Evaluation of various hematological parameters in patients with periodontitis after nonsurgical therapy at different intervals

The Bloody Crossroads: Interactions between Periodontitis and Hematologic Diseases

Periodontitis is a common oral condition that can have a significant impact on the overall health of the body. In recent years, attention has been paid to potential relationships between periodontitis and various hematological disorders. This publication aims to present information available in the literature on this relationship, focusing on examples of red blood cell disorders (such as aplastic anemia and sickle cell anemia) and white blood cell disorders (such as cyclic neutropenia, maladaptive trained immunity, clonal hematopoiesis, leukemia, and multiple myeloma). Understanding these associations can help physicians and dentists better diagnose, monitor, and treat patients associated with both groups of conditions, highlighting the need for interdisciplinary care for patients with oral disorders and hematologic diseases.

Association between cardiovascular diseases and periodontal disease: more than what meets the eye

Cardiovascular diseases (CVDs) are inflammatory diseases of coronary arteries accompanying atheroma formation that can spawn impairment and, in severe cases, death. CVDs are the leading cause of death in the world. In recent decades, investigators have focused their impact on CVD by periodontal disease (PD). PD is a risk factor that can trigger the formation, maturation, and instability of atheroma in the arteries. Two mechanisms have been proposed to explain this relationship: periodontopathic pathogens explicitly invade the circulation or indirectly increase systemic levels of inflammatory mediators. It has been suggested that improvement in disease state has a positive effect on others. This review summarizes evidence from epidemiological studies as well as researches focusing on potential causation channels to deliver a comprehensive representation of the relationship between PD and CVD.

Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited

Atherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, it has been suggested that improvement in the condition of one disease positively impact the condition of the other one. Highlighting the association between these two diseases, the importance of early diagnosis and treatment of PD and its impact on cardiovascular status may be of great value in reducing the complications associated with ACVDs. Further in vitro and in vivo studies with longer follow up are necessary to confirm the causal relationship between PD and ACVDs.

Quantification of lipid bodies in monocytes from patients with periodontitis

OBJECTIVES

For the first time in the history of periodontics, the production of lipid bodies by monocytes was assessed from blood of patients with periodontitis in comparison to systemically healthy individuals. The purpose of this study was to compare the lipid body frequency within monocytes between healthy patients and those with periodontal disease.

MATERIALS AND METHODS

A total of 30 participants (11 males and 19 females), were divided between orally healthy control subjects (C, n = 16) and periodontitis subjects (P, n = 14), in a cross-sectional study. Both groups were systemically healthy. The following clinical periodontal parameters were assessed: probing depth, clinical attachment level, visible plaque index and gingival bleeding on probing index. Blood samples were collected to obtain monocytes containing lipid bodies, which were analyzed by light microscopy.

RESULTS

The periodontitis group demonstrated a higher corpuscular index than the control group (nonopsonized p = .0296 or opsonized p = .0459; Mann-Whitney). The frequency of monocyte cells containing lipid bodies (basal p = .0147, opsonized p = .0084 or nonopsonized, p = .026; Mann-Whitney) was also higher compared to those observed in healthy individuals.

CONCLUSIONS

The data suggest that periodontitis may contribute to a higher production of lipid bodies. It was also hypothesized that a major production of lipid bodies by monocytes in severe periodontitis, compared to orally healthy subjects, could interfere with the innate immune response or represents a higher reservoir of cholesterol esters within macrophages and a major risk to systemic implications, such as atherosclerosis.

Levels of Pro and Anti-inflammatory Citokynes and C-Reactive Protein in Patients with Chronic Periodontitis Submitted to Nonsurgical Periodontal Treatment

Aim

to compare the levels of IFN-γ, TGF-β and C-reactive protein (CRP) in healthy patients (HP) and chronic periodontitis patients (CP) before and seven days after the last session of Non-Surgical Periodontal Treatment (NSPT).

Materials and Methods

40 subjects were divided into two groups: healthy (n= 20), and with chronic periodontitis (n = 20). Serum and gingival crevicular fluid (GCF) were collected from each patient and quantified for IFN-γ, TGF-β and CRP using the enzyme-linked immunosorbent assay (ELISA).

Results

IFN-γ was found to be higher in the GCF of the CP group before NSPT in relation to the HP group (p<0.05), and it had significant higher levels after seven days of NSPT (p<0.05). The levels of TGF-β in the GCF of CP patients before NSPT were significantly higher when compared to HP (p<0.05), but they decreased after seven days of NSPT (p>0.05). Serum CRP levels did not show statistical difference between CP and HP before or after NSPT.

Conclusion

Therefore, our results demonstrated for the first time that NSPT causes early exacerbation of the immune response at the local level represented by increased levels of IFN-γ and decreased levels of TGF-β in the gingival crevicular fluid after seven days of treatment.