Non-surgical periodontal therapy with and without subgingival minocycline administration in patients with poorly controlled type II diabetes: a randomized controlled clinical trial

Abstract

The aim of this study was to evaluate changes in clinical parameters and levels of inflammatory biomarkers in plasma in periodontal patients with poorly controlled type 2 diabetes mellitus (T2DM) after non-surgical periodontal therapy. Twenty-eight poorly controlled T2DM patients were randomly assigned to treatment with scaling and root planning (SRP) and SRP + subgingival minocycline administration. Clinical parameters, including the probing depth (PD), bleeding on probing (BOP), plaque score (PS), clinical attachment level (CAL), and plasma interleukin (IL)-6, soluble receptor of advanced glycation end products (sRAGE), chronic reactive protein (CRP), and hemoglobin A1c (HbA1c) were measured before and after a 6-month treatment period. Significant changes in PD, BOP, PS, and CAL were found in both groups. The latent growth curve model showed an overall reduction in the log HbA1c level in the SRP group (-0.082, p = 0.033). Small changes in the log sRAGE level and log CRP level in plasma were found in both groups. IL-6 in the plasma increased in the SRP group, but slightly decreased in the SRP+minocycline group (0.469 pg/ml, p = 0.172). Non-surgical periodontal therapy with or without subgingival minocycline application may achieve significant periodontal improvement and moderate improvement in HbA1c, but had no significant effect on plasma levels of IL-6, CRP, or sRAGE in patients with poorly controlled T2DM. For patients with both periodontal diseases and diabetes, non-surgical periodontal treatments may be helpful in their diabetic control.

The Influence of Anti-Infective Periodontal Treatment on C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Among studies with an active comparator, only 3 of 6 trials compare periodontal therapy+antibiotics to periodontal therapy alone[50,51,56] and these results show no evidence that antibiotic therapy provides stronger reductions in CRP. However, there is considerable heterogeneity between study.…”

Short‐Term Effects of Non‐Surgical Periodontal Treatment on the Gingival Crevicular Fluid Cytokine Profiles in Sites With Induced Periodontal Defects: A Study on Dogs With and Without Streptozotocin‐Induced Diabetes

“…Non‐surgical periodontal therapy (NSPT) (with and without adjunctive remedies) is a classic non‐surgical therapy for treating periodontitis 6,10,19,20 . It was reported that NSPT is effective in reducing the levels of proinflammatory cytokines in GCF from patients with periodontitis with and without type 2 diabetes 10 .…”

Effects of Periodontal Treatment on Glycated Hemoglobin A Levels in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials

“…These literatures included nine literatures that were not RCTs [15][16][17][18][19][20][21][22][23] , six in which the method of periodontal treatment was not SRP 13,[24][25][26][27][28] , two in which the participants were not patients with type 2 diabetes and periodontal disease 29,30) , one in which the outcome variable was not HbA1c 31) , and two without data 32,33) .…”