Effect of periodontal therapy on type 2 diabetes mellitus patients with chronic periodontitis with the evaluation of HbA1c

Agarwal, Manvi Chandra; Chaubey, Krishna Kumar; Madan, Ellora; Agarwal, Swati

doi:10.4103/2231-0754.176248

Cited by 6 publications

(7 citation statements)

References 1 publication

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“…Regarding HbA1c level, it did not correlate with any of the clinical parameters in the present study which is in agreement with Bacic et al, 1988, who assumed no association found between the duration of diabetes and glycated hemoglobin level with the severity of periodontal disease. On the other hand, the present result is not in consistence with Lösche et al, 2000 andAgarwal et al, 2016). This may be due to the inclusion criteria adopted in the present study which included only controlled t2DM patients.…”

Section: Discussioncontrasting

confidence: 65%

Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Amr

Mostafa

Shaker

2019

Advanced Dental Journal

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Background:The relation between diabetes mellitus and periodontitis has been discussed for years. Many adipokines were reported to play a major role in periodontal inflammation. Chemerin is one of these adipokines which is blamed to be involved in inflammatory conditions such as diabetes. Fibroblast growth factor 21 (FGF21) is another adipokine which is believed to induce regulation of glucose. The current study aimed to spot the light on the potential role of gingival crevicular fluid (GCF) level of FGF21 and chemerin as biomarkers of periodontal disease activity and an attempt to understand their role in the link between periodontitis and diabetes. Methods: The study was conducted on 45 individuals, 15 diabetic patients with periodontitis, 15 periodontitis patients and 15 healthy controls. GCF samples were collected from all participants for assessment of chemerin and FGF 21. Samples were analysed using enzyme linked immunosorbent assay (ELISA). Results: Periodontitis patients with diabetes had significant higher levels of chemerin and FGF21 than the periodontitis patients without diabetes followed by healthy controls. ROC analysis showed a 100% diagnostic accuracy for chemerin and FGF21. Conclusion: FGF21 and chemerin in GCF are valuable biomarkers of periodontal disease suggesting a role in the link between diabetes and periodontitis.

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Section: Discussioncontrasting

confidence: 65%

Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Amr

Mostafa

Shaker

2019

Advanced Dental Journal

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“…Higher BI is correlated to increased inflammation in DM patients. Similar to studies by Acharya et al [ 24 ] and Agarwal et al [ 25 ], significant reductions in the GI were noted in individual groups at baseline and in 6 months. Improved GI scores correspond to the reduction in plaque, calculus, and subsequent resolution of gingival inflammation.…”

Section: Discussionsupporting

confidence: 87%

“…This corresponds to the effectiveness of SRP in reducing blood glucose levels and HbA1c levels and the corresponding local inflammatory response. [ 24 , 25 ]…”

Section: Discussionmentioning

confidence: 99%

Effects of Scaling and Root Planing on Salivary Interleukine-6 Levels in Chronic Periodontitis Patients and Glycemic Controls

Ghosh,

Buyyanapragada,

Gavali

et al. 2023

Cureus

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Background: Type 2 diabetes mellitus (DM) and periodontitis have a bidirectional relationship that is well documented in many reviews and epidemiological studies. Periodontitis has been referred to as the sixth complication of diabetes mellitus. Various studies showed improvement in Interleukin-6 levels as well as metabolic parameters after non-surgical periodontal therapy in chronic periodontitis patients with type 2 DM. Objective: To evaluate the effect of scaling and root planing (SRP) on salivary levels of IL-6 and assessment of clinical parameters in CP patients with and without T2DM. Methods: We included 50 CP patients with well-controlled T2DM (Group I), and 50 CP patients without T2DM as controls (Group II) with evident clinical inflammation, ≥ 5mm probing depth (PD) and a relative attachment level (RAL) of ≥ 5mm. Following a brief medical and dental history plaque index (PI), gingival index (GI), gingival bleeding index (BI), PD, and RAL were recorded, and an unstimulated saliva was collected. Following SRP therapy, the clinical parameters and IL-6 levels were measured after seven days, 14 days, and 30 days. Intragroup and intergroup comparisons were carried out using a paired t-test and an independent t-test. The statistical significance was set at P < 0.05. Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) v. 22.0 (IBM Corp., Armonk, NY). Results: Intergroup comparisons of IL-6 levels at different intervals showed a significantly higher reduction in Group II than in Group I (p=0.000). While the mean difference in the GI scores from baseline to 30 days was significantly higher in Group I patients (p=0.000), the difference in the mean PI (p=0.004), mean BI (p=0.000), mean PD (p=0.000) and mean RAL scores (p=0.000) were significantly higher in Group II patients. Conclusion: This study indicates that scaling and root planing is effective in glycemic control and also has a role to play in the level of salivary IL-6 in periodontal health and T2DM with chronic periodontitis. Elevated salivary IL-6 levels indicate periodontal inflammation which is further increased in T2DM patients. Hence, elevated IL-6 can be considered a marker of periodontal destruction.

