Navarro-Sanchez Ana Belén, Faria-Almeida Ricardo, Bascones-Martinez Antonio
Complutense University, Madrid, Spain.
J Clin Periodontol. 2007 Oct;34(10):835-43. doi: 10.1111/j.1600-051X.2007.01127.x.
The purpose of this study was to compare the local efficacy of nonsurgical periodontal therapy between type 2 diabetic and non-diabetic patients and the effect of periodontal therapy on glycaemic control.
A complex two-way relationship exists between diabetes mellitus and periodontitis.
After selection, 20 subjects (10 diabetic and 10 non-diabetic) underwent baseline examination, periodontal clinical study and biochemical analysis of gingival crevicular fluid (GCF). After the pre-treatment phase, subgingival scaling and root planing were performed. Subsequently, all subjects continued the maintenance programme and were re-examined at 3 and 6 months.
Diabetic and non-diabetic subjects responded well after therapy, showing a very similar progression during the follow-up period. Both groups showed clinically and immunologically significant improvements. Significant reductions were also found in the total volume of GCF and levels of interleukin-1beta and tumour necrosis factor-alpha. Diabetic subjects showed an improvement in their metabolic control. The change in glycosylated haemoglobin (HbA(1C)) was statistically significant at 3 and 6 months.
The clinical and immunological improvements obtained were accompanied by a significant reduction in HbA(1C) values in type 2 diabetic subjects. Larger studies are needed to confirm this finding and establish whether periodontal therapy has a significant effect on glycaemic control.
本研究旨在比较2型糖尿病患者和非糖尿病患者非手术牙周治疗的局部疗效以及牙周治疗对血糖控制的影响。
糖尿病与牙周炎之间存在复杂的双向关系。
经过筛选,20名受试者(10名糖尿病患者和10名非糖尿病患者)接受了基线检查、牙周临床研究以及龈沟液(GCF)的生化分析。在预处理阶段之后,进行了龈下刮治和根面平整。随后,所有受试者继续维持治疗方案,并在3个月和6个月时进行复查。
糖尿病患者和非糖尿病患者在治疗后反应良好,在随访期间表现出非常相似的进展。两组在临床和免疫方面均有显著改善。龈沟液总量以及白细胞介素-1β和肿瘤坏死因子-α水平也有显著降低。糖尿病患者的代谢控制得到改善。糖化血红蛋白(HbA1C)在3个月和6个月时的变化具有统计学意义。
在2型糖尿病患者中,临床和免疫方面的改善伴随着HbA1C值的显著降低。需要进行更大规模的研究来证实这一发现,并确定牙周治疗是否对血糖控制有显著影响。