Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus

Abstract

PurposeThe present study was conducted to evaluate the impact of scaling and root planing (SRP) on the C-reactive protein (CRP) levels of gingival crevicular fluid (GCF) and serum in chronic periodontitis patients with type 2 diabetes mellitus (T2DM-CP) or without type 2 diabetes mellitus (NDM-CP).MethodsForty-eight human participants were divided into two groups: an experimental (T2DM-CP) group (group I, n=24) comprising chronic periodontitis patients with random blood sugar ≥200 mg/dL and type 2 diabetes mellitus, and control (NDM-CP) group (group II, n=24) of those with chronic periodontitis and random blood sugar <200 without T2DM for the study. All subjects underwent nonsurgical periodontal therapy (NSPT) including complete SRP and subgingival debridement. Periodontal health parameters, plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), GCF volume (GCF vol), GCF-CRP, random blood glucose (RBS), glycated hemoglobin, and systemic inflammatory markers, serum CRP, total leukocyte count (TLC), neutrophil count (Neutr) and lymphocyte count (Lymph), were evaluated at baseline, 1 month, and 3 months after SRP.ResultsNSPT resulted in statistically significant improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum as well as GCF of both groups I and II. The mean improvement in periodontal health parameters (PI, GI, PPD, CAL, GCF vol), CRP levels in serum and GCF was greater in group I than group II after NSPT. There was nonsignificant increase in GCF-CRP, TLC, Lymph, and RBS, and a significant increase in Neutr and Serum CRP in group II at 1 month. The Serum CRP level of 20 out of 24 group II patients had also increased at 1 month.ConclusionsThe CRP levels in both GCF and serum were higher in T2DM-CP patients than in NDM-CP patients. Although there was a significant improvement in both the groups, greater improvement was observed in both GCF and serum samples of T2DM-CP patients.Graphical Abstract

Effects of periodontal treatment on inflammation and oxidative stress markers in patients with metabolic syndrome

“…The levels of hs-CRP and IL-6 are increased in both MetS and chronic periodontitis (6,31) and are decreased after periodontal treatment (32,33). Similarly to the results of the present study, it was reported that CRP levels decreased after NSPT (34)(35)(36)(37). In this study, the baseline serum levels of hs-CRP and IL-6 were significantly higher in the MetS group than in the SH group and decreased * p<0.05, significant difference compared to baseline, p<0.05, significant difference compared to 3 M § p<0.05 significant difference between groups 3 M = 3 rd Month 6 M = 6 th Month Fig.…”

“…The levels of hs‐CRP and IL‐6 are increased in both MetS and chronic periodontitis and are decreased after periodontal treatment . Similarly to the results of the present study, it was reported that CRP levels decreased after NSPT . In this study, the baseline serum levels of hs‐CRP and IL‐6 were significantly higher in the MetS group than in the SH group and decreased significantly in both groups after NSPT.…”

Evaluation of long‐term effects of diode laser application in periodontal treatment of poorly controlled type 2 diabetic patients with chronic periodontitis

“…In some studies, it has been reported that serum CRP level may decrease after successful periodontal treatment or DM treatment . Mohan et al reported that there was a greater reduction in serum CRP levels after periodontal treatment in T2DM patients than in non‐DM patients. Lalla et al reported that there was a significant decrease in serum CRP levels after periodontal treatment in patients with DM and CP.…”

Clinical efficacy of semiconductor laser-assisted minocycline in moderate-to-severe chronic periodontitis patients with type 2 diabetes mellitus

“…Patients with T2MD are affected by CP, and their increased levels of inflammatory factors enhance insulin resistance [22]. It has been suggested that with treatment, C-creative protein (CRP) in CP patients with T2DM greatly decreases and that the control of the inflammatory responses associated with CP is helpful to the control of blood glucose in these patients [23]. In this study, the pattern of changes in FPG and HbA1c in the study group and the control group shows that semiconductor laser-assisted minocycline therapy in treating CP was able to control blood glucose, weaken the effect of hyperglycemia on the periodontal tissues, and enhance the therapeutic effect of CP.…”