{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T20:18:29Z","timestamp":1773433109056,"version":"3.50.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"Background<\/jats:title>Periodontitis is a chronic multifactorial inflammatory disease of the supportive tissues of the teeth. In more recent years, remarkable epidemiological and pathophysiological associations between periodontitis and cardiovascular disease (CVD) have been presented. Whether or not treatment of periodontitis is valuable for primary or secondary prevention of cardiovascular disease, has not yet been fully established. In this practice-based pilot study we focused on primary prevention of cardiovascular disease, by investigating the effect of periodontal treatment on the earliest detectable stage of CVD; endothelial dysfunction.<\/jats:p><\/jats:sec>Methods<\/jats:title>Otherwise healthy periodontitis and non-periodontitis participants 45\u201370 years of age were included in the study. One year after completing periodontal (non-surgical and surgical) treatment of the periodontitis patients and 1 year after inclusion of the controls, all baseline measurements were repeated. Full-mouth examinations were performed by a periodontist to determine their Periodontal Inflamed Surface Area (PISA) score and other dental parameters. To assess the cardiovascular conditions, endothelial function through the reactive hyperemia index (RHI) assessed by the EndoPAT\u2122, and several physical and biochemical parameters were measured.<\/jats:p><\/jats:sec>Results<\/jats:title>21 patients with diagnosed, untreated periodontitis and 21 participants without periodontitis were included in this follow-up study. After periodontal therapy in the periodontitis patients, the PISA reduced significantly. The RHI did not show a significant improvement after treatment of the periodontitis patients (\u22120.1 \u00b1 0.8, p<\/jats:italic> = 0.524). Similarly, other secondary cardiovascular outcome measurements, hsCRP, total cholesterol, HDL cholesterol, triglycerides, HbA1c, and systolic blood pressure did not improve significantly after periodontal treatment. Controls did not show any significant changes in the RHI, in other CVD parameters and in the PISA after 1-year follow-up.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In this practice-based pilot study, periodontal treatment did not improve the endothelial function in otherwise healthy adults with periodontitis. Future studies are needed to be of larger size and could focus on periodontitis patients with co-morbidities to investigate whether periodontal treatment has secondary preventive effect on endothelial function and other CVD parameters.<\/jats:p><\/jats:sec>Clinical Trial Registration<\/jats:title>[www.ClinicalTrials.gov<\/jats:ext-link>], identifier [ISRCTN55656827].<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2022.851397","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T05:19:58Z","timestamp":1649913598000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Periodontal Treatment on the Reactive Hyperemia Index. A 1-Year Follow-Up Pilot Study"],"prefix":"10.3389","volume":"9","author":[{"given":"H. C. M.","family":"Donders","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. O.","family":"Veth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. A.","family":"Edens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. W. J.","family":"van \u2019t Hof","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"de Lange","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. G.","family":"Loos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1016\/S0140-6736(05)67728-8","article-title":"Periodontal diseases.","volume":"366","author":"Pihlstrom","year":"2005","journal-title":"Lancet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1111\/prd.12200","article-title":"Periodontitis epidemiology: is periodontitis under-recognized, over-diagnosed, or both?","volume":"75","author":"Papapanou","year":"2017","journal-title":"Periodontol 2000."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1177\/0022034514552491","article-title":"Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression.","volume":"93","author":"Kassebaum","year":"2014","journal-title":"J Dent Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1902\/jop.2005.76.11-s.2106","article-title":"Systemic markers of inflammation in periodontitis.","volume":"76","author":"Loos","year":"2005","journal-title":"J Periodontol."},{"key":"B5","first-page":"1","article-title":"Periodontal diseases.","volume":"3","author":"Kinane","year":"2017","journal-title":"Nat Rev Dis Prim."},{"key":"B6","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1177\/0022034517699786","article-title":"Genetic susceptibility contributing to periodontal and cardiovascular disease.","volume":"96","author":"Aarabi","year":"2017","journal-title":"J Dent Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1136\/bmj.298.6676.779","article-title":"Association between dental health and acute myocardial infarction.","volume":"298","author":"Mattila","year":"1989","journal-title":"BMJ."},{"key":"B8","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/jcpe.13189","article-title":"Periodontitis and cardiovascular diseases: consensus report.","volume":"47","author":"Sanz","year":"2020","journal-title":"J Clin Periodontol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2520","DOI":"10.1161\/CIR.0b013e31825719f3","article-title":"Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American heart association.","volume":"125","author":"Lockhart","year":"2012","journal-title":"Circulation."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1161\/hypertensionaha.118.11528","article-title":"Poor oral health and blood pressure control among US hypertensive adults: results from the national health and nutrition examination survey 2009 to 2014.","volume":"72","author":"Pietropaoli","year":"2018","journal-title":"Hypertension."