糖尿病伴牙周炎患者牙周植骨术的疗效评价

目的 探讨Ⅱ型糖尿病伴牙周炎患者牙周植骨术的临床疗效.方法 选择Ⅱ型糖尿病伴牙周炎需植骨患者为实验组,慢性牙周炎需植骨患者为对照组,每组20例.牙周基础治疗3个月后行牙周翻瓣植骨术.检测术前与术后1个月牙龈出血指数、牙周探诊深度、附着丧失水平并拍摄术后4、8、12周平行定位投照片.Ⅱ型糖尿病患者术前及术后3个月测量糖化血红蛋白,术前与术后1个月测量肿瘤坏死因子水平.结果 两组38例手术均获成功,失败2例.对照组术后1个月各项临床指标与实验组比较统计学无意义(P＞0.05);两组术后较术前各指标明显降低(P＜0.001);手术前后肿瘤坏死因子及糖化血红蛋白检测统计学意义(P＞0.05).结论 对Ⅱ型糖尿病伴牙周炎患者牙周基础治疗后行牙周植骨手术可取得满意疗效.     

超声刮治在老年重度慢性牙周炎患者维护期的应用效果

目的:观察龈下超声根面平整在老年重度慢性牙周炎患者牙周支持治疗期间(原为维护期)的应用效果.方法:选择60岁以上诊断为重度牙周炎,经基础治疗后仍有5 mm以上牙周袋和探诊出血,为翻瓣术的适应证,且拒绝手术治疗的患者60例.分别于基础治疗后4周(基线)、6个月和12个月复诊行超声刮治前,检测菌斑指数(plaque index,PLI)、出血指数(bleeding index,BI)、探诊出血(bleeding on probing,BOP)、探诊深度(probing depth,PD)的变化.1年后对结果进行t检验.结果:与基线相比,6个月复查时所有临床牙周指数均有显著改善(P<0.01),6个月与12个月相比无显著差异(P>0.05).结论:未经翻瓣术治疗的老年重度牙周炎患者,在其牙周支持治疗期间定期施以龈下超声治疗短期可取得较好的治疗效果.     

吸烟对牙周基础治疗效果影响的研究

目的评价吸烟与非吸烟慢性牙周炎患者牙周基础治疗1个月后的疗效差异。方法选择36例慢性牙周炎患者,吸烟组20例,非吸烟组16例,基线时两组牙周炎病情相似。从牙列的4个象限选取探诊深度在5～9mm范围的位点1～2个,吸烟组108个位点,非吸烟组88个位点,观察这些位点在牙周基础治疗前、治疗后1个月临床指标的变化,包括菌斑指数(PLI),牙龈出血指数(BI),牙周袋探诊深度(PPD)和附着丧失(AL);在作临床观察的同时,对治疗前后龈沟液白介素(IL)-1β进行检测。结果治疗前(基线时)两组PLI、BI、PPD、AL以及IL-1β差异不显著,牙周基础治疗1个月后,两组的各项指标均有明显的改善,但吸烟组改善程度明显低于非吸烟组(P<0.05)。结论慢性牙周炎患者,吸烟者牙周基础治疗的效果差于     

慢性牙周炎伴咬合紊乱的多学科治疗观察

目的:观察慢性牙周炎伴咬合紊乱的多学科治疗效果。方法:选取10例依从性好的慢性牙周炎伴咬合紊乱病例,采用牙周基础治疗与正畸、修复多学科联合治疗,观察1～7年,所有病例均拍摄口内像及X线牙片,分别于基线、牙周基础治疗后3个月、牙周系统治疗后1年分别记录探诊出血(BOP)、探诊深度(PD)及松动度(TM)。结果:牙周基础治疗后3个月BOP、PD较基线时有统计学差异(P<0.05),TM无明显差异(P>0.05)。基础治疗后3个月BOP、PD、TM与系统治疗后1年相比较无统计学差异(P>0.05)。结论:慢性牙周炎伴咬合紊乱病例多学科治疗有利于牙周炎的控制及疗效的维持,但患者的依从性及适应症的选择尤为重要。     

