Schara Rok, Medvescek Marko, Skaleric Uros
Dept of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Slovenia.
J Int Acad Periodontol. 2006 Apr;8(2):61-6.
Some studies demonstrated that local mechanical periodontal treatment and systemic antibiotics might improve the level of metabolic control in patients with diabetes. The aim of this clinical pilot trial was to evaluate if type 1 diabetes patients with periodontitis will experience improvement in periodontal status and glycemic control after a full-mouth disinfection treatment. Ten adult patients with poor metabolic control (mean glycated hemoglobin (HbA1c) = 10.7 %) and periodontitis were included in the study. All patients received a full-mouth disinfection in 24 hours as described by Quirynen et al. (1995) at baseline and 6 months later. The periodontal parameters included plaque index (PI), bleeding on probing, probing depth and clinical attachment loss. Metabolic control was measured by the serum level of HbA1c. All measurements were done at baseline and at 3, 6, 9 and 12 months. The results demonstrated a significantly lower PI, less bleeding on probing, reduction in probing depth and gain of clinical attachment at 3 months and 9 months of the study. Similarly, a significant reduction in the serum level of HbA1c was measured three months after full-mouth disinfection but disappeared 6 months later at the 6- and 12-month check points. We conclude that a full-mouth disinfection approach significantly improves periodontal status and metabolic control in type 1 diabetes patients with periodontitis. However, the results of our study imply that a full-mouth disinfection method has to be applied at least every 3 months to control periodontal status and glycemic control in type 1 diabetes patients. Further studies with greater numbers of diabetes patients are needed to confirm the long-term beneficial effects of a full-mouth disinfection approach on diabetic metabolic control.
一些研究表明，局部机械性牙周治疗和全身使用抗生素可能会改善糖尿病患者的代谢控制水平。这项临床试点试验的目的是评估患有牙周炎的1型糖尿病患者在进行全口消毒治疗后，牙周状况和血糖控制是否会有所改善。该研究纳入了10名代谢控制不佳（平均糖化血红蛋白（HbA1c）= 10.7%）且患有牙周炎的成年患者。所有患者在基线时以及6个月后，按照Quirynen等人（1995年）描述的方法在24小时内接受了全口消毒。牙周参数包括菌斑指数（PI）、探诊出血、探诊深度和临床附着丧失。通过HbA1c的血清水平来衡量代谢控制情况。所有测量均在基线以及第3、6、9和12个月时进行。结果显示，在研究的第3个月和第9个月时，PI显著降低，探诊出血减少，探诊深度减小，临床附着增加。同样，全口消毒三个月后，HbA1c的血清水平显著降低，但在6个月后的6个月和12个月检查点时消失。我们得出结论，全口消毒方法可显著改善患有牙周炎的1型糖尿病患者的牙周状况和代谢控制。然而，我们的研究结果表明，必须至少每3个月应用一次全口消毒方法，以控制1型糖尿病患者的牙周状况和血糖控制。需要更多糖尿病患者参与的进一步研究来证实全口消毒方法对糖尿病代谢控制的长期有益效果。
