The Role of Inflammation in Wound Healing and Periodontal Disease

Objectives: In separate past studies, higher inflammatory responses have been associated with the pathogenesis of periodontal disease (periodontitis) and delayed wound healing in oral mucosa. The relationship between these factors is yet to be investigated. Using a standardized model of wound healing, this study objectively examined differences in oral mucosal healing rates and local tissue inflammation in response to wounding between individuals with periodontitis and healthy controls. Materials and Methods: Subjects included 20 systemically healthy, non-smoking, adult male participants (age range 24-45 years); 10 individuals classified as having periodontitis and 10 healthy age-matched controls. Three excisional wounds were placed on the hard palate under local anesthesia, and were standardized for size, location and depth. Oral mucosal healing rates were determined using daily videographs. Tissue was biopsied at 0h, 6h and 24h post-wounding and analyzed for local tissue inflammation through real-time PCR. Results: Preliminary results indicate that wound healing in systemically healthy young men with periodontitis is the same as healing in men without periodontitis in an unaffected area of the mouth. Local inflammation at baseline (0 hours) and after wounding (6 hours and 24 hours) was also found to be the same (no statistically significant differences) in healthy young men with periodontitis and healthy young men without periodontitis in an unaffected area of the mouth. Conclusion: These results suggest that moderate periodontal disease and its associated inflammation, even when untreated, does not affect healing rates in unaffected oral tissues. Despite higher levels of inflammation in the periodontally diseased tissues, baseline inflammation and inflammatory responses in the unaffected site (in local biopsied tissue) appeared similar between healthy controls and periodontitis subjects. Clinical significance: These results may have clinical implications in young healthy males in the management of surgical procedures and implant placement into unaffected tissue sites. Tissue repair seems to occur normally in unaffected tissue despite these patients having untreated periodontal disease. Additional studies are required to explore additional factors such as saliva and systemic inflammatory status that have led to our findings.