Key result
Periodontal surgery transiently increases local periostin without altering systemic inflammatory markers.
Why the study?
Periostin is involved in periodontal stability and atherosclerotic plaques, but the effect of periodontal treatment on markers of atherosclerotic coronary artery disease and circulating periostin remains to be analyzed.
Does periodontal surgery compared to non-surgical therapy improve systemic markers of atherosclerotic coronary artery disease and circulating periostin in patients with severe periodontal disease and a history of CAD?
RCT (n=22)
randomized
Does periodontal surgery compared to non-surgical therapy improve systemic markers of atherosclerotic coronary artery disease and circulating periostin in patients with severe periodontal disease and a history of CAD?
In patients with CAD and severe periodontal disease, periodontal surgery increases local periostin levels but does not significantly alter systemic inflammatory or cardiovascular biomarkers compared to non-surgical therapy.
Periodontal surgery yields no systemic inflammatory benefit in CAD patients; extends RCT evidence of limited cardiovascular biomarker effects.
OBJECTIVE: The aim of this study was to analyze the effects of periodontal treatment on markers of atherosclerotic coronary artery disease and circulating levels of periostin. BACKGROUND: Periostin is necessary for periodontal stability, but it is highly present in atherosclerotic plaques. Treatment of periodontal disease, with low levels of local periostin, is thought to reduce systemic levels of periostin. Thus, this may contribute to cardiovascular health. METHODS: A pilot randomized controlled clinical trial was designed to include patients with severe periodontal disease and history of atherosclerotic coronary artery disease. Samples of gingival crevicular fluid (GCF) and serum were collected before and after periodontal treatment by periodontal surgery or non-surgical therapy. The levels of several markers of inflammation and cardiovascular damage were evaluated including CRP, IFN-γ, IL-1ß, IL-10, MIP-1α, periostin, and TNF-α in GCF and CRP, Fibrinogen, IFN-γ, IL-1ß, IL-6, IL-10, L-Selectin, MIP-1α, Periostin, TNF-α, and vWF in serum. RESULTS: A total of 22 patients with an average of 56 years old were recruited for participating in this study. Twenty of them were male. Most of them (82%) had suffered an acute myocardial event and underwent surgery for placing 1, 2, or 3 stents in the coronary arteries more than 6 months ago but less than 1 year. The treatment of periodontal disease resulted in an overall improvement of all periodontal parameters. Regarding the evaluation of GCF and serum, a significant increase of periostin in the GCF was observed after periodontal surgery. In contrast, although other markers in GCF and serum improved, no significant correlations were found. CONCLUSION: Treatment of periodontal disease through periodontal surgery induces a local and transient increase in the levels of periostin in the gingival crevicular fluid. The effects on systemic markers of inflammation and cardiovascular function have not been confirmed.
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Padial‐Molina et al. (2023) conducted an RCT in Severe periodontal disease and history of atherosclerotic coronary artery disease (n=22). Periodontal surgery vs. Non-surgical therapy was evaluated on Markers of atherosclerotic coronary artery disease and circulating levels of periostin in gingival crevicular fluid and serum. Periodontal surgery induced a significant local and transient increase in periostin levels in the gingival crevicular fluid, without confirmed effects on systemic markers of inflammation.
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