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非手术牙周治疗改善吸烟者的2型糖尿病状况:一项随机对照试验。

Nonsurgical periodontal treatment improved the type 2 diabetes mellitus status in smokers: A randomized controlled trial.

作者信息

Pham Thuy Anh Vu, Nguyen Phuc Anh, Tran Thao Thi Phuong, Nguyen Van Thi Thao

机构信息

Division of Odonto-Stomatology, School of Medicine, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam.

Division of Odonto-Stomatology, School of Medicine, Ho Chi Minh City, Viet Nam; Vietnam National University, Ho Chi Minh City, Viet Nam.

出版信息

Diabetes Res Clin Pract. 2022 Dec;194:110150. doi: 10.1016/j.diabres.2022.110150. Epub 2022 Nov 12.

Abstract

AIM

Type 2 diabetes mellitus (T2D) and periodontal disease have bilateral associations. The effect of periodontal treatment on T2D patients who smoke is scarce. This study aimed to assess the effect of nonsurgical periodontal treatment (NSPT) in periodontitis smokers with T2D for a duration of 6 months of follow-up.

MATERIALS AND METHODS

Forty moderate to severe periodontitis smokers with T2D were randomly distributed into two different treatment groups: the test group (NSPT including oral hygiene instructions, scaling and root planing; and 0.05% Chlorhexidine mouthrinse) and the control group (treatment including oral hygiene instructions, supragingival removal of plaque and calculus and 0.05% Chlorhexidine mouthrinse). Periodontal parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), periodontal probing depth (PPD) and clinical attachment loss (CAL) were examined. Metabolic parameters, including fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline and at 1, 3, and 6 months of follow-up.

RESULTS

The test group significantly improved all periodontal parameters and reduced metabolic parameters and hs-CRP, whereas improvements in PI and GI were observed in the control group at 1, 3 and 6 months of follow-up. However, the PPD, CAL, metabolic parameters and hs-CRP increased in the control group at 3 and 6 months of follow-up, but the differences were not significant.

CONCLUSIONS

NSPT improves the periodontal status of smokers with T2D, has a favorable effect on glycemic control and reduces pro-inflammatory mediators, which may limit complications due to T2D in these patients.

摘要

目的

2型糖尿病(T2D)与牙周病存在双向关联。牙周治疗对吸烟的T2D患者的影响鲜有研究。本研究旨在评估非手术牙周治疗(NSPT)对患有T2D的牙周炎吸烟者进行6个月随访的效果。

材料与方法

40名患有中度至重度牙周炎的吸烟T2D患者被随机分为两个不同的治疗组:试验组(NSPT包括口腔卫生指导、龈上洁治和根面平整;以及0.05%氯己定漱口水)和对照组(治疗包括口腔卫生指导、龈上菌斑和牙石清除以及0.05%氯己定漱口水)。检查牙周参数,包括菌斑指数(PI)、牙龈指数(GI)、探诊出血(BOP)、牙周探诊深度(PPD)和临床附着丧失(CAL)。在基线以及随访的1、3和6个月时评估代谢参数,包括空腹血糖(FPG)、糖化血红蛋白(HbA1c)以及高敏C反应蛋白(hs-CRP)。

结果

试验组所有牙周参数均显著改善,代谢参数和hs-CRP降低,而对照组在随访的1、3和6个月时PI和GI有所改善。然而,对照组在随访的3和6个月时PPD、CAL、代谢参数和hs-CRP升高,但差异不显著。

结论

NSPT改善了患有T2D的吸烟者的牙周状况,对血糖控制有积极影响,并减少了促炎介质,这可能会限制这些患者因T2D引起的并发症。

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