},{"key":"B11","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1093\/cvr\/cvz201","article-title":"Periodontitis is associated with hypertension: a systematic review and meta-analysis.","volume":"116","author":"Mu\u00f1oz Aguilera","year":"2020","journal-title":"Cardiovasc Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1111\/prd.12304","article-title":"Mechanisms underlying the association between periodontitis and atherosclerotic disease.","volume":"83","author":"Schenkein","year":"2020","journal-title":"Periodontol 2000."},{"key":"B13","first-page":"S51","article-title":"Inflammatory mechanisms linking periodontal diseases to cardiovascular diseases.","author":"Schenkein","year":"2013","journal-title":"J Clin Periodontol."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.709438","article-title":"Periodontal inflammation and systemic diseases: an overview.","volume":"12","author":"Mart\u00ednez-Garc\u00eda","year":"2021","journal-title":"Front Physiol."},{"key":"B15","article-title":"Cardiovascular disease in people with periodontitis (review).","volume":"9","author":"Liu","year":"2019","journal-title":"Cochrane Database Syst Rev."},{"key":"B16","doi-asserted-by":"publisher","first-page":"620","DOI":"10.1161\/CIRCRESAHA.115.306301","article-title":"Endothelial cell dysfunction and the pathobiology of atherosclerosis.","volume":"118","author":"Gimbrone","year":"2016","journal-title":"Circ Res."},{"key":"B17","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1056\/NEJMoa063186","article-title":"Treatment of periodontitis and endothelial function.","volume":"356","author":"Tonetti","year":"2007","journal-title":"N Engl J Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1111\/odi.12909","article-title":"Periodontal therapy and endothelial function in coronary artery disease: a randomized controlled trial.","volume":"24","author":"Ronsoni","year":"2018","journal-title":"Oral Dis."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0257247","article-title":"Effect of advanced periodontal self-care in patients with early-stage periodontal diseases on endothelial function: an open-label, randomized controlled trial.","volume":"16","author":"Okada","year":"2021","journal-title":"PLoS One."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcrp.2021.200110","article-title":"The association between periodontitis and cardiovascular risks in asymptomatic healthy patients.","volume":"11","author":"Donders","year":"2021","journal-title":"Int J Cardiol Cardiovasc Risk Prev."},{"key":"B21","doi-asserted-by":"crossref","DOI":"10.1002\/9781118032923","author":"Fleiss","year":"1999","journal-title":"The Design and Analysis of Clinical Experiments."},{"key":"B22","doi-asserted-by":"crossref","first-page":"S162","DOI":"10.1111\/jcpe.12946","article-title":"Periodontitis: Consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions.","volume":"45","author":"Papapanou","year":"2018","journal-title":"J Clin Periodontol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1111\/j.1600-051X.2008.01249.x","article-title":"Periodontal inflamed surface area: quantifying inflammatory burden.","volume":"35","author":"Nesse","year":"2008","journal-title":"J Clin Periodontol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1093\/eurheartj\/ehq010","article-title":"Assessment of endothelial function by non-invasive peripheral arterial tonometry predicts late cardiovascular adverse events.","volume":"31","author":"Rubinshtein","year":"2010","journal-title":"Eur Heart J."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2137","DOI":"10.1016\/j.jacc.2004.08.062","article-title":"Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia.","volume":"44","author":"Bonetti","year":"2004","journal-title":"J Am Coll Cardiol."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002270","article-title":"Prognostic value of flow-mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: a systematic review and meta-analysis.","volume":"4","author":"Matsuzawa","year":"2015","journal-title":"J Am Heart Assoc."},{"key":"B27","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1111\/jcpe.12171","article-title":"Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis.","volume":"41","author":"Teeuw","year":"2014","journal-title":"J Clin Periodontol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.atherosclerosis.2014.06.002","article-title":"Association between periodontal disease and its treatment, flow-mediated dilatation and carotid intima-media thickness: a systematic review and meta-analysis.","volume":"236","author":"Orlandi","year":"2014","journal-title":"Atherosclerosis."},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2020.625579","article-title":"Association between periodontal disease and atherosclerotic cardiovascular diseases: revisited.","volume":"7","author":"Zardawi","year":"2021","journal-title":"Front Cardiovasc Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/prd.12302","article-title":"Periodontal diseases and association with atherosclerotic disease.","volume":"83","author":"Herrera","year":"2020","journal-title":"Periodontol 2000."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230843","article-title":"Reporting quality and spin in abstracts of randomized clinical trials of periodontal therapy and cardiovascular disease outcomes.","volume":"15","author":"Shaqman","year":"2020","journal-title":"PLoS One."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.851397\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T05:20:06Z","timestamp":1649913606000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2022.851397\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":31,"alternative-id":["10.3389\/fcvm.2022.851397"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2022.851397","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,14]]},"article-number":"851397"}}