rica. The initial values are found in a previous publication (1). In this second stage, the sample was reduced to 14 patients, of whom 57% presented metabolic compromise such as rheumatoid arthritis, arterial hypertension and diabetes mellitus, and 50% decreased PCR levels. As for the mean level of the total sample, in both stages of the study, PCR increased from 2.72 (SD: 2.25) to 5.36 (SD: 9.68). Of the patients who received periodontal treatment, 21.4% had low PCR levels (<1 mg/L), 50% medium (1-3 mg/L) and 28.6% high (>3 mg/L). There was no statistically significant difference in any of the variables analyzed for cholesterol, triglycerides and fibrinogen. Of the total number of patients in whom carotid ultrasound was performed, 52.4% were diagnosed as healthy, 33.3% had bulbar myointimal hyperplasia and 14.3% had atheromatous plaques. One of the participants died of myocardial infarction. This study does not conclude that there is a relationship between periodontal disease and cellular markers, which are also found in atheromatous disease, but it can be affirmed that there is a probability that periodontal disease contributes to affect the metabolic condition of the patient.
... 68 PD inflammation has been found to trigger increased production of CRP, even in otherwise healthy adults. [69][70][71] Regular dental flossing has been found to mitigate the inflammation associated with PD and lower the risk of developing elevated CRP. 72 This suggests that the increased prevalence of CVD events and the higher risk of experiencing CVD-linked mortality among participants who do not floss could possibly be due to systemic consequences of elevated CRP levels associated with poor flossing behavior. ...
... A periodontite é uma infecção complexa do tecido de suporte dentário que pode ser causada por diversos fatores etiológicos, sendo uma enfermidade de grande prevalência em pessoas idosas e de baixa renda. Pesquisas apontam que a periodontite apresenta uma relação direta com pelo menos quarenta e três doenças sistêmicas (Slots, 2017 (Slade, 2000;Vieira, 2014). ...
As doenças da cavidade oral podem afetar não apenas a região bucal, mas também a saúde geral do organismo. Estudos científicos apontam a relação entre essas afecções com o risco para doenças sistêmicas, como as cardiovasculares. O objetivo desta pesquisa é analisar as repercussões da saúde bucal frente aos indicadores da saúde cardiovascular. Foi realizada uma Revisão Integrativa de Literatura (RIL), sendo as buscas realizadas nas bases de dados: Biblioteca Virtual em Saúde (BVS), Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e PUBMED. Dos 1502 trabalhos encontrados, de acordo com os critérios de inclusão e exclusão, foram selecionados para este estudo 46 artigos. Os artigos foram analisados e observou-se que, a periodontite, cárie, perda dentária e inadequada higiene bucal, configuram como os principais fatores de risco para afecções como insuficiência cardíaca, hipertensão arterial, doenças coronarianas e infarto agudo do miocárdio. O que torna essa temática de grande relevância para a Saúde Pública, pelo número de achados que apresentam as correlações das repercussões da saúde bucal e os indicadores da saúde cardiovascular. Sugere-se que novos estudos sejam realizados visando a criação de estratégias e protocolos que evitem ou minimizem estas enfermidades, favorecendo uma compreensão crítico-reflexiva sobre o processo saúde-doença na perspectiva de oferecer uma assistência holística e multidisciplinar.
... The observed positive correlation between CRP and periodontal disease could potentially serve as a plausible underlying mechanism in explaining the association between periodontal disease and the heightened risk of cardiovascular disease (CVD) among afflicted individuals 15,16) . Elevated CRP levels among individuals with advanced periodontal disease remained significant in multivariate analyses (P<0.01), even after accounting for established risk factors associated with heightened CRP levels such as diabetes, arthritis, emphysema, smoking, and anti-inflammatory medications, while also considering sociodemographic factors 17) . Elevated CRP has also been observed in edentulous individuals, suggesting a possible role for this increased inflammation in dementia. ...
... CRP and S100A8 were chosen as relevant markers of systemic inflammation associated with both periodontitis and CVD. Increased circulating levels of CRP have been reported in periodontitis [73][74][75] as well as in CVD patients [61,76]. Subclinical inflammation, as indicated by plasma CRP levels, was associated not only with the presence of coronary atherosclerosis but also with the severity of coronary plaque burden and the clinical manifestation of ischemia [77]. ...
