| IntroductionChronic periodontitis is a local chronic inflammatory process mediating the destruction of periodontal tissues, triggered by plaque biofilm, which is the primary reason for tooth loss in humans.Coronary atherosclerotic heart disease is the leading cause of death worldwide, with high medical costs and rates of disability. In recent years,a large number of epidemiological investigation and research shows, periodontitis is associated with coronary heart disease and atherosclerosis,a growing number of evidence suggests that periodontitis may be an independent risk factor for coronary heart disease and it’s acute attack.The mechanism of periodontitis leading to coronary heart disease is very complex, inflammatory cytokines such as hs-CRP, IL-8 and TNF-α may play an important role in the process.It has been confirmed that hs-CRP, IL-8 and TNF-α play an important role in the nosogenesis and development of coronary heart disease. They may participate the physio-act through the complic information transfer and then adjust the host immune function. Together with the other cytokines,these cytokines may cause the adherency and accumulation of platelet and may effect the function of vescular endothelial cell and then may accelerate and aggravate the patho-course of coronary heart disease. In addition, these inflammatory cytokines play an active role in the pathological process of chronic periodontitis.C- reactive protein has been identified as an independent risk factor for coronary heart disease, its sensitivity is better than the other inflammatory factors, and the existing research about CRP is greater.This article will determine the effectiveness of periodontal therapy on serum C-reactive protein in coronary heart disease patients with chronic periodontitis reported by articles and assess the quality of the studies by evidence-based medicine. With the experimental study of periodontal treatment in coronary heart disease patients with chronic periodontitis, we will investigate the effects of periodontal therapy on serum levels of hs-CRP, IL-8 and TNF-α and the results of the intervention in coronary heart disease patients with chronic periodontitis. This article will also make a preliminary study of the effect of periodontal therapy in the prevention and treatment of coronary heart disease, and further provide credible evidence for correlation between the two diseases. Objective1. To determine the effectiveness of periodontal therapy on hs-CRP in coronary heart disease patients with chronic periodontitis reported by articles and to assess the quality of the studies by evidence-based medicine.2. To investigate the effects of periodontal therapy on hs-CRP, IL-8 and TNF-α and the results of the intervention in coronary heart disease patients with chronic periodontitis. Methods1. The databases such as CNKI, wanfangdata, VIP, CBM published from the 1994 to 2013 were searched. Collect all published literatures about the effectiveness of periodontal therapy on serum C-reactive protein in coronary heart disease patients with chronic periodontitis. Literatures were screening and the data were extracted in accordance with inclusion criteria. Analyze literature based on evidence-based medicine.2. Totally 46 coronary heart disease patients with chronic periodontitis were randomly divided into treatment group(n=23) and control group(n=23), compared periodontal clinical parameters and serum levels of CRP, IL-8 and TNF-α before and after periodontal therapy. Results1. There were totally 15 articles that met the criteria. Randomized controlled trials(RCT) was in a small number and low research quality. Meta-analysis could not be done. The results showed that: for now, periodontal therapy may reduce the levels of serum C-reactive protein in coronary heart disease patients with chronic periodontitis.2. After periodontal therapy the periodontal clinical indices of all patients became better and the serum levels of CRP, IL-8 and TNF-α reduced. Conclusions1. There are not enough articles about the effectiveness of periodontal therapy on serum C-reactive protein in coronary heart disease patients with chronic periodontitis. The quantity and quality of the reviewed studies are far from satisfaction and can not meet the clinical needs. Further trials of high methodological quality need to be undertaken in order to guide the effectiveness of periodontal therapy on serum C-reactive protein in coronary heart disease patients with chronic periodontitis.2. Periodontal therapy can not only improve periodontal condition, but also reduce serum levels of CRP, IL-8 and TNF-α. It can be conducive to the prevention and treatment of coronary heart disease. |
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