Acute-Phase Response Following Different Modalities of Non-Surgical Periodontal Treatment in Subjects Affected by Periodontitis and Co-Morbid Hypertension: A Randomised Clinical Trial

Abstract

Aim: To compare acute-phase response and blood pressure levels following full-mouth or quadrant non-surgical periodontal treatment (FM-SRP or Q-SRP) in patients affected by hypertension and periodontitis. Patients and Methods: Forty patients affected by hypertension and periodontitis were enrolled and randomly allocated to either the FM-SRP or Q-SRP group. Periodontal parameters were registered at baseline and 3 months after treatment. Blood samples and vital signs were collected at baseline, 24 h and 3 months after treatment. Primary outcomes were high-sensitivity C-reactive protein (hs-CRP) concentration 24 h post operation and the variation in levels of blood pressure (BP). Results: Significant increase in hs-CRP levels was observed at 24 h, with FM-SRP presenting higher values than Q-SRP (p < 0.05). In terms of periodontal outcomes, both treatment regimens proved equally effective. Systolic BP was significantly reduced at days 1 and 90 in both groups (p < 0.01), while a 90-day significant decrease in diastolic BP was detected only in the Q-SRP group (p < 0.01). Multiple regression analysis suggests that the peak of hs-CRP at 24 h may influence BP reduction at Day 90. Conclusions: Q-SRP may be preferred in patients affected by hypertension and periodontitis, as a higher post-operative inflammatory response was associated with lower improvements in BP control in the medium term.