The effects of non‐surgical periodontal therapy on glycemic control in diabetic patients: A randomized controlled trial

Abstract

Aim The present study aimed to monitor the clinical outcomes and the metabolic response of periodontal therapy (non‐surgical) in patients with periodontitis (chronic) and uncontrolled diabetes (type 2). Methods Eighty‐eight subjects with periodontitis (chronic) and uncontrolled diabetes (type 2) were enrolled in this controlled trial and allocated randomly to the test group (44 patients were received immediate periodontal therapy) or the control group (44 patients were received delayed periodontal therapy). The metabolic and clinical evaluations were conducted at baseline and 3 months. This included clinical attachment level, glycated hemoglobin (HbA1c), bleeding on probing, visible plaque, and pocket depth. The periodontal therapy in this study consists of one‐stage scaling and root planning, a combination of systemic antibiotics (amoxicillin 500 mg and metronidazole 400 mg), and oral hygiene instructions. Results Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at 3‐month follow‐up period the patients within the test group demonstrated significantly better clinical and metabolic outcomes than patients in the control group. Conclusion The non‐surgical periodontal treatment using a combination of metronidazole and amoxicillin significantly improved the metabolic outcome in addition to periodontal health in diabetic subjects with chronic periodontitis.

Baseline HbA1c Level Influences the Effect of Periodontal Therapy on Glycemic Control in People with Type 2 Diabetes and Periodontitis: A Systematic Review on Randomized Controlled Trails

“…No significant heterogeneity was detected (p = 0.162; I 2 = 45.1%). Influence analysis showed that deleting Makaky et al's study [25] increased the width of the 95% confidence interval, but the WMD did not change significantly and was still significant (WMD -0.983, 95% CI -1.904, -0.061; p = 0.037), indicating that the pooled result was relative stable (ESM Fig. 2b).…”

Actualización de la Relación Bidireccional de la Diabetes Mellitus y la Enfermedad Periodontal

“…La mayoría de estudios que evaluaron el impacto del tratamiento periodontal en los valores de hemoglobina glicosilada evidenciaron una reducción significativa de este marcador glucémico (El-Makaky & Shalaby, 2020;Rapone et al, 2021;Bala & Kumari, 2021;Qureshi et al, 2021) esto es clínicamente relevante, pues una disminución en el nivel de hemoglobina glicosilada, por más limitada que sea, tiene un impacto favorable en la reducción del riesgo de complicaciones en pacientes diabéticos (Chen et al, 2021) tal como se evidenció en un estudio de seguimiento de 10 años, sobre el control de la glucosa en pacientes con DM, en el que, una disminución de la hemoglobina glicosilada de 1 % se tradujo en la reducción del 35 % de riesgo de microangiopatía diabética, e incluso una disminución de 0,2 % de la media de hemoglobina glicosilada significó la reducción del 10 % de la mortalidad en estos pacientes (Holman et al, 2008). En una reciente revisión sistemática de ensayos clínicos aleatorizados (Benrachadi et al, 2019) los autores reportaron que la terapia periodontal contribuyó al control de la hemoglobina glicosilada en pacientes diabéticos con periodontitis.…”

Effectiveness of Non-Surgical and Surgical Periodontal Therapy in Lowering HbA1c in Diabetic Patients

“…The elevated serum level of IL-1β, IL-6 and TNF-α that, associated with periodontitis, antagonize the action of insulin and increase the insulin resistance; re-establishing good periodontal health in type 2 diabetics with periodontal disease has the potential of greatly improving metabolic control and systemic inflammatory challenge, and therefore non-surgical periodontal therapy can significantly reduce the level of HbA1c in T2DM patients with periodontitis [21,29].…”