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“…Several studies were consistent with the results of this clinical trial concerning the enhanced clinical parameters after SRP in diabetic patients as Agarwal et al [54] reported a statistically signi cant decrease in mean PPD and CAL at 6 months (P < 0.005) after SRP for moderately controlled T2DM patients and chronic periodontitis. Similarly, Vincent et al and Soi et al [44] [55] con rmed a statistically signi cant decrease in GI, PPD and CAL values after SRP in T2DM patients with chronic periodontitis after 6 weeks and 6 months respectively.…”

Section: Discussionsupporting

confidence: 85%

The Effect of Systemic Administration of Zinc on The Gingival Crevicular Fluid Level of Total Oxidant Capacity in Type 2 Diabetic Patients with Stage II and III Periodontitis After Non-Surgical Periodontal Therapy: A Randomized Clinical Trial

Alqawi

Mahmoud

Darhous

et al. 2022

Preprint

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Objectives: This study aimed to evaluate the effect of systemic administration of zinc supplementation on the total oxidant capacity in the gingival crevicular fluid level of controlled type 2 diabetic patients with stage-II and III periodontitis after non-surgical periodontal therapy.Materials and Methods: This clinical trial was registered at ClinicalTrials.gov Identifier: ID: NCT03923829 on April 23, 2019. Twenty-eight controlled type 2 diabetic patients with periodontitis stages II or III were randomly assigned into two groups, test and control where both received non-surgical periodontal therapy while the test group received 50 mg zinc one tablet/day for 12 weeks. Total oxidant capacity (TOC) level was measured in GCF of both groups at baseline and after 3 months. HbA1c level, GI, PPD and CAL were also reported at baseline and 3 months postoperatively.Results: After 3 months a statistically significant decrease in mean TOC µmol/L was reported in both groups being more significantly lower in test group. No significant difference in mean percentage HbA1c was reported after 3 months neither within each group nor between the two groups. In both groups there was a significant reduction in GI scores, PPD reduction and CAL gain after 3 months with no significant difference between them, while the test group showed significantly lower GI than the control group.Conclusions: Systemic administration of zinc supplements as an adjunct to non-surgical periodontal therapy might improve the clinical parameters and oxidative stress in T2DM patients with stage II-III periodontitis.Clinical Relevance:Zinc supplements can be an effective adjunct to nonsurgical periodontal therapy in type 2 diabetic patients with stages II or III periodontitis.

show abstract

Effect of periodontal therapy on type 2 diabetes mellitus patients with chronic periodontitis with the evaluation of HbA1c

Cited by 6 publications

References 1 publication

Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Possible role of gingival crevicular fluid levels of Chemerin and Fibroblast growth factor 21 as biomarkers of periodontal disease in diabetic and non-diabetic patients. A diagnostic accuracy study

Effects of Scaling and Root Planing on Salivary Interleukine-6 Levels in Chronic Periodontitis Patients and Glycemic Controls

The Effect of Systemic Administration of Zinc on The Gingival Crevicular Fluid Level of Total Oxidant Capacity in Type 2 Diabetic Patients with Stage II and III Periodontitis After Non-Surgical Periodontal Therapy: A Randomized Clinical Trial

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