Abstract
BackgroundTreating periodontitis through non-surgical periodontal therapy (NSPT) may improve glycemic control in type-2 Diabetes Mellitus (T2DM) patients. However, the evidence to maintain this improvement beyond four months is insufficient. Hence, this trial was conducted to assess clinical efficacy of NSPT on glycemic control in T2DM patients.MethodsThis three-arm randomized controlled trial recruited 150 known T2DM participants (35–65 years), suffering from moderate to severe periodontitis, having HbA1c level ≥ 6.5% at baseline. Participants were followed up at 3 and 6 months. Intervention for test group-1 included scaling and root planing (SRP) with metronidazole (MET) and oral hygiene instructions (OHI). Test group-2 was intervened with SRP + OHI and control group with OHI only. Stata v. 14 was used to observe inter and intragroup mean changes in glycemic [glycated hemoglobin (HbA1c), fasting blood glucose (FBG)] and periodontal variables [bleeding on probing (BOP), periodontal pocket depth (PPD), clinical attachment loss (CAL)] using ANOVA and RMANOVA. Proportion of change in outcome variable (HbA1c) was assessed between treatment groups using chi-square test. Change was considered significant at p-value ≤ 0.05.ResultsA significant reduction was observed in BOP, PPD, CAL, HbA1c and FBG over time [p < 0.05]. Significant reductions were observed in same variables in both test groups in comparison to control arm [p < 0.05]. No change between the two test groups was observed [p > 0.05].ConclusionScaling and root planing improves glycemic control of T2DM patients independently of the use of MET. Therefore, SRP after every 6 months may be suggested and included as a part of overall diabetes management for patients suffering from T2DM.Clinical trial registration NCT 03,343,366 [Date of Registration: 17/11/2017]
Highlights
Research on systemic sequel of periodontitis has remained an area of particular interest in dentistry
Individuals were included if they had ≥ 2 interproximal sites having ≥ 5 mm periodontal pocket depth (PPD) or ≥ 4 mm of clinical attachment loss (CAL) [19]
Over a period of 3 months our study found 0.76 mm and 1.35 mm significant reduction in mean PPDin both test trial arms respectively relative to that measured at baseline [Table 2]
Summary
Research on systemic sequel of periodontitis has remained an area of particular interest in dentistry. Qureshi et al BMC Oral Health (2021) 21:253 control of DM patients [3] Their main outcome was a significant post-periodontal therapy reduction of HbA1c level in type-2 DM (T2DM) patients after 3 to 4 months. Further research was recommended to evaluate adjunct drug therapies included as periodontal treatment, along with an extended follow up period and addition of third “no treatment” control group. They further added that the researches in this area were small in number and underpowered. The evidence to maintain this improvement beyond four months is insufficient This trial was conducted to assess clinical efficacy of NSPT on glycemic control in T2DM patients
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