The Complex Interplay between C-reactive Protein and Periodontal Health: A Narrative Review

Abstract

ABSTRACT Aim: The aim of this review is to comprehensively explore and elucidate the intricate relationship between C-reactive protein (CRP) levels and periodontal health. It involves an examination of the existing literature to understand the role of CRP as a biomarker and potential mediator in the pathogenesis, progression, and management of periodontal disease. Material and Methods: A literature search was conducted between January 2010 and December 2023, in PubMed/MEDLINE, Google Scholar, and Scopus databases, using keywords such as “acute phase reactants,” “C-reactive protein,” “cardiovascular disease,” and “periodontal disease” combined by Boolean operators. Employing a multistep screening process, which included literature search, evaluation of article titles and abstracts, and full-text reading, we considered studies that met the inclusion/exclusion criteria for the review. Results: Twenty-two articles meeting the inclusion and exclusion criteria were selected for analysis, focusing on the association between CRP and periodontal diseases. The findings consistently demonstrated a positive correlation, implying a potential nexus between periodontal inflammation and systemic inflammatory processes as evidenced by elevated CRP levels. Conclusion: This review article aims to provide a comprehensive overview of the complex relationship between CRP and periodontal health, also shedding light on novel insights that have been uncovered in recent research. It discusses the role of CRP as an acute-phase reactant, which explores the role of CRP in modulating inflammatory pathways, endothelial dysfunction, and oxidative stress within the periodontal tissues. Furthermore, the impact of genetic variations in the CRP gene on periodontal disease susceptibility and severity is discussed. It explores the potential of CRP as a diagnostic and prognostic marker for periodontal disease and its role in assessing treatment outcomes and predicting systemic health risks associated with periodontitis and open avenues for targeted therapeutic strategies and personalized approaches to periodontal management.