Periodontal therapy and endothelial function in coronary artery disease: A randomized controlled trial.

Abstract

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 3months 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.