Department of Periodontology, Guangdong Provincial Stomatological Hospital, Southern Medical University, Guangzhou, China.
J Periodontol. 2012 Apr;83(4):435-43. doi: 10.1902/jop.2011.110327. Epub 2011 Aug 22.
Scientific evidence on the effects of chronic periodontitis on diabetes mellitus remains inadequate and inconclusive. This intervention study is designed to evaluate the effects of periodontal treatment on clinical response, systemic inflammatory parameters, and metabolic control in patients with Type 2 diabetes.
A total of 134 patients were randomly allocated into two treatment groups and one control group. Treatment group 1 underwent non-surgical periodontal treatment at baseline and additional subgingival debridement at the 3-month follow-up. Patients in treatment group 2 received non-surgical periodontal treatment and supragingival prophylaxis at the 3-month follow-up, and those in the control group received no intervention throughout the study. All participants were reexamined at 1.5, 3, and 6 months after initial treatment. At each visit, clinical periodontal examinations were conducted and blood samples were taken to evaluate high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and lipid profiles.
Both treatment groups had a significantly lower hsCRP level after periodontal therapy (P <0.05). Although HbA1c declined significantly in treatment group 2 (P <0.05), the intergroup difference for HbA1c, FPG, TNF-α, and lipid profiles was not statistically significant after therapy (P >0.05).
Non-surgical periodontal treatment can effectively improve periodontal and circulating inflammatory status. Despite a lack of strong evidence, trends in some results support improved glycemic control after periodontal treatment in patients with diabetes.
慢性牙周炎对糖尿病的影响的科学证据仍然不足且不确定。本干预研究旨在评估牙周治疗对 2 型糖尿病患者临床反应、全身炎症参数和代谢控制的影响。
共有 134 名患者被随机分配到两组治疗组和一组对照组。治疗组 1 在基线时接受非手术牙周治疗,并在 3 个月随访时进行额外的龈下清创术。治疗组 2 患者在 3 个月随访时接受非手术牙周治疗和龈上预防,对照组患者在整个研究期间未接受任何干预。所有参与者在初始治疗后 1.5、3 和 6 个月重新检查。每次就诊时,进行临床牙周检查并采集血样,以评估高敏 C 反应蛋白 (hsCRP)、肿瘤坏死因子-α (TNF-α)、糖化血红蛋白 (HbA1c)、空腹血糖 (FPG) 和血脂谱。
两组在牙周治疗后 hsCRP 水平均显著降低(P<0.05)。尽管治疗组 2 的 HbA1c 显著下降(P<0.05),但治疗后 HbA1c、FPG、TNF-α 和血脂谱的组间差异无统计学意义(P>0.05)。
非手术牙周治疗可有效改善牙周和循环炎症状态。尽管缺乏强有力的证据,但一些结果的趋势支持糖尿病患者牙周治疗后血糖控制的改善。