Is obesity associated with healing after non-surgical periodontal therapy? A local vs. systemic evaluation

Background: We aimed to detect the role of obesity on the healing response to periodontal therapy in terms of serum lipids, C-reactive protein (CRP) and both serum and gingival crevicular fluid adipocytokines. Material and Methods: Thirty patients with periodontitis with (CPO) (n = 15) and without (n = 15) obesity and 15 healthy controls were included. Serum high-density lipoprotein, low-density lipoprotein, triglyceride, CRP levels and levels of adiponectin, interleukin (IL)-6, tumor necrosis factor (TNF)-alpha and IL-10 were evaluated before and 3 mo after initial periodontal therapy. Clinical periodontal measurements were also recorded at baseline and 3 mo. Results: Periodontal parameters improved significantly in both periodontitis groups with or without obesity (p < 0.05) with no significant difference in terms of gain clinical attachment level (p > 0.05) and change in numbers of sites with probing depth >= 4 mm. High-density lipoprotein significantly increased in both groups (p > 0.05). CRP decreased significantly solely in the normal weight group. IL-6, IL-10 and TNF-alpha levels in gingival crevicular fluid improved significantly based on therapy in both groups (p < 0.05). Only TNF-alpha decreased significantly in the CPO, while adiponectin and IL-10 in addition to TNF-alpha improved significantly in the group of patients with periodontitis without obesity. Conclusion: Patients with CPO respond to periodontal therapy as well as the non-obese controls. This similar response is accompanied with consistent adipokine levels in gingival crevicular fluid. However, obesity affects the CRP and serum adipocytokine levels in response to therapy.