Effect of Periodontal Therapy on GCF and Serum Levels of High-Sensitive C- reactive protein in Chronic Periodontitis Patients Alaa M Attia: Associate Professor of Periodontology Faculty of Dentistry, Umm Alqura University & Faculty of Dentistry, Al-Azhar University, Egypt Aza Biomy: Professor of Clinical Pathology, Faculty of Medicine Mansoura University, Egypt Introduction Periodontitis, a very common chronic infection of the tissue surrounding the teeth is associated with elevated levels of CRP and other inflammatory biomarkers (1). As a consequence, markers of inflammation including acute phase proteins such as CRP and serum amyloid A, proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1 and interleukin-6, and soluble forms of intercellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1) have been used in terms of risk assessment for cardiov ascular disease (2). C-reactive protein is synthesized and secreted mainly by hepatocytes in response to cytokines such as interleukin-6 and has long been considered to be an inflammatory marker, with no specific role in the pathogenesis of atherosclerosis. Furthermore, it has been proposed that patients with periodontitis may have elevated circulating levels of some of those inflammatory markers (3). Aim of the study The aim of the present study was to determine whether the presence of chronic periodontitis and subsequent periodontal treatment could influence the GCF and serum level of CRP. Results 1- Non-surgical periodontal therapy resulted in a significant improvement of all clinical parameters after periodontal therapy (in chronic periodontitis patients). Severe periodontitis case Subjects and Methods Study Population: Subjects presenting with moderate to severe periodontitis, in comparison, healthy periodontally subjects also selected. Exclusion criteria: (i) known systemic diseases, (ii) history and/or presence of other infections, (iii) systemic antibiotic treatment in the preceding 3 months, (iv) treatment with any medication known to affect the serum level of inflammatory markers and (v) smokers (vi) pregnant or lactating females. Grouping Group I = 20 patients (14 males and 6 females) with chronic periodontitis, age 33 to 55 years. Group II = Healthy control group, 10 healthy subjects (6 males and 4 females), age 30 to 50 years. Periodontal examination Prior to GCF & serum samples collection, the following parameters were taken Gingival index (GI), Pocket depth (PD) , Attachment loss (CAL) (13) Collection of samples 1- GCF samples 2- Serum samples The samples stored - 70C until assaying of CRP level.by ELIZA technique. Non surgical periodontal therapy (NSPT) NSPT oral hygiene instructions, scaling and root planning through 4 visits consequently. Metronidazole was prescribed in many cases when indicated at dose 500 mg twice daily for 7 days 2- Serum-CRP level was significantly reduced in chronic periodontitis patients after periodontal treatment. Also, serum-CRP level in periodontitis patient before treatment was significant in comparison to healthy control group. G I = Chronic periodontitis patients G II= Healthy periodontally subjects 3- GCF-CRP levels was detected in all sites in health and diseased subjects, the statistical comparisons were non significant. G I = Chronic periodontitis patients G II= Healthy periodontally subjects Conclusions 1- Successful periodontal therapy significantly reduced the serum-CRP level that is associated with cardiovascular risk. 2- Further studies are needed to clarify the relationship between GCF-CRP levels and periodontal diseases. GCF Sample by using of Micropipette capillary tube Nosurgical treatment for chronic periodontitis patient Refrences: 1. Shojaee M1, Fereydooni Golpasha M2, Maliji G3, et al. C - reactive protein levels in patients with periodontal disease and normal subjects. Int J Mol Cell Med. 2013;2(3):151-5. 2. Buhlin K, Gustafsson A, Pockley A, Frostegrd J and Klinge B. risk factors for cardiovascular disease in patients with periodontitis. European Heart Journal 2003;24:2099-2107. 3. Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M, Baumann H, Genco R and De Nardin E. systemic inflammation in cardiovascular and periodontal disease: comparative study. Clinical and Diagnostic Laboratory Immunology, 2002;3:425-432. 4. Joshipura K, Wand H, Merchant and Rimm E. Periodontal disease and biomarkers related tocardiovascular disease. J Dent Res 2004;83(2):151 155.

2. Buhlin K, Gustafsson A, Pockley A, Frostegrd J and Klinge B 2. Buhlin K, Gustafsson A, Pockley A, Frostegrd J and Klinge B. risk factors for cardiovascular disease in patients with periodontitis. European Heart Journal 2003;24:2099-2107. 3. Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M, Baumann H, Genco R and De Nardin E. systemic inflammation in cardiovascular and periodontal disease: comparative study. Clinical and Diagnostic Laboratory Immunology, 2002;3:425-432. 4. Joshipura K, Wand H, Merchant and Rimm E. Periodontal disease and biomarkers related tocardiovascular disease. J Dent Res 2004;83(2):151 155. 5Libby P, Ridker PM, and Maseri A. inflammation and atherosclerosis. Circulation 2002;105:1135-1143.

