Abstract
ObjectiveObesity is a chronic disease that negatively affects an individual’s general and oral health. The present study aimed to compare the clinical and microbiological effects of non-surgical periodontal therapy with the full mouth disinfection (FMD) protocol on obese and non-obese individuals at 9 months post-therapy.MethodologyThis clinical study was first submitted and approved by the Ethics Committee. Fifty-five obese patients and 39 non-obese patients with periodontitis were evaluated. The full-mouth periodontal clinical parameters, clinical attachment level (CAL), probing depth (PD), gingival index (GI), and plaque index (PI), were monitored at baseline, 3, 6, and 9 months after periodontal treatment with full mouth disinfection (FMD) protocol. The mean count of Tannerella forsythia , Porphyromonas gingivalis , Treponema Denticola , and Aggregatibacter actinomycetemcomitans was determined by quantitative polymerase chain reaction on subgingival biofilm samples. Demographic data were assessed by Chi-square test. For clinical and microbiological parameters, two-factor repeated-measures ANOVA was used.ResultsIn both groups, periodontal therapy using the one-stage full-mouth disinfection protocol significantly improved CAL, PD, GI, and PI (p<0.05). Obese and non-obese patients equally responded to non-surgical periodontal therapy (p>0.05). Microbial count found no major differences (p>0.05) between obese and non-obese individuals who had undergone non-surgical periodontal therapy.ConclusionsObesity did not affect the clinical and microbiological outcomes of non-surgical periodontal therapy.
Highlights
Several systemic diseases have been associated with periodontitis, including obesity.[4,5]
The cellular and molecular mechanisms that might explain obesity and periodontitis relationship are systemic inflammatory changes in tumor necrosis factor (TNF)-α, Interleukin-6 (IL-6), oxidative stress, and adiponectin and leptin levels, which may result in greater susceptibility to chronic inflammatory diseases and infections.[8-10]
Several epidemiological studies have established the relationship between obesity and periodontal disease.[11-13]
Summary
Periodontitis is a highly prevalent chronic inflammatory disease characterized by the progressive destruction of the tooth-supporting tissues, resulting in tooth loss.[1,2] Periodontitis represents a simple bacterial infection, and a complex interaction among host inflammatory responses, subgingival biofilm, and host modifying factors.[3]. The cellular and molecular mechanisms that might explain obesity and periodontitis relationship are systemic inflammatory changes in tumor necrosis factor (TNF)-α, Interleukin-6 (IL-6), oxidative stress, and adiponectin and leptin levels, which may result in greater susceptibility to chronic inflammatory diseases and infections.[8-10]. Cross-sectional studies have demonstrated that obese individuals present greater odds-ratio for periodontitis than non-obese.[11,13]. Longitudinal studies demonstrated that obesity is associated with increased periodontal attachment loss and inflammation,[12,14,15] and systematic reviews showed that periodontitis severity and extension are associated with increased levels of overweight.[16-18]. The question of whether these individuals would have a worse response to periodontal therapy than non-obese individuals was posed, and a few clinical studies were conducted.[20-25]. As inflammatory changes in obese individuals may impair wound healing and worsen periodontal status, this study hypothesized that obese individuals would present a worse response to periodontal therapy than non-obese ones. The aim of this prospective 9-month clinical study was to compare the clinical and microbiological effects of non-surgical periodontal therapy with the FMD protocol on obese and non-obese individuals
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