Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial

Koçak, Emrah; Sağlam, Mehmet; Kayış, Seyit Ali; Dündar, Niyazi; Kebapçılar, Levent; Loos, Bruno G.; Hakkı, Sema S.

doi:10.1007/s10103-016-1868-0

Cited by 40 publications

(30 citation statements)

References 57 publications

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“…30,31 This is in contradiction to a recent study by Koçak and Sağlam which showed SRP+ Diode laser group showed statistically significant improvement in glycemic control (HbA1c) than in SRP group in patients with DM2 and CP. 32 The present study showed improvement in all clinical parameters (PI, GI, PD, CAL) from baseline to 3 months in SRP and SRP+LANAP group which was statistically significant. The value of plaque index reduced from 2.31 at baseline to 1.56 at 3 months in control and from 2.45 to 1.26 in the test group.…”

Section: Hba1c(%)supporting

confidence: 64%

Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial

Chandra

Shashikumar

2018

J Lasers Med Sci

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Please cite this article as follows: Chandra S, Shashikumar P. Diode laser -a novel therapeutic approach in the treatment of chronic periodontitis in type 2 diabetes mellitus patients: a prospective randomized controlled clinical trial. AbstractIntroduction: Maturity-onset diabetes mellitus affecting the elderly population is marked by insulin resistance and decreased insulin production. The relationship between periodontitis and diabetes is bidirectional. Type 2 diabetic patients are more prone to chronic periodontitis (CP) and severe periodontitis affects the glycemic control in such patients. Recently, dental diode laser has become an effective tool in controlling CP. To date, very few studies have been conducted to check the efficacy of diode laser in control of periodontal destruction in type 2 diabetes mellitus (DM2) patients. Hence, the need of the study was to evaluate whether diode laser helps improvement of periodontal outcome and reduction in anaerobic bacteria in elderly diabetic patients with CP. Methods: Forty DM2 patients with CP were randomized into group A (control): scaling and root planing (SRP) only and group B (test): SRP followed by soft tissue dental diode laser (808 nm) application. Four patients (2 in each group) were lost during follow up. Clinical parameters, plaque samples and glycated hemoglobin levels were evaluated at both baseline and 90 days post-treatment. Results: Improvement in clinical, microbiological and glycemic parameters were noted in the group that received SRP as well as SRP + LANAP (laser-assisted new attachment procedure). The reductions in clinical parameters were statistically significant after 3 months (P < 0.001). The microbial analysis of plaque samples for Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) decreased significantly after 3 months in group B than in group A. Glycated hemoglobin level (HbA1c) decreased significantly after 90 days in both the groups (P < 0.001) with more reduction in the SRP+LANAP group (6.49%) in comparison to SRP alone (16.25% vs. 9.76%). However, on the intergroup comparison, the difference in HbA1c reduction was nonsignificant. Conclusion: Laser as an adjunct to SRP is an effective procedure for improving clinical and microbiological parameters in maturity onset diabetes mellitus patients with CP. Also, there was a better improvement in glycemic control in the test group compared to control group after 3 months. Hence, medically compromised patients like DM2 with CP with delayed wound healing can effectively be treated by laser as an adjunct to nonsurgical periodontal therapy for better results.

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Section: Hba1c(%)supporting

confidence: 64%

Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial

Chandra

Shashikumar

2018

J Lasers Med Sci

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“…Hence, considerable attention was paid in drawing an association between periodontitis and certain inflammatory cytokines, such as interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase-8 (MMP-8). Moreover, the presence of such inflammatory cytokines has been proved to be altered in serum, gingival crevicular fluid, and saliva in patients with periodontitis [8–11]. …”

Section: Introductionmentioning

confidence: 99%

Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis

et al. 2017

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BackgroundThis study aimed to assess the difference in serum levels of leptin and adiponectin in patients with periodontitis and in periodontally healthy individuals and evaluate the changes in circulating leptin and adiponectin after periodontal therapy. Leptin and adiponectin are the most generally studied adipokines that function as inflammatory cytokines. Although the association between periodontitis and serum levels of leptin and adiponectin has been studied extensively, the results were not consistent.MethodsA systematic search of the Pubmed, Embase, Web of Science, and Cochrane Library up to September 2016 was conducted. The studies were screened and selected by two writers according to the specific eligibility criteria. The quality of included cross-sectional studies was assessed using the quality assessment form recommended by the Agency for Healthcare Research and Quality and Methodological Index for Nonrandomized Studies. The meta-analyses were conducted using the STATA 12.0 software.ResultsA total of 399 manuscripts were yielded and 25 studies were included in the present meta-analysis. Significantly elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis were observed in the subgroup analysis of body mass index (BMI) <30. The overall and subgroup analyses showed no significant change in the serum levels of leptin in patients with periodontitis after periodontal treatment. The subgroup analysis of systemically healthy patients showed no significant change in serum levels of adiponectin in patients with periodontitis after periodontal treatment.ConclusionsThe present meta-analysis supported elevated serum levels of leptin and decreased serum levels of adiponectin in patients with periodontitis compared with controls in the BMI <30 population. In systemically healthy patients with periodontitis, serum levels of leptin and adiponectin do not significantly change after periodontal treatment.

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“…For the second time in the literature, this study investigated the effects of DL application in addition to SRP on systemic inflammatory response (CRP) and metabolic control of DM (HbA 1c level) in poorly controlled DM patients . Findings of this study indicate that both SRP and SRP+DL application provided positive contributions to periodontal and systemic conditions in patients with T2DM.…”

Section: Discussionmentioning

confidence: 91%

“…In the literature, there is only one study evaluating the effects of DL, which has been applied in contact mode in addition to scaling and root planing (SRP). This study reported SRP+DL reduced haemoglobin A 1c (HbA 1c ) levels more significantly compared to SRP in T2DM patients …”

Section: Introductionmentioning

confidence: 78%

“…The fact that there were statistically significant differences especially in deep periodontal pockets supports that DL application may increase the healing potential of the periodontal tissues in areas where conventional methods are inadequate for treatment. Kocak et al expressed SRP + DL in contact mode has more improvement in PD and CAL levels compared to SRP in DM2 with periodontitis …”

Section: Discussionmentioning

confidence: 99%

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

Eltas

Gürsel

Eltas³

et al. 2019

Int J Dental Hygiene

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Purpose: This study aimed to investigate the effects of diode laser (DL) in addition to non-surgical periodontal treatment on periodontal parameters, systemic inflammatory response and serum haemoglobin A 1c (HbA 1c ) level in patients with poorly controlled type 2 diabetes mellitus (T2DM) and chronic periodontitis. Methods:Thirty-seven patients with poorly controlled T2DM and chronic periodontitis completed this study. The patients were divided into two groups. The individuals in the control group received placebo laser treatment in addition to scaling and root planing (SRP). The individuals in the study group received DL (1 watt) in addition to SRP. Clinical index measurements were performed before treatment (T0), 3 months after treatment (T1) and 6 months after treatment (T2). Plaque index, gingival index, bleeding on probing, clinical attachment level and probing depth were measured to determine periodontal status. HbA1 c and C-reactive protein (CRP) levels were also analysed using blood samples. Results:In both groups, clinical and laboratory parameters were significantly improved at T1 and T2 compared to baseline (P < 0.05). Gingival index, bleeding on probing and probing depth were more significantly reduced after treatment in the SRP+DL group than in the SRP group (P < 0.05). The serum CRP and HbA 1c levels were similar between the groups (P > 0.05). Conclusion: The use of DL in addition to SRP in periodontal treatment of T2DM individuals makes positive contribution to the reduction of local inflammation and to periodontal healing. On the other hand, it has no beneficial effects on systemic inflammatory response and glycaemic control. K E Y W O R D S chronic periodontitis, C-reactive protein, diabetes mellitus, glycated haemoglobin A, laser therapy | 293 DENGIZEK ELTAS ET AL.

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Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial

Cited by 40 publications

References 57 publications

Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial

Diode Laser - A Novel Therapeutic Approach in the Treatment of Chronic Periodontitis in Type 2 Diabetes Mellitus Patients: A Prospective Randomized Controlled Clinical Trial

Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis

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

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