Adam Lang

Periodontology Paper
Effect of Obesity on Periodontal Treatment Response
Many scholarly studies, along with standardized reviews, have determined an
epidemiological association between obesity and periodontal disease. Upon
publication of this article, the author states little has been studied on the clinical
response to treatment. Differing adipose tissues secretes various cytokines such as
TNF alpha, and Il6. Attention to possible pro-inlammatory adipose-produced
cytokines such as leptin, and adiponectin was scrutinized to rule causality in their
positive contribution to secure definitive causality between obesity and chronic
periodontitis.
Quantitative information gathered in these studies to demonstrate causality
are BMI, body dimensions, probe depth, gingival inflammation, and CAL. The test
population included approximately 48 persons, half female half male, median age of
48.7, half with periodontal disease, and half without. Each participant was provided
SRP, (six appointments, 1 hour each) by a periodontist using hand, ultrasonic, and
sodium bicarbonate air polisher initially, 3 month, and six month marks. Detailed
home care instruction/demonstration with given to each participant.
As stated earlier, adipose tissue resembles that of an endocrine gland which
secretes cytokines called adipocytokines, (i.e adipocytokine and leptin.) These
serve not only in the regulation of appetite and energy metabolism, they also play a
role in the immune response and function as inflammatory mediators. Elevated
presence of adipocytokines trigger a cascading event of pro-inflammation, which
consequently results in a pro-inflammatory environment and at systemic and
periodontal levels. This unbalanced level of inflammatory mediators effects proper
performance of the innate CD-4 response not only effecting those with CPD, it may
alter CPD onset for obese individuals. (Congalves, et al., 2015)
The study concludes that all participants responded to the non-surgical
periodontal maintenance schedule throughout the three month intervals. Those
that had existing chronic periodontal disease experienced less gains in clinical
attachment loss. The SRP delivered did not lower the adipocytokines, (i.e
adiponectin, leptin) in either of the groups which were collected initially, three
month, and six month intervals. (Congalves, et al., 2015)
Medical literature totes that intestinal gut flora, (especially that of the
stomach) is remarkably different in those who are obese, to those who arent. The

study focused on adipocytokines, and weighed their involvement with SRP recovery
with CPD. However, even though gut flora knowlege and its effects on our overall
health is in its infancy. Until then, we can only speculate the interplay between the
host microbiome and its relation to non-surgical perio therapy recovery.
Goncalves, D., et al., (2015). Effects of scaling and root planning on clinical
response and serum levels
of adipocytokines ini patients with obesity and chronic periodontitis. Journal
of Periodontology
Online, 149. 53-61. doi: 10.1902/jop.2014.140226.