口腔卫生指导对2型糖尿病伴慢性牙周炎患者牙周炎症控制及血糖代谢水平的影响

目的探讨口腔卫生指导对2型糖尿病伴慢性牙周炎患者牙周状况和血糖水平的影响。方法 31例2型糖尿病伴慢性牙周炎患者,接受口腔卫生指导后,分别在基线、6周、3个月、6个月、12个月和18个月检测牙周临床指标和血糖代谢指标。牙周临床指标包括:探诊深度、附着丧失、探诊出血、菌斑指数;血糖代谢指标包括:空腹血糖、糖化血红蛋白。结果 31例患者基线、6周、3个月、6个月、12个月和18个月6个时间点的附着丧失量(P=0.003)和探诊出血阳性率(P=0.022)差异有统计学意义;其它指标如探诊深度(P=0.203)、菌斑指数(P=0.087)、空腹血糖(P=0.352)和糖化血红蛋白(P=0.071)的变化没有统计学意义。结论口腔卫生指导可以短期改善2型糖尿病伴慢性牙周炎患者的牙周炎症,但对牙周组织退缩没有更大的帮助,尚不能认为口腔卫生指导对血糖代谢有显著影响。     

牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎患者血糖水平的影响

目的:观察牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎患者牙周炎症的控制和糖化血红蛋白的影响。方法:选取62例患者分为牙周治疗组(31例)和非牙周治疗组(31例),牙周治疗组给予牙周基础治疗和药物治疗,记录术前和术后8周龈沟出血指数(SBI)、牙周探诊深度(PD)、附着水平丧失(AL)、糖化血红蛋白(HbAIc)。非牙周治疗组仅给予药物治疗并记录治疗前及治疗后8周的PD、AL、HbAIc。结果:牙周治疗组PD、AL、HbAIc均有明显下降(P<0.01)。非牙周治疗组无显著性差异。结论:牙周基础治疗对Ⅱ型糖尿病伴慢性牙周炎患者具有良好的治疗反应。     

侵袭性牙周炎患者牙周基础治疗的近期疗效观察

目的 观察侵袭性牙周炎患者牙周基础治疗的近期效果。方法 选择侵袭性牙周炎患者及慢性牙周炎患者各7例,分别于牙周基础治疗前、后3个月进行牙周参数的检查和记录,并比较分析。结果 两组患者牙周基础治疗3个月后的探诊出血指数(BOP)、探诊深度(PD)和附着丧失(AL)均较治疗前有明显改善(P<0.001)。基础治疗后3个月时,两组的BOP、PD、AL差异无显著性(P>0.05)。结论 侵袭性牙周炎患者经过牙周基础治疗,近期能够取得良好的治疗效果。     

Er:YAG激光治疗慢性牙周炎临床疗效观察

目的 比较单独应用Er:YAG激光与常规牙周基础治疗治疗慢性牙周炎的临床疗效.方法 纳入22例慢性牙周炎患者,采用单盲、随机和自身对照设计,患者一侧用Er:YAG激光治疗,另一侧用超声联合手工刮治.分别于基线、治疗后6周、3个月和6个月进行牙周临床指标检查,内容包括菌斑指数、探诊深度、牙龈出血指数和附着丧失;并对基线时探诊深度≥4mm的位点进行统计和比较.结果 2组探诊深度、牙龈出血指数和附着丧失在治疗后6周、3个月和6个月时与基线比较均有明显下降,2组菌斑指数在基线及治疗后各时间点均无明显变化.且同一时间点2组间各项临床指标均无显著性差异.结论 Er:YAG激光作为治疗慢性牙周炎的方法可行有效,可取得与常规牙周基础治疗相似的临床疗效.     

高频次牙周洁治对2型糖尿病伴慢性牙周炎患者的临床疗效

目的:评价高频次的牙周洁治对2型糖尿病伴慢性牙周炎患者的临床疗效.方法:将40名2型糖尿病伴慢性牙周炎患者按照性别、年龄匹配的原则分配到A组(高频次牙周洁治组,20例)和B组(单次牙周洁治组,20例),并于基线检查和治疗完成后6个月进行复查,A组在此过程中每月复诊一次并进行牙周龈上洁治,B组基线时洁治后无处理,比较两组牙周检查指标及血糖检查指标的变化.结果:A组各项牙周指标及血糖指标均较基线显著降低,且对两组间差异进行协方差分析(糖化血红蛋白水平为协变量)处理,两组差异有统计学意义.结论:高频次的牙周洁治能显著改善2型糖尿病伴慢性牙周炎患者的牙周炎症状及血糖水平.     

