Abstract
Background and aimsObservational studies support an association between periodontitis and cardiovascular diseases. The study objective was to assess vascular inflammation after periodontal treatment in patients with peripheral arterial disease. MethodsNinety patients with peripheral arterial disease (PAD) and severe periodontitis were enrolled in a randomized, controlled trial. Thirty patients underwent non-surgical periodontal therapy and received additional systemic antibiotics (PT1 group), while 30 patients received the same therapy without antibiotics (PT2 group). The remaining thirty patients did not receive periodontal therapy (CG, control group). The primary outcome of this treatment was a reduction in vascular inflammation three months after periodontal treatment as determined by 18F-FDG PET/CT values. Secondary outcomes were changes in the inflamed periodontal surface area (PISA) and other periodontal parameters, changes in vascular biomarkers, and adverse cardiovascular events. ResultsAfter three months of treatment, a significant improvement in periodontal health was observed in the treatment groups. However, no difference in the primary outcome in the aorta was observed in the three study groups (median target to background ratio follow-up/baseline, PT1 1.00; 95% CI 0.97–1.10, PT2 1.00; 95% CI 0.98–1.1, CG 1.1; 95% CI 0.99–1.1, p = 0.75). No significant differences were detected in most diseased segments and active segments. In addition, no differences were observed in 18F-FDG uptake in the carotid, iliac, femoral, and popliteal arteries.No differences with regard to relative changes in vascular biomarkers were noted, and no serious cardiovascular adverse events occurred. ConclusionsPeriodontal treatment was effective and safe but did not reduce vascular inflammation in patients with PAD.
Highlights
Recent meta-analyses and consensus reports have summarized the association between periodontal disease and atherosclerotic cardiovas cular diseases [1,2,3,4]
When changes in the maximal TBR seen in the individual aortic segments were compared, reflecting the most diseased segments (MDS), we found no significant differences between the study groups
From a practical point of view, periodontal disease seems to be a potent marker for the presence of atherosclerotic arterial damage, since cardiovascular risk factors are common in both diseases
Summary
Recent meta-analyses and consensus reports have summarized the association between periodontal disease and atherosclerotic cardiovas cular diseases [1,2,3,4]. Tonetti et al conducted a randomized controlled trial and demonstrated that intensive periodontal treatment resulted in acute, short-term systemic inflammation and endothelial dysfunction in 120 patients with severe periodontitis [8]. Six months after these patients received therapy, the benefits in oral health could be associated with an improvement in endothelial function. Observational studies support an association between periodontitis and cardiovascular diseases. The study objective was to assess vascular inflammation after periodontal treatment in patients with peripheral arterial disease. Methods: Ninety patients with peripheral arterial disease (PAD) and severe periodontitis were enrolled in a randomized, controlled trial.
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