1 Department of Restorative Dentistry, Periodontology, Endodontology, and Preventive and Pediatric Dentistry, Unit of Periodontology, University Medicine Greifswald, Greifswald, Germany.
2 Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
J Dent Res. 2019 Feb;98(2):171-179. doi: 10.1177/0022034518804185. Epub 2018 Oct 16.
Evidence is limited regarding whether periodontal treatment improves hemoglobin A1c (HbA1c) among people with prediabetes and periodontal disease, and it is unknown whether improvement of metabolic status persists >3 mo. In an exploratory post hoc analysis of the multicenter randomized controlled trial "Antibiotika und Parodontitis" (Antibiotics and Periodontitis)-a prospective, stratified, double-blind study-we assessed whether nonsurgical periodontal treatment with or without an adjunctive systemic antibiotic treatment affects HbA1c and high-sensitivity C-reactive protein (hsCRP) levels among periodontitis patients with normal HbA1c (≤5.7%, n = 218), prediabetes (5.7% < HbA1c < 6.5%, n = 101), or unknown diabetes (HbA1c ≥ 6.5%, n = 8) over a period of 27.5 mo. Nonsurgical periodontal treatment reduced mean pocket probing depth by >1 mm in both groups. In the normal HbA1c group, HbA1c values remained unchanged at 5.0% (95% CI, 4.9% to 6.1%) during the observation period. Among periodontitis patients with prediabetes, HbA1c decreased from 5.9% (95% CI, 5.9% to 6.0%) to 5.4% (95% CI, 5.3% to 5.5%) at 15.5 mo and increased to 5.6% (95% CI, 5.4% to 5.7%) after 27.5 mo. At 27.5 mo, 46% of periodontitis patients with prediabetes had normal HbA1c levels, whereas 47.9% remained unchanged and 6.3% progressed to diabetes. Median hsCRP values were reduced in the normal HbA1c and prediabetes groups from 1.2 and 1.4 mg/L to 0.7 and 0.7 mg/L, respectively. Nonsurgical periodontal treatment may improve blood glucose values among periodontitis patients with prediabetes (ClinicalTrials.gov NCT00707369).
关于牙周治疗是否能改善糖尿病前期和牙周病患者的血红蛋白 A1c（HbA1c），证据有限，而且代谢状态的改善是否能持续 >3 个月尚不清楚。在多中心随机对照试验“Antibiotika und Parodontitis”（抗生素和牙周炎）的一项探索性事后分析中——一项前瞻性、分层、双盲研究——我们评估了是否非手术牙周治疗联合或不联合辅助全身抗生素治疗会影响正常 HbA1c（≤5.7%，n=218）、糖尿病前期（5.7%<HbA1c<6.5%，n=101）或未知糖尿病（HbA1c≥6.5%，n=8）的牙周病患者的 HbA1c 和高敏 C 反应蛋白（hsCRP）水平。27.5 个月期间，非手术牙周治疗使两组的平均牙周袋探诊深度均减少了 >1 毫米。在正常 HbA1c 组中，HbA1c 值在整个观察期间保持不变，为 5.0%（95%CI，4.9%至 6.1%）。在糖尿病前期牙周病患者中，HbA1c 从 5.9%（95%CI，5.9%至 6.0%）下降到 15.5 个月时的 5.4%（95%CI，5.3%至 5.5%），然后在 27.5 个月时增加到 5.6%（95%CI，5.4%至 5.7%）。在 27.5 个月时，46%的糖尿病前期牙周病患者 HbA1c 水平正常，47.9%保持不变，6.3%进展为糖尿病。正常 HbA1c 和糖尿病前期组的 hsCRP 中位数分别从 1.2 和 1.4mg/L 降低到 0.7 和 0.7mg/L。非手术牙周治疗可能改善糖尿病前期牙周病患者的血糖值（ClinicalTrials.gov NCT00707369）。
