• RADITYA PRIHARNANTO Periodontology Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
  • ROBERT LESSANG Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
  • SRI LELYATI C MASULILI Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
  • FATIMAH MARIA TADJOEDIN Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
  • HERLIS RAHDEWATI Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
  • PITU WULANDARI Department of Periodontology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia, Indonesia.
  • ELZA IBRAHIM AUERKARI Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.


Objective: Periodontitis is an infection that involved tooth-supporting tissues by dental plaque biofilm on the tooth surface and host immune response
as causal to as inflammation resolution. Prostaglandin E2 (PGE2) as an inflammatory mediator has been implicated in the pathogenesis of various
chronic inflammatory diseases, including periodontitis, and as a regulator of blood pressure. This study aims to compare the levels of prostaglandin
in the gingival crevicular fluid (GCF) of periodontitis patients with hypertension and non-hypertension.
Methods: A total sample of 62 patients was examined and consists of 44 patients (aged 50–90 years) who were hypertension group and 18 patients
(aged 30–49 years) who were non-hypertension groups as a control. Hypertension state was measured by blood pressure based on anamnesis
and using sphygmomanometer mercury. The clinical sample was collected from 62 gingival crevicular fluids [GCF] of periodontal disease subject.
Measurement of the clinical parameter of probing pocket depth [PD], and bleeding on probing [BOP ≥1] was included as a diagnostic requisition.
The PD and clinical attachment loss [CAL] was defined as present if the PD was ≥5 mm and CAL was ≥1 mm. Prostaglandin E2 level was estimated in
gingival crevicular fluid samples by using the enzyme-linked immunosorbent assay.
Results: The level of PGE2 was statistically significant difference in hypertension patient compare with non-hypertension (p<0.05). There was a
significant difference in PD, recession, and CAL (p<0.05).
Conclusion: Higher blood pressure might be related to the potential risk of inflammation and progression periodontal disease.

Keywords: Prostaglandin E2, Periodontitis, Hypertension, Inflammation


1. Buford TW. Hypertension and aging. Ageing Res Rev 2016;26:96-111.
2. Nayor M, Stevenson MD, Musani SK, Xanthakis V, LaVealley MP,
Larson MG, et al. Incidence of cardiovascular disease in individuals
affected by recent changes to U.S. blood pressure treatment guidelines.
J Hypertension 2018;36:436-43.
3. Pikir BS, Andrianto, Aritonang FAE. The difference of blood pressure
and arterial stiffness after intake of arabica and robusta coffee in
controlled hypertension. Folia Med Indones 2017;53:209-16.
4. Preshaw MP. Periodontal disease pathogenesis. In: Carranza’s Clinical
Periodontology. 13th ed. Philadelphia, PA: Elsevier, Inc.; 2018. p. 451-
5. Rivas-Tumanyan S, Campos M, Zevallos JC, Joshipura KJ. Periodontal
disease, hypertension, and blood pressure among older adults in Puerto
Rico. J Periodontol 2013;84:203-11.
6. Holmlund A, Holm G, Lind L. Severity of periodontal disease and
number of remaining teeth are related the prevalence of myocardial
infarction and hypertension in a study based on 4.254 subjects. J
Periodontol 2006;77:1173-8.
7. Rivas-Tumanyan S, Spiegelman D, Curhan GC, Forman JP, Joshipura KJ.
Periodontal disease and incidence of hypertension in the health
professionals follow-up study. Am J Hypertension 2012;25:770-6.
8. Aiuto FD, Sabbah W, Netuveli G, Donos N, Hingorani AD, Deanfield J,
et al. Association of the metabolic syndrome with severe periodontitis
in a large U.S. population-based survey. J Clin Endocrin Metabol
9. Swan CE, Breyer RM. Prostaglandin E2 modulation of blood pressure
homestasis: Studies in rodent model. J Prostaglandins Other Lipid
Mediat 2011;96:10-3.
10. Belibasakis GN, Guggenheim B. Induction of prostaglandin E2 and
interleukin-6 in gingival fibroblast by oral biofilm. FEMS Immunol
Med Microbiol 2011;63:381-6.
11. Camargo GACG, Santos MP, Silva NLC, Miranda ALP, Tributino JLM.
Levels of prostaglandin E2 (PGE2) in gingival crevicular fluid from
smokers and non-smokers with gingivitis and chronic periodontal
disease. J Dent Oral Hyg 2015;7:54-9.
12. Subrahmanyam MV, Sangeetha M. Gingival crevicular fluid a marker
of the periodontal disease activity. Indian J Clin Biochem 2003;18:5-7.
13. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH,
et al. Periodontitis: Consensus report of workgroup 2 of the 2017 world
workshop on the classification of periodontal and peri-Implant diseases
and conditions. J Periodontol 2018;89:173-82.
14. Mishra B, Sinha ND, Gidwani H, Shukla SK, Kawatra A, Mehta SC.
Equipment errors: A prevalent cause for fallacy in blood pressure
recording a point prevalence estimate from an Indian health university.
Indian J Commun Med 2013;38:15-21.
15. Beevers G, Lip GYH, O’Brien E. ABC of hypertension. Blood pressure
measurement. Part I-sphygmomanometry: Factors common to all
techniques. BMJ Clin Res 2001;322:981-5.
16. Nonnenmacher C, Helms K, Bacher M, Nüsing RM, Susin C, Mutters R,
et al. Effect of age on gingival crevicular fluid concentrations of MIF
and PGE2. J Dent Res 2009;88:639-43.
17. Aguilera EM, Suvan J, Buti J, Czesnikiewics-Guzik M, Ribeiro AB,
Orlandi M, et al. Periodontitis is associated with hypertension: A
systematic review and meta-analysis. Cardiovasc Res 2019;116:28-39.
18. Ricciotti E, FitzGerald GA. Prostaglandins and inflammation. J Am
Heart Associat 2011;31:986-1000.
19. Gomez I, Foudi N, Longrois D, Norel X. The role of prostaglandin E2
in human vascular inflammation. Prostaglandins Leukot Essent Fatty
Acids 2013;89:55-63.
20. Rajakariar R, Hilliard M, Lawrence T, Trivedi S, Colville-Nash P,
Bellingan G, et al. Hematopoietic prostaglandin D2 synthase controls the
onset and resolution of acute inflammation through PGD2 and 15-deoxy
Delta12 14 PGJ2. Proc Natl Acad Sci USA 2007;104:20979-84.
21. Lisowska B, Kosson D, Domaracka K. Lights and shadows of NSAIDs
in bone healing: The role of prostaglandins in bone metabolism. Drug
Des Devel Ther 2018;12:1753-8.
22. Yang T, Du Y. Distinct roles of central and peripheral prostaglandin E2 and
EP subtypes in blood pressure regulation. Am J Hypertens 2012;25:1042-9.
23. Andrew W, Evelyn W, Francis M, Mark J, Mark C. Pattern of gingival
overgrowth among patients on antihypertensive pharmacotherapy at a
Nairobi Hospital in Kenya. Open J Stomatol 2014;4:169-73.
24. Gaetti-Jardim EJ, Marcelino SL, Feitosa ACR, Romito GA, Avila-Campos
MJ. Quantitative detection of periodontopathic bacteria in atherosclerotic
plaques from coronary arteries. J Med Microbiol 2009;58:1568-75.
25. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M.
Hypertension in the elderly. World J Cardiol 2012;4:135-47.
26. Wahid A, Chaudhry S, Ehsan A, Butt S, Khan AA. Bidirectional
relationship between chronic kidney disease and periodontal disease.
Pak J Med Sci 2013;29:211-5.
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