title: The short-term effectiveness of non-surgical treatment in reducing levels of interleukin-1beta and proteases in gingival crevicular fluid from patients with type 2 diabetes mellitus and chronic periodontitis.
abstract: BACKGROUND
  This study aimed to compare the effectiveness of non-surgical periodontal treatment in improving periodontal status and reducing gingival crevicular fluid (GCF) levels of interleukin (IL)-1beta and IL-18, elastase activity, and matrix metalloproteinase (MMP)--8 and --9 in periodontitis patients with and without type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Twenty-three patients with T2DM (diabetes group) and 26 systemically healthy subjects (control group) with chronic periodontitis participated in this study. The clinical examination included visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing. GCF samples were collected from five or six deep sites to evaluate the levels of IL-1beta and -18, elastase, and MMP-8 and -9. Shallow sites were analyzed for IL-1beta and elastase. The glycemic control was analyzed by the concentration of glycated hemoglobin (HbA1c). The subjects received non-surgical periodontal treatment and were reexamined 90 days later.
  
  
  RESULTS
  All clinical parameters showed a significant improvement after treatment, which was accompanied by a significant reduction in IL-1beta, elastase activity, and MMP-8 and -9 levels in deep sites. The shallow sites also showed significant reductions in IL-1beta and elastase activity levels. Treatment did not significantly reduce HbA1c concentrations in patients with T2DM.
  
  
  CONCLUSIONS
  Non-surgical periodontal treatment was effective in reducing the levels of IL-1beta, elastase activity, and MMP-8 and -9 in GCF from diabetes and control groups. Patients with T2DM showed less reduction only in elastase activity in shallow sites compared to controls. This reduction was associated with improvement of the clinical periodontal status.
authors.affiliation: Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.
authors.forename: Fernanda O B
authors.initials: FO
authors.lastname: Correa
authors.forename: Daniela
authors.initials: D
authors.lastname: Gonçalves
authors.forename: Carlos M S
authors.initials: CM
authors.lastname: Figueredo
authors.forename: Anders
authors.initials: A
authors.lastname: Gustafsson
authors.forename: Silvana R P
authors.initials: SR
authors.lastname: Orrico
mesh_terms: D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000150:complications / Q000276:immunology*; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology*; D010450:Endopeptidases / Q000378:metabolism*; D005260:Female; D005883:Gingival Crevicular Fluid / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D020382:Interleukin-18 / Q000378:metabolism; D053583:Interleukin-1beta / Q000378:metabolism*; D019272:Leukocyte Elastase / Q000378:metabolism; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D010512:Periodontal Index; D012016:Reference Values; D018709:Statistics, Nonparametric
chemical_list: D020382:Interleukin-18; D053583:Interleukin-1beta; D010450:Endopeptidases; D019272:Leukocyte Elastase; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9