Effect of Compliance During Periodontal Maintenance Therapy on CRP Levels

 

TAKE-HOME MESSAGE

  • This age- and gender-matched longitudinal case–control study included 30 matched pairs each consisting of one individual who practiced regular compliance with periodontal maintenance therapy and one individual who did not. Each participant had clinical periodontal parameters and plasma samples collected at T1 (prior to active periodontal therapy, T2 (after active therapy), and T3 (after 6 years). Those who practiced regular compliance maintained significantly better clinical periodontal status, had significantly lower recurrence of periodontitis, and significantly lower C-reactive protein (CRP) concentrations over time compared with those whose compliance was irregular. Logistic regression analysis demonstrated that the altered CRP levels (values  3 mg/L) were 2.19 times higher among individuals with periodontitis recurrence than among those without recurrence (P = .017). At T3, CRP levels among participants who complied with therapy only irregularly were 2.85 times higher than among those who regularly complied. (P = .009).

  • CRP is one of the most sensitive markers used to evaluate the inflammatory status of an individual. Compliance with periodontal maintenance therapy positively influenced CRP plasma levels and stability of periodontal clinical status 6 years after active periodontal therapy.
–  Laurie C. Carter, DDS, PhD

AIMS

To longitudinally evaluate the effects of compliance during periodontal maintenance therapy (PMT) on C-reactive protein (CRP) levels and its relation to periodontal status.

MATERIALS AND METHODS

A subsample comprising of 30 matched pairs was taken from a previous 6-year longitudinal study under PMT. Pairs were composed of one regular (RC) and one irregular (IC) compliers, matched by age and sex. Periodontal parameters and plasma samples were collected at 3 times: T1[prior to active periodontal therapy (APT)], T2(after APT), and T3(after 6 years). CRP plasma levels were quantified using ELISA.

RESULTS

RC presented better clinical periodontal status, lower recurrence of periodontitis (sites with PD ≥4 mm and CAL ≥3 mm, together with the persistence and/or presence of BOP and/or suppuration, during any of the subsequent recall evaluations) and significant reductions in CRP levels over time [(T1: RC = 3.64 ± 2.13 and IC = 3.92 ± 2.02 mg/L) and (T3: RC = 2.12 ± 1.39 mg/L and IC = 3.71 ± 1.82 mg/L)]. Logistic regression analysis demonstrated that individuals with periodontitis recurrence presented 2.19 higher chances of presenting altered CRP levels (values ≥3 mg/L- T2 to T3) than those without periodontitis recurrence (95%CI:1.16-3.27; p = 0.017).

CONCLUSIONS

Higher CRP plasma levels were associated with higher recurrence of periodontitis and worse clinical periodontal parameters among IC when compared to RC.

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