Influence of Periodontal Treatment on Systemic Inflammatory Mediators

Inclusion criteria

A. General/Medical

• Any race/ethnic group
• Aged > 30 years
• Male or female
• CHD case (CHD angiographically confirmed)
• CHD diagnosed > 3 months prior to entry into study.
• No acute or chronic systemic conditions (see exclusion criteria below)
• No medications/medication history that can interfere with the study (see exclusion criteria below)
• Non-smoker (=Never smoker) or former smoker (=Does not smoke now and has not smoked at all for a minimum of the last 12 consecutive months)
• Able and willing to comply with study procedures
• Able and willing to be available for the duration of the study
• Able and willing to provide signed informed consent

B. Oral/Periodontal

• Dentate with at least 14 natural teeth, excluding third molars, that can be evaluated periodontally.
• Baseline whole mouth BOP > 20% of sites.
• Periodontitis case; periodontitis case defined as subject having ≥ 4 teeth with ≥ 1 site with PPD ≥ 4 mm & CAL ≥ 3 mm at same site
• No mechanical periodontal therapy in the last 6 months.
• No acute oral diseases (mucosal lesions), oral infections, need for immediate dental/periodontal care (e.g., NUG).

Exclusion criteria

A. General/Medical

• Age ≤ 30 years
• Not fulfilling criteria of defined CHD case
• Fulfilling criteria of defined CHD case, but diagnosed ≤ 3 months prior to start of study
• Current smoker
• Former smoker who does not smoke but who has smoked ≥ 1 cigarette (or equivalent, in form of water pipe, pipe, cigar) in the last 12 months.
• Females pregnant or lactating
• Systemic chronic conditions known to be associated with periodontitis or with changes in systemic inflammation: Diabetes,Rheumatoid Arthritis, Rheumatic Fever, SLE, Malignancy, Respiratory diseases, Renal diseases, Other (e.g., autoimmune diseases, fungal infections, immunological deficiencies, etc.)
• Systemic acute conditions known to affect systemic markers of inflammation: Acute bacterial infection, Acute viral infection (common cold, influenza, sinusitis), Orthopedic trauma, Surgery
• Medications known to affect systemic inflammatory biomarkers: Statins, Systemic steroids, Non-steroidal anti-inflammatory drugs, Immunosuppressants,
• Medications potentially affecting systemic inflammatory markers, if therapy started less than 3 months prior to study such as Hormone replacement therapy, Contraceptives
• Systemic antibiotic therapy in the last 3 months
• Unable or unwilling to comply with study procedures
• Unable or unwilling to be available for the duration of the study
• Unable or unwilling to provide signed informed consent

B. Oral/Periodontal

• <14 teeth that can be periodontally evaluated (excluding 3rd molars)
• BOP ≤ 20% of sites
• Not fulfilling criteria of defined periodontitis case
• Having received any periodontal therapy within last 6 months
• Topical/local antibiotic or anti-inflammatory therapy in last 6 months
• Acute oral infections
• Oral wounds, including recent (< 2 months) extractions