Effect of Periodontal Treatment on Reducing Chronic Inflammation in Systemically Healthy Patients With Periodontal Disease

Shinji Matsuda; Tomoaki Shintani; Tsuyoshi Miyagawa; Hiromichi Yumoto; Yasutaka Komatsu; Nanae Dewake; Takanori Iwata; Takatoshi Nagano; Toshiya Morozumi; Ryoma Goto; Satsuki Kato; Masahiro Kitamura; Kitetsu Shin; Satoshi Sekino; Akiko Yamashita; Keiko Yamashita; Atsutoshi Yoshimura; Tsutomu Sugaya; Shogo Takashiba; Yoichiro Taguchi; Eiji Nemoto; Hiromi Nishi; Noriyoshi Mizuno; Yukihiro Numabe; Hiroyuki Kawaguchi

doi:10.1016/j.amjmed.2023.11.001

Effect of Periodontal Treatment on Reducing Chronic Inflammation in Systemically Healthy Patients With Periodontal Disease

Am J Med. 2024 Mar;137(3):273-279.e2. doi: 10.1016/j.amjmed.2023.11.001. Epub 2023 Nov 19.

Authors

Shinji Matsuda¹, Tomoaki Shintani², Tsuyoshi Miyagawa³, Hiromichi Yumoto⁴, Yasutaka Komatsu⁵, Nanae Dewake⁶, Takanori Iwata⁷, Takatoshi Nagano⁸, Toshiya Morozumi⁹, Ryoma Goto¹⁰, Satsuki Kato¹¹, Masahiro Kitamura¹², Kitetsu Shin¹³, Satoshi Sekino¹⁴, Akiko Yamashita¹⁵, Keiko Yamashita¹⁶, Atsutoshi Yoshimura¹⁷, Tsutomu Sugaya¹⁸, Shogo Takashiba¹⁹, Yoichiro Taguchi²⁰, Eiji Nemoto²¹, Hiromi Nishi²², Noriyoshi Mizuno²³, Yukihiro Numabe¹⁴, Hiroyuki Kawaguchi²²

Affiliations

¹ Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. Electronic address: matsudas@hiroshima-u.ac.jp.
² Center of Oral Clinical Examination.
³ Clinical Research Center in Hiroshima, Hiroshima University Hospital, Hiroshima, Japan.
⁴ Department of Periodontology and Endodontology, Institute of Biomedical Sciences, Tokushima University Graduate school, Tokushima, Japan.
⁵ Periodontal Clinic, Niigata University, Medical and Dental Hospital, Niigata, Japan.
⁶ Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Nagano, Japan.
⁷ Department of Periodontology, Tokyo Medical and Dental University, Tokyo, Japan.
⁸ Department of Periodontology, Tsurumi University School of Dental Medicine, Kanagawa, Japan.
⁹ Department of Periodontology, Faculty of Dentistry, Kanagawa Dental University, Kanagawa, Japan; Department of Endodontics, The Nippon Dental University School of Life Dentistry at Niigata, Japan.
¹⁰ Department of Periodontology, School of Dentistry, Aichi Gakuin University, Aichi, Japan.
¹¹ Health Sciences University of Hokkaido, School of Dentistry, Division of Periodontology and Endodontology, Department of Oral Rehabilitation, Hokkaido, Japan.
¹² Graduate School of Dentistry, Department of Periodontology and Regenerative Dentistry, Osaka University, Osaka, Japan.
¹³ Division of Periodontology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, Saitama, Japan.
¹⁴ School of Life Dentistry Department of Periodontology, The Nippon Dental University, Tokyo, Japan.
¹⁵ Section of Periodontology, Division of Oral Rehabilitation Faculty of Dental Science, Kyushu University, Fukuoka, Japan.
¹⁶ Department of Periodontology, Tokyo Dental College, Tokyo, Japan.
¹⁷ Department of Periodontology and Endodontology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
¹⁸ Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan.
¹⁹ Department of Pathophysiology-Periodontal Science, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
²⁰ Faculty of Dentistry, Department of Periodontology, Osaka Dental University, Osaka, Japan.
²¹ Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Miyagi, Japan.
²² Department of General Dentistry, Hiroshima University Hospital, Hiroshima, Japan.
²³ Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

PMID: 37984772
DOI: 10.1016/j.amjmed.2023.11.001

Abstract

Background: We determined the effects and an accurate marker of periodontal treatment on serum interleukin (IL)-6 and high-sensitivity C-reactive protein (HsCRP) levels in systemically healthy individuals with periodontal disease.

Methods: This multicenter study included systemically healthy individuals with periodontal disease who received initial periodontal treatment and had no periodontal treatment history. Periodontal parameters, including periodontal inflamed surface area, masticatory efficiency, and periodontal disease classification; serum IL-6 and HsCRP levels; and serum immunoglobulin (Ig)G titers against periodontal pathogens were evaluated at baseline and after treatment. Subjects were classified as low or high responders (group) based on periodontal inflamed surface area changes.

Results: There were 153 participants. Only periodontal inflamed surface area changes were markedly different between low and high responders. Periodontal treatment (time point) decreased both serum IL-6 and HsCRP levels. The interaction between group and time point was remarkable only for serum IL-6 levels. Changes in serum immunoglobulin (Ig)G titers against periodontal pathogens were not associated with IL-6 changes in high responders. We analyzed the indirect effect of serum anti-Porphyromonas gingivalis type 2 IgG titer changes using mediation analysis and found no significance. However, the direct effect of group (low or high responder) on IL-6 changes was considerable.

Conclusions: Periodontal treatment effectively decreased serum IL-6 levels, independent of periodontal pathogen infection, in systemically healthy individuals with periodontal disease.

Keywords: Chronic inflammation; HsCRP; Periodontal inflamed surface area; Periodontal pathogens; Serum IL-6; Systemically healthy patients with periodontal disease.

Publication types

Multicenter Study

MeSH terms

C-Reactive Protein* / analysis
Humans
Immunoglobulins
Inflammation
Interleukin-6
Periodontal Diseases* / therapy

Substances

C-Reactive Protein
Interleukin-6
Immunoglobulins