牙周治疗对2型糖尿病患者血清白细胞介素6及糖化白蛋白的影响

目的 探讨牙周非手术治疗对伴牙周炎2型糖尿病患者血清白细胞介素-6及糖化白蛋白的影响.方法 选择2型糖尿病伴重度慢性牙周炎患者32例,于牙周治疗前、后一个月分别检测血清白细胞介素-6(IL-6)和糖化白蛋白(FA)、甘油三酯(TG)水平、牙周指数.结果 经牙周治疗后,伴重度牙周炎的2型糖尿病患者除TG水平外,血清IL-6阳性百分率(P＜0.05)、FA水平(P＜0.001)有明显下降;探诊深度(PD)、附着丧失(AL)治疗后均较基线明显下降(P＜0.001).结论 非手术牙周治疗可能降低糖尿病牙周炎患者外周血循环IL-6水平,糖化白蛋白水平、牙周状况也有明显改善.     

牙周炎伴糖尿病患者对牙周非手术治疗的疗效观察

目的：观察慢性牙周炎伴糖尿病患者对牙周非手术治疗的疗效。方法：观察36例中、重度牙周炎伴糖尿病患者(DM组)，其中20例血糖较高或高低波动(DM-H组)，16例血糖相对较低或较稳定(DM-L组)。以28例非糖尿病慢性牙周炎患者作为对照(Non-DM组)。所有患者每个牙分6个位点，分别观察牙周治疗前及治疗后（口腔卫生指导、洁治、根面平整)1、3、6个月的菌斑指数(P1I)、牙龈指数(GI)、探针出血(BOP)、探针深度（PD)和临床附着丧失（AL)的变化。结果：牙周非手术治疗后，所有患者的牙龈炎症显著改善，牙周袋深度显著下降且牙周附着再获得。伴糖尿病及非糖尿病牙周炎患者对牙周非手术治疗的反应类似。结论：牙周炎伴糖尿病患者对牙周非手术治疗具有良好的治疗反应，糖尿病患者血糖的不同水平并不影响短期治疗反应。     

牙周基础治疗对2型糖尿病伴慢性牙周炎患者龈沟液丝氨酸蛋白酶抑制剂和肿瘤坏死因子-α水平的影响

目的 观察牙周基础治疗对2型糖尿病伴发或不伴发慢性牙周炎患者龈沟液(gingival crevicular flu-id,GCF)丝氨酸蛋白酶抑制剂(vaspin)和肿瘤坏死因子-α(TNF-α)水平的影响.方法 本研究包含60个研究对象,分为4组:15例2型糖尿病伴发慢性牙周炎患者为DM-CP组;15例慢性牙周炎不伴发2型糖尿病患者为CP组;15例牙周健康的2型糖尿病患者为DM组;15例牙周及全身系统均健康的个体为CTRL组.治疗前与牙周基础治疗8周后取样GCF并检测牙周临床指标.通过ELISA法检测GCF样本中vaspin和TNF-α的水平.结果 治疗前慢性牙周炎组GCF中vaspin和TNF-α水平显著高于牙周健康组(P<0.05),治疗后慢性牙周炎组GCF中vaspin和TNF-α水平显著降低(P<0.05).各组vaspin总量与TNF-α总量、糖化血红蛋白水平、牙龈指数以及探诊深度在统计学上存在正相关关系(P<0.05).结论 牙周基础治疗能明显降低慢性牙周炎患者GCF中vaspin和TNF-α的水平.提示GCF中vaspin和TNF-α可作为糖尿病、牙周炎诊断及其预后的炎性标志物.     

