Graduate Program in Cardiovascular Sciences: Cardiology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Department of Cardiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.
Oral Dis. 2018 Oct;24(7):1349-1357. doi: 10.1111/odi.12909. Epub 2018 Jul 10.
To assess the effects of periodontal treatment on endothelial function in patients with coronary artery disease.
A randomized controlled trial was conducted with 69 patients with stable coronary disease and severe periodontitis. The test group received nonsurgical periodontal therapy consisting of personalized oral hygiene instructions, subgingival scaling, and root planing per quadrant, whereas the control group received equal treatment after the study period. Endothelial function was assessed by measurement of brachial artery flow-mediated dilation, concentrations of sVCAM-1, sICAM-1, and P-selectin in serum before and 3 months after periodontal therapy.
The test group exhibited statistically better periodontal parameters-plaque, probing depth, periodontal attachment loss, and bleeding on probing. No significant improvements were observed in the control (1.37%) and test (1.39%) groups in flow-mediated dilation, with no significant between-group difference. sVCAM-1 concentration increased in the control group (997.6 ± 384.4-1201.8 ± 412.5; p = 0.03), whereas in the test group, no significant changes were observed (915.1 ± 303.8-1050.3 ± 492.3; p = 0.17), resulting in a significant difference between the two groups (p = 0.04). The same pattern was observed for concentrations of sICAM-1.
Periodontal treatment did not provide better vasodilation in patients with coronary disease in a short-term follow-up period, although it maintained blood concentrations of markers of vascular inflammation.
评估牙周治疗对冠心病患者内皮功能的影响。
一项随机对照试验纳入了 69 例稳定型冠心病合并严重牙周炎患者。试验组接受非手术牙周治疗,包括个性化口腔卫生指导、龈下刮治和根面平整,每象限一次,而对照组在研究期间后接受同等治疗。在牙周治疗前和 3 个月后,通过测量肱动脉血流介导的扩张来评估内皮功能,并检测血清中 sVCAM-1、sICAM-1 和 P-选择素的浓度。
试验组的牙周参数(菌斑、探诊深度、牙周附着丧失和探诊出血)有统计学上的显著改善。对照组(1.37%)和试验组(1.39%)的血流介导扩张均无显著改善,两组间无显著差异。对照组 sVCAM-1 浓度升高(997.6 ± 384.4-1201.8 ± 412.5;p = 0.03),而试验组无显著变化(915.1 ± 303.8-1050.3 ± 492.3;p = 0.17),两组间存在显著差异(p = 0.04)。sICAM-1 的浓度也呈现出相同的模式。
在短期随访期间,牙周治疗并未为冠心病患者提供更好的血管舒张作用,尽管它维持了血管炎症标志物的血液浓度。