Evaluation of Nonsurgical Periodontal Therapy in Chronic Periodontitis Patients with Anemia by Estimating Hematological Parameters and High-sensitivity C-reactive Protein Levels

Overview

Journal J Pharm Bioallied Sci

Specialty Pharmacology

Date 2014 Sep 12

PMID 25210388

Citations 6

Authors

S V V S Musalaiah

M Anupama

M Nagasree

Ch Murali Krishna

Aravind Kumar

P Mohan Kumar

Affiliations

Soon will be listed here.

Abstract

Background: Periodontal tissues mount an immune inflammatory response to bacteria and their products. Certain inflammatory cytokines produced during periodontal inflammation increase the production of acute phase proteins like high‑sensitivity C‑reactive protein (hs‑CRP) and can depress erythropoietin production leading to the development of anemia.

Aim: The aim of this study is to investigate the efficacy of nonsurgical periodontal therapy on red blood cell (RBC) parameters and hs-CRP in chronic periodontitis patients with anemia.

Materials And Methods: This is a longitudinal, interventional study with 6-month follow-up. A total of 30 subjects with anemia and chronic periodontitis with age group of 33-55 years were selected by screening hemoglobin (Hb) levels and examining periodontal findings. The clinical parameters plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at baseline. Laboratory blood investigations were performed to evaluate RBC count, Hb, packed cell volume (PCV), erythrocyte sedimentation rate (ESR) and red cell indices, hs-CRP at baseline. Nonsurgical periodontal therapy was performed for all patients. Patients were recalled after 6 months. The clinical and hematological parameters were re-evaluated to analyze the changes after nonsurgical periodontal therapy.

Results: The results showed that there was a significant increase in Hb levels, RBC count and PCV from baseline to 6 months after nonsurgical periodontal therapy. There is significant decrease in levels of ESR and hs-CRP levels after nonsurgical periodontal therapy indicating resolution of periodontal inflammation. There is a significant decrease in PPD, scores of PI and GI and significant increase in CAL gain. Minimal changes in mean corpuscular volume, mean corpuscular hemoglobin (MCH) and MCH concentration indicated that the lower values of red cell parameters are not due to any vitamin and mineral deficiencies, but secondary to the chronic inflammatory changes associated with chronic periodontal disease.

Conclusion: The present study strengthens the hypothesis that chronic periodontitis may lead to anemia and provides evidence that nonsurgical periodontal therapy can improve the anemic status and reduce levels of hs-CRP in patients with chronic periodontitis.

Citing Articles

Comparison of hematological parameters among chronic periodontitis patients and healthy individuals.

Timothy C, Rajasekar A J Adv Pharm Technol Res. 2023; 13(Suppl 2):S545-S548.

PMID: 36798578 PMC: 9926587. DOI: 10.4103/japtr.japtr_170_22.

Blood Cell Count Inflammatory Markers as Prognostic Indicators of Periodontitis: A Systematic Review and Meta-Analysis.

Almasan O, Leucuta D, Hedesiu M J Pers Med. 2022; 12(6).

PMID: 35743775 PMC: 9225277. DOI: 10.3390/jpm12060992.

Effect of nonsurgical periodontal therapy on C-reactive protein and iron indices in hemodialysis patients.

Vrinda S, Sadasivan A, Koshi E, Unnikrishnan B, Chandradas N, Saraswathi I J Indian Soc Periodontol. 2021; 25(6):485-490.

PMID: 34898913 PMC: 8603799. DOI: 10.4103/jisp.jisp_32_20.

Endodontic infections increase leukocyte and lymphocyte levels in the blood.

Samuel R, Gomes-Filho J, Azuma M, Sumida D, de Oliveira S, Chiba F Clin Oral Investig. 2017; 22(3):1395-1401.

PMID: 29022128 DOI: 10.1007/s00784-017-2222-z.

C-Reactive Protein in Peripheral Blood of Patients with Chronic and Aggressive Periodontitis, Gingivitis, and Gingival Recessions.

Podzimek S, Mysak J, Janatova T, Duskova J Mediators Inflamm. 2015; 2015:564858.

