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Response to periodontal therapy in patients who had weight loss after bariatric surgery and obese counterparts: a pilot study.

BACKGROUND
Periodontitis and obesity are both chronic health problems, and the literature supports an association between the two. Weight loss after bariatric surgery (BS) has been shown to decrease overall mortality as well as the development of new health-related conditions in morbidly obese patients. The present study aims to assess whether significant weight loss would improve the response to non-surgical periodontal therapy in obese patients.


METHODS
This study included 30 obese (body mass index >30 kg/m(2)) patients affected with chronic periodontitis. Of these, 15 patients had previously undergone BS and lost ≥40% of their excess weight for ≥6 months after surgery. The other 15 patients were also obese but did not have the surgery, nor did they lose weight to serve as a control group. All participants received non-surgical periodontal therapy (scaling and root planing and oral hygiene instructions). Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), and plaque index were measured at baseline and at 4 to 6 weeks after the periodontal treatment. Descriptive statistics, linear mixed-effects models, and linear regression models were used for data analysis.


RESULTS
The mean age of the study participants was 47.1 ± 11.5 years, and 36.7% of the participants were males. There was a statistically significant improvement after periodontal therapy in the BS compared with the obese group (P <0.05). The PD had a mean reduction of 0.45 mm in the BS group versus 0.28 mm in the control group. The reduction in CAL was 0.44 mm versus 0.30 mm, percentage of BOP sites was 16% versus 15%, and GI was 1.03 versus 0.52 in the BS and control groups, respectively.


CONCLUSION
An improved response to non-surgical periodontal therapy is observed in obese patients who had significant weight loss after BS compared with obese patients who did not have such a surgery.