Date of Award
MSOB (Master of Science in Oral Biology)
Thomas P. Sollecito, DMD, FDS, RCSEd
Background: Coronary heart disease is a common manifestation of atherosclerosis. Various inflammatory markers including C-reactive protein, tumor necrosis factor-alpha, interleukin-6, and fibrinogen play role in the development of atherosclerosis. Periodontitis is the inflammation of teeth supporting structures initiated by bacteria of the oral biofilm. Several studies have shown that periodontitis is associated with increased levels of serum inflammatory markers involved in atherosclerosis. Recently, there is an increasing number of trials investigating the effect of scaling and root planing on reducing level of systemic inflammation between periodontal maintenance visits in patients with coronary heart disease to decrease the inflammatory burden in this targeted population and the risk of secondary cardiovascular event. Objective: The aim of this study is to conduct a systematic review to investigate the effect of dental scaling and root planning on reducing the serum levels of inflammatory markers in patients with stable coronary heart disease. Method: Electronic searches were conducted in PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, World Health Organization (WHO) International Trials Registry Platform, and Google Scholar beta to identify randomized controlled trial evaluated the effect of scaling and root planing on the level of serum inflammatory markers in patients with stable coronary heart disease to those who have coronary heart disease but received no treatment or simple oral hygiene measures only. Results: A total of 358 studies were initially identified from the search; 4 studies met the inclusion criteria and were selected for this systematic review. All of the included studies have considered C-reactive protein as a main outcome measure. Only one study considered evaluating the effect on fibrinogen, another study on interleukin-6, and two studies on tumor necrosis factor-alpha. In general, the results of the included randomized controlled trials appear to support the effectiveness of scaling and root planing in reducing serum levels of inflammatory markers. However, most of the studies involved small sample sizes except for one study, and there was inconsistency between the studies in the time considered for assessing the change in the level of serum inflammatory markers. Conclusion: There is a low evidence from the current literature supporting the effect of scaling and root planing in reducing systemic inflammatory markers including C-reactive protein, tumor necrosis factor-alpha, interleukin-6, and fibrinogen in patients with stable coronary heart disease. Future research should include observational studies to assess the effect of scaling and root planing in reducing the inflammatory burden in this targeted population and the risk of secondary cardiovascular event.
Alomar, Dalal, "Effect of Dental Scaling and Root Planing on Serum Inflammatory Markers in Patients with Coronary Heart Disease: A Systematic Review" (2018). Dental Theses. 31.