The goal of this study was to determine if systemic inflammation could impair vascular function. Endothelial function may represent a pathway through which risk factors, such as inflammation, may affect the long-term process of atherogenesis and acute cardiovascular events, and indeed existing data reported in the biomedical literature support an association of periodontitis to cardiovascular disease.

The investigators studied a group of 120 patients who presented with severe periodontal disease to determine if intensive periodontal therapy (i.e., scaling and root planing, local antibiotic therapy, and tooth extraction) could result in short-term effects on endothelial dysfunction (endothelium-dependent vasodilatation of the brachial artery – primary outcome), and biomarkers associated with systemic inflammation (C-reactive protein [CRP] levels, interleukin-6 and other mediators – secondary outcomes), as compared to patients treated in a community-based periodontal treatment program (control group).

Patients were randomized based on key risk factors associated with cardiovascular disease status, such as smoking, social status, and other systemic diseases, including diabetes mellitus. The patients presented at baseline for treatment randomization, and for subsequent follow-up visits at days 1, 7, 30, 60, and 180 after therapy. It is noteworthy that baseline CRP levels in these subjects were relatively high, indicating that chronic inflammation from severe periodontitis is having a systemic impact on these individuals.

The intensive periodontal therapy resulted in a transient short-term increase in systemic inflammation and endothelial dysfunction, followed by significant improvements in periodontal health and endothelial function as early as two months after therapy and sustained at six months after therapy. Improvements in endothelial function were positively correlated with improvements in measures of periodontal disease. Also of interest is that the control therapy (supragingival mechanical scaling and polishing) was found to be inadequate at improving either the oral or systemic parameters investigated.