The effect of periodontal therapy on serum TNF‐α and HbA1c levels in type 2 diabetic patients

Abstract

Background: To determine the effect of non-surgical periodontal therapy on serum TNF-a and HbA1c levels in poorly and well-controlled type 2 diabetic patients. Methods: In total, 45 patients were enrolled in the study; 30 patients with type 2 diabetes mellitus with periodontitis (15 with poorly controlled diabetes, HbA1c ‡ 7%, group 1A and 15 with well-controlled diabetes, HbA1c < 7%, group 1B) and 15 patients that were systemically healthy with periodontitis (group 2). The plaque index, gingival index, probing depth, clinical attachment loss, gingival bleeding index, HbA1c value, and circulating TNF-a concentration were measured at baseline and three months after the non-surgical periodontal therapy. Results: All periodontal parameters and serum TNF-a levels were significantly decreased three months after the nonsurgical periodontal therapy compared to the baseline values in all groups. The HbA1c values were significantly decreased only in well-controlled diabetic patients. We found no significant differences in the periodontal parameters or TNF-a levels at baseline and after three months between the two groups. Conclusions: Although non-surgical periodontal therapy eliminates local ⁄ systemic infection and inflammation via decreases in TNF-a, it is insufficient for significantly reducing HbA1c levels without strict glycaemic control in poorly controlled diabetic patients in a short time period.

Effects of periodontal treatment on the medical status of patients with type 2 diabetes mellitus: a pilot study

“…Therefore, it was suggested that periodontal treatment is effective in improving metabolic control in patients with T2DM, possibly through reduction in the serum concentration of TNF-α and decreased insulin resistance. Though some studies have shown improved glycemic control with periodontal treatment in T2DM patients through reduction of peripheral TNF-α concentrations [37, 38], no reduction in serum TNF-α levels has been found following periodontal therapy in T2DM patients in other studies [39, 40]. However, a recent systematic review found that periodontal treatment reduced serum levels of TNF-α and CRP in T2DM patients [41].…”

Levels of vaspin and omentin-1 in gingival crevicular fluid as potential markers of inflammation in patients with chronic periodontitis and type 2 diabetes mellitus

“…A number of researchers have reported an increased concentration of TNF-α in GCF in activated periodontal locations, and decreased concentrations following periodontal treatment. It has also been found that periodontal treatment is followed by a notable decrease in HbA1c levels in T2DM patients (46,47). In this study, we examned the correlation of GCF vaspin and omentin 1 levels with the GCF levels of TNF-α, because TNF-α has a recognizable pro-inflammatory impact on CP and T2DM.…”

Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA_1c

“…Intervention studies of the effect of nonsurgical periodontal treatment in diabetic patients generally show improved periodontal status, while results concerning changes in glycemic status are rather contradictory. Some found significant improvements in glycemic control (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19); others did not (20)(21)(22)(23)(24)(25)(26). Meta-analyses of intervention studies indicate a need for additional trials to clarify this relationship (27)(28)(29)(30).…”