Treatment of periodontitis reduces systemic inflammation in type 2 diabetes.

Abstract

To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes. Adults with type 2 diabetes (n=83) and without diabetes (controls, n=75) were recruited, and participants with periodontitis received periodontal treatment and 12months' follow-up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin-6, tumour necrosis factor-α, interleukin-1β, interferon-γ, matrix metalloproteinase-8, matrix metalloproteinase-9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C-reactive protein, interleukin-6, tumour necrosis factor-α, interleukin-1β, interferon-γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation. Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non-diabetic controls with periodontitis (Δ=0.20, p=.002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ=-0.25, p=.01). Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment.