The study will cover 80 patients under 70 years of age. Initially they will be assigned to
three groups: patients generally healthy with periodontitis (P), patients after myocardial
infarction with periodontitis (CP) and patients generally healthy with a healthy periodontium
(H). Periodontal examination will be performed before treatment, 2 weeks and 3 months after
the treatment with a Williams probe calibrated at intervals 1-2-3-5-7-8-9-10mm. Pocket depth
(PD), clinical loss of the attachment (CAL) bleeding on probing (BOP), plaque control record
(PCR) measurements will be performed. Clinical data will be collected at six sites per tooth
(mesiobuccal, midbuccal, distobuccal, mesiolingual, midlingual, and distolingual) of the
designated study teeth. PD will be measured in millimeters from the free gingival margin to
the base of the probable pocket using a periodontal probe. The presence of BOP will be
determined as being present or absent (+/−) within 30 seconds after probing. CAL will be
defined as the distance from the cementoenamel junction to t the base of the probable pocket
.
Patients within CP and P groups will be randomly assigned to one of the two groups (study
group and control group) and an later visit will be scheduled.
Before treatment, teeth will be rinsed and the study areas will be isolated with cotton rolls
and dried gently. Supragingival plaque will then be removed with a sterile curret without
coming into contact with the gingiva. GCF samples will be collected from the deepest single
root tooth pockets previously identified. The sample will be collected from the deepest
pocket using the Periopaper strips (OraflowInc., USA). Before collecting the material, the
teeth will be insulated with cotton swabs. The teeth will then be dried with air. The strips
will be placed in pockets until a slight resistance is perceived, and they will be left in
place for 30 seconds and then transferred to Periotron 8000 (OraflowInc., USA) for the
determination of fluid volume. Strips contaminated by bleeding will be discarded.
Next, each strip will be inserted into the Eppendorff tube and sent to the laboratory at the
Medical Analytics Department of PUM in Szczecin for further analysis. The volume of the
gingival fluid will be given in μl, in accordance with the conversion of values displayed as
a reading on the device.
The microbiological examination (via Real-PCR method) for the presence of pathogenic bacteria
for periodontium will be performed using commercial standard sets PET-MIP deluxe ® (MIP
Pharma). Samples will be taken from the patient's deepest periodontal pocket. After isolation
of the examined tooth from the access of saliva, sterile paper will be placed inside the
pocket for 10 seconds following transfer to the transport containers included in the PET-Mip
deluxe ® kits and sent to the MIP-Pharma laboratory in St. Ingbert in Germany.
In the control and study group, supra and subgingival scaling and root smoothing with Gracey
currets will be performed. Individual oral hygiene instructions will also be given to each
patient. In addition laser therapy of the pockets with a 980nm diode laser will be carried
out in the study group.
The levels of TC, LDL, HDL, TG, hsCRP, leukocytes, fibrinogen, OB, IL-6, AST, ALT in the
peripheral blood will be marked three times (before treatment, 2 weeks and 3 months post
treatment). For this purpose, the blood will be taken from the superficial veins of the
forearm and sent for further analysis at the Medical Analytics Department of PUM in Szczecin.