牙周非手术治疗对2型糖尿病伴牙周炎患者糖化血红蛋白A1c和血清可溶性细胞间黏附分子-1的影响

目的 探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎（DMCP）患者牙周状况、糖代谢及血清可溶性细胞间黏附分子-1（sICAM-1）的影响。方法 选择诊断为2型糖尿病伴慢性牙周炎的患者,按糖化血红蛋白A1c （ GHbA1c ）控制水平分为血糖控制良好组（GHbA1c＜7.00％,DMCP1组,30例）和血糖控制较差组（GHbA1c≥7.00％,DMCP2组,30例）;选择不伴有系统性疾病的慢性牙周炎患者（CP组,30例）为对照组。所有患者均进行牙周非手术治疗,分析治疗前（基线）及治疗后1、3个月时探诊深度（PD）、临床附着丧失（CAL）、菌斑指数（PLI）、龈沟出血指数（SBI）、探诊出血（BOP）、空腹血糖（FPG）、GHbA1c及血清sICAM-1水平的变化。结果 治疗后1、3个月时,3组PD、SBI、PLI、BOP阳性率、血清sICAM-1水平比基线时均明显降低（P＜0.05）,CP组和DMCP1组CAL比基线时亦均明显降低（P＜0.05）,但DMCP2组CAL无明显变化（P＞0.05）。治疗后3个月时,DMCP2组GHbA1c水平与基线时比较平均降低1.12%,差异有统计学意义（P＜0.05）,但CP组和DMCP1组在整个观察期间GHbA1c水平与基线时比较差异均无统计学意义（P＞0.05）。结论 牙周非手术治疗可降低2型糖尿病伴牙周炎患者的牙周炎症程度及血清sICAM-1的水平,并可改善血糖控制良好者的牙周附着水平;该治疗还可以降低血糖控制较差者的GHbA1c水平。     

The effect of non-surgical periodontal therapy on peroxidase activity in diabetic patients: a case-control pilot study

Objective: To evaluate the effect of periodontal therapy on clinical parameters as well as on total salivary peroxidase (TSP) activity and myeloperoxidase (MPO) activity in the gingival crevicular fluid (GCF) of patients with type 2 diabetes mellitus (DM2) and of systemically healthy individuals.
Material and Methods: Twenty DM2 subjects with inadequate metabolic control (test group) and 20 systemically healthy individuals (control group), both groups with chronic periodontitis, were enrolled. Periodontal clinical parameters, namely periodontal probing depth (PD), clinical attachment level (CAL), visible plaque index (VPI), bleeding on probing (BOP), gingival bleeding index (GBI) and presence of suppuration (SUP), as well as TSP activity and GCF MPO activity, were assessed before and 3 months after non-surgical periodontal therapy.
Results: At baseline and 3 months post-treatment, the test group presented a higher percentage of sites with VPI and BOP ( p <0.01). MPO activity in the GCF presented lower values ( p <0.05) for the test group at both baseline and the post-treatment period. The periodontal treatment resulted in a significant improvement of most clinical and enzymatic parameters for both groups ( p <0.05).
Conclusions: In both groups, the periodontal therapy was effective in improving most clinical parameters and in reducing salivary and GCF enzymatic activity. The diabetic individuals presented lower MPO activity in the GCF.     

牙周非手术治疗对2型糖尿病伴慢性牙周炎患者血糖代谢水平的影响

目的探讨牙周非手术治疗对2型糖尿病伴慢性牙周炎患者牙周状况和血糖代谢水平的影响。方法 2型糖尿病伴慢性牙周炎患者135例,糖化血红蛋白（glycosylated hemoglobin,HbA1c）平均值（7.33±1.42）%,随机分为治疗组和对照组。治疗组接受牙周非手术治疗,对照组暂不接受治疗,只接受口腔卫生宣教。观察2组干预前及干预后3个月、干预后6个月的牙周临床指标,包括探诊深度（probing depth,PD）、菌斑指数（plaque index,PLI）、探诊出血（bleeding on probing,BOP）和血糖代谢指标,包括空腹血糖（fasting plasma glucose,FPG）、HbA1c的变化情况。结果同治疗前相比,治疗组全口平均PD（F=89.956,P=0.000）、PLI（F=82.399,P=0.000）、BOP（F=169.535,P=0.000）随时间推移下降,差异有统计学意义。对照组全口平均PD随时间推移差异无统计学意义（F=3.002,P=0.076）;PLI（F=11.443,P=0.001）、BOP（F=6.537,P=0.008）下降有统计学意义。干预后6个月,组间比较PD（t=-3.318,P=0.001）、PLI（t=-4.354,P=0.000）、BOP（t=-5.868,P=0.000）差异有统计学意义。治疗组FPG（F=4.325,P=0.015）和HbA1c（F=6.654,P=0.003）随时间推移下降,差异有统计学意义;对照组FPG（F=0.215,P=0.756）和HbA1c（F=1.767,P=0.184）随时间推移变化无统计学意义;干预后6个月,两组间FPG（t=-1.386,P=0.171）和HbA1c（t=-1.065,P=0.289）差异无统计学意义。结论牙周非手术治疗能有效控制2型糖尿病伴牙周炎患者的牙周炎症;尚不能认为牙周非手术治疗可以改善糖尿病患者的血糖代谢。     

