title: Clinical, microbial, and immune responses observed in patients with diabetes after treatment for gingivitis: a three-month randomized clinical trial.
abstract: BACKGROUND
  Although patients with diabetes are frequently affected by periodontitis, only a few investigations have focused on gingivitis in this at-risk population. This randomized placebo-controlled clinical trial compared the response to a gingivitis treatment protocol that combined mechanical procedures and daily use of an essential oil (EO) mouthrinse between patients with and without diabetes.
  
  
  METHODS
  The whole-mouth periodontal probing depth (PD), gingival index (GI), and plaque index (PI) were monitored in gingivitis cases among systemically healthy patients (n = 60) or those with diabetes (n = 60) at baseline and 3 months after treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and total bacterial load were determined by a real-time polymerase chain reaction in intrasulci plaque samples. The volume of gingival crevicular fluid (GCF) was quantified, and interleukin-1β (IL-1β) levels were determined in GCF samples. After a full-mouth ultrasonic debridement, patients were randomly assigned to an EO or a placebo rinse for 90 days (40 mL/day). The data were analyzed through repeated-measures analysis of variance and multiple comparisons Tukey tests (P <0.05).
  
  
  RESULTS
  GI was more severe in the diabetes group. Diabetes impaired GI and reduced GCF volume. PD, bacterial levels, and IL-1β improved similarly in both systemic conditions. The adjunctive use of EO provided greater reductions of PI, GI, total bacterial load, T. forsythia, A. actinomycetemcomitans, and GCF volume.
  
  
  CONCLUSIONS
  Response to gingivitis treatment in patients with diabetes can slightly differ from that in patients without diabetes. Daily use of an EO mouthrinse after ultrasonic debridement benefited patients with and without diabetes.
authors.affiliation: Dental School, University of Taubaté, Taubaté, São Paulo, Brazil.
authors.forename: Suzane A
authors.initials: SA
authors.lastname: Raslan
authors.forename: Jose R
authors.initials: JR
authors.lastname: Cortelli
authors.forename: Fernando O
authors.initials: FO
authors.lastname: Costa
authors.forename: Davi R
authors.initials: DR
authors.lastname: Aquino
authors.forename: Gilson C N
authors.initials: GC
authors.lastname: Franco
authors.forename: Luis O M
authors.initials: LO
authors.lastname: Cota
authors.forename: Antonio
authors.initials: A
authors.lastname: Gargioni-Filho
authors.forename: Sheila C
authors.initials: SC
authors.lastname: Cortelli
mesh_terms: D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects / Q000302:isolation & purification; D058491:Bacterial Load / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects / Q000302:isolation & purification; D003773:Dental Plaque / Q000382:microbiology; D003774:Dental Plaque Index; D048909:Diabetes Complications / Q000276:immunology / Q000382:microbiology; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000737:chemistry / Q000276:immunology; D005891:Gingivitis / Q000276:immunology / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009822:Oils, Volatile / Q000627:therapeutic use; D057747:Periodontal Debridement / Q000379:methods; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification; D010919:Placebos; D016966:Porphyromonas gingivalis / Q000187:drug effects / Q000302:isolation & purification; D055815:Young Adult
chemical_list: D053583:Interleukin-1beta; D009067:Mouthwashes; D009822:Oils, Volatile; D010919:Placebos
keywords: Bacteria; diabetes mellitus; gingivitis; interleukin-1; oils; therapeutics