Effect of glycemic control on periodontitis in type 2 diabetic patients with periodontal disease

Abstract

Aims/IntroductionDiabetes mellitus and periodontitis are closely related. A huge number of reports has addressed the effect of periodontal intervention therapy on glycemic control, but no reports have addressed the effect of glycemic intervention therapy on periodontal disease in type 2 diabetic patients. The aim of this study was to examine the effect of improved glycemic control by glycemic intervention therapy on periodontitis in type 2 diabetic patients.Materials and MethodsA total of 35 patients underwent intervention therapy to improve glycemic control without periodontal treatment. Glycohemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), bleeding on probing (BOP), probing pocket depth (PPD) and intraoral community periodontal index (CPI) codes of the World health Organization (WHO) were examined at baseline, and 2 and 6 months after the intervention therapy to improve glycemic control.ResultsAfter the improvement of glycemic control, BOP lesions improved, but deep PPD lesions and WHO CPI codes did not improve. Subanalyses showed that effective glycemic control (average HbA1c reduction 1.8%) improved BOP lesions, but did not affect deep PPD lesions and WHO CPI codes. In addition, high BOP lesions at baseline responded more effectively to glycemic intervention. Further analysis of CPI codes in all individual periodontal sites independent of WHO CPI codes in 35 patients showed that only gingival inflammation without a deep periodontal pocket improved after glycemic intervention.ConclusionsEffective glycemic control improves BOP lesions in type 2 diabetic patients with periodontitis through ameliorating inflammation at the gingival sites of periodontal tissue. This trial was registered with the University Hospital Medical Information Network (no. UMIN000007670).

Effectiveness of Lifestyle Change Plus Dental Care Program in Improving Glycemic and Periodontal Status in Aging Patients with Diabetes: A Cluster, Randomized, Controlled Trial

“…Dental care is the maintenance of healthy teeth and gingiva 9 . Periodontal intervention programs, 10‐14 i.e., the methods to maintain healthy gingiva by periodontal treatment, including oral hygiene instruction, full‐mouth scaling and root planing (SRP), and periodontal flap surgery, also improved periodontal status. However, the results of glycemic control after periodontal treatment were inconsistent 10‐14 .…”

“…Periodontal intervention programs, 10‐14 i.e., the methods to maintain healthy gingiva by periodontal treatment, including oral hygiene instruction, full‐mouth scaling and root planing (SRP), and periodontal flap surgery, also improved periodontal status. However, the results of glycemic control after periodontal treatment were inconsistent 10‐14 . Periodontal intervention programs in others countries 10‐14 that have emphasized periodontal therapy include toothbrushing instruction, oral health education, and supragingival scaling.…”

“…However, the results of glycemic control after periodontal treatment were inconsistent 10‐14 . Periodontal intervention programs in others countries 10‐14 that have emphasized periodontal therapy include toothbrushing instruction, oral health education, and supragingival scaling. All of these programs 10‐13 reportedly improved glycemic control by decreasing glycated hemoglobin A1c (HbA1c) and periodontal status with statistically significant differences 10‐14 .…”

“…Periodontal intervention programs in others countries 10‐14 that have emphasized periodontal therapy include toothbrushing instruction, oral health education, and supragingival scaling. All of these programs 10‐13 reportedly improved glycemic control by decreasing glycated hemoglobin A1c (HbA1c) and periodontal status with statistically significant differences 10‐14 . In contrast, Promsudthi et al, 14 who performed their study in Thailand, found a decrease of HbA1c 3 months after periodontal treatment of SRP without a statistically significant difference.…”

Periodontal Tissue Status in Patients with Newly-Diagnosed and Treated Type 2 Diabetes – Comparative Analysis

“…U pacjentów z zapaleniem przyzębia i towarzyszą-cą cukrzycą typu II po wdrożeniu jedynie leczenia przeciwcukrzycowego Katagiri et al [31] zaobser-…”