Methods: 67 adults with advanced periodontitis requiring full clearance were studied. Blood samples were collected at three timepoints: T1, at initial presentation, immediately before treatment of presenting symptoms; T2, one to two weeks later, before full clearance; T3, 12 weeks after clearance. Assays included C-reactive protein (CRP), fibrinogen, and plasminogen activator inhibitor antigen (PAI-1). White cell and differential counts, platelets, haemoglobin and red blood cells were measured.
Comparisons were made before and after treatment using paired t-tests. Individual values were log transformed to comply with criteria for normality and equality of variances. Wilcoxon signed rank tests were used when these criteria could not be fulfilled by mathematical transformation.
Results: CRP levels fell significantly from T1 to T3 (2.5 (0.9-6.9) versus 1.8 (0.6-6.0) mg/L, P=0.04) and from T2 to T3 (2.3 (0.8-6.4) versus 1.8 (0.6-6.0) mg/L, P=0.01). PAI-1 levels fell significantly from T1 to T3 (19.6 (9.7-39.6) versus 17.2 (8.2-35.9) ng/mL, P=0.03). Fibrinogen values decreased significantly from T2 to T3 (3.9 (3.1-4.9) versus 3.7 (2.9-4.7) g/L, P=0.04). There was a significant reduction from T1 to T3 in total white cell count (7.4 (6.2-9.2) versus 6.3 (5.2-8.4) x109/L, P=0.001), neutrophils (4.7 (3.8-5.9) versus 4.0 (2.9-5.5) x109/L, P=0.04), lymphocytes (2.0 (1.7-2.4) versus 1.8 (1.5-2.1) x109/L, P=0.005) and platelets (250 (204-294) versus 230 (193-278) x109/L, P=0.002). There were significant increases between T2 and T3 in haemoglobin levels (146 (131-162) versus 149 (136-164) g/L, P=0.005) and red blood cells (5.0 (4.5-5.3) versus 5.0 (4.6-5.4) x1012/L).
Conclusions: The data support the hypothesis that periodontal disease has systemic effects and that periodontal treatment may lower cardiovascular risk.