Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: a randomized controlled clinical trial
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Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35–45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c (R2=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.
Abstract
Purpose: Diabetes and periodontal disease are two common diseases with high prevalence rates. Recent evidence has shown a bidirectional relationship between diabetes and periodontitis. The aim of this study was to investigate the effects of nonsurgical periodontal therapy on glycemic control in type 2 diabetes mellitus patients. Methods: Sixty subjects aged 35–45 years with blood sugar controlled by oral hypoglycaemic agents were randomly divided equally among 3 groups: group A (scaling, mouthwash, and brushing), group B (mouthwash and brushing), and group C (brushing only). Glycated haemoglobin (HbA1c), fasting blood sugar (FBS), probing pocket depth (PPD), gingival index (GI), plaque index (PI), and the relevant drug history were recorded at baseline and after 3 months of intervention. Comparison of the mean difference among the variables was performed by parametric and nonparametric tests, which were further evaluated using multiple regression analysis. Results: The mean differences between the PPD, FBS, HbA1c, GI, and PI in groups A and B were found to be statistically significant (P<0.001). Multiple regression analysis in group A showed that out of all the independent variables, GI and frequency of drug administration independently (b=0.3761 and b=0.598) showed a significantly greater impact on HbA1c (R2=0.832, P<0.05). Conclusions: Nonsurgical periodontal therapy can effectively decrease HbA1c levels in type 2 diabetes mellitus patients on medication.
참고문헌 (28)
- Mealy B., "Diabetes Mellitus, In Burket’s oral medicine diagnosis and treatment. 10th ed", pp.563~577 (2003), B.C. Decker
- Taylor GW., "The effects of periodontal treatment on diabetes", J Am Dent Assoc, 134, pp.41~48 (2003)
- Chinese Diabetes Society, "China guideline for type 2 diabetes", Chin J Diabetes Mellitus, 2(2), pp.6~56 (2010)
- Seppala B, "A site-by-site follow-up study on the effect of controlled versus poorly controlled insulin-dependent diabetes mellitus", J Clin Periodontol, 21, pp.161~165 (1994)
- Tervonen T, "Relation of diabetes control to periodontal pocketing and alveolar bone level", Oral Surg Oral Med Oral Pathol, 61, pp.346~349 (1986)
- Southerland JH, "Diabetes and periodontal infection : making the connection", Clin Diabetes, 23, pp.171~178 (2005)
- Dag A, "The effect of periodontal therapy on serum TNF-alpha and HbA1c levels in type 2 diabetic patients", Aust Dent J, 54, pp.17~22 (2009)
- Mealey BL., "Periodontal disease and diabetes: a two-way street", J Am Dent Assoc, 137, pp.26~31 (2006)
- Loe H, "Periodontal disease in pregnancy: I. prevalence and severity", Acta Odontol Scand, 21, pp.533~551 (1963)
- Silness J, "Periodontal disease in pregnancy: II. correlation between oral hygiene and periodontal condtion", Acta Odontol Scand, 22, pp.121~135 (1994)
- Cohen DW, "Diabetes mellitus and periodontal disease: two-year longitudinal observations. I", J Periodontol, 41, pp.709~712 (1970)
- Lowe GD., "The relationship between infection, inflammation, and cardiovascular disease: an overview", Ann Periodontol, 6, pp.1~8 (2001)
- Moeintaghavi A, "Non-surgical periodontal therapy affects meta bolic control in diabetics : a randomized controlled clinical trial", Aust Dent J, 57, pp.31~37 (2012)
- Lowenguth RA, "Clinical and microbiological response to nonsurgical mechanical periodontal therapy", Periodontol 2000, 9, pp.14~22 (1995)
- da Cruz GA, "Clinical and laboratory evaluations of non-surgical periodontal treatment in subjects with diabetes mellitus", J Periodontol, 79, pp.1150~1157 (2008)
- Tervonen T, "Alveolar bone loss in type 1 diabetic subjects", J Clin Periodontol, 27, pp.567~571 (2000)
- Losche W, "Plasma lipid and blood glucose levels in patients with destructive periodontal disease", J Clin Periodontol, 27, pp.537~541 (2000)
- Teeuw WJ, "Effect of periodontal treatment on glycemic control of diabetic patients : a systematic review and meta-analysis", Diabetes Care, 33, pp.421~427 (2010)
- Svenson KL, "Impaired glucose handling in active rheumatoid arthritis : relationship to the secretion of insulin and counter-regulatory hormones", Metabolism, 36, pp.940~943 (1987)
- Beck-Nielsen H., "Clinical Disorders of Insulin Resistance, In International textbook of diabetes mellitus", pp.531~568 (1992), Wiley
- Sammalkorpi K, "Glucose intolerance in acute infections", J Intern Med, 225, pp.15~19 (1989)
- Grossi SG, "Periodontal disease and diabetes mellitus : a two-way relationship", Ann Periodontol, 3, pp.51~61 (1998)
- Iwamoto Y, "The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes", J Periodontol, 72, pp.774~778 (2001)
- Feingold KR, "Role of cytokines in inducing hyperlipidemia", Diabetes, 41(2), pp.97~101 (1992)
- Ling PR, "Differential effects of interleukin-1 receptor antagonist in cytokine- and endotoxin-treated rats", Am J Physiol, 268(2), pp.255~261 (1995)
- Westfelt E, "The effect of periodontal therapy in diabetics : results after 5 years", J Clin Periodontol, 23, pp.92~100 (1996)
- Alpagot T, "Risk indicators for periodontal disease in a racially diverse urban population", J Clin Periodontol, 23, pp.982~988 (1996)
- Kiran M, "The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus", J Clin Periodontol, 32, pp.266~272 (2005)
