Radafshar G, Shad B, Ariamajd E, Geranmayeh S
Assistant Professor, Dental Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
J Dent (Tehran). 2010 Winter;7(1):24-30. Epub 2010 Mar 31.
To assess whether non-surgical periodontal treatment is associated with changes in serological markers of systemic inflammation.
Thirty-five systemically healthy subjects with severe generalized periodontitis meeting the inclusion criteria participated in a four-month single blind interventional trial of which thirty-two completed the study. Periodontal parameters and inflammatory markers [C-reactive protein (CRP) and plasma fibrinogen] and also the white blood cell count (WBC) were evaluated prior to and four months after delivery of intensive non-surgical periodontal therapy with simultaneous lavage of chlorhexidine 0.1% from the tip of the ultrasonic instrument into the pockets.
Significant differences in serum CRP levels were observed four months after treatment compared to the baseline (1.85, SD=1.93 vs 2.46, SD=2.32, respectively, P<0.0001). Periodontal treatment also resulted in a significant difference in WBC and neutrophil counts compared to the baseline (P<0.0001). The reduction in fibrinogen levels was not significant at the end of the research period. Significant improvement in the pocket probing depth and clinical attachment level for pockets with initially 4-6 mm and then more than 7 mm depth was observed. Changes in plaque and bleeding scores were also statistically significant (82.75 vs. 35.84 and 19.03 vs. 1.81, respectively).
Periodontal treatment is effective in reducing CRP levels and white blood cell count, while fibrinogen levels are not influenced by periodontal therapy. Periodontal treatment may therefore decrease the systemic inflammatory burden in patients with advanced periodontitis.
评估非手术牙周治疗是否与全身炎症血清学标志物的变化相关。
35名符合纳入标准的全身健康的重度广泛性牙周炎患者参与了一项为期四个月的单盲干预试验，其中32名完成了研究。在进行强化非手术牙周治疗并同时从超声器械尖端向牙周袋内冲洗0.1%洗必泰之前及治疗四个月后，评估牙周参数、炎症标志物[C反应蛋白（CRP）和血浆纤维蛋白原]以及白细胞计数（WBC）。
与基线相比，治疗四个月后血清CRP水平存在显著差异（分别为1.85，标准差=1.93和2.46，标准差=2.32，P<0.0001）。牙周治疗还导致WBC和中性粒细胞计数与基线相比有显著差异（P<0.0001）。在研究期结束时，纤维蛋白原水平的降低不显著。观察到初始深度为4 - 6mm然后超过7mm的牙周袋的探诊深度和临床附着水平有显著改善。菌斑和出血评分的变化也具有统计学意义（分别为82.75对35.84和19.03对1.81）。
牙周治疗可有效降低CRP水平和白细胞计数，而纤维蛋白原水平不受牙周治疗影响。因此，牙周治疗可能会减轻晚期牙周炎患者的全身炎症负担。