牙周非手术治疗对2型糖尿病伴牙周炎患者糖代谢及血清白细胞介素6的影响

目的 观察牙周非手术治疗对2型糖尿病伴慢性牙周炎(chronic periodontitis,CP)患者牙周状况、糖代谢及血清白细胞介素6(IL-6)的影响,探讨其可能的影响机制.方法 选取2型糖尿病伴慢性牙周炎(type 2 diabetes mellitus with chronic periodontitis,DMCP组)和不伴有全身系统性疾病的CP患者(CP组)各55例进行牙周非手术治疗,其中DMCP组中糖化血红蛋白(glycated hemoglobin,HbA1c)＜7.00%的患者为血糖控制较好组(A1组),HbAlc≥7.00%的为血糖控制较差组(A2组).在治疗前及治疗后6周、3个月时分别记录全口探诊深度(probing depth,PD)、附着丧失(attachment loss,AL)、出血指数(beeding index,BI)和菌斑指数(plaque index,PLI),并检测空腹血糖(fasting plasma glucose,FPG)、HbA1c及血清IL-6水平.结果 DMCP组和CP组PD、AL、BI、PLI和血清IL-6水平在治疗后6周及3个月时均显著降低(P＜0.05),其中DMCP组血清IL-6从(3.47±0.33)ng/L(治疗前)显著降至(3.21±0.66)ng/L(治疗后6周),再降至(3.03±0.54)ng/L(治疗后3个月).DMCP组治疗后3个月HbA1c水平[(6.80±1.21)%]与治疗前[(7.35±1.73)%]相比显著降低(P＜0.05),其中A2组HbA1c水平从治疗前的(8.72±1.51)%显著降至治疗后3个月的(7.59±1.28)%(P＜0.05),而A1组HbA1c水平则无明显变化(P＞0.05).结论 牙周非手术治疗能够降低DMCP患者血清IL-6水平,并在一定程度上改善患者糖代谢状况;该治疗能显著改善血糖控制较差者的糖代谢,而对血糖控制较好者的糖代谢则无明显影响.

Abstract：

Objective To evaluate the effect of non-surgical periodontal therapy on periodontal status, glycemic control and the level of serum interleukin(IL)-6 in type 2 diabetic patients with chronic periodontitis (DMCP). Methods Fifty-five DMCP and 55 systemically healthy patients with chronic periodontitis(CP) were recruited in this study. The diabetes were classified into two groups, the wellcontrolled group [glycated hemoglobin (HbA1c) ＜ 7.00%]and the poorly controlled group (HbA1c ≥7.00%). All subjects received non-surgical periodontal therapy. Periodontal clinical parameters including periodontal probing depth (PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were recorded at baseline, 6 weeks and 3 months after the treatment. Fasting plasma glucose(FPG), HbA1c and the concentration of serum IL-6 were measured. Results At 6 weeks and 3 months after treatment, PD,AL, BI, PLI and the concentration of serum IL-6 of both groups significantly reduced(P ＜ 0. 05). The level of IL-6 in diabetic patients reduced significantly from (3.47 ±0.33) ng/L to (3.21 ±0.66) ng/L and to (3.03 ± 0. 54) ng/L. The HbA1c of diabetic patients reduced significantly 3 months after treatment [(6.80±1.21%]compared with the baseline[(7.35 ± 1.73)%, P ＜0.05]. HbA1c of the poorly controlled group reduced significantly(P ＜0. 05), while HbA1c of the well-controlled diabetes did not show any apparent reduction (P ＞ 0. 05). Conclusions Non-surgical periodontal therapy can effectively reduce the concentration of serum IL-6, thereby improving glycemic control in type 2 diabetes patients with chronic periodontitis. However, there was no any significant reduction of HbA1c in the well-controlled diabetes.     

