Evaluation Of C-Reactive Protein Levels And Blood Parameters in Chronic Periodontitis patients following non-surgical periodontal therapy: A Clinico-biochemical study

Chronic periodontitis is a disease characterized by an intense inflammatory infiltrate associated with irreversible loss of alveolar bone and connective tissue attachment in the periodontium which ultimately results in the loss of teeth. The mechanism underlying this destructive process involves both direct tissue damage resulting from plaque bacterial products and indirect damage through bacterial induction in the host cells by an activation of inflammatory mediators such as cytokines, prostaglandins and acute phase proteins. In response to bacteria or endotoxins derived from these periodontal pathogens, several acute phase proteins orchestrate the inflammatory cascade to bring about a balance between host and inflammatory stimuli. One consequence of these inflammatory reactions has been the elevated levels of various acute phase proteins in the serum, plasma, saliva and in gingival crevicular fluid. These acute phase response are initiated by activation of local macrophages and other cells such as fibroblast and endothelial cells, leading to the release of mediators such as Tumor necrosis factor (TNF-α), Interleukin-6 (IL-6) and Interleukin-1β (IL-1β) which in turn stimulate these proteins causing systemic changes.

C-reactive protein (CRP) is a very strong acute phase protein produced in the liver and circulates in the blood. It was discovered by Tillett and Francis laboratory in 1930. It is a systemic marker of inflammation induced by various inflammatory stimuli such as trauma, infection and hypoxia. CRP and other acute phase proteins are usually present at low levels in plasma, but may arise dramatically within 72 hours of injury or with infection. It receives much attention as their level guides decision for diagnosis, monitoring and therapy for inflammatory process and associated diseases. It was proved to be a significant predictor of future cardiovascular events.

The main purpose of this study is to compare and to evaluate the serum level of hs-CRP and CBC in moderate and advanced chronic periodontitis patients before and after nonsurgical periodontal treatment correlated with clinical findings.