Diagnostic Value of Acute Phase Proteins in Periodontal, Psychosomatic and Cardiometabolic Diseases: Response to Treatment

Abstract

The host response to bacterial plaque biofilm on tooth surfaces initiates periodontal disease and its progression affecting the supporting structures of teeth. Stressor responses of the host to plaque biofilm result in markers of inflammation that are common to diabetes mellitus and coronary heart disease (Pussinen et al 2007). These inflammatory markers are relevant to periodontitis, anxiety states, associated systemic diseases and their sequelae in a bi-directional manner. The extent and clinical significance of these associations have received increasing coverage in the literature. This is largely dependent on the scale of the inflammatory loading based on the severity of periodontal inflammation at the time of examination and the number of sites involved (Norse et al 2008). Response to periodontal treatment with decreased levels of serum markers is indicative of the importance of this source of systemic inflammatory loading. The impact of inflammatory loading from the periodontium as a significant source of systemic inflammation has been an area of debate. The extent and severity of periodontal inflammation in the presenting population determine its significance in this context. It has wider implications in the context of co-morbidities in periodontal patients. In addition to the commoner co-morbidities, coronary heart disease (CHD), diabetes mellitus and arthritis, other autoimmune conditions and anxiety states also show similar links. This chapter aims to provide such evidence, conflicting at times due to multifactorial presentations of clinical conditions and individual susceptibility. In relevant cases, given a sufficient impetus from inflammatory loading it highlights the importance of controlling periodontal disease in a systemically-ill population. Searches were done over the past 10-15 years, using keywords relevant to the title; subsequently limited to those representing key information focusing on inflammatory markers, their significance and relevance to periodontal, psychosomatic and cardiometabolic diseases with implications on treatment.