| BACKGROUND Chronic periodontitis and coronary heart disease are two of the most popular diseases which do great harm to our health. There are a lot of articles indicating that chronic periodontitis is an independent risk factor to cardiovascular diseases. The influence of chronic periodontitis as an independent risk factor to cardiovascular diseases may has a complicated mechanism, and cytokines play an important role in the mechanism. Cytokines, as the signal factors between cells, can modulate the immune function by regulating the physiological activities of cells. These cytokines with regulatory function can initiate platelet adhesion and aggregation, promote the formation of lipid-laden foam cells and the deposition of cholesterol with the intima, thus increase smooth muscle abnormal proliferation leading to a thickening of the vesselwall and accelerate the pathologic process of cardiovascular diseases such as coronary heart disease. The aim of the study was to evaluate the influence of periodontal basic therapy to serum cytokines and C- reactive protein in patients with chronic periodontitis and coexistent coronary heart disease so that we could determine the relationship between the two kinds of diseases and further more, provide reliable evidence that can be used in the clinical diagnosis, treatment and prophylaxis for the two kinds of diseases.METHODS Thirty-two patients (15 male, 17 female) aged from 45 to 65 years old were involved in the study. Combined with chronic periodontitis and coronary heart disease, absent from other systemic diseases such as diabetes, thyroid gland disease and nephropathy, normal with liver and pneumonic function, all the patients had no less than 20 teeth left but never gone through the treatment of scaling and root planning. Before treatment, we carefully investigated the health record and present condition of the patients, measured blood pressure and made sure there were no contraindications to the treatment. Supergingival scaling was performed by EMS ultrasonic scaler. Subgingival scaling and root planning were finished by two to four times of visit. We also performed pulp treatment, occlusive adjustment and periodontal immobility if necessary. We regularly presented ten minutes of communication and oral hygiene indication at the first visit. All the patients were avoided to use antibiotics. Peripheral veto blood samples were taken before and two weeks after treatment. We used radioimmunoassay method to measure the serum levels of interleukin-1β(IL-1β), interleukin-2(IL-2), interleukin-6(IL-6) and tumor necrosis factor alpha (TNF-alpha), and immunoturbidimetry method to measure the serum level of CRP. RESULTS After periodontal basic therapy, the mean levels of serum IL-1β, IL-2 and IL-6 indicated a little bit of declines, while TNF-α,CRP indicated a little bit of increase. After t test, we found that the decline of serum IL-1βlevel and the increase of serum TNF-αlevel were statistically significant (P＜0.05).CONCLUSION After periodontal basic therapy for patients with chronic periodontitis and coexistent coronary heart disease, the level of serum IL-1βindicated a significant decline, and the level of serum TNF-αindicated a significant increase, while the changes of IL-2,IL-6 and CRP level were not statistically significant. The levels of cytokines and CRP may have a kind of homeostasis. Cytokines and CRP, as the products of inflammation, have dual effects of promotion and restraint to the occurrence and development of some diseases. There is some difference between the results we reported and the domestic results through gingival flood study, but there is some basic common between our study results and some results from abroad. The reason of the difference between the results might be the multimedia factors that influence the serum level of cytokines and CRP in the patients we studied.
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