Effects of periodontal treatment on the medical status of patients with type 2 diabetes mellitus: a pilot study

Abstract

BackgroundStudies have demonstrated that periodontal disease is associated with the development of systemic complications in patients with type 2 diabetes mellitus (T2DM). The purpose of this pilot study was to investigate which markers among various systemic disease parameters are affected by periodontal treatment in patients with T2DM.MethodsTwelve patients with T2DM were given oral hygiene instructions and subsequent subgingival scaling and root planing. The periodontal status was recorded, and blood and urine samples were taken to measure various parameters of glucose control and systemic status at baseline and 1 month following the periodontal treatment. Serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were measured by enzyme-linked immunosorbent assay.ResultsAfter the periodontal treatment, the glycated hemoglobin value was significantly improved. The levels of urinary N-acetyl-β-D-glucosaminidase and albumin, which are markers of renal dysfunction, also decreased significantly after treatment. Among the parameters measured in serum, the γ-glutamyl transpeptidase level, which is usually interpreted as a marker of liver dysfunction, was significantly reduced. The serum concentrations of tumor necrosis factor-α and high-sensitivity C-reactive protein were also significantly reduced by periodontal treatment.ConclusionWithin the limitations of this pilot study, periodontal treatment may be effective not only in improving metabolic control, but also in reducing the risk of diabetic kidney and liver disease in patients with T2DM.

Glycemic control and adipokines after periodontal therapy in patients with Type 2 diabetes and chronic periodontitis

“…Both healthy individuals and diabetic patients exhibit similar outcomes after periodontal therapy in terms of PD and AL reductions. 18,19,20 In the present study, we also found that the levels of PD and AL were improved significantly after PT. *: more than 1 cigarettes/day and continuing for more than 1 year; **:"No": never drinking; "Seldom": drinking ≤1 time/week; "Often": drinking> 1 time/week; ***: "Often"= regular exercise ≥2 times/week, each time more than 30 minutes; ****: diagnosis of hypertension at a grade three hospital.…”

The directional and non‐directional associations of periodontitis with chronic kidney disease: A systematic review and meta‐analysis of observational studies

“…Furthermore, CKD shares common risk factors with periodontitis, such as smoking, hypertension and diabetes mellitus (DM) . Notably, DM is closely linked with periodontitis, and periodontal treatment may improve glycemic control and reduce the risk of diabetic kidney disease in DM subjects . Interestingly, a recent study shows that the severity of periodontitis and glycemic control could be valuable predictors of progression of CKD .…”

A influência do tratamento periodontal convencional não cirúrgico no controle glicêmico de pacientes diagnosticados com diabetes mellitus e periodontite – revisão de literatura

“…Among the 10 prospective clinical trials that assessed the correlation between CPT and the level of systemic inflammation, six studies found reductions in serum concentrations of inflammatory mediators and/or CRP during the post-CPT reassessment period. 16,21,25,26,28,30 Nevertheless, in one study no serum reduction in HbA1C levels and improvements in glycemic control in diabetic patients were observed, 30 even though the plasma concentration of IL-17 was decreased by CPT.…”

“…In addition, serum concentrations of inflammatory mediators and/or C-reactive protein (CRP) were evaluated in 10 studies and compared to glycemic te sts. 11,15,16,18,21,22,25,26,28,30 Regarding prospective clinical trials, CPT improved periodontal conditions in PI, GBI, BP, CIL and/or PD, but in a minority there were no improvements in CIL and/or PD. 14,19,22,24,27 With regard to the influence of CPT on glycemic control in patients with diabetes and periodontitis, it was found that 06 studies, 11,15,22,23,30,32 out of these 23 clinical trials, did not detect any benefit from reductions in periodontal inflammatory parameters, obtained after CPT, on glycemic tests, especially HbA1C.…”

“…35 Corroborating these findings, clinical trials contemplated in the present review (Table 1) observed elevated serum levels of pro-inflammatory mediators in decompensated diabetic patien ts. 11,15,16,18,21,22,25,26,28,30 Associated with this serum overexpression of inflammatory mediators, hyperglycemia also compromises the immune defense system by interfering phagocytic capacity of neutrophils and macrophages. 35,39 Additionally, chronic hyperglycemia associated with oxidative stress also culminates in alteration of the vascular antiatherogenic profile, resulting in vascular thickening by smooth muscle cell proliferation, platelet aggregation, monocyte adhesion, and additional proinflammatory cytokine production.…”