title: Effect of non-surgical periodontal therapy on C-reactive protein, oxidative stress, and matrix metalloproteinase (MMP)-9 and MMP-2 levels in patients with type 2 diabetes: a randomized controlled study.
abstract: BACKGROUND
  It is well accepted that glycemic control in patients with diabetes mellitus (DM) is affected by systemic inflammation and oxidative stress. The effect of periodontal therapy on these systemic factors may be related to improvement on glycemic status. The aim of the present study is to assess over a period of 6 months the effect of non-surgical periodontal therapy on serum levels of high-sensitivity C-reactive protein (hsCRP), d-8-iso prostaglandin F2a (d-8-iso) as a marker of oxidative stress, and matrix metalloproteinase (MMP)-2 and MMP-9 on patients with type 2 DM.
  
  
  METHODS
  Sixty participants with type 2 DM and moderate to severe periodontal disease were randomized into intervention (IG) and control (CG) groups. IG received scaling and root planing, whereas CG received supragingival cleaning at baseline and scaling and root planing at 6 months. Participants of both groups were evaluated at baseline and 1, 3, and 6 months. Periodontal data recorded at each visit included probing depth, clinical attachment loss, bleeding on probing, and gingival index. Blood was collected at each visit for the assay of serum glycated hemoglobin A1c (A1c), hsCRP, d-8-iso, MMP-2, and MMP-9.
  
  
  RESULTS
  Although there was a trend to a reduction in hsCRP, d-8-iso and MMP-9 it did not reach statistical significance. MMP-2 levels remained unchanged after periodontal treatment.
  
  
  CONCLUSIONS
  Effective non-surgical periodontal treatment of participants with type 2 DM and moderate to severe periodontal disease improved significantly A1c levels but did not result in a statistically significant improvement in hsCRP, d-8-iso, MMP-2, and MMP-9 levels.
authors.affiliation: Department of Periodontology, School of Dentistry, University of Athens, Athens, Greece. pkoroman@yahoo.com
authors.forename: Panagiotis A
authors.initials: PA
authors.lastname: Koromantzos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Makrilakis
authors.forename: Xanthippi
authors.initials: X
authors.lastname: Dereka
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katsilambros
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Vrotsos
authors.forename: Phoebus N
authors.initials: PN
authors.lastname: Madianos
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016009:Chi-Square Distribution; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000378:metabolism*; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress; D010510:Periodontal Diseases / Q000097:blood / Q000150:complications* / Q000628:therapy*; D010512:Periodontal Index; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D002097:C-Reactive Protein; D015237:Dinoprost; D006442:Glycated Hemoglobin; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9; C075750:8-epi-prostaglandin F2alpha