Role of adjunctive therapy with subantimicrobial doses of doxycycline in glycemic control (HbA1c) in patients with diabetes and endo‑periodontal lesions to prevent sinus complications

Abstract

The present study aimed to analyze local and regional changes in regards to odontogenic sinusitis in subjects with endo-periodontal lesions and diabetes mellitus and to investigate the effect on the level of glycemic control (glycated hemoglobin) that could be generated by adjunctive therapy with subantimicrobial doses of doxycycline. This study was performed on 51 subjects with diabetes who were divided into two therapeutic groups: 31 patients with diabetes (the study group) who underwent conventional endo-periodontal therapy and subantimicrobial doses of doxycycline and 20 patients with diabetes who followed only conventional endo-periodontal therapy (the control group). Patients underwent endodontic and periodontal clinical examination, with retro-dental-alveolar radiographs and CBCT examinations. For each patient, glycated hemoglobin A1c (HbA1c) was determined. This evaluation was performed at the beginning of the study, as well as 3, 6 and 12 months after baseline. A significant percentage of patients, both in the study group and in the control group, showed radiological signs of odontogenic sinusitis, totaling 29 patients (56.86%). Periodontal parameters revealed lower levels in patients who underwent the regimen which consisted of subantimicrobial doses of doxycycline; these results were maintained over the study period. Moreover, we demonstrated significantly reduced glycated hemoglobin levels throughout the study (12 months) in the doxycycline-treated group. This fact has far-reaching effects in the sphere of loco-regional complications as well, and the risk of odontogenic sinusitis can be significantly reduced.

Association between Clinical Periodontal Features and Glycated Hemoglobin in Patients with Diabetes and Controlled Periodontitis: A Cross-Sectional Study

“…In addition to basic periodontal therapy for periodontitis in patients with diabetes, other useful non-surgical adjunctive therapies include melatonin, laser, and doxycycline, which have relatively few side effects and can be used safely in patients with systemic diseases, including DM [ 27 , 28 , 29 ]. Even in the SPT phase, it is important to treat worsening periodontitis and DM, and our study may contribute to the examination of the effectiveness of such treatment options.…”

The Efficiency of the BTR-Pen System in Removing Different Types of Broken Instruments from Root Canals and Its Effect on the Fracture Resistance of Roots

“…Excessive loss of tooth substance can reduce root fracture resistance in endodontically treated teeth [ 12 , 14 ]. This might lead to the extraction of single-rooted teeth and the amputation or hemisection of multi-rooted teeth and periodontal disease [ 31 , 32 ]. The process of gaining access to the fractured instrument and removing it involves dentine removal, regardless of the technique used.…”

The Effects of 810 nm Diode Laser and Indocyanine Green on Periodontal Parameters and HbA1c in Patients with Periodontitis and Type II Diabetes Mellitus: A Randomized Controlled Study

“…For the analysis of glycated hemoglobin, venous blood was collected in 3 mL vacutainer with EDTA K3 (FL Medical, Torreglia PD, Italy). The quantification of glycated hemoglobin in total hemolyzed blood was based on a turbidimetric inhibition reaction, as previously described [ 24 , 25 ]. Glycated hemoglobin A1c (HbA1c) was determined for each patient at baseline and after 6 months.…”