非手术性牙周治疗与口腔卫生指导对慢性牙周炎 2 型糖尿病患者的影响：一项随机临床试验。
Effect of nonsurgical periodontal therapy verses oral hygiene instructions on type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial.
机构信息
Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
出版信息
BMC Oral Health. 2014 Jun 25;14:79. doi: 10.1186/1472-6831-14-79.
BACKGROUND
40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals.
METHODS
40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals.
RESULTS
15 subjects from NSPT group and 17 from OHI group completed the study. The difference in plaque index (PI) between NSPT and OHI groups were significant at 2 months recall (p = 0.013). There was no significant difference between NSPT and OHI group for all other clinical periodontal parameters, HbA1c and CRP levels. At 3 months post-therapy, periodontal parameters improved significantly in both groups with sites with probing pocket depth (PPD) < 4 mm reported as 98 ± 1.8% in NSPT group and 92 ± 14.9% in OHI group. Mean PPD and mean probing attachment loss (PAL) within the NSPT group reduced significantly from baseline (2.56 ± 0.57 mm, 3.35 ± 0.83 mm) to final visit (1.94 ± 0.26 mm, 2.92 ± 0.72 mm) (p = 0.003, p < 0.001). For OHI group, improvements in mean PPD and mean PAL were also seen from baseline (2.29 ± 0.69 mm, 2.79 ± 0.96 mm) to final visit (2.09 ± 0.72 mm, 2.62 ± 0.97 mm) (p < 0.001 for both). Similarly, HbA1c levels decreased in both groups with NSPT group recording statistically significant reduction (p = 0.038). Participants who demonstrated ≥ 50% reduction in PPD showed significant reductions of HbA1c and hs-CRP levels (p = 0.004 and p = 0.012).
CONCLUSION
NSPT significantly reduced PI at 2 months post-therapy as compared to OHI. Both NSPT and OHI demonstrated improvements in other clinical parameters as well as HbA1c and CRP levels.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT01951547.
背景
40 例 2 型糖尿病伴中重度慢性牙周炎（CP）患者随机分为接受非手术牙周治疗（NSPT）或口腔卫生健康教育（OHI）的两组。分别在基线、2 个月和 3 个月时评估牙周参数、糖化血红蛋白（HbA1c）和高敏 C 反应蛋白（hs-CRP）。
方法
40 例 2 型糖尿病伴中重度 CP 患者随机分为接受 NSPT 或 OHI 的两组。分别在基线、2 个月和 3 个月时评估牙周参数、糖化血红蛋白（HbA1c）和高敏 C 反应蛋白（hs-CRP）。
结果
NSPT 组 15 例和 OHI 组 17 例患者完成了研究。在 2 个月的随访时，NSPT 组和 OHI 组的菌斑指数（PI）差异有统计学意义（p = 0.013）。NSPT 组和 OHI 组的其他所有临床牙周参数、HbA1c 和 CRP 水平均无显著差异。在治疗后 3 个月，两组的牙周参数均显著改善，探诊袋深度（PPD）<4mm 的位点分别为 NSPT 组 98 ± 1.8%和 OHI 组 92 ± 14.9%。NSPT 组的平均 PPD 和平均探诊附着丧失（PAL）从基线（2.56 ± 0.57mm、3.35 ± 0.83mm）到最终随访（1.94 ± 0.26mm、2.92 ± 0.72mm）显著降低（p = 0.003，p<0.001）。OHI 组的平均 PPD 和平均 PAL 也从基线（2.29 ± 0.69mm、2.79 ± 0.96mm）到最终随访（2.09 ± 0.72mm、2.62 ± 0.97mm）有所改善（p<0.001）。同样，两组的 HbA1c 水平均有所下降，NSPT 组的下降具有统计学意义（p = 0.038）。PPD 降低≥50%的患者的 HbA1c 和 hs-CRP 水平显著降低（p = 0.004 和 p = 0.012）。
结论
与 OHI 相比，NSPT 在治疗后 2 个月时可显著降低 PI。NSPT 和 OHI 均可改善其他临床参数以及 HbA1c 和 CRP 水平。
试验注册
ClinicalTrials.gov：NCT01951547。
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