Systemic inflammation following non-surgical and surgical periodontal therapy

P>Aim To describe the kinetics of serum inflammatory markers after a course of treatment comprising surgical and non-surgical treatment of chronic periodontitis (CP). Material and Methods Fourteen CP cases received full-mouth non-surgical treatment and, after 6 months, at least two surgical sessions. Blood samples were collected at various time-points after treatment. Blood markers of systemic inflammation/coagulation including leucocyte counts, C-reactive protein (CRP), serum amyloid-A (SAA) and D-dimers and renal function (cystatin C) were determined using high-sensitivity assays. Results Periodontal treatment resulted in substantial reductions of the number of pockets, gingival bleeding and plaque at 3 and 6 months after non-surgical therapy (p < 0.001). Surgical therapy led to an additional reduction of periodontal pockets (p < 0.01). Marked increases in the serum levels of CRP and SAA were noted 24 h after non-surgical therapy (p < 0.01) and periodontal surgeries (p < 0.05). D-dimer levels increased drastically 24 h after non-surgical therapy (p < 0.05). The drastic increase of CRP after non-surgical therapy was greater than both the surgical therapy sessions (p < 0.05). Conclusions Patients undergoing periodontal treatment experience perturbations of systemic inflammation of a greater magnitude after non-surgical than surgical periodontal therapy.