Efficacy of adjunctive photodynamic therapy on the clinical periodontal, HbA1c and advanced glycation end product levels among mild to moderate chronic periodontal disease patients with type 2 diabetes mellitus: A randomized controlled clinical trial.

Abstract

To evaluate the clinical periodontal, serum glycated haemoglobin (HbA1c) and levels of advanced glycation end-products (AGEs) in the gingival crevicular fluid (GCF) among patients with periodontitis and type 2 diabetes mellitus (DM) after photodynamic therapy (PDT) as an adjunct to full-mouth disinfection (FMD). Thirty type 2 DM patients with mild to moderate periodontitis were divided into two main groups: Group-A receiving adjunctive PDT with FMD and Group-B receiving FMD alone. Full-mouth plaque index (PI), bleeding on probing (BOP), probing depth (PD), attachment level (AL) were recorded. Serum HbA1c was assessed among all participants using a HbA1c analyser kit. Levels of AGEs in GCF were determined using enzyme-linked immunosorbent assay. Clinical periodontal and metabolic parameters were assessed at baseline, 3 months and 6 months. Differences were compared using the Friedman test within the groups for different time points. Kruskal-Wallis test with Bonferroni correction test was applied for intragroup and multiple comparisons, respectively. All the clinical periodontal parameters showed significant reduction from baseline to 3 months (P < 0.05) and 6 months follow-up in both the groups (P < 0.01). Only PD showed statistically significant difference from baseline to 3 months in Group-A (P < 0.01). Mean percentage of HbA1c remained constant throughout the study period in both the groups. Mean level of AGEs significantly reduced in both the groups at all time-points. Mean AGEs level reduced slightly higher in Group-A compared to Group-B at 3 months follow-up. However, this difference was not statistically significant (P > 0.05). No additional benefit was seen in the improvement of clinical periodontal parameters and systemic (HbA1c levels) outcomes with PDT except that a minor reduction in the levels of AGEs in the GCF was observed with PDT in the short term.