title: Factors associated with the clinical response to nonsurgical periodontal therapy in people with type 2 diabetes mellitus.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) is a growing health problem worldwide. People with T2DM are at risk of experiencing periodontitis and likely require treatment. Using data from the national multicenter Diabetes and Periodontal Therapy Trial (DPTT), the authors assessed patient-based characteristics associated with the clinical response to nonsurgical therapy.
  
  
  METHODS
  The DPTT investigators randomly assigned adults with T2DM (hemoglobin A1c [HbA1c] ≥ 7 percent and < 9 percent) and moderate to advanced periodontitis to receive immediate or delayed therapy (scaling and root planing, oral hygiene instruction, chlorhexidine rinse). The investigators assessed probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and medical conditions at baseline, three months and six months. Six-month changes in mean PD, CAL and BOP defined the treatment response. Complete data were available for 473 of 514 DPTT participants. The authors used multiple regression models to evaluate participant-level factors associated with the response.
  
  
  RESULTS
  More severe baseline PD, CAL and BOP were associated with greater improvements in these same measurements (P < .0001). Hispanic participants experienced greater improvements in PD and CAL than did non-Hispanic participants (P < .0001). Obese participants (those with a body mass index > 30 kilograms per square meter) experienced greater reductions in PD and BOP than did participants who were not obese (P < .001). Age, sex, HbA1c values, diabetes duration, and smoking were not associated with change in any outcome (P > .1).
  
  
  CONCLUSIONS
  In patients with T2DM, baseline disease severity was associated with the clinical response to nonsurgical periodontal therapy. Body mass index and Hispanic ethnicity-but not glycemic control, diabetes duration or smoking-also may be useful in predicting clinical changes in this population.
authors.affiliation: Dr. Michalowicz is a professor, Department of Developmental and Surgical Sciences, University of Minnesota School of Dentistry, 17-116 Moos Tower, 515 Delaware St. SE, Minneapolis, Minn. 55455, e-mail micha002@umn.edu. Address correspondence to Dr. Michalowicz.
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Michalowicz
authors.affiliation: Dr. Hyman is a professor, Department of Preventive Medicine, School of Medicine, Stony Brook University, State University of New York.
authors.forename: Leslie
authors.initials: L
authors.lastname: Hyman
authors.affiliation: Dr. Hou is an assistant professor, Department of Preventive Medicine, School of Medicine, Stony Brook University, State University of New York.
authors.forename: Wei
authors.initials: W
authors.lastname: Hou
authors.affiliation: Dr. Oates is a professor, Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Oates
authors.affiliation: Dr. Reddy is a professor and the dean, School of Dentistry, University of Alabama at Birmingham.
authors.forename: Michael
authors.initials: M
authors.lastname: Reddy
authors.affiliation: Dr. Paquette is a professor, Department of Dental Medicine, School of Dental Medicine, Stony Brook University, State University of New York.
authors.forename: David W
authors.initials: DW
authors.lastname: Paquette
authors.affiliation: Dr. Katancik is an associate professor, Department of Periodontics, School of Dentistry, Oregon Health and Science University, Portland.
authors.forename: James A
authors.initials: JA
authors.lastname: Katancik
authors.forename: Steven P
authors.initials: SP
authors.lastname: Engebretson
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D015992:Body Mass Index; D002710:Chlorhexidine / Q000627:therapeutic use; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010353:Patient Education as Topic; D010518:Periodontitis / Q000208:ethnology / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors; D016745:Root Planing; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine
keywords: Diabetes mellitus; periodontitis; treatment