Introduction: Periodontitis, an infectious inflammatory condition, is a key contributor to sustained systemic inflammation, intricately linked to atherosclerotic cardiovascular disease (CVD), the leading cause of death in developed nations. Treating periodontitis with subgingival mechanical instrumentation with or without adjunctive antimicrobials reduces the microbial burden and local inflammation, while also potentially bringing systemic benefits for patients with both periodontitis and CVD. This review examines systemic effects of subgingival instrumentation with or without antimicrobial products in individuals with periodontitis and CVD, and explores intricate pathogenetic interactions between periodontitis and CVD. Material and Methods: English-language databases (PubMed MEDLINE and Cochrane Library) were searched for studies assessing the effects of nonsurgical periodontal therapies in periodontitis patients with or without CVD. Results: While the ability of periodontal therapy to reduce mortality- and morbidity-related outcomes in CVD patients with periodontitis remains uncertain, some studies indicate a decrease in inflammatory markers and blood cell counts. Subgingival mechanical instrumentation delivered over multiple short sessions carries lower risks of adverse effects, particularly systemic inflammation, compared to the full-mouth delivery, making it a preferable option for CVD patients. Conclusions: Subgingival mechanical instrumentation, ideally conducted in a quadrant-based therapeutic approach, to decontaminate periodontal pockets has the potential to reduce both local and systemic inflammation with minimal adverse effects in patients suffering from periodontitis and concurrent CVD.
... It plays a crucial role in the body's systemic response to inflammation, serving as a significant biomarker in medical research. Numerous studies have demonstrated a positive link between chronic periodontitis and elevated serum CRP levels [14] [15]. This association is biologically plausible due to the release of inflammatory mediators such as interleukin-1(IL-1), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) during periodontitis, which can stimulate hepatocytes to produce CRP. ...
Chronic periodontitis, a widespread inflammatory condition, compromises the supporting structures of teeth through the progressive destruction of the periodontal ligament and alveolar bone. This damage is primarily initiated by the buildup of bacterial biofilm on tooth surfaces, triggering a host immune response that leads to tissue deterioration. While scaling and root planing (SRP) are standard treatments, there is a need to explore adjunctive therapies that can enhance these outcomes. The laser therapy both soft tissue lasers and hard tissue lasers, has shown promise in enhancing the outcomes of SRP by targeting and reducing bacterial biofilm more efficiently. But however, the biochemical parameters such as inflammatory markers and enzymes involved in tissue destruction after application of Er,Cr: YSGG laser remains unexplored. Aim: The objective of the study was to investigate the additional benefits of incorporating the Erbium, chromium-doped yttrium, scandium, gallium and garnet laser (Er,Cr: YSGG laser) with traditional scaling and root planing (SRP) in the treatment of chronic periodontitis. Specifically, this research seeks to evaluate how the laser impacts biochemical markers indicative of inflammation and tissue destruction along with clinical outcomes such as pocket depth reduction and attachment level gains. By examining these parameters, the study aims to provide a comprehensive assessment of the effectiveness of the Er,Cr:YSGG laser as a supplementary treatment modality, potentially leading to improved therapeutic strategies for managing chronic periodontitis. Materials and Methods: The study was performed at Saveetha Dental College, in Chennai, Tamil Nadu, India. The study was conducted for a duration of 3 months from November 2023 to February 2024.Thirty patients who were diagnosed with chronic periodontitis were included in the study. They were divided into two groups. The first group included fifteen patients who were subjected to scaling and root planing (SRP) alone. The second group included fifteen patients who were treated with Er,Cr:YSGG laser as an adjunct to scaling and root planing. Clinical parameters like clinical attachment level(CAL), periodontal probing depth(PPD) were assessed at baseline and 3 months after the non surgical periodontal therapy. Biochemical parameter C-reactive protein levels were evaluated at baseline and 3 months after periodontal therapy. Statistical analysis was done using IBM SPSS Statistics for Windows, version 23. Intergroup analysis was done using independent t-test and intra-group analysis was done using a paired t-test. Statistical significance was set at a p-value of less than 0.05. Results: The mean probing depth scores were 5.69 ± 0.04 mm and 5.69 ± 0.35 mm in the SRP group and Er,Cr:YSGG laser group respectively at baseline. The periodontal probing depth scores were 5.01 ± 0.02 mm and 3.80 ± 0.58 in the SRP group and Er, Cr:YSGG laser group respectively after 3 months. There was a statistically significant difference between SRP and SRP with Er,Cr:YSGG group at the end of 3 months with a p value of 0.01*. The mean clinical attachment level scores were 7.55 ± 0.02 mm and 7.56 ± 0.03 