Effect Of Non-surgical Periodontal Therapy Research Articles

Effect of nonsurgical periodontal therapy on haematological parameters in grades B and C periodontitis: an exploratory analysis

AimAssessment of the effect of nonsurgical periodontal therapy on haematological parameters in patients with grades B (BP) and C periodontitis (CP).MethodsEight BP and 46 CP patients received full-mouth periodontal debridement within 48 h, if positive for Aggregatibacter actinomycetemcomitans with adjunctive systemic antibiotics (4 BP, 17 CP). Clinical data were collected prior and 12 weeks after periodontal therapy. Blood was sampled prior to and 1 day as well as 6 and 12 weeks after the first SD visit. Erythrocyte count, haemoglobin value, haematocrit (HCT), mean erythrocyte volume (MCV), mean corpuscular haemoglobin (MCH), MCH concentration (MCHC), platelets (PLT) and heat shock protein 27 (Hsp27) were assessed.ResultsBoth groups showed significant clinical improvement (p < 0.05). Using univariate analysis, MCV was noticeably lower in CP than BP at all examinations, HCT only at baseline. For CP, MCHC was noticeably higher 12 weeks after SD than at baseline and 1 day (p ≤ 0.005) and Hsp27 increased noticeably at 1 day (p < 0.05). Repeated measures analysis of variance revealed African origin to be associated with lower MCV and female sex with lower MCHC.ConclusionBased on multivariate analysis, periodontal diagnosis (BP/CP) was not associated with haematological parameters measured in this study or serum Hsp27. In CP, nonsurgical periodontal therapy improved MCHC 12 weeks after SD. Also in CP Hsp27 was increased 1 day after SD.

Periodontitis phenotypes and clinical response patterns to non-surgical periodontal therapy: reflections on the new periodontitis classification.

We aimed to identify response patterns to non-surgical periodontal therapy and to investigate whether the new classification system for periodontitis reflects response to treatment after 1yr. At baseline, data on sociodemographic status, smoking, and diabetes were obtained from participants with periodontal disease. Clinical periodontal data and subgingival plaque were also collected. Participants underwent non-surgical periodontal therapy, and after 3 and 12months, clinical data were reassessed. Factor analyses, group-based-trajectory modeling, and mixed-effects regression models were used for data analysis. Factor analysis of the baseline periodontal parameters revealed two different periodontitis dimensions: 'moderate' and 'severe'. Two response patterns for each of these periodontitis dimensions were identified. Periodontal therapy had a beneficial effect on both 'moderate' and 'severe' periodontitis; however, individuals with higher levels of disease at baseline experienced greater treatment effect. Regarding the new classification system, while the staging component distinguished different levels of 'moderate' and 'severe' periodontitis before and after treatment, the grading component did not. This study shows the beneficial effect of non-surgical periodontal therapy on both 'moderate' and 'severe' periodontitis. However, the benefit was limited among individuals with low levels of disease. The new classification system did not adequately reflect the periodontal response to therapy in this patient group.

Effects of non-surgical periodontal therapy on systemic inflammation and metabolic markers in patients undergoing haemodialysis and/or peritoneal dialysis: a systematic review and meta-analysis

BackgroundThis systematic review aimed to investigate whether non-surgical periodontal therapy (NSPT) can reduce systemic inflammatory levels and improve metabolism in patients undergoing haemodialysis (HD) and/or peritoneal dialysis (PD).MethodsElectronic databases (PubMed, EMBASE, CENTRAL, CNKI, and WFPD) were searched for randomized controlled trials (RCTs) performed through July 2019. The risk of bias within studies was assessed with the Cochrane Collaboration’s risk assessment tool. The systemic inflammatory and metabolic outcomes included the highly sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6), tumour necrosis factor-a (TNF-a), the albumin (Alb), and lipid metabolite levels. Meta-analyses (MAs) were performed to calculate the overall effect size where appropriate.ResultsFive RCTs were included in this study. Compared with untreated periodontitis groups, the dialysis patients after NSPT significantly showed decreased hs-CRP levels at less than or equal to 2 months (standardized mean difference: − 1.53, 95% confidence interval − 2.95 to − 0.11). No significant difference was found in IL-6 and Alb levels following NSPT at either the 3- or 6- month follow-ups. No MAs could be performed on the TNF-a level and the lipid metabolic markers.ConclusionsNSPT can moderately reduce serum hs-CRP levels in HD and/or PD patients, but did not significantly change IL-6 or Alb levels. For TNF-a and lipid metabolism markers, no sufficient evidence supports that these levels are changed after NSPT. Additional scientific research is necessary to assess the effects of NSPT on systemic inflammation and metabolic parameters in dialysis patients.

Effect of nonsurgical periodontal therapy on serum levels of interleukin-1β and interleukin-8 in smokers and nonsmokers with chronic periodontitis

