Improvement in periodontal health and systemic markers of inflammation

The relationship between periodontal disease, systemic inflammation and atherosclerosis is complex. Chronic periodontal infections are known to elevate systemic levels of inflammatory mediators. It has been proposed that this may lead to endothelial cell activation and atherogenesis. Objectives: To examine changes in serum levels of inflammatory mediators following improvement in periodontal health in patients with cardiovascular disease (CVD) and in patients with high cardiovascular (CV) risk and low CV risk. Methods: Patients were selected from two longitudinal studies and had undergone yearly periodontal examinations and peripheral blood collections. CVD patients selected from one study had experienced a significant CV event (myocardial infarct or unstable angina requiring hospitalisation) while patients derived from the other study had not. These latter patients were further classified according to CV risk (6 classical risk factors=high CV risk; 1 classical risk factor=low CV risk). Patients demonstrating a quantifiable improvement in periodontal health (62% reduction in number of sites with probing depth4mm) from the baseline visit were selected. Commercial high sensitivity ELISA kits were used to measure serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), IL-6, IL-1 and tumour necrosis factor- in CVD patients (n=8), high CV risk (n=18) and low CV risk (n=14) patients. Results: Improved periodontal health resulted in reductions in mean levels of the four inflammatory markers in patients with CVD. Reductions in sICAM-1 levels following improved periodontal health reached significance in CVD (