Effect of Non-Surgical Periodontal Therapy On Anemic Status In Chronic Periodontitis Patients: A Randomized Clinical Case Control Study.
Abstract
ABSTRACT
Back Ground: The aim of this current study is to identify the changes in haematological values of subjects with periodontal disease as compared to periodontally healthy individuals and to establish the relationship between chronic periodontitis and anemic status of the patients by correlating the periodontal parameters with haematological values following Nonsurgical Periodontal Therapy.
Methodology: The present case-control study included hundred subjects, out of which test group included fifty chronic periodontitis. The control group included fifty periodontally healthy subjects. Both periodontal and haematological parameters were assessed for both the groups at baseline and three months who had undergone non-surgical periodontal therapy later for the test group. Ten patients in the test group were excluded from the study and the remaining forty patients completed the study period and hence their results were analysed statistically by employing Mann-Whitney U Test, Wilcoxon Matched Pairs Test, Karl-Pearson’s Correlation Coefficient Method.
Results: The results in this study have shown that by treating the periodontal inflammation, it has led to a significant improvement in erythrocyte count as well as haemoglobin levels. Following NSPT in the test group, out of all the haematological values, ESR has shown major statistically significant difference along with TRBC and Hb. Whereas there was much less significant improvement in the remaining values viz. PCV, MCV, MCH, MCHC.
Conclusion: The results of this study have clearly demonstrated that the treatment of periodontitis condition does lead to the improvement in various haematological values. Hence, its proven that chronic generalized periodontitis could lead to anemia of chronic disease in the long run. Thereby it is advisable that we should monitor the anemic status of the patients on a regular basis and advice the patients accordingly.
References
2. Glossary of Periodontal Terms, 4th ed. Chicago: American Academy of Periodontology 2001:43.
3. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Periodontal medicine: Impact of periodontal infection on systemic health. Clinical periodontology;10th edition, WB Saunders,2006;312-329.
4. Hutter JW, Velden U, Varoufaki A, Huffels RAM. Lower numbers of erythrocytes and lower levels of hemoglobin in periodontitis patients compared to control subjects. J Clin Periodontol 2001;28;930-936;doi:10.1034/j.1600-051x.2001.028010930.x
5. Takami Y, Nakagaki H. Blood test values and community periodontal index scores in medical checkup recipients. J Periodontol 2003;74:1778-1784; doi:10.1902/jop.2003.74.12.1778
6. Pradeep AR, Anuj S, Raju AP . Anemia of chronic disease and chronic periodontitis: Does periodontal therapy have an effect on anemic status. J Periodontol 2010; 82: 388-394; doi:10.1902/jop.2010.100336.
7. Geoffrey. Anaemia of chronic disease. CME; 26: 2008;238-240.
8. Naik V,Acharya A. Generalized, severe, chronic periodontitis is associated with anemia of chronic disease: a pilot study in urban Indian males. J Investig Clin Dent 2010; 1: 139-143;doi:10.1111/j.2041-1626.2010.00028.x
9. Weiss G, Goodnough T . Anemia of chronic disease. N Engl J Med 2005; 352; 1011-1023. doi: 10.1056/NEJMra041809.
10. Means R. Recent developments in the anemia of chronic disease. Current Hematology Reports 2003; 2: 116-121.
11. Peter S. Indices in dental epidemiology. Preventive and Community dentistry;3rd edition;123-231.
12. Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol 2005(suppl), 76: 2106-2115;doi:10.1902/jop.2005.76.11-s.2106.
13. Shah C, Kumar S, Sinha S. Quantitative estimation of acute-phase protein (C reactive protein) in gingival crevicular fluid in chronic periodontitis, before and after non-surgical therapy- A clinico biochemical study. J Int Oral Health 2010; 2: 23-31.;ISSN: 2394-9414.
14. Marcaccini AM, Meschiari CA. Circulating interleukin-6 and high sensitivity C-reactive protein decrease after periodontal therapy in otherwise healthy subjects. J Periodontol 2009; 80:594-602;doi:10.1902/jop.2009.08056.
15. Gokhale SR, Sumanth S, Padhye AM. Evaluation of blood parameters in patients with chronic periodontitis for signs of anemia. J Periodontol 2010; 81: 1202-1206; doi:10.1902/jop.2010.100079.
16. Yamamoto T, Tsuneishi M, Furuta M, Ekuni D, Morita M, Hirata Y. Relationship between decrease of erythrocyte count and progression of periodontal disease in a rural Japanese Population. J Periodontol 2011;82:106-113; doi:10.1902/jop.2010.100211.
17. Chakravarthy Muppalla, Ramakrishnan Theyagarajan, Geetha Ari, Jaideep Mahendra. Evaluation of systemic markers related to anemia in peripheral blood of patients with chronic generalized severe periodontitis a comparative study. International Journal of Current Research and Review 2016; Vol-08 ; Issue 09; 59-63; ISSN: 0975-5241.
18. P. S. Samyuktha, R. Gayatri Devi, A. Jyothipriya. Association between anemia of inflammation and hematological parameters of aggressive periodontitis. Drug Invention Today ;2019;Vol - 11;Issue 4;941-944;ISSN: 0975-7619.
19. Agarwal N, Veerendra S.C Kumar. Effect of periodontal therapy on hemoglobin and erythrocyte levels in chronic generalized periodontitis patients: An interventional study. J Indian Soc Periodontol 2009; 13: 6-11;doi:10.4103%2F0972-124X.51887
20. Malhotra R, Grover V, Kaur A. Effect of scaling and root planing on erythrocyte count, hemoglobin and hematocrit in patients with chronic periodontal disease. J Dent Hygiene 2012; 86:195-203;PMID:22947842.
21. Zarychanski R, Houston. Anemia of chronic disease: A harmful disorder or an adaptive, beneficial response? CMAJ 2008; 17: 333-337; doi:10.1503%2Fcmaj.071131.
22. Weiss G. Pathogenesis and treatment of anemia of chronic disease. Blood reviews 2002; 16: 87-96.
23. Sears DA. Anemia of chronic disease. Med Clin North Am1992; 76: 567-579;doi:10.1016/S0025-7125(16)30340-6.
24. Swaak A. Anemia of chronic disease in patients with Rheumatoid arthritis: Aspects of prevalence, outcome, diagnosis and the effect of treatment on disease activity.J Rheumatol2006; 33: 1467-1468; PMID: 16881103.
25. Ali S. The correlation between hemoglobin level and generalized moderate chronic periodontitis. J Bagh College Dentistry 2012; 24: 85-88.
26. Williams RC, Offenbacher S. Periodontal medicine: the emergence of a new branch of periodontology. Perio 2000;2000; 23: 9–12;doi:10.1034/j.1600-0757.2000.2230101.x
27. Nicki RC,Walker BR,Ralston SH.Blood disease.Davidson’s principle’s and practice of medicine;21st edition; 2010;985-1082.
28. Hind A. Aljohani. Association between Hemoglobin Level and Severity of Chronic Periodontitis. Med Sci, 17: 53-64;doi:10.4197/med.17-1.6.
29. Bokhari SA, Khan AA. Non-surgical Periodontal therapy lowers serum inflammatory markers:A pilot study. J Periodontol 2009; 80: 15 1580; doi:10.1902/jop.2009.090001.
30. Graziani F, Cei S, Tonetti M Systemic inflammation following non-surgical and surgical periodontal therapy. J Clin Periodontol 2010; 37: 848-854; doi:10.1111/j.1600-051x.2010.01585.x.
