PD081: The effect of quadrant versus one stage full-mouth scaling and root planing on C-reactive protein and proinflammatory biomarkers in the treatment of aggressive periodontitis: a randomized clinical trial

Background & Aim: The aim of this study was to examine whether full-mouth scaling and root planing (FM-SRP) in one visit or quadrant scaling and root planing (Q-SRP) resulted in greater improvements in C-reactive protein levels, and in proinflammatory biomarkers in patients affected by generalized aggressive periodontitis (GAgP) over a period of 6 months following treatment. Methods: Thirty-four patients affected by GAgP were included in the study. Subjects were randomised into two groups. The FM-SRP group received full-mouth scaling and root planing completed within the same day, while the Q-SRP group received quadrant scaling and root planing at 2-weekly intervals over four consecutive sessions. Full-mouth clinical measurements were recorded at baseline and at 3 and 6 months after therapy. Serum samples were taken at baseline, 24 h, and at 7, 90 and 180 days after treatment. The primary outcome of this study was serum C-reactive protein levels over time. Secondary outcomes include levels of CD34+, interleukin (IL) -1b, IL-6, Tumor Necrosis Factor (TNF) -a, fibrinogen, ICAM-1, VCAM-1, and E-selectin. Results: FM-SRP treatment produced twofold increase in serum C-reactive protein, TNF-a and IL-6 levels after 24 h and at 7 days compared to Q-SRP. In both groups, there was a significant correlation between levels of TNF-a and IL-6 with the number of deeper periodontal pockets (>7 mm) (P = 0.001). Moreover, in both groups, treatment time (recorded in minutes) and the number of deeper pockets were positively related to the serum levels of CRP, CD34+, and IL-6 (P < 0.001). Conclusion: Both therapies lead to decreasing in C-reactive protein and in proinflammatory biomarkers levels at 6 months after treatment. However, FM-SRP determines a higher shortterm increasing of C-reactive protein, TNF-a, and IL-6 levels compared to Q-SRP. In both groups, the duration of SRP badly influenced the serum levels of CRP, CD34+, and IL-6.