Effects of periodontal therapy on glycemic control and inflammatory markers.
BACKGROUND
Periodontitis, a complication of diabetes mellitus (DM), can induce or perpetuate systemic conditions. This double-masked, placebo-controlled study evaluated the effects of periodontal therapy (scaling and root planing [SRP]) on the serum levels of glycated hemoglobin (HbA1c) and on inflammatory biomarkers.


METHODS
Thirty subjects with type 2 DM and periodontitis were treated with SRP + placebo (SRP; N = 15) or with SRP + doxycycline (SRP+Doxy; N = 15), 100 mg/day, for 14 days. Clinical and laboratory data were recorded at baseline and at 3 months after treatment.


RESULTS
After 3 months, the reduction in probing depth was 0.8 mm for the SRP group (P <0.01) and 1.1 mm for the SRP+Doxy group (P <0.01) followed by a 0.9% (SRP; P = 0.17) and 1.5% (SRP+Doxy; P <0.01) reduction in HbA1c levels. A significant reduction in interleukin (IL)-6; interferon-inducible protein 10; soluble fas ligand; granulocyte colony-stimulating factor; RANTES; and IL-12 p70 serum levels were also verified (N = 30). To our knowledge, this is the first report on the effects of periodontal therapy on multiple systemic inflammatory markers in DM.


CONCLUSIONS
Periodontal therapy may influence the systemic conditions of patients with type 2 DM, but no statistical difference was observed with the adjunctive systemic doxycycline therapy. Moreover, it is possible that the observed improvement in glycemic control and in the reduction of inflammatory markers could also be due to diet, which was not controlled in our study. Therefore, a confirmatory study with a larger sample size and controlled diet is necessary.
O'Connell
Patricia A A
PA
Department of Oral Surgery and Periodontology, School of Dentistry, University of São Paulo-Ribeirão Preto, Avenida do Café s/n, Ribeirão Preto, SP, Brazil.
Taba
Mario
M
Nomizo
Auro
A
Foss Freitas
Maria C
MC
Suaid
Flavia A
FA
Uyemura
Sergio A
SA
Trevisan
Glauce L
GL
Novaes
Arthur B
AB
Souza
Sergio L S
SL
Palioto
Daniela B
DB
Grisi
Marcio F M
MF
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000502:physiology; D018946:Chemokine CCL5 / Q000097:blood; D054357:Chemokine CXCL10 / Q000097:blood; D003131:Combined Modality Therapy; D016207:Cytokines / Q000097:blood*; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000276:immunology; D004311:Double-Blind Method; D004318:Doxycycline / Q000627:therapeutic use*; D053222:Fas Ligand Protein / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D016179:Granulocyte Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D018664:Interleukin-12 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000097:blood / Q000150:complications / Q000276:immunology / Q000628:therapy*
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D001786:Blood Glucose; D018946:Chemokine CCL5; D054357:Chemokine CXCL10; D016207:Cytokines; D004318:Doxycycline; D053222:Fas Ligand Protein; D006442:Glycated Hemoglobin; D016179:Granulocyte Colony-Stimulating Factor; D018664:Interleukin-12; D015850:Interleukin-6; C517652:hemoglobin A1c protein, human