Influence of Chlorhexidine and Cetylpyridine on Periodontal Status and Indicators of Oxidative Stress in Patients with Type 1 Diabetes

Abstract

Objective: One of the treatment goals in type 1 diabetes and periodontitis is to address chronic inflammation to prevent the development of neurovascular complications. The aim of this study was to assess the local anti-inflammatory effects of chlorhexidine digluconate and cetylpyridine chloride on periodontal status and indicators of oxidative stress in saliva in patients with type 1 diabetes. Materials and Methods: A total of 42 subjects aged 27 (interquartile range, IQR 22–35) years, with type 1 diabetes for a duration of 12 (IQR 9–18) years, and glycated hemoglobin 8.05 (IQR 7.1–9.4)% were included. Patients were examined twice—initially, and after 14 days of using toothpaste with chlorhexidine and cetylpyridine. Clinical examination of gingival tissues was performed. Certain oxidative stress markers (TP, TEAC, TBARS, AOPP) were measured in the saliva samples. Results: There were significant changes in clinical indicators of periodontal status before and after the application of the toothpaste (API before 0.35 (0.24–0.65) vs. API after 0.265 (0.18–0.39), p = 0.03; SBI before 0.07 (0.04–0.15) vs. SBI after 0.035 (0-0.06), p = 0.002; GI before 0.88 (0.46–1) vs. GI after 0.67 (0.25–1), p = 0.0008). The concentration of saliva TBARS decreased (p = 0.00005) and TEAC increased (p = 0.09). Conclusion: Proper oral hygiene supported by antibacterial chemicals may improve the periodontal status and reduce inflammation.

Investigating the Interplay: Periodontal Disease and Type 1 Diabetes Mellitus - A Comprehensive Review of Clinical Studies

“…Nevertheless, salivary total oxidative status levels were linked to both diabetes status and the extent of gingival inflammation, warranting further exploration through clinical studies encompassing varying degrees of periodontal disease (Aroonrangsee et al, 2023). Additionally, Lipski et al (2021) revealed that reinforcing proper oral hygiene with antibacterial dentifrices notably reduced specific salivary oxidative stress biomarkers in young T1DM patients with gingivitis (Lipski et al, 2021). Moreover, analyses of GCF microbiology and metabolomics in adults with T1DM undergoing continuous subcutaneous insulin infusion suggested early alterations in the GCF microbiome and metabolite concentrations, potentially attributed to increased oxidative stress markers, thus urging further investigation (Gregorczyk-Maga et al, 2023).…”