Effect of Initial Periodontal Therapy on Serum Nitric Oxide Levels in Chronic Periodontitis Patients with or without Type 2 Diabetes Mellitus

Abstract

To evaluate the effect of initial periodontal therapy on serum NO levels in chronic periodontitis (CP) patients with or without type2 diabetes mellitus (T2DM) Materials and methods: A total of 90 subjects (group I-30 healthy controls, group I-30 CP and group III-30 CP with T2DM) participated in this study. Groups II and III subjects received initial periodontal therapy. Clinical periodontal parameters (OHI-S, GI, PPD, and CAL) and serum NO levels were evaluated at baseline and 4 weeks after initial periodontal therapy. Serum NO levels were determined by the Spectrophotometric assay based on the Griess colorimetric reaction. Four weeks after initial periodontal therapy both groups II and III exhibited improvement in clinical periodontal parameters (OHI-S, GI, PPD, CAL) and reduction in serum levels of NO from its baseline values (Baseline-Group II: 3.64 ± 0.53, 1.93 ± 0.30, 3.29 ± 0.42, 3.60 ± 0.42, 89.21 ± 1.46 respectively, group III: 3.66 ± 0.44, 2.03 ± 1.32, 3.57 ± 0.40, 3.65 ± 0.45, 85.54 ± 1.54 respectively. Post-treatment-Group II: 1.73 ± 0.42, 1.27 ± 0.23, 3.16 ± 0.46, 3.47 ± 0.58, 70.91 ± 1.68 respectively, group III: 2.39 ± 0.49, 1.71 ± 0.33, 3.44 ± 0.42, 3.61 ± 0.48, 68.69 ± 1.17 respectively). However, statistically significant differences were observed only with OHI-(S) and serum NO values in both groups II and III (p < 0.05). When the baseline values of groups II and III were compared the differences were non-significant except for GI (p < 0.05). However, when the post-treatment clinical periodontal parameters and serum NO level of groups II and III were compared, statistically significant differences (p < 0.05) were observed except for PPD and CAL between the groups. NO can be utilized as a good indicator of the inflammatory status of the periodontium. Initial periodontal therapy is effective in reducing serum levels of NO in CP patients with or without T2DM. A bidirectional relationship exists between periodontal disease and diabetes mellitus. NO is found to play a significant role in the pathobiology of both CP and T2DM. Initial periodontal therapy seems to be beneficial in reducing serum NO levels along with periodontal parameters in CP patients with or without T2DM. However further studies are warranted to enhance our knowledge about the role of NO in periodontal diseases in the course of diabetes.