Goel Khushboo, Pradhan Shaili, Bhattarai Madhur Dev
Department of Periodontology and Oral Implantology, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan.
Department of Dental Surgery, Periodontics Unit, Bir Hospital.
Clin Cosmet Investig Dent. 2017 Jul 17;9:73-80. doi: 10.2147/CCIDE.S138338. eCollection 2017.
Despite several investigations, evidence is still controversial regarding the effect of periodontal treatment on diabetes. This study evaluates and compares the effect on glycemic control and periodontal status with or without nonsurgical periodontal therapy in patients with type 2 diabetes mellitus and chronic periodontitis in a Nepalese population.
A total of 82 patients attending the diabetes clinic and fulfilling enrollment criteria with moderate to severe periodontitis were selected. They were assigned in an alternative sequence, into test and control group. Both groups were instructed to continue with their medical treatment without modifications. Scaling and root surface debridement were performed in the test group whereas the control group received oral hygiene instructions with no treatment during the 3-month study period.
There were 41 participants in each group with the mean age of 50.66±7.70 and 53.80±9.16 years, average diabetes duration of 6.32±4.21 and 6.24±4.00 years, mean body mass index of 24.78±1.85 and 24.6±1.79 kg/m, and glycated hemoglobin (HbA1c) level of 6.71±0.50% and 6.80±0.45%, in the test and control group, respectively. After 3 months, there was significant reduction in HbA1c levels in the test group compared to the control group (=0.029). Clinical periodontal parameters of gingival index, probing depth (PD), and clinical attachment level (CAL) significantly improved in the test group (<0.001) with PD reduction by 0.9 mm and gain in CAL by 0.3 mm compared to the control group (>0.001) who showed an increase by 0.05 mm.
This study showed that nonsurgical periodontal therapy may have a beneficial effect on HbA1c level in moderately controlled type 2 diabetic patients.
尽管进行了多项研究,但关于牙周治疗对糖尿病的影响,证据仍存在争议。本研究评估并比较了在尼泊尔人群中,非手术牙周治疗对2型糖尿病合并慢性牙周炎患者血糖控制和牙周状况的影响。
共选取82名到糖尿病门诊就诊且符合中度至重度牙周炎纳入标准的患者。他们被交替分配到试验组和对照组。两组均被要求继续其原有治疗方案不变。试验组进行了龈上洁治和根面平整,而对照组在3个月的研究期间仅接受了口腔卫生指导,未接受治疗。
每组各有41名参与者,试验组和对照组的平均年龄分别为50.66±7.70岁和53.80±9.16岁,平均糖尿病病程分别为6.32±4.21年和6.24±4.00年,平均体重指数分别为24.78±1.85 kg/m和24.6±1.79 kg/m,糖化血红蛋白(HbA1c)水平分别为6.71±0.50%和6.80±0.45%。3个月后,试验组的HbA1c水平与对照组相比有显著降低(P = 0.029)。试验组的牙龈指数、探诊深度(PD)和临床附着水平(CAL)等临床牙周参数显著改善(P<0.001),与对照组(P>0.001)相比,PD降低了0.9 mm,CAL增加了0.3 mm,而对照组的PD增加了0.05 mm。
本研究表明,非手术牙周治疗可能对中度控制的2型糖尿病患者的HbA1c水平有有益影响。