Local levels of biomarkers after surgical and nonsurgical debridement of residual pockets and nonresidual sites in diabetic patients: a 12-month follow-up.
There is scarce evidence on suitable approaches for the treatment of unresponsive or residual periodontal sites in diabetic patients. This study assessed the effects of surgical debridement (SD) and nonsurgical debridement (NSD), associated with amoxicillin and metronidazole, on clinical and immunological outcomes of residual pockets and adjacent healthy sites in patients with type 2 diabetes. A split-mouth, randomized controlled trial was conducted in 21 patients presenting at least 2 residual pockets in contralateral quadrants 12 months after basic nonsurgical periodontal therapy. Patients received systemic antibiotics, and contralateral quadrants were assigned to receive SD or NSD. The changes in clinical parameters were evaluated from baseline to 12 months. Local levels of 14 cytokines and chemokines were measured with multiplex bead immunoassays at baseline and 3 and 12 months after therapy. There were no statistically significant differences between SD and NSD for changes in clinical parameters from baseline to 12 months (P > 0.05). There was a significantly greater increase in the levels of granulocyte-macrophage colony-stimulating factor and interleukin 6 from baseline to 3 months in the healthy sites adjacent to residual pockets receiving SD (P < 0.05). A significant decrease in the levels of monocyte chemoattractant protein-1 and macrophage inflammatory protein 1α occurred from baseline to 12 months in the residual pockets treated by SD (P < 0.05). In conclusion, SD and NSD resulted in similar clinical benefits at 12 months. The short-term increase in the levels of proinflammatory biomarkers in SD sites probably can be attributed to tissue trauma and healing, and the long-term decrease in the levels of chemotactic factors in residual pockets treated by surgery may reflect remission of infection and stable wound healing in these sites at 12 months.
Joyce Pinho
JP
Bezerra
Luciana Machion
LM
Shaddox
Adriana Cutrim
AC
de Mendonca
Marta Ferreira
MF
Bastos
Tamires Szeremeske
TS
de Miranda
Vanessa Renata
VR
Santos
Poliana Mendes
PM
Duarte
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D018932:Chemokine CCL2 / Q000032:analysis; D054405:Chemokine CCL3 / Q000032:analysis; D018925:Chemokines / Q000032:analysis*; D016207:Cytokines / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D057747:Periodontal Debridement / Q000379:methods*; D010514:Periodontal Pocket / Q000601:surgery / Q000628:therapy*; D010519:Periodontium / Q000737:chemistry; D013997:Time Factors
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D018932:Chemokine CCL2; D054405:Chemokine CCL3; D018925:Chemokines; D016207:Cytokines; D015850:Interleukin-6; D008795:Metronidazole; D000658:Amoxicillin; D016178:Granulocyte-Macrophage Colony-Stimulating Factor
chronic periodontitis; cytokines; diabetes mellitus; root planing; surgical procedures