Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy.
Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, Milan, Italy.
J Periodontol. 2023 Dec;94(12):1414-1424. doi: 10.1002/JPER.23-0063. Epub 2023 Jul 11.
N-terminal portion of the B-type natriuretic propeptide (NT-proBNP) has potentially been shown to play an important role in the development of periodontitis and cardiovascular disease (CVD). This study evaluated the efficacy of periodontal treatment on NT-proBNP and related CVD biomarkers and explored whether subjects harboring high NT-proBNP at baseline showed increased clinical benefits with the non-surgical periodontal treatment performed with full-mouth scaling and root planing (FM-SRP) at 6-month follow-up.
Forty-eight patients with stage III periodontitis were randomized to receive minimal standard oral care (SOC) (n = 24) or FM-SRP (n = 24) protocol. Clinical periodontal parameters (probing depth, clinical attachment loss, bleeding on probing), serum NT-proBNP, α1-antitrypsin, C-reactive protein (hs-CRP), endothelial cell-specific molecule-1 (ECM-1), and neutrophil gelatinase-associated lipocalin (NGAL) concentrations were assessed at baseline and at 1-, 3-, and 6- month follow-up.
At 6 months, FM-SRP was more effective than SOC in reducing periodontal parameters and mean proportions of NT-proBNP (p = 0.004), hs-CRP (p = 0.003), α1-antitrypsin (p = 0.012), ECM-1 (p = 0.014), and NGAL (p = 0.045). At 6-month follow-up, the reduced NT-proBNP, α1-antitrypsin, hs-CRP, ECM-1, and NGAL levels were significantly correlated with the extent of periodontitis (p < 0.05). Furthermore, the analysis of variance analysis evidenced that, at 6-month follow-up, FM-SRP significantly impacted the reduction of NT-proBNP, hs-CRP, ECM-1, and NGAL. Moreover, high levels of NT-proBNP, hs-CRP, ECM-1, and NGAL at baseline significantly influenced the efficacy of periodontal treatment positively.
In this study, FM-SRP was more effective than SOC in reducing clinical variables and NT-proBNP levels, although subjects who harbored high NT-proBNP concentrations at baseline showed greater clinical benefits of periodontal treatment at 6-month follow-up.
B 型利钠肽前体氨基末端片段（NT-proBNP）可能在牙周炎和心血管疾病（CVD）的发展中发挥重要作用。本研究评估了牙周治疗对 NT-proBNP 及相关 CVD 生物标志物的疗效，并探讨了基线时 NT-proBNP 水平较高的患者在接受 6 个月随访时接受全口牙周刮治和根面平整（FM-SRP）的非手术牙周治疗后是否能获得更多的临床获益。
48 例牙周炎 3 期患者被随机分为接受最低标准口腔护理（SOC）（n=24）或 FM-SRP（n=24）方案。基线时和 1、3 和 6 个月随访时评估临床牙周参数（探诊深度、临床附着丧失、探诊出血）、血清 NT-proBNP、α1-抗胰蛋白酶、C 反应蛋白（hs-CRP）、内皮细胞特异性分子-1（ECM-1）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）浓度。
6 个月时，FM-SRP 较 SOC 更有效地降低牙周参数和 NT-proBNP 的平均比例（p=0.004）、hs-CRP（p=0.003）、α1-抗胰蛋白酶（p=0.012）、ECM-1（p=0.014）和 NGAL（p=0.045）。6 个月随访时，NT-proBNP、α1-抗胰蛋白酶、hs-CRP、ECM-1 和 NGAL 水平的降低与牙周炎的严重程度呈显著相关（p<0.05）。此外，方差分析表明，6 个月随访时，FM-SRP 显著影响 NT-proBNP、hs-CRP、ECM-1 和 NGAL 的降低。此外，基线时 NT-proBNP、hs-CRP、ECM-1 和 NGAL 水平较高显著正向影响牙周治疗的疗效。
在本研究中，FM-SRP 较 SOC 更有效地降低临床变量和 NT-proBNP 水平，但基线时 NT-proBNP 浓度较高的患者在 6 个月随访时牙周治疗的临床获益更大。
