The Relationship between Periodontal Disease and Motor Impairment in the Course of Parkinson's Disease

Introduction: The incidence of Parkinson's disease and the severity of accompanying motor impairment increase significantly with age. The etiopathogenesis and progression of Parkinson's disease at the molecular level is associated with the production of cytokines and acute phase proteins, which are also typical for inflammatory diseases, such as periodontitis and gingivitis. Objectives: The aim of the study was to assess the correlation between neurological parameters, the indices of periodontal status and systemic parameters of inflammation, as well as their change after treatment. Patients/Methods: The presented study is a retrospective analysis of data obtained from medical histories and patient charts. Charts of 93 patients diagnosed with Parkinson's disease and periodontal diseases over the period 2015-2017 were selected. Sixty-one of these patients received periodontal treatment: professional scaling, root planning - SRP and periodontal pockets rinsing with 3% H2O2 and constituted a study group. Additionally, the patients were instructed to use a 0.2% chlorhexidine mouthwash. The other 32 patients, who were not periodontally treated, formed a control group. Both groups continued their anti-parkinsonian treatment. Results: The mean pocket depth at the baseline was 4.0 mm (SD 0.9 mm), mean bleeding index was 56.2%, and 63.9% of patients presented tooth mobility grade II or III. A significant correlation between periodontal and neurological parameters was observed at the baseline. After periodontal treatment, an improvement of both periodontal parameters and those related to the Parkinson's disease was observed in the study group. Those periodontally treated exhibited lower number of anti-parkins onian medicines, lower number of falls, as well as better results in10-m walk test and timed-up-and-go test, as compared to the control group. The improvement was observed both 3 and 9 months after the end of treatment.