Effect of advanced periodontal self-care in patients with early-stage periodontal diseases on endothelial function: An open-label, randomized controlled trial

• Published in: PloS one 2021-09, Vol.16 (9), p.e0257247-e0257247
• Main Authors: Okada, Ayako, Murata, Takatoshi, Matin, Khairul, Ariyoshi, Meu, Otsuka, Ryoko, Yamashita, Mamiko, Suzuki, Masayuki, Wakiyama, Rumi, Tateno, Ken, Suzuki, Megumi, Aoyagi, Hitomi, Uematsu, Hiromi, Imamura, Akiko, Kosaka, Miki, Mizukaki, Tomoko, Sato, Tsutomu, Kawahara, Hiroshi, Hanada, Nobuhiro
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Aged; Anesthesiology; Arginine - analogs & derivatives; Arginine - blood; Arteriosclerosis; Atherosclerosis; Atherosclerosis - complications; Atherosclerosis - prevention & control; Biology and Life Sciences; Biomarkers - blood; Brachial Artery - pathology; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Clinical trials; Confidence intervals; Dental plaque; Dentistry; Dilatation, Pathologic; Disinfectants; Endothelium, Vascular - drug effects; Evaluation; Female; Follow-Up Studies; Gum disease; Health sciences; Hospitals; Humans; Hypotheses; Japan; Male; Mandible - physiology; Maxilla - physiology; Medicine; Medicine and Health Sciences; Middle Aged; Oral hygiene; Oral Hygiene - methods; Patients; People and Places; Periodontal disease; Periodontal diseases; Periodontal Diseases - prevention & control; Periodontal Diseases - therapy; Reduction; Research and Analysis Methods; Self Care; Self-care, Health; Social research; Treatment Outcome; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0257247

Although a significant association between periodontal disease and atherosclerotic cardiovascular disease has been reported, their cause-to-effect relationship remains controversial. This randomized controlled clinical trial aimed to investigate the effect of advanced self-care on atherosclerotic cardiovascular disease-related vascular function markers flow-mediated brachial artery dilatation (FMD) and serum asymmetric dimethylarginine (ADMA) level in patients with early-stage periodontal disease. The study was designed as a parallel group, 3-month follow-up, open-label, randomized controlled trial. The control group received standard care for periodontal diseases, whereas the test group additionally applied disinfectant using a custom-fabricated prescription tray for advanced self-care twice a day. Overall, 110 patients provided data for FMD and serum ADMA level. No significant improvements in FMD were observed in the control (mean increase, -0.1%; 95% confidence interval [CI], -1.0-0.8; P = 0.805) or test (mean increase, -0.3%; 95% CI, -1.1-0.4; P = 0.398) group. No significant changes in serum ADMA levels were observed (mean reduction, 0.01 μmol/L; 95% CI, -0.00-0.02; P = 0.366 and mean reduction, 0.00 μmol/L; 95% CI, -0.01-0.01; P = 0.349, respectively). No significant between-group differences were found in FMD (mean difference, -0.2%; 95% CI, -1.4-0.9; p = 0.708) or serum ADMA levels (mean difference, 0.01 nmol/L; 95% CI, -0.00-0.03; p = 0.122). Significant improvements in the average probing pocket depth were observed in the control and test groups. The bleeding on probing score in the test group was significantly reduced, while that in the control group was reduced, although not significantly. Periodontal care for a 3-month duration did not provide better endothelial function although improvements of periodontal status in patients with early-stage periodontal diseases. This trial is registered in UMIN Clinical Trials Registry (www.umin.ac.jp/ctr/; ID: UMIN000023395).