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Periodontal therapy: a novel non-drug-induced experimental model to study human inflammation.

AbstractBACKGROUND:
Chronic periodontitis causes a low-grade systemic inflammatory response; its standard treatment, however, induces an acute inflammatory response. The aim of this study was to describe the systemic inflammatory reactions to an intensive periodontal treatment regimen.
METHODS:
Fourteen otherwise healthy subjects suffering from severe chronic periodontitis were enrolled in a 1 month pilot single-blind trial. Intensive periodontal treatment, consisting of full-mouth subgingival root debridement delivered within a 6-h period, was performed. Periodontal parameters were recorded before and 1 month after completion of treatment. Blood samples were taken at baseline and 1, 3, 5, 7 and 30 days after treatment. Interleukin-1 receptor antagonist (IL-1Ra), Interleukin-6 (IL-6) and C-reactive protein (CRP) serum concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Complete blood counts were also performed.
RESULTS:
One day after treatment, mild neutrophilia and monocytosis (p < 0.05) and lymphopenia (p < 0.01) were accompanied by a sharp increase in inflammatory markers (IL-1Ra, IL-6, p < 0.01). A 10-fold increase in CRP (p < 0.001) was detected on day 1 and its kinetics followed a pattern of a classical acute phase response (significantly raised concentrations up to 1 week, p < 0.01). At 3-7 days after treatment, subjects presented also with a mild tendency towards a normocytic anaemic state (p < 0.01) and a degree of lympho-thrombocytosis (p < 0.05). The observed changes were similar to those expected following the well-characterized endotoxin-challenge model of inflammation.
CONCLUSIONS:
Intensive periodontal treatment produced an acute systemic inflammatory response of 1 week duration and might represent an alternative to classic endotoxin-challenge or drug-induced models to study acute inflammation in humans.
AuthorsF D'Aiuto, L Nibali, V Mohamed-Ali, P Vallance, M S Tonetti
JournalJournal of periodontal research (J Periodontal Res) Vol. 39 Issue 5 Pg. 294-9 (Oct 2004) ISSN: 0022-3484 [Print] United States
PMID15324349 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • IL1RN protein, human
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-6
  • Sialoglycoproteins
  • C-Reactive Protein
Topics
  • Acute-Phase Reaction (blood, etiology)
  • Analysis of Variance
  • Blood Cell Count
  • C-Reactive Protein (analysis)
  • Chronic Disease
  • Dental Scaling (adverse effects)
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-6 (blood)
  • Male
  • Middle Aged
  • Models, Biological
  • Periodontitis (blood, therapy)
  • Pilot Projects
  • Prospective Studies
  • Sialoglycoproteins (blood)
  • Single-Blind Method
  • Statistics, Nonparametric

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