Background Periodontitis significantly increases the risk of diabetic complications. This clinical trial investigated the effects of periodontal therapy on cardiac function in patients with type 2 diabetes mellitus (T2DM) and periodontitis. Materials and methods Fifty‐eight subjects with T2DM and periodontitis were randomly allocated to Treatment Group (n = 29) receiving non‐surgical periodontal therapy, and Control Group (n = 29) having only oral hygiene instructions with delayed periodontal treatment until completion of this 6‐month study. The left ventricle (LV) diastolic function was assessed by echocardiography with the tissue Doppler imaging index (E/e' ratio); and LV hypertrophy was evaluated by LV mass index (LVMI). Blood samples were collected for biochemical analysis. Results The intention‐to‐treat analysis showed that periodontal treatment significantly reduced the E/e' ratio by 1.66 (95% CI: −2.64 to −0.68, p < .01), along with marked improvement of periodontal conditions (p < .05). LVMI was not altered at the 6‐month follow‐up. The serum levels of N‐terminal pro‐B type natriuretic peptide (NT‐proBNP) as a cardiac stress biomarker, C‐reactive protein and interleukin‐6 decreased numerically without reaching statistical significance. Conclusion The present study provides the first evidence that non‐surgical periodontal therapy may improve cardiac diastolic function in type 2 diabetic patients with periodontitis.

Background and Objective Subjects with diabetes and periodontitis are at high risk of cardiovascular events, while the subclinical alterations of cardiac function in this cohort remain unclear. This cross‐sectional study investigated the association of periodontitis with left ventricle (LV) structural and functional abnormalities in subjects with type 2 diabetes mellitus (T2DM). Material and Methods A total of 115 subjects with T2DM were divided into Control group (n = 32) with no or mild periodontitis, and the rest with moderate to severe chronic periodontitis (CP) were further categorized into CP‐1 (n = 41) and CP‐2 (n = 42) based on disease severity. Echocardiography was performed to precisely assess (a) LV hypertrophy by LV mass index (LVMi); (b) LV diastolic function by tissue Doppler imaging index E/e’ ratio; and (c) LV systolic function by speckle tracking derived global longitudinal strain (GLS). Results Overall, a linear trend in LVMi, E/e’, and GLS existed among the Control, CP‐1, and CP‐2 groups, respectively (P < 0.05). After adjustments of multiple confounders, CP‐2 subjects showed significantly higher E/e’ (log scale, 2.22 ± 0.05 vs 2.07 ± 0.06, P < 0.01) and GLS (−17.42 ± 0.46% vs −18.95 ± 0.54%, P < 0.05) than the Controls. Multivariate analysis revealed that sites% with probing depth ≥4 mm and sites% with clinical attachment loss ≥5 mm were independent indicators for E/e’ (β = 0.005 and β = 0.002, P < 0.01) and GLS (β = 0.03 and β = 0.02, P < 0.05) , respectively. Moreover, the number of missing teeth was significantly associated with LVMi (β = 0.01, P < 0.01). Conclusion This study provides the first evidence that severe periodontitis is significantly associated with the exacerbation of LV diastolic and systolic dysfunction in subjects with T2DM.

This preliminary study suggests that periodontal treatment may contribute to a notable reduction in immuno-inflammatory gene expression measured by IL-6 and IL-8 transcripts in EPCs.