Evaluation of the Effect of Phase 1 Periodontal Therapy on Serum Procoagulant State of Systemically Healthy Chronic Periodontitis Subjects: A Clinico-Biochemical Study

评估第一阶段牙周治疗对全身健康慢性牙周炎患者血清促凝状态的影响:一项临床生化研究

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Abstract

BACKGROUND: Periodontitis is a chronic inflammatory condition that targets the structures supporting the teeth and has been linked to various systemic diseases, particularly cardiovascular conditions. The field of periodontal medicine highlights the influence of periodontitis on overall health, primarily through inflammatory markers such as C-reactive protein (CRP) and fibrinogen. MATERIALS AND METHODS: This randomized controlled prospective cohort study included 60 systemically healthy participants aged 30-60 years from Modern Dental College and Research Center, Indore. Participants were divided into two groups: Group I (30 periodontally healthy individuals, bleeding on probing (BOP) <20%) and Group II (30 chronic periodontitis patients, probing pocket depth (PPD) ≥4 mm in ≥30% of sites). Exclusion criteria were systemic diseases, smoking, alcohol use, and body mass index (BMI) ≥25 kg/m². Clinical parameters (BOP, PPD, clinical attachment loss (CAL), Vermillion's Simplified Oral Hygiene Index (OHI-S)) and biochemical markers (CRP, plasma fibrinogen) were measured pre- and post-treatment. Group II received scaling and root planing, with follow-up after three weeks. Data were analyzed using SPSS (IBM corporation, USA), with significance set at P < 0.05. RESULTS: Group II showed significantly higher BOP (1.00 ± 0.00 vs. 0.22 ± 0.03, P = 0.00) and PPD (5.99 ± 0.55 mm vs. 1.52 ± 0.27 mm, P = 0.00) compared to Group I. After therapy, BOP reduced to 0.31 ± 0.35, PPD to 3.54 ± 1.48 mm, and CAL improved from 6.15 ± 0.51 mm to 3.71 ± 1.49 mm (all P = 0.00). Serum CRP in Group II decreased from 1.99 ± 1.05 mg/L to 1.71 ± 0.62 mg/L (P = 0.017), and fibrinogen levels dropped from 2.16 ± 0.32 g/L to 1.86 ± 0.49 g/L (P = 0.003). CONCLUSION: Phase I periodontal therapy significantly improved clinical periodontal parameters, including BOP, PPD, and CAL, in patients with chronic periodontitis. The therapy also reduced systemic inflammatory markers, including CRP and fibrinogen.

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