PMID: 26346216 PMC: 4539496. DOI: 10.1155/2015/564858.

References

Pepys M . C-reactive protein fifty years on. Lancet. 1981; 1(8221):653-7. DOI: 10.1016/s0140-6736(81)91565-8. View

Radafshar G, Shad B, Ariamajd E, Geranmayeh S . Effect of intensive non-surgical treatment on the level of serum inflammatory markers in advanced periodontitis. J Dent (Tehran). 2011; 7(1):24-30. PMC: 3184718. View

Correa F, Goncalves D, Figueredo C, Bastos A, Gustafsson A, Orrico S . Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes. J Clin Periodontol. 2009; 37(1):53-8. DOI: 10.1111/j.1600-051X.2009.01498.x. View

Page R . The role of inflammatory mediators in the pathogenesis of periodontal disease. J Periodontal Res. 1991; 26(3 Pt 2):230-42. DOI: 10.1111/j.1600-0765.1991.tb01649.x. View

Gokhale S, Sumanth S, Padhye A . Evaluation of blood parameters in patients with chronic periodontitis for signs of anemia. J Periodontol. 2010; 81(8):1202-6. DOI: 10.1902/jop.2010.100079. View

Lainson P, Brady P, FRALEIGH C . Anemia, a systemic cause of periodontal disease?. J Periodontol. 1968; 39(1):35-8. DOI: 10.1902/jop.1968.39.1.35. View

Agarwal N, Kumar V, Gujjari S . Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional study. J Indian Soc Periodontol. 2010; 13(1):6-11. PMC: 2846680. DOI: 10.4103/0972-124X.51887. View

Herrera J, Parra B, Herrera E, Botero J, Arce R, Contreras A . Periodontal disease severity is related to high levels of C-reactive protein in pre-eclampsia. J Hypertens. 2007; 25(7):1459-64. DOI: 10.1097/HJH.0b013e3281139ea9. View

SEIGEL E . Total erythrocyte, leucocyte and differential white cell counts of blood in chronic periodontal disease. J Dent Res. 2010; 24:270. View

10.

Gomes-Filho I, Coelho J, Cruz S, Passos J, Freitas C, Aragao Farias N . Chronic periodontitis and C-reactive protein levels. J Periodontol. 2010; 82(7):969-78. DOI: 10.1902/jop.2010.100511. View

11.

Noack B, Genco R, Trevisan M, Grossi S, Zambon J, De Nardin E . Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001; 72(9):1221-7. DOI: 10.1902/jop.2000.72.9.1221. View

12.

Pitiphat W, Savetsilp W, Wara-Aswapati N . C-reactive protein associated with periodontitis in a Thai population. J Clin Periodontol. 2007; 35(2):120-5. DOI: 10.1111/j.1600-051X.2007.01179.x. View

13.

Yamamoto T, Tsuneishi M, Furuta M, Ekuni D, Morita M, Hirata Y . Relationship between decrease of erythrocyte count and progression of periodontal disease in a rural Japanese population. J Periodontol. 2010; 82(1):106-13. DOI: 10.1902/jop.2010.100211. View

14.

Pradeep A, Anuj S . Anemia of chronic disease and chronic periodontitis: does periodontal therapy have an effect on anemic status?. J Periodontol. 2010; 82(3):388-94. DOI: 10.1902/jop.2010.100336. View

15.

Thakare K, Deo V, Bhongade M . Evaluation of the C-reactive protein serum levels in periodontitis patients with or without atherosclerosis. Indian J Dent Res. 2010; 21(3):326-9. DOI: 10.4103/0970-9290.70787. View

16.

Moore W, Moore L . The bacteria of periodontal diseases. Periodontol 2000. 1994; 5:66-77. DOI: 10.1111/j.1600-0757.1994.tb00019.x. View

17.

Tillett W, Francis T . SEROLOGICAL REACTIONS IN PNEUMONIA WITH A NON-PROTEIN SOMATIC FRACTION OF PNEUMOCOCCUS. J Exp Med. 2009; 52(4):561-71. PMC: 2131884. DOI: 10.1084/jem.52.4.561. View