Pandey R , Madhumala R , Saranyan R, Sreekanth P: of Fisiograft in Intrabony Defects- A Clinical and Radiological Study. Journal of Clinical and Diagnostic Research. 2013 Oct, Vol-7(10): 2364-2367

Severe periodontitis case Effect of Periodontal Therapy on GCF and Serum Levels of High-Sensitive C- reactive protein in Chronic Periodontitis Patients Alaa M Attia: Associate Professor of Periodontology Faculty of Dentistry, Umm Alqura University & Faculty of Dentistry, Al-Azhar University Aza Biomy: Professor of Clinical Pathology, Faculty of Medicine Mansoura University Introduction Periodontitis, a very common chronic infection of the tissue surrounding the teeth is associated with elevated levels of CRP and other inflammatory biomarkers (1). As a consequence, markers of inflammation including acute phase proteins such as CRP and serum amyloid A, proinflammatory cytokines such as tumor necrosis factor-α (TNF-α), interleukin-1 and interleukin-6, and soluble forms of intercellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1) have been used in terms of risk assessment for cardiovascular disease (2). C-reactive protein is synthesized and secreted mainly by hepatocytes in response to cytokines such as interleukin-6 and has long been considered to be an inflammatory marker, with no specific role in the pathogenesis of atherosclerosis. Furthermore, it has been proposed that patients with periodontitis may have elevated circulating levels of some of those inflammatory markers (3). Aim of the study The aim of the present study was to determine whether the presence of chronic periodontitis and subsequent periodontal treatment could influence the GCF and serum level of CRP. be Results 1- Non-surgical periodontal therapy resulted in a significant improvement of all clinical parameters after periodontal therapy. G I = Chronic periodontitis patients G II= Healthy periodontally subjects Severe periodontitis case Subjects and Methods Study Population: Subjects presenting with moderate to severe periodontitis, in comparison, healthy periodontally subjects also selected. Exclusion criteria: (i) known systemic diseases, (ii) history and/or presence of other infections, (iii) systemic antibiotic treatment in the preceding 3 months, (iv) treatment with any medication known to affect the serum level of inflammatory markers and (v) smokers (vi) pregnant or lactating females. Grouping Group I = 20 patients (14 males and 6 females) with chronic periodontitis, the age was ranged from 33 to 55 years. Group II = Healthy control group in comprised of 10 healthy subjects (6 males and 4 females) as a control group, the age was ranged 30 to 50 years. Periodontal examination Prior to GCF & serum samples collection, the following parameters were taken Gingival index (GI), Pocket depth (PD) , Attachment loss (CAL) (13) Collection of samples 1- GCF samples 2- Serum samples The samples stored - 70C until assaying of CRP level.by ELIZA techqnique. Non surgical periodontal therapy (NSPT) NSPT oral hygiene instructions, scaling and root planning through 4 visits consequently. Metronidazole was prescribed in many cases when indicated at dose 500 mg twice daily for 7 days 2- Serum-CRP level was significantly reduced in chronic periodontitis patients after periodontal treatment. Also, serum-CRP level in periodontitis patient before treatment was significant in comparison to healthy control group. G I = Chronic periodontitis patients G II= Healthy periodontally subjects 3- GCF-CRP levels was detected in all sites in health and diseased subjects, the statistical comparisons were non significant. G I = Chronic periodontitis patients G II= Healthy periodontally subjects Conclusions 1- Successful periodontal therapy significantly reduced the serum-CRP level that is associated with cardiovascular risk. 2- Further studies are needed to clarify the relationship between GCF-CRP levels and periodontal diseases. GCF Sample by using of Micropeppite capillary tube Nosurgical treatment for chronic periodontitis patient Refrences: 1. Shojaee M1, Fereydooni Golpasha M2, Maliji G3, et al. C - reactive protein levels in patients with periodontal disease and normal subjects. Int J Mol Cell Med. 2013;2(3):151-5. 2. Buhlin K, Gustafsson A, Pockley A, Frostegrd J and Klinge B. risk factors for cardiovascular disease in patients with periodontitis. European Heart Journal 2003;24:2099-2107. 3. Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M, Baumann H, Genco R and De Nardin E. systemic inflammation in cardiovascular and periodontal disease: comparative study. Clinical and Diagnostic Laboratory Immunology, 2002;3:425-432. 4. Joshipura K, Wand H, Merchant and Rimm E. Periodontal disease and biomarkers related tocardiovascular disease. J Dent Res 2004;83(2):151 155.

The aim of the present study was to determine whether the presence of periodontitis and periodontal therapy effectiveness on local (GCF) and systemic (serum) level of CRP in chronic periodontitis patients.