Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
Department of Laboratory Medicine, Centre for Internal Medicine, Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
Clin Oral Investig. 2018 Dec;22(9):3079-3089. doi: 10.1007/s00784-018-2398-x. Epub 2018 Feb 27.
The aim of the study is to assess the long-term effect of active periodontal therapy on serum inflammatory parameters in patients with aggressive (AgP) and chronic (ChP) periodontitis in a non-randomised clinical study.
Twenty-five ChP and 17 AgP were examined clinically prior to (baseline), 12 weeks and 60 months after subgingival debridement of all pockets within 2 days. Systemic antibiotics were prescribed if Aggregatibacter actinomycetemcomitans was detected (10 AgP, 8 ChP), flap surgery was rendered if required. Neutrophil elastase (NE), C-reactive protein (CRP), lipopolysaccharide binding protein, interleukin 6, 8, and leukocyte counts were assessed at baseline, 12 weeks and 60 months.
Clinical parameters improved significantly in both groups from 12 weeks to 60 months. Eleven AgP and 18 ChP patients received surgical treatment after the 12 weeks examination. Only 3 patients in each group attended ≥ 2 supportive maintenance visits per year. NE and CRP were significantly higher in AgP than ChP at baseline and 60 months (p < 0.01). For leukocyte counts in ChP, significant changes were observed (baseline: 6.11 ± 1.44 nl; 12 weeks: 5.34 ± 1.40 nl; 60 months: 7.73 ± 2.89 nl; p < 0.05). Multiple regression analysis identified African origin, surgical treatment and female sex to correlate with better clinical improvement.
Despite comprehensive periodontal treatment, AgP patients exhibit higher NE and CRP levels than ChP patients up to 5 years after therapy.
Systemic inflammatory burden in AgP patients is higher than in ChP patients even 5 years after periodontal treatment.
本研究旨在通过非随机临床研究评估强化牙周治疗对侵袭性（AgP）和慢性（ChP）牙周炎患者血清炎症参数的长期影响。
25 例 ChP 和 17 例 AgP 在牙周袋内所有部位于 2 天内接受龈下刮治术治疗前（基线）、12 周和 60 个月时进行临床检查。如果检测到伴放线放线杆菌（10 例 AgP，8 例 ChP），则给予全身抗生素治疗；如果需要，则进行翻瓣手术。在基线、12 周和 60 个月时评估中性粒细胞弹性蛋白酶（NE）、C 反应蛋白（CRP）、脂多糖结合蛋白、白细胞介素 6、8 和白细胞计数。
两组患者的临床参数均在 12 周至 60 个月间显著改善。11 例 AgP 和 18 例 ChP 患者在 12 周检查后接受了手术治疗。每组只有 3 例患者每年接受≥2 次支持性维持治疗。AgP 患者的 NE 和 CRP 在基线和 60 个月时均显著高于 ChP（p<0.01）。ChP 患者的白细胞计数发生显著变化（基线：6.11±1.44nl；12 周：5.34±1.40nl；60 个月：7.73±2.89nl；p<0.05）。多元回归分析显示，非洲裔、手术治疗和女性与更好的临床改善相关。
尽管进行了全面的牙周治疗，AgP 患者在治疗后 5 年内仍表现出比 ChP 患者更高的 NE 和 CRP 水平。
即使在牙周治疗 5 年后，AgP 患者的全身炎症负担仍高于 ChP 患者。
