title: The Effect of Scaling and Root Planing on Glycaemic Control, Periodontal Status and Gingival Crevicular Fluid TNF-α Levels in an Indian Population- To Reveal the Ambivalent Link.
abstract: BACKGROUND
  Periodontal disease and diabetes mellitus(DM) share a two - way relationship. It can be hypothesized that successful management of periodontal infection in diabetes will lead not only to reduction of local signs and symptoms of the disease, but also to better control of glucose metabolism.
  
  
  OBJECTIVE
  To monitor the effect of Scaling and Root planing (SRP) on glycaemic control in patients with type 2 diabetes mellitus by estimating the HbA1c and GCF TNF-α levels.
  
  
  METHODS
  This Interventional clinicobiochemical study was carried out over a period of 6 months from December 2010-May 2011 in Bengaluru, Karnataka, India.
  
  
  METHODS
  Fifteen well-controlled, 15 moderately controlled and 15 poorly controlled diabetic subjects were enrolled in this study. All participants were subjected to non-surgical periodontal (SRP) therapy. GCF sampling and clinical periodontal parameters assessment were done at baseline and 3 months post-therapy. TNF-α levels in GCF were analyzed by enzyme-linked immunosorbent assay (ELISA) at baseline and 3 months post therapy. The improvement in glycaemic control was assessed using HbA1c levels at 3 months reevaluation.
  
  
  METHODS
  The data obtained were statistically analysed using Kruskal-Wallis test, Mann-Whitney test and Wilcoxon Signed Rank test.
  
  
  RESULTS
  Following periodontal treatment, all patients demon- strated a significant improvement in periodontal status. A reduction in TNF-α level and the HbA1c values were also observed.
  
  
  CONCLUSIONS
  The result indicates that SRP is effective in improving metabolic control in Type 2 Diabetes Mellitus patients possibly through the reduction of TNF-α which in turn might improve the insulin resistance.
authors.affiliation: Senior Lecturer, Department of Periodontics, Mahatma Gandhi Post Graduate Institute , Pondicherry, DAPM RV Dental College, Bangalore, India .
authors.forename: Soorya
authors.initials: S
authors.lastname: K V
authors.affiliation: Professor and Head, Department of Periodontics, DAPM RV Dental College , Bangalore, India .
authors.forename: Suchetha
authors.initials: S
authors.lastname: A
authors.affiliation: PG Student, Department of Periodontics, DAPM RV Dental College , Bangalore, India .
authors.forename: Lakshmi
authors.initials: L
authors.lastname: P
authors.affiliation: Reader, Department of Periodontics, APM RV Dental College , Bangalore, India .
authors.forename: Sapna
authors.initials: S
authors.lastname: N
authors.affiliation: Reader, Department of Periodontics, DAPM RV Dental College , Bangalore, India .
authors.forename: Apoorva
authors.initials: A
authors.lastname: S M
authors.affiliation: Senior Lecturer, Department of Periodontics, DAPM RV Dental College , Bangalore, India .
authors.forename: Divya
authors.initials: D
authors.lastname: Bhat
authors.affiliation: Reader, Department of Periodontics, DAPM RV Dental College , Bangalore, India .
authors.forename: Darshan B
authors.initials: DB
authors.lastname: Mundinamane
keywords: Diabetes mellitus; HbA1c; Periodontal therapy; TNF