Reazione di fase acuta dopo terapia parodontale

Abstract Aim. Aim of this study was to compare quadrant scaling (Q-SRP) versus FM-SRP and conservative surgical periodontal therapy (C-SPT) versus resective SPT (R-SPT) in terms of systemic acute (24 hours) and medium-term (3 months) inflammation. Methods. 38 patients suffering from periodontitis after a baseline visit were randomly allocated to either FM-SRP or Q-SRP and 28 to either C-SPT and R-SPT. Periodontal and anthropometric parameters were collected at baseline and after 3 months. Serum samples were drawn at baseline and 1 and 7 and 90 days after treatment. High sensitivity assays for a broad array of inflammatory and endothelial assays were performed on all samples. Results. FM-SRP produced a greater acute phase response after 24 hours when compared to Q-SRP (3-fold increase in C-Reactive Protein (CRP), p<0.001 and 2-fold increase in Interleukin (IL-6). All periodontal treatments produced a comparable improvement in standard clinical periodontal parameters with no between-group differences. For SRP groups treatment time was positively associated with the relative 24 hrs increase in CRP (R=0.5, p<0.001) and IL-6 (R=0.5, p=0.002), whilst the number of deeper (greater than 6mm) pockets predicted only the relative increase in IL-6 (R=0.4, p<0.05). No statistical significant differences were observed in terms of systemic biomarkers at any time points for C-SPT and R-SPT groups. Conclusions. FM-SRP triggers a moderate acute phase response of one-week duration compared to Q-SRP. C-SPT and R-SPT seems to not produce a significant acute phase response at 24 hours. Clinicians may choose conventional (quadrant scaling) treatment in patients with complicated medical history and/or uncontrolled co-morbidities, while it doesn’t appear important perform a conservative surgical approach to prevent a systemic inflammatory perturbation if the candidate area of intervention is restricted to less of 4 teeth.