mm in the SRP group and Er,Cr:YSGG laser group respectively at baseline. The CAL scores were 6.97 ± 0.08 mm and 5.96 ±0.52 mm in the SRP and Er,Cr:YSGG laser groups respectively at the end of 3rd month indicating a statistically significant difference between the intervened group and the control group with a p-value of 0.03*. The mean CRP levels were 2.41 ± 0.05 ng/ml and 2.41 ± 0.36 ng/ml in the SRP and Er,Cr:YSGG laser groups respectively in the baseline. The CRP levels were 2.42 ± 0.40 ng/ml and 2.18 ± 0.12 ng/ml in the SRP and Er,Cr:YSGG laser group respectively at the end of 3 months which was statistically significant with a p-value of 0.04*. Conclusion: The integration of Er, Cr: YSGG laser therapy as an adjunct to traditional scaling and root planing (SRP) has demonstrated significant clinical and biochemical benefits in the management of periodontal disease. This combination therapy showed marked reduction in biochemical marker of inflammation, indicating a systemic anti-inflammatory effect. Additionally clinical parameters also demonstrated reduced probing depths and enhanced attachment levels, compared to SRP alone. These findings suggest that the Er, Cr: YSGG laser enhances the effectiveness of SRP, promoting better periodontal health and potentially offering a more comprehensive approach to periodontal therapy.
... CRP promotes foam cell formation by stimulating increased expression of cell adhesion molecules, enhancing monocyte recruitment to the arterial wall, and promoting LDL uptake by macrophages [47]. Numerous studies have reported that patients with severe periodontitis have elevated levels of systemic inflammatory markers like IL-6, CRP and haptoglobin and these increased levels can intensify the atherosclerosis and its associated complications [50][51][52]. ...
Atherosclerosis is a progressive disease marked by the accumulation of lipids and fibrous components in the large arteries. It is one of the primary causes of heart disease and stroke. Periodontal diseases encompass conditions like gingivitis and periodontitis, which are multifactorial diseases associated with dysbiotic plaque biofilms that trigger an immune-inflammatory host response, eventually resulting in the destruction of periodontal tissues. Links between periodontal disease and atherosclerosis may be based on direct invasion of periodontal pathogens or inflammatory mechanisms triggered by bacteria related to periodontal lesions, locally or systemically, that may impact the initiation of the atherosclerotic lesion. The presence of periodontal pathogens within an atheromatous lesion implies hematogenous dissemination. The invasion of atheroma by periodontal pathogens results in changes in the proatherogenic and proinflammatory properties of endothelial cells, leading to endothelial dysfunction, which is a hallmark of atherosclerosis. Clinical and epidemiological studies have offered sufficient evidence of periodontitis having an adverse effect on systemic health, including atherosclerosis; however, a direct causal effect has not yet been proved. This review aims to analyse scientific results regarding the mechanism by which periodontal pathogens may cause atherosclerosis as well as to describe the role of Porphyromonas gingivalis in atherosclerotic plaque development and progression.
... CRP, on the other hand, may stimulate the complementary system and play a role in the production of foam cells [14,21]. According to research, elevated CRP levels associated with other clinical diseases may serve as an extra stimulus for a systemic inflammatory response [22,23]. Serum CRP measurement in clinical settings could be used to screen for organic illnesses. ...
This study aimed to quantify serum C-reactive protein (CRP) values in periodontally healthy people and explore the relationship between serum CRP levels and chronic periodontitis, and the influence of scaling as well as root planing (SRP) on serum CRP levels. The study included 100 systemically healthy adults (n = 100; 50 males and 50 females) who were separated into two groups: Group A (control) n = 50; periodontally healthy subjects and Group B (test) n = 50; subjects with chronic periodontitis. The test group (group B) was further separated randomly into two groups: B1 (n = 25) and B2 (n = 25). The clinical parameters and serum CRP levels were measured only once in Group A and before SRP in Group B1 subjects. In Group B2 subjects the clinical parameters and serum CRP levels were measured only after two months following SRP. For group A, B1, and B2 (the readings recorded after SRP) the mean gingival index scores were 0.146, 2.437, and 1.052, respectively, while the plaque index was 0.414, 2.499, and 0.954, respectively. Probing pocket depth (PPD) and clinical attachment loss (CAL) showed statistically significant differences between three groups, with higher values in patients with periodontitis before intervention (2.196 ± 0.49; 1.490 ± 0.23), respectively. Healthy controls (Group A) had a C-reactive protein level of 0.04820 mg/dL, while group B1 (test) had 1.678 mg/dL and 0.8892 mg/dL (group B2). C-reactive protein levels were observed to be greater in the test group (groups B1 and B2), and these differences were statistically significant (p < 0.001). Chronic periodontitis enhances blood levels of systemic inflammatory markers like CRP, which has been reduced by periodontal treatment with SRP.
