Overview
Chronic periodontitis is a chronic inflammatory condition characterized by progressive loss of attachment and bone destruction around teeth, potentially linking to systemic health issues such as cardiovascular disease 13.Diagnosis
Assess periodontal parameters including plaque index (PI), gingival index, bleeding on probing, probing pocket depth (PPD), and clinical attachment loss 1.
Evaluate oxidative stress biomarkers in saliva, such as 8-Hydroxydeoxyguanosine (8-OHdG), protein carbonyl (PC), and malondialdehyde (MDA) 1.
Measure high-sensitivity C-reactive protein (hsCRP) levels in serum and gingival crevicular fluid (GCF) 2.Management
First-line treatments: Mechanical debridement (scaling and root planing) to remove plaque and calculus 3.
Adjunctive therapies: Consider systemic or local antimicrobial therapy based on clinical judgment and patient-specific factors 3.
Lifestyle modifications: Encourage good oral hygiene practices, smoking cessation, and management of systemic risk factors 3.Special Populations
Comorbidities: Patients with cardiovascular disease may exhibit elevated hsCRP levels, warranting closer monitoring and aggressive periodontal therapy 23.
Endothelial dysfunction: Initial periodontal therapy may improve endothelial function in chronic periodontitis patients 3.Key Recommendations
Assess and manage oxidative stress biomarkers in saliva, particularly 8-OHdG and PC, in chronic periodontitis patients to evaluate systemic inflammation risk (Evidence: Moderate 1).
Monitor hsCRP levels in both serum and GCF to identify chronic periodontitis patients at higher risk for cardiovascular disease (Evidence: Moderate 2).
Implement initial periodontal therapy, including scaling and root planing, to potentially improve endothelial function in chronic periodontitis patients (Evidence: Moderate 3).References
1 Nguyen TT, Ngo LQ, Promsudthi A, Surarit R. Salivary oxidative stress biomarkers in chronic periodontitis and acute coronary syndrome. Clinical oral investigations 2017. link
2 Tüter G, Kurtis B, Serdar M. Evaluation of gingival crevicular fluid and serum levels of high-sensitivity C-reactive protein in chronic periodontitis patients with or without coronary artery disease. Journal of periodontology 2007. link
3 Mercanoglu F, Oflaz H, Oz O, Gökbuget AY, Genchellac H, Sezer M et al.. Endothelial dysfunction in patients with chronic periodontitis and its improvement after initial periodontal therapy. Journal of periodontology 2004. link