Influence of Periodontal Treatment on Systemic Inflammatory Mediators

Inclusion Criteria: A. General/Medical 1. Any race/ethnic group 2. Aged \> 30 years 3. Male or female 4. CHD case (CHD angiographically confirmed) 5. CHD diagnosed \> 3 months prior to entry into study. 6. No acute or chronic systemic conditions (see exclusion criteria below) 7. No medications/medication history that can interfere with the study (see exclusion criteria below) 8. Non-smoker (=Never smoker) or former smoker (=Does not smoke now and has not smoked at all for a minimum of the last 12 consecutive months) 9. Able and willing to comply with study procedures 10. Able and willing to be available for the duration of the study 11. Able and willing to provide signed informed consent B. Oral/Periodontal 1. Dentate with at least 14 natural teeth, excluding third molars, that can be evaluated periodontally. 2. Baseline whole mouth BOP \> 20% of sites. 3. Periodontitis case; periodontitis case defined as subject having ≥ 4 teeth with ≥ 1 site with PPD ≥ 4 mm \& CAL ≥ 3 mm at same site 4. No mechanical periodontal therapy in the last 6 months. 5. No acute oral diseases (mucosal lesions), oral infections, need for immediate dental/periodontal care (e.g., NUG). Exclusion Criteria: A. General/Medical 1. Age ≤ 30 years 2. Not fulfilling criteria of defined CHD case 3. Fulfilling criteria of defined CHD case, but diagnosed ≤ 3 months prior to start of study 4. Current smoker 5. Former smoker who does not smoke but who has smoked ≥ 1 cigarette (or equivalent, in form of water pipe, pipe, cigar) in the last 12 months. 6. Females pregnant or lactating 7. Systemic chronic conditions known to be associated with periodontitis or with changes in systemic inflammation: Diabetes,Rheumatoid Arthritis, Rheumatic Fever, SLE, Malignancy, Respiratory diseases, Renal diseases, Other (e.g., autoimmune diseases, fungal infections, immunological deficiencies, etc.) 8. Systemic acute conditions known to affect systemic markers of inflammation: Acute bacterial infection, Acute viral infection (common cold, influenza, sinusitis), Orthopedic trauma, Surgery 9. Medications known to affect systemic inflammatory biomarkers: Statins, Systemic steroids, Non-steroidal anti-inflammatory drugs, Immunosuppressants, 10. Medications potentially affecting systemic inflammatory markers, if therapy started less than 3 months prior to study such as Hormone replacement therapy, Contraceptives 11. Systemic antibiotic therapy in the last 3 months 12. Unable or unwilling to comply with study procedures 13. Unable or unwilling to be available for the duration of the study 14. Unable or unwilling to provide signed informed consent B. Oral/Periodontal 1. \<14 teeth that can be periodontally evaluated (excluding 3rd molars) 2. BOP ≤ 20% of sites 3. Not fulfilling criteria of defined periodontitis case 4. Having received any periodontal therapy within last 6 months 5. Topical/local antibiotic or anti-inflammatory therapy in last 6 months 6. Acute oral infections 7. Oral wounds, including recent (\< 2 months) extractions