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-alpha (TNF-alpha) and on the metabolic control in type 2 diabetes mellitus (T2DM) patients.


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-alpha. 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-alpha 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.
Correa
Fernanda O B
FO
Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University, Araraquara, SP, Brazil.
Gonçalves
Daniela
D
Figueredo
Carlos M S
CM
Bastos
Alliny S
AS
Gustafsson
Anders
A
Orrico
Silvana R P
SR
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000097:blood / Q000628:therapy*; D016207:Cytokines / Q000032:analysis* / Q000097:blood; D003774:Dental Plaque Index; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000517:prevention & control; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D016745:Root Planing; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D001786:Blood Glucose; D002097:C-Reactive Protein; D016207:Cytokines; D005340:Fibrinogen; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D016753:Interleukin-10; D015847:Interleukin-4; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha