Effects of Periodontal Therapy on Systemic Markers in Healthy Patients

Objectives: Periodontitis is associated with increased in inflammatory markers, especially cytokines and these inflammatory markers in turn have been observed in individuals with various systemic diseases. Periodontal therapy has also been believed to induce bacteremia and is thought to be a risk factor for distant site infections such as infective endocarditis in susceptible individuals. There are also reports of deleterious effects of blood loss following a periodontal surgery. However, there is conflicting data that reflects lack of evidence suggesting strong causal association between periodontal therapy and its effects on inflammatory marker, bacteremia and blood loss. This literature review will assess systemic effects (cytokines, bacteremia and blood loss) of invasive periodontal therapy and dental implants in systemically healthy individuals. Methods: A comprehensive MEDLINE/PubMed literature search was conducted in January 2012 on systemic effects of surgical periodontal therapy and dental implant therapy. Of the 227 articles identified from literature; 23 articles were identified as highly relevant for the purposes of this literature review and the findings of these selected articles are summarized based on the intervention received. Results: Inflammatory markers, TNF-α, IL-6, CRP and fibrinogen, significantly increase up to 24 h. After periodontal therapy and reaches its baseline levels after 1 month. Circulating PMNs, erythrocytes and Hemoglobin decreases after therapy and returns to baseline levels at 7 days. Transient bacteremia in the range of 3.3% to 80.9% was found in patients undergoing periodontal therapy. This transient bacteremia was reported to increase significantly during the point of maximum trauma to the soft tissues. Despite individual variation of the extent, invasiveness and duration of periodontal surgery, blood loss after routine periodontal therapy remains below 500 ml. Conclusion: This literature review identifies anecdotal reports on incidence of cardiovascular and other systemic events following periodontal treatment. It further concludes that the relationship between periodontal treatment, bacteremia and inflammatory markers is dynamic and not completely understood. Further research is required to understand the causative model of post periodontal therapy systemic events. Rachana Hegde* Department of Periodontology, Roseman University of Health Sciences College of Dental Medicine, USA Rachana Hegde Journal of Dentistry and Oral Biology Remedy Publications LLC. 2017 | Volume 2 | Issue 8 | Article 1055 2 present American Heart Association recommendations of antibiotic prophylaxis before dental procedures [12]. These recommendations are based on data concerning surrogate measures of risk such as invasiveness of a dental procedure and degree of periodontal disease at surgical site. However, there is conflicting data that reflects lack of evidence suggesting strong causal association between dental procedure-induced bacteremia and infective endocarditis [13]. It is hypothesized that other factors such as host immune and inflammatory response may play a role in determining the systemic effects of invasive dental procedures [14]. The purpose of the present literature review is to assess the systemic effects of invasive periodontal therapy and dental implants in systemically healthy individuals.