Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Clin Periodontol. 2024 Jun;51(6):733-741. doi: 10.1111/jcpe.13958. Epub 2024 Mar 6.
This study aimed to investigate the effects of diabetes care on periodontal inflammation.
This prospective cohort study included 51 Japanese patients with type 2 diabetes who underwent intensive diabetes care including educational hospitalization and regular outpatient treatment for 6 months. Dental prophylaxis without subgingival scaling was provided three times during the observational period. Associations between changes in periodontal parameters and glycaemic control levels were evaluated using multiple regression analysis.
Overall, 33 participants (mean age: 58.7 ± 12.9) were followed up for 6 months. At baseline examination, 82% were diagnosed with Stage III or IV periodontitis. Haemoglobin A1c (HbA1c) level changed from 9.6 ± 1.8% at baseline to 7.4 ± 1.3% at 6 months. The ratio of probing pocket depth (PPD) ≥4 mm, bleeding on probing (BOP), full-mouth plaque control record (PCR), periodontal epithelial surface area (PESA) and periodontal inflamed surface area (PISA) also significantly improved. The reduction in PPD and PESA was significantly associated with changes in both HbA1c and fasting plasma glucose (FPG) levels, and the reduction in PISA was significantly associated with an improvement in FPG after adjusting for smoking, change in body mass index and full-mouth PCR.
This is the first study to report a significant improvement in PPD and BOP after intensive diabetes care and dental prophylaxis without subgingival scaling.
UMIN000040218.
本研究旨在探讨糖尿病护理对牙周炎炎症的影响。
本前瞻性队列研究纳入了 51 名接受强化糖尿病护理的日本 2 型糖尿病患者，该护理包括住院教育和定期门诊治疗，持续 6 个月。在观察期间，共进行了 3 次不进行龈下刮治的口腔卫生维护。采用多元回归分析评估牙周参数变化与血糖控制水平之间的关系。
总体而言，有 33 名参与者（平均年龄：58.7±12.9）完成了 6 个月的随访。基线检查时，82%的患者被诊断为牙周炎 3 期或 4 期。血红蛋白 A1c（HbA1c）水平从基线时的 9.6±1.8%降至 6 个月时的 7.4±1.3%。探诊深度（PPD）≥4mm、探诊出血（BOP）、全口菌斑控制记录（PCR）、牙周上皮表面积（PESA）和牙周炎表面面积（PISA）的比例也显著改善。PPD 和 PESA 的减少与 HbA1c 和空腹血糖（FPG）水平的变化显著相关，而 PISA 的减少与调整吸烟、体重指数变化和全口 PCR 后 FPG 的改善显著相关。
这是第一项报告强化糖尿病护理和不进行龈下刮治的口腔卫生维护后 PPD 和 BOP 显著改善的研究。
UMIN000040218。
