Systemic Effect of Periodontal Therapy on Acute Cardiovascular Events Risk Markers

• Grant number: 17/20770-6
• Support Opportunities: Regular Research Grants
• Start date: May 01, 2018
• End date: October 31, 2020
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Mario Taba Junior
• Grantee: Mario Taba Junior
• Host Institution: Faculdade de Odontologia de Ribeirão Preto (FORP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated researchers: Catarina Martins Tahim ; Karine Figueredo da Costa

Abstract

Periodontal disease is characterized as a chronic inflammatory process caused by local microbial infection that leads to destruction of the supporting tissues of the teeth. Systemically, the disease elevates the amount of inflammatory mediators, stimulating an immune response that, in addition to favoring prethrombotic events, dyslipidemia and contribute to the formation of atheromatous plaques may be associated with acute cardiovascular events. Due to tissue trauma and bacteremia, the treatment of the disease itself is capable of raising markers of risk for acute cardiovascular events. However, to date, there is no definition whether basic periodontal therapy can cause cardiovascular damage. Thus, considering the large number of periodontal procedures that are performed and the high prevalence of individuals with cardiovascular problems, the objective of this study will be to evaluate the systemic effect of periodontal therapy through the monitoring of biomarkers. Thus, the expression of acute phase proteins associated with tissue trauma (IL-6, TNF-alpha, C-Reactive Protein), sepsis-associated proteins (Procalcitonin), stress (Copeptine) and myocardial injury (BNP, NT-proBNP) as risk indicators for cardiovascular events. The evaluations will be performed at critical times of greater expression of the markers according to the literature, 24h and 48h after tissue damage and induction of bacteremia. Individuals selected for the study will be randomly assigned to two groups, Group 1 Full-Mouth Ultrasonic Debridement (FMUD) and Group 2-Quadrant Debridement (QD), and will have periodontal clinical parameters recorded. Confirming the hypothesis that periodontal treatment may be a trigger for late systemic post-care disorders with the possible occurrence of cardiovascular events, when the patient is already at home and outside the professional follow-up, the results of this investigation will have a potential impact on the clinical approaches and therapeutic protocols. Thus, new protective and less invasive therapies should be recommended to minimize risk and protect the patient. (AU)