Impact of Scaling and Root Planing on Systemic Inflammation and Serum Bone Resorption Markers in Premenopausal Women With Periodontitis and Low Bone Mineral Density- A Prospective Interventional Study.

Periodontitis is a chronic multifactorial inflammatory disease associated with dysbiotic plaque biofilms and characterized by progressive destruction of the tooth supporting apparatus. Its primary features include the loss of periodontal tissue support, manifested through clinical attachment loss (CAL) and radiographically assessed alveolar bone loss, presence of periodontal pocketing and gingival bleeding.

Periodontitis is multifactorial inflammatory disease with numerous systemic or local risk factors playing a part in its clinical sequences. Periodontitis causes increased local inflammation as well as contributes to systemic inflammation with an increase in the levels of local and systemic inflammatory mediators including tumor necrosis factor alpha (TNF-α), interleukin-1 and interleukin-6 (IL-6).

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase bone fragility and susceptibility to fracture.

The development of osteoporosis occurs through spontaneous increase in pro-inflammatory and pro-osteoclastic cytokines such as , IL-6 and IL-1 β that activates receptor activator of nuclear factor-Kb ligand (RANKL) leading to an enhanced ability of osteoclasts to resorb bone.

The Studies on systemic influence of periodontitis have suggested that locally produced proinflammatory cytokines such as IL-1β , TNF-α and IL-6 may be released into circulation. Most studies shows that IL-6 and TNF-α is major cytokine responsible for resorption of bone in osteoporosis and increase of bone turnover markers. Periodontitis is chronic inflammatory disease characterized by destruction of tooth supporting tissues by virtue of the immunologic response to bacterial challenge originating from dental plaque. In Periodontitis, the increased released of proinflammatory cytokines such as TNF- α, IL-1β, and IL-6 in systemic circulation which causes increase in systemic bone loss through their osteoclastic activity. The systemic inflammation and rate of bone loss is measured by systemic inflammatory and bone resorption markers respectively.