title: Surgical and non-surgical therapy with systemic antimicrobials for residual pockets in type 2 diabetics with chronic periodontitis: a pilot study.
abstract: OBJECTIVE
  This study evaluated the effects of surgical (SD) and non-surgical (NSD) debridements, associated with systemic antimicrobials, on clinical and immunological outcomes of residual pockets [RP; probing depth (PD) ≥5 mm with bleeding on probing] in type 2 diabetics.
  
  
  METHODS
  A split-mouth, randomized controlled trial was conducted in 21 subjects presenting at least two RP per contralateral quadrant. Subjects received metronidazole plus amoxicillin for 10 days and, contralateral quadrants were assigned to receive SD or NSD. Clinical parameters and local levels of interferon-γ, interleukin (IL)-17, IL-23 and IL-4 were assessed at baseline, 3 and 6 months post-therapies.
  
  
  RESULTS
  Overall, the mean number, PD and clinical attachment level (CAL) of RP improved significantly after therapies (p < 0.05), without differences between groups at any time-point (p > 0.05). At quadrant level, only SD produced significant reductions in the mean CAL. Also, SD promoted higher reduction in PD from baseline to 6 months than NSD (p < 0.05). Levels of all cytokines were increased after SD compared with NSD (p < 0.05).
  
  
  CONCLUSIONS
  SD and NSD associated with systemic antimicrobials did not differ in terms of clinical benefits for RP in diabetics up to 6 months post-therapies. RP treated by SD presented increased levels of cytokines.
authors.affiliation: Dental Research Division, Department of Periodontology, Guarulhos University, São Paulo, São Paulo, Brazil.
authors.forename: Adriana Cutrim
authors.initials: AC
authors.lastname: Mendonça
authors.forename: Vanessa Renata
authors.initials: VR
authors.lastname: Santos
authors.forename: Fernanda Vieira
authors.initials: FV
authors.lastname: Ribeiro
authors.forename: Jadson Almeida
authors.initials: JA
authors.lastname: Lima
authors.forename: Tamires Szeremeske
authors.initials: TS
authors.lastname: Miranda
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.forename: Poliana Mendes
authors.initials: PM
authors.lastname: Duarte
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000150:complications / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy*; D016207:Cytokines / Q000378:metabolism*; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D004338:Drug Combinations; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D020381:Interleukin-17 / Q000378:metabolism; D053759:Interleukin-23 / Q000378:metabolism; D015847:Interleukin-4 / Q000378:metabolism; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D057747:Periodontal Debridement; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000150:complications / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000658:Amoxicillin; D000900:Anti-Bacterial Agents; D016207:Cytokines; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007371:Interferon-gamma; D020381:Interleukin-17; D053759:Interleukin-23; D015847:Interleukin-4; D008795:Metronidazole