BackgroundGrowing evidence suggests the type of periodontal treatment could differentially influence the reduction of key cardiovascular risk mediators in periodontitis patients. This randomized, controlled clinical trial compared the impact of minimally invasive non‐surgical therapy (MINST) with quadrant‐wise subgingival instrumentation (Q‐SI) on C‐reactive protein (CRP) together with lipoprotein‐associated phospholipase A2 (Lp‐PLA2) levels, and clinical periodontal outcomes in patients with periodontitis. Moreover, it was evaluated if baseline CRP levels impacted the efficacy of non‐surgical periodontal therapy protocols.MethodsForty‐two periodontitis patients were enrolled and randomly treated by means of MINST (n = 21) or Q‐SI (n = 21). The outcomes assessed were serum CRP and Lp‐PLA2, and periodontal parameters (probing depth [PD], clinical attachment level [CAL], full‐mouth bleeding score [FMBS]), at baseline and at follow‐ups at 1, 3, and 6 months and at 1 year after treatment.ResultsAt 1 year, MINST significantly reduced, among others, mean PD (p = 0.007), mean CAL (p = 0.007), the number of pockets >4 mm (p = 0.011) and ≥6 mm (p = 0.005), and FMBS (p = 0.048) compared to Q‐SI. Generalized multivariate analysis evidenced that high baseline CRP (p = 0.039) and FMBS (p = 0.046) levels, together with MINST treatment (p = 0.007) were significant predictors of PD reduction at 1‐year follow‐up. Moreover, the Jonckheere–Terpstra test showed that patients with high baseline CRP levels gained more benefits from MINST treatment at 1‐year follow‐up than they did from Q‐SI.ConclusionPatients receiving MINST showed a greater reduction in CRP levels than patients with Q‐SI after 1 year of follow‐up. Moreover, patients with high baseline levels of CRP and Lp‐PLA2 gained more benefits from the MINST approach at 1‐year follow‐up.

中文翻译：

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微创非手术治疗对牙周炎患者 C 反应蛋白、脂蛋白相关磷脂酶 A2 和临床结果的影响：一项为期 1 年的随机对照临床试验


背景越来越多的证据表明，牙周治疗的类型可能会对牙周炎患者关键心血管风险介质的减少产生不同的影响。这项随机对照临床试验比较了微创非手术治疗 （MINST） 与象限龈下器械 （Q-SI） 对牙周炎患者 C 反应蛋白 （CRP） 和脂蛋白相关磷脂酶 A2 （Lp-PLA2） 水平和临床结局的影响。此外，还评估了基线 CRP 水平是否影响非手术牙周治疗方案的疗效。方法纳入 42 例牙周炎患者，采用 MINST （n = 21） 或 Q-SI （n = 21） 随机治疗。评估的结局是血清 CRP 和 Lp-PLA2，以及牙周参数 （探诊深度 [PD] 、临床附着水平 [CAL]、全口出血评分 [FMBS]），在基线和治疗后 1 、 3 和 6 个月以及 1 年的随访中。结果1 年时，MINST 显著降低，其中包括平均 PD （p = 0.007）、平均 CAL （p = 0.007）、口袋数量 >4 mm （p = 0.011） 和 ≥6 mm （p = 0.005） 和 FMBS （p = 0.048） 与 Q-SI 相比。广义多变量分析证明，高基线 CRP （p = 0.039） 和 FMBS （p = 0.046） 水平以及 MINST 治疗 （p = 0.007） 是 1 年随访中 PD 降低的重要预测因子。此外，Jonckheere-Terpstra 测试显示，基线 CRP 水平高的患者在 1 年随访中从 MINST 治疗中获得的益处比从 Q-SI 中获得的更多益处。结论随访 1 年后，接受 MINST 的患者比 Q-SI 患者 CRP 水平降低得更大。 此外，CRP 和 Lp-PLA2 基线水平高的患者在 1 年随访中从 MINST 方法中获得了更多益处。