Effect of periodontal treatment on metabolic control, systemic inflammation and cytokines in patients with type 2 diabetes

Objective: The aim of this study was to investigate the effect of periodontal therapy on the circulating concentration of high-sensitivity capsule-reactive protein (hs-CRP), fibrinogen (FIB), interleukin (IL)-4, IL-6, IL-8, IL-10 and tumour necrosis factor- α (TNF- α ) and on the metabolic control in type 2 diabetes mellitus (T2DM) patients.
Material and Methods: Twenty-three T2DM patients with chronic periodontitis were enrolled in this study. Periodontal clinical parameters, namely visible plaque index, gingival bleeding index, bleeding on probing, probing depth and clinical attachment levels, were evaluated. Blood samples for plasma were collected and assessed for the levels of hs-CRP, FIB, IL-4, IL-6, IL-8, IL-10 and TNF- α . The glycated haemoglobin (HbA_1c) and fasting plasma glucose were also measured. All parameters were evaluated before and 3 months after non-surgical periodontal therapy.
Results: All clinical parameters were significantly improved 3 months after the periodontal therapy. A univariate comparison showed a tendency towards a decrease of the measured biomarkers, most pronounced for TNF- α and FIB, after therapy. Periodontal treatment also reduced HbA_1c and hs-CRP levels, albeit not significantly.
Conclusions: The clinically successful non-surgical periodontal therapy tended to reduce systemic inflammation and the concentration of some circulating cytokines.     

Periodontal status and cytoplasmic enzyme activities in gingival crevicular fluid of type 2 diabetic and/or obese patients with chronic periodontitis

Type 2 diabetes mellitus and obesity are the most common nutritional disorders in developed and developing countries. Increased prevalence of periodontal disease is a well-known complication of type 2 diabetes mellitus (DM). As obesity is generally the first step toward type 2 diabetes mellitus, it is possible to find exacerbated periodontal disease in obese patients, also. The purpose of this cross-sectional study was to investigate the periodontal status and aspartate aminotransferase and lactate dehydrogenase enzyme activities in gingival crevicular fluid (GCF) of type 2 diabetic and/or obese chronic periodontitis patients. A total of 39 chronic periodontitis patients participated in the study. The study population was divided into four groups according to body mass index and type 2 DM status: 1) type 2 DM obese patients, n = 8; 2) type 2 DM patients, n = 12; 3) obese patients, n = 8; 4) systemically healthy control group, n = 11. Enzyme activities in gingival crevicular fluid and periodontal status were evaluated. No significant differences in age, gingival index, plaque index, aspartate aminotransferase and lactate dehydrogenase enzyme activities were observed, but probing depths were significantly higher in the DM groups than in the control group. Obesity did not seem to be a significant factor in any parameters evaluated. The present study showed increased probing depth values for the diabetic groups but failed to show any significant relation between obesity and enzyme activity or periodontal status. However, the slightly increased probing depth values in the obese groups might be a clue to an impaired immune response and predisposition to periodontitis in that patient group.     

Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis

BACKGROUND: The aim of this study was to compare the response to conventional periodontal treatment between patients with or without type 2 diabetes mellitus from a clinical and metabolic standpoint. METHODS: A prospective, parallel, comparative longitudinal clinical study was performed between type 2 diabetics and non-diabetics with moderate generalized chronic periodontitis. The study period was 6 months. Conventional periodontal scaling and root planing were performed, and the response to this treatment was compared between the groups at 3 and 6 months, measuring the plaque index, bleeding on probing, probing depth, level of clinical attachment, and gingival recession. In the diabetic patients, the clinical response was related to measurements of HbA1c and glucose in blood at 3 and 6 months. RESULTS: An improvement in all clinical variables was observed, with no statistically significant differences between the groups, with the exception of probing depth (P <0.0207). The improvement observed in blood HbA1c levels confirmed a positive metabolic response to periodontal treatment, with a lower value for this variable at each measurement time. CONCLUSIONS: Both groups of patients showed a clinical improvement after basic non-surgical periodontal treatment. The diabetic patients showed improved metabolic control (lower HbA1c) at 3 and 6 months after periodontal treatment.     

The effect of periodontal therapy on serum TNF-α and HbA1c levels in type 2 diabetic patients

Background:  To determine the effect of non-surgical periodontal therapy on serum TNF-α and HbA1c levels in poorly and well-controlled type 2 diabetic patients.
Methods:  In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c ≥ 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-α concentration were measured at baseline and three months after the non-surgical periodontal therapy.
Results:  All periodontal parameters and serum TNF-α levels were significantly decreased three months after the non-surgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-α levels at baseline and after three months between the two groups.
Conclusions:  Although non-surgical periodontal therapy eliminates local/systemic infection and inflammation via decreases in TNF-α, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period.