ABSTRACTAim:The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on serum levels of interleukin-1β (IL-1β) and interleukin-8 (IL-8) in smokers and nonsmokers with chronic periodontitis before and after scaling and root planing (SRP).Materials and Methods:This was a comparative interventional study including a total of 52 (26 smokers and 26 nonsmokers with chronic periodontitis) subjects. Clinical parameters (gingival index [GI], plaque index [PI], recession, probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and 4 weeks after initial periodontal therapy. Initial periodontal therapy included oral hygiene instructions and full mouth SRP. Venous blood sample of 5 mL was collected from each subject at baseline and 4 weeks after initial periodontal therapy to evaluate serum IL-1β and IL-8. These biochemical parameters were assayed using enzyme-linked immunosorbent assay (ELISA) method.Results:The periodontal parameters such as PI, GI, recession, PPD, and CAL were reduced after nonsurgical periodontal therapy. Smokers with chronic periodontitis showed statistically significant lower GI and higher PI, gingival recession, PPD, and CAL as compared to nonsmokers with chronic periodontitis. Statistically significant reduction in periodontal parameters was seen in both groups after periodontal therapy. IL-1β and IL-8 were increased in both groups at baseline; after SRP both groups showed statistically significant reduction in IL-1β and smokers with chronic periodontitis showed statistically significant increase in IL-8 after SRP.Conclusion:Smokers with chronic periodontitis showed more periodontal destruction and systemic inflammatory markers compared to nonsmokers with chronic periodontitis. After periodontal therapy both groups showed statistically significant improvement in clinical parameters and biochemical parameters excluding IL-8.

Effect of Nonsurgical Periodontal Therapy on Serum Level of Interleukin-6 and Tumor Necrosis Factor-&amp;alpha; in Chronic Periodontitis Patients with and without Hypothyroidism

The aim of this article was to determine the effect of nonsurgical periodontal therapy on clinical parameters and also to evaluate serum level of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in chronic periodontitis patients with and without hypothyroidism. Subjects were 40 female patients (20 systemically healthy subjects with chronic periodontitis and 20 subjects with hypothyroidism and chronic periodontitis). Clinical parameters like plaque score, gingival score, gingival recession, probing pocket depth, and clinical attachment level were recorded at baseline and 4 weeks after nonsurgical periodontal therapy. Nonsurgical periodontal therapy included oral hygiene instructions and full-mouth scaling and root planing. A total of 5 mL of venous blood sample was collected from each subject at baseline and 4 weeks after nonsurgical periodontal therapy. The clinical parameters and biochemical parameters like IL-6 and TNF-α in both groups showed pronounced reduction at the end of 4 weeks following nonsurgical periodontal therapy. However, simultaneous comparison of clinical and biochemical parameters between the two groups was not statistically significant. This study provides evidence that nonsurgical periodontal therapy contributes to reduction in serum level of IL-6 and TNF-α in systemically healthy subjects with chronic periodontitis and subjects with hypothyroidism and chronic periodontitis. The prevalence of periodontitis as well as hypothyroidism is increasing nowadays. Interleukin-6 and TNF-α are found to play a significant role in pathobiology of both periodontitis and hypothyroidism. With the treatment of periodontitis, it is found that there is improvement in periodontal and thyroid status of the patients. So, it is an alert to health professionals about the relation of hypothyroidism and periodontitis so that they consider a multidisciplinary approach.

Sex steroid levels and stress-related markers in pregnant and non-pregnant women and the effect of periodontal therapy.

Periodontal disease during pregnancy can produce adverse events; in the current study stress was investigated as an exacerbating factors of periodontal disease. The aims of this study were to evaluate the possible associations between stress and pregnancy through scanning for gingivitis and to explore the effect of non-surgical periodontal therapy (NPT) on stress-related markers (CgA, AA, β-endorphin, DHEA, sIgA and NPY) and sex steroid levels (estrogen and progesterone) in pregnant and non-pregnant women. A total of 87 subjects; 22 pregnant women with gingivitis, 25 periodontally healthy pregnant women; 22 non-pregnant women with gingivitis and 15 periodontally healthy non-pregnant women, participated in this study. Periodontal clinical measures, stress hormones and sex steroid levels were measured at baseline and following the periodontal therapy. While periodontal therapy showed an improvement in salivary CgA, AA, β-endorphin, DHEA, and sIgA levels (p<0.05) in non-pregnant women with gingivitis; neuropeptide Y levels were found to be unaffected (p>0.05). There were no significant changes in salivary CgA, AA, DHEA, sIgA, and neuropeptide Y levels in pregnant women with gingivitis (p>0.05); however, a decrease in β-endorphin levels was observed after therapy (p<0.05). Pregnant women with gingivitis had higher gingival crevicular fluid (GCF) β-endorphin levels in comparison to non-pregnant women with gingivitis. Gingival inflammation can be a psychosocial stress inducing factor during pregnancy. Furthermore, periodontal therapy may assist in reducing stress-related hormone levels in GCF during pregnancy.

Effect of Non-Surgical Periodontal Therapy on the Severity of Rheumatoid Arthritis—A Clinical and Hematological Study

Background: The epidemiological and pathological relations between Periodontitis and Rheumatoid arthritis (RA) have been stated. The citrullination and attendant autoantibody responses are defining features of RA. It has been recognized that the oral bacteria, inflammation and its mediators might play an important role in RA activity. Hence this study aimed to evaluate the effect of Non-surgical Periodontal Therapy in reducing the severity of Rheumatoid arthritis. Materials and Method: Totally 25 participants diagnosed with RA and Periodontitis were included in the study. Clinical parameters such as CPSS index, BOP% and CAL, estimation of ESR and calculation of DAS28 done at baseline, after Pre-NSPT and after next Post-NSPT were recorded. Results: Statistically significant improvement was noted for CPSS (p Conclusion: Reduction in the periodontal inflammation positively affects the rheumatoid arthritis activity, hence improving the patient’s health.

PERIODONTAL THERAPY AFFECTS ORAL COLONIZATION OF CANDIDA SPP AND HIV INFECTION STATUS IN PATIENTS WITH PERIODONTITIS

Objectives This study investigated the effect of nonsurgical periodontal therapy (NSPT) on the clinical and immunologic profile and oral colonization of Candida spp in patients infