Reduction in HbA1c levels following non-surgical periodontal therapy in type-2 diabetic patients with chronic generalized periodontitis: A periodontist′s role

Abstract

Background:Aim of the study was to compare the response to non-surgical periodontal therapy between patients with and without type-2 diabetes from clinical and metabolic stand point.Materials and Methods:A comparative clinical study was performed between type 2 diabetics and non-diabetics with moderate generalized chronic periodontitis. The study period was six months. Conventional periodontal scaling and root planing were performed, and the response to this treatment was compared between the groups at three and six months, measuring the plaque index, bleeding index, gingival index, and probing depth. In diabetic patients, the clinical response was related to measurements of HbA1c and glucose in blood at three and six months.Statistical Analysis:Multi Variant Analysis of Variance was used to compare following variables between groups and function of time.Results:Improvement in all clinical variables was observed in both the groups. The improvement observed in blood HbA1c levels in diabetic group confirmed a positive metabolic response to non-surgical periodontal treatment.Conclusion:With this study, we conclude that there is a definite reduction in HbA1c level in diabetic patients after conventional non-surgical periodontal treatment.

Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population

“…However the mean change in HbA1c seems to be larger than the one found in similar studies in diabetic patients from other regions and especially in developed countries [ 19 – 21 , 30 , 34 ]. This can be related to study population and periodontal therapy used.…”

Efeitos clínicos e metabólicos da terapia periodontal não cirúrgica em pacientes diabéticos e não diábeticos - revisão de literatura

“…Nos estudos de Da Cruz et al 17 foram melhorados o índice de placa em todos os tempos para diabéticos e não diabéticos após 3 meses, assim como o índice de sangramento gengival. Resultados semelhantes com respeito a essas variáveis foram encontradospor outros autores para o índice de placa 8,12,13,16,18,19,25 e índice gengival. 8,13,16,18,19 A redução significativa desses parâmetros após a terapia confirma a eficácia do controle de higiene oral e redução da inflamação gengival.…”

“…O nível clínico de inserção também reduziu após o tratamento nãocirúrgico nos estudos realizados por Navarro-Sanchez, Faria-Almeida e Bascones-Martinez. 20 No entanto, Da Cruz et al 17 não encontrou diferenças estatisticamente significativas para ambos os grupos, assim como outros autores 8,13,18,19 quando comparados diabéticos com não diabéticos após o tratamento periodontal.…”

“…8,13,16,18,25 Em contrapartida Correa et al 16 e Da Cruz et al 17 não atingiram significância estatística para glicemia em jejum e níveis de HbA1c. Gonçalves et al 13 e Monteghavi et al 26 não encontraram resultados significativos para redução dos níveis de HbA1c o que não confirma a hipótese de que o tratamento periodontal não-cirúrgico ocasiona controle glicêmico.…”

The clinical and metabolic effects of subgingival application of xanthan-based chlorhexidine gel in Type 2 diabetic patients with chronic periodontitis

“…Many studies clearly reported that the estimation of HbA1c can be an important and reliable parameter to evaluate the effective periodontal treatment on the level of glycemic control. [ 20 ] The purpose of this study is to investigate the effects clinical and metabolic effects of a xanthan-based CHX (Xan-CHX) gel used as an adjunct to SRP in the treatment of Type 2 diabetic patients with chronic periodontitis.…”