Effect of periodontal therapy on metabolic control and an inflammatory mediator in type 2 diabetic subjects: a report on 17 consecutive cases.
BACKGROUND
A reciprocal relationship between diabetes mellitus and chronic periodontitis has been described, whereby chronic periodontal infection could affect diabetic metabolic control. Therefore, periodontal therapy could influence metabolic control or systemic inflammation leading to diabetic complications. This case report series presents the effect of therapy on periodontal indices, glycated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) in a group of type 2 diabetic patients.


METHODS
Seventeen diabetic patients diagnosed with moderate to severe chronic periodontitis received periodontal therapy. All patients received a hygienic phase of treatment and were re-examined 3 months later. At re-examination, subjects judged to need periodontal surgery were treated and re-examined after a further 3 months. A complete clinical examination and measurements of HbA1c and hs-CRP were evaluated.


RESULTS
Periodontal treatment led to a significant improvement in periodontal indices; only five patients required periodontal surgery. The percentage of bleeding on probing was reduced by nearly 40%; percentage of pockets > or = 5 mm was less than half baseline values; mean pocket depth reduction was 1.21 mm (0.58) and attachment level gain was 0.74 mm (0.69). Nevertheless, no changes were present for HbA1c; a reduction in hs-CRP of 1.37 mg/L (2.67) was present.


RESULTS
Periodontal therapy in this case series group produced a significant improvement in the clinical condition, butdid not affect metabolic control. It led to a decrease in hs-CRP.
Department of Oral Medicine and Basic Science, School of Dentistry, Universidad Nacional de Colombia. caserranom@unal.edu.co
Carlos
C
Serrano
Clara
C
Pérez
Diego
D
Sabogal
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D055113:Chronic Periodontitis / Q000628:therapy*; D003777:Dental Prophylaxis; D003793:Dental Restoration, Permanent; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D016745:Root Planing; D013524:Surgical Flaps; D014081:Tooth Extraction
D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators