Effect of Exposure to Portland Cement Dust on the Periodontal Status and on the Outcome of Non-Surgical Periodontal Therapy

Background: Cement dust contains heavy metals like nickel, cobalt, lead and chromium, pollutants hazardous to the biotic environment, with adverse impact for vegetation, human and animal health and ecosystems. Objective: To investigate if long term exposure to cement dust can affect the periodontal health and affect the outcome of non-surgical periodontal therapy. Methods: A total of sixty subjects were included in this study. Forty patients with chronic periodontitis were grouped into; Group I comprised of 20 patients with chronic periodontitis working in the Portland Cement Company and Group II comprised of 20 patients with chronic periodontitis who does not work in cement factories nor live near any of them. Twenty healthy subjects were included in this study as healthy control group (Group III). Clinical parameters including gingival index (GI), plaque index (PI), pocket depth (PD) and clinical attachment loss (CLA) were scored for all patients before and after periodontal therapy. All patients received non-surgical periodontal therapy together with strict oral hygiene program for one month. Gingival crevicular fluid (GCF) samples were collected from both groups at baseline and one month after periodontal therapy. Real time PCR (RT-PCR) was used to analyze the GCF samples for detection and assessment of the levels of IL-1β and TNFα. Results: The two studied groups responded well to non-surgical periodontal treatment and there was no significant difference between GI and GII (P>0.05). The levels of TNFα was higher in GI than in GII before and after periodontal therapy (P<0.05).The levels of IL-1β did not show any significant difference between the two groups at base line (P>0.05), but represented with a highly significant difference between G1 and GII after periodontal therapy (P<0.001). A significant positive correlation was found between the levels of both IL-1β and TNFα and all the clinical parameters in GI before and after periodontal therapy and in GII before periodontal therapy (P<0.05). Conclusion: It seems that long term exposure to cement dust does not affect the clinical outcome of non-surgical periodontal treatment but it affects the levels of the pro-inflammatory mediators leading to more periodontal tissue destruction.