title: Comparative evaluation of adjunctive oral irrigation in diabetics.
abstract: OBJECTIVE
  The purpose of this study was to assess the response of diabetics to scaling and root planing treatment and subgingival oral irrigation as adjunctive therapy.
  
  
  METHODS
  A total of 52 type 1 and 2 diabetics (mean age 51.3+/-14) with adult periodontitis were randomized to two groups. Treatment included ultrasonic scaling and scaling and root planing in both groups (control and test) plus subgingival water irrigation 2x daily for the test group. Assessments were made prior to and at 6 and 12 weeks after treatment. Parameters measured were modified gingival index (MGI), probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), and bleeding on probing (BOP). Systemic measurement of Reactive Oxygen Species (ROS) generation, cytokines (TNF-alpha, IL-1beta, IL-10, and PGE2), and glycated hemoglobin (HbA1C).
  
  
  RESULTS
  After treatment, analysis of data showed that both groups had clinical and systemic improvement. The test group had a statistically significant reduction for MGI, PI, and BOP compared to controls (p<0.03) at 12 weeks and for ROS generation at 12 weeks (p<0.012). Unlike controls, systemic analysis of cytokines showed a statistically significant reduction from baseline for IL-1beta at 6 weeks and PGE2 at 6 and 12 weeks (p<0.05) within test group.
  
  
  CONCLUSIONS
  These results suggest that scaling and root planing and adjunctive therapy may be of value in establishing a healthy periodontium in diabetics.
authors.affiliation: Armed Forces Hospital of Riyadh, Saudi Arabia.
authors.forename: Sultan
authors.initials: S
authors.lastname: Al-Mubarak
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ciancio
authors.forename: Ahmad
authors.initials: A
authors.lastname: Aljada
authors.forename: P
authors.initials: P
authors.lastname: Mohanty
authors.forename: Candy
authors.initials: C
authors.lastname: Ross
authors.forename: Paresh
authors.initials: P
authors.lastname: Dandona
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003774:Dental Plaque Index; D012534:Dental Scaling; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D015232:Dinoprostone / Q000032:analysis; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis; D016018:Least-Squares Analysis; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000628:therapy; D010510:Periodontal Diseases / Q000628:therapy*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D017382:Reactive Oxygen Species / Q000032:analysis; D016745:Root Planing; D016037:Single-Blind Method; D007507:Therapeutic Irrigation; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014867:Water
chemical_list: D015232:Dinoprostone; D006442:Glycated Hemoglobin; D007375:Interleukin-1; D016753:Interleukin-10; D017382:Reactive Oxygen Species; D014409:Tumor Necrosis Factor-alpha; D014867:Water