Faculty of Dentistry, Department of Periodontology, Süleyman Demirel University, Isparta, Turkey.
Faculty of Science, Department of Biochemistry, Süleyman Demirel University, Isparta, Turkey.
Clin Oral Investig. 2023 Sep;27(9):5549-5558. doi: 10.1007/s00784-023-05174-0. Epub 2023 Aug 3.
Cardiovascular disease (CVD) and periodontal disease have a common pathogenesis with inflammation and resolution steps. Although the relationships among periodontal disease, CVD, and specialized pro-resolving lipid mediator (sPRLM)s are well known, there is no study about the combined effects of cardiovascular and periodontal treatments on sPRLM levels. It was aimed to evaluate the effects of periodontal and cardiovascular therapies on sPRLMs (lipoxin A4, protectin (PD)1, resolvin (Rv) E1, RvD1, and maresin (MaR)1) in patients with CVD and periodontal disease.
This observational study consisted of fifty-five patients with CVD and mild or moderate periodontitis. The clinical periodontal parameters (plaque index, gingival index, probing pocket depth, percentage of bleeding on probing, and clinical attachment level) and blood and unstimulated total saliva samples were obtained at baseline, at 3 months (following only cardiovascular therapy), and at 6 months (following cardiovascular and periodontal therapies). The blood count and serum levels of cardiometabolic biomarkers (white blood cell, neutrophil/lymphocyte, serum total cholesterol (TC), triglyceride, and low and high-density lipoprotein (HDL) levels) were evaluated. sPRLMs were evaluated by ELISA.
There were significant decreases in body mass index, clinical periodontal parameters, WBC, LDL, PD1, and RvD1 at 6 months compared to baseline. The decreases in TC/HDL, RvE1, and MaR1 levels were significant at 3 and 6 months compared to baseline (p < 0.05).
CONCLUSION(S): The combination of cardiovascular and periodontal treatments leads to significant reductions in clinical periodontal and cardiometabolic parameters and sPRLMs.
Our report, which is the first in their field, suggested that cardiovascular and periodontal therapies provide an important contribution via decreasing the periodontal and atherosclerotic inflammation modulating sPRLMs. This finding will be a big step toward increasing the quality of life in these patients by drawing attention to importance of public health associated with oral hygiene, periodontal health, and systemic phase of periodontal treatment.
心血管疾病（CVD）和牙周病具有共同的发病机制，包括炎症和解决步骤。尽管牙周病、CVD 和专门的促解决脂质介质（sPRLM）之间的关系众所周知，但尚无关于心血管和牙周治疗对 sPRLM 水平的联合影响的研究。本研究旨在评估牙周和心血管治疗对 CVD 和牙周病患者 sPRLMs（脂氧素 A4、保护素（PD）1、消退素（Rv）E1、RvD1 和maresin（MaR）1）的影响。
本观察性研究包括 55 名 CVD 和轻度或中度牙周炎患者。在基线、治疗 3 个月（仅接受心血管治疗后）和治疗 6 个月（接受心血管和牙周治疗后）时，获取临床牙周参数（菌斑指数、牙龈指数、探诊牙周袋深度、探诊出血百分比和临床附着水平）和血样及非刺激全唾液样本。评估血液计数和血清心脏代谢生物标志物（白细胞、中性粒细胞/淋巴细胞、血清总胆固醇（TC）、甘油三酯和低、高密度脂蛋白（HDL）水平）。通过 ELISA 评估 sPRLMs。
与基线相比，6 个月时体重指数、临床牙周参数、白细胞、LDL、PD1 和 RvD1 显著下降。与基线相比，TC/HDL、RvE1 和 MaR1 水平在 3 个月和 6 个月时显著下降（p<0.05）。
心血管和牙周治疗的联合应用可显著降低临床牙周和心脏代谢参数及 sPRLMs。
我们的报告首次表明，心血管和牙周治疗通过降低牙周和动脉粥样硬化炎症调节 sPRLMs，为改善这些患者的生活质量做出了重要贡献。这一发现将引起人们对口腔卫生、牙周健康和牙周治疗全身阶段与公众健康相关的重要性的关注，从而提高这些患者的生活质量。
