Antimicrobial Periodontal Treatment Decreases Serum C‐Reactive Protein, Tumor Necrosis Factor‐Alpha, But Not Adiponectin Levels in Patients with Chronic Periodontitis

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Abstract
Elevated levels of C-reactive protein (CRP) and decreased plasma adiponectin are associated with increased risk of atherosclerosis. Furthermore, recent observations suggested that adiponectin and tumor necrosis factor-alpha (TNF-alpha) suppressed each other's production. Since periodontal disease has been suggested to act as a risk factor for atherosclerosis, we examined the effects of antimicrobial periodontal treatment on CRP, adiponectin, and TNF-alpha levels. Fifteen chronic periodontitis patients with various systemic conditions at high risk for atherosclerosis were enrolled in the study. Patients were non-surgically treated with topical application of antibiotics and mechanical debridement of calculus once a week for 1 month. Before and after therapy, CRP, adiponectin, and TNF-alpha levels were measured. Both CRP and TNF-alpha levels were significantly decreased after treatment (P<0.01 and P<0.03, respectively), while adiponectin levels did not change significantly. Periodontal treatment is effective in reducing CRP and TNF-alpha, while adiponectin does not appear to be influenced by periodontal treatment. Elevated levels of CRP and TNF-alpha may be associated with increased risk for future development of atherosclerosis in periodontitis patients.