... To screen people at high risk for periodontitis, certain inflammatory markers associated with periodontitis are considered reference indicators, such as serum C-reactive protein (CRP) [13], interleukin-6 and tumour necrosis factor levels [11,14]. A correlation between C-reactive protein levels and periodontal disease was found in one cross-sectional study of the U.S. population older than two months using data from 1988 to 1994 [15]. This study was therefore interested in examining the potential relationship between CRP and periodontal disease in updated National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2010. ...
... In the chronic and aggressive periodontitis group, mean serum CRP and plasma fibrinogen levels were higher than those in the control group [35]. According to NHANES III data, a cross-sectional investigation of the US population revealed a link between periodontal disease and CRP [15]. These data were further corroborated by a large population-based investigation from Pomerania, demonstrating that both obesity and periodontitis are linked with increased systemic CRP and fibrinogen levels [36]. ...
Background
Various data have been obtained on the relationship between body mass index (BMI) and C-reactive protein (CRP) and periodontitis. The aim of this study was to determine whether CRP/BMI are associated with periodontitis using data from the National Health and Nutrition Examination Survey (NHANES) database.
Methods
A cross-sectional analysis of data from 3602 participants in the 2009–2010 NHANES cycle was performed. The definition of periodontitis was used to divide participants into four groups according to the criteria of Eke. Correlations between CRP/BMI and periodontitis were tested for statistical significance by means of descriptive statistics, multivariate regression, and subgroup-stratified analyses, with and without adjustments for confounders (such as age and sex).
Results
There were no statistically significant differences (p > 0.05) regarding BMI and the development of periodontitis. After adjustment for age, sex, race, marital status, annual family income, alcohol consumption, hypertension, smoking, chronic pulmonary disease, cardiovascular disease, diabetes, flossing, and arthritis, CRP correlated significantly with the development of periodontitis in the subgroups stratified by obesity, with an odds ratio (OR) of 1.2 (95% CI, 1.0 to 1.5).
Conclusion
Through data analysis, we found an association between CRP levels and periodontitis prevalence in the American population, although this association was only present in the obese population. While there are several hypotheses about the underlying mechanism, further studies are needed to validate these findings.
... Various studies have proved a positive association between the presence of chronic periodontitis and high saliva CRP levels [36][37][38] because it is biologically plausible that inflammatory mediators (IL-1, IL-6 and TNF-α) are released under conditions of periodontitis and present the capacity to stimulate the hepatocytes to produce CRP. ...
Objective:
The aim: To work out the predictive system that can help to determine the group of patients to whom the hemodynamic surgery of varicose disease, CHIVA, is beneficial.
Patients and methods:
Materials and methods: Results of examination and treatment of 58 patients of the main group who underwent hemodynamic surgery and 65 patients of the comparison group who underwent stripping. Patients of both groups were evaluated in the preoperative period using an evaluation scale, and divided into three subgroups depending on the scores: 5- 8, 9 - 11, and 12 - 15 points.
Results:
Results: The best treatment results with the lowest number of relapses were obtained in the subgroup of patients with low scores on the prognostic scale (5-8 points) after hemodynamic treatment and in the subgroup of patients with a high the number of points (12 -15 points) after the classic stripping (p < 0.05). The same subgroups received more improvement in the quality of life of patients according to CIVIQ 20 (p < 0.001). The subgroup of patients with a high number of points (12 -15 points) after the stripping received significantly more reduction in scores VCSS (p < 0,01).
Conclusion:
Conclusions: Comprehensive assessment of factors such as the anamnestic duration of the disease, the diameter of the great saphenous vein, the presence of skin complications, dilated varicose collaterals and previous surgical treatment using a prognostic preoperative assessment score allows the surgeon to be more clearly guided in choosing the optimal method of treatment for each patient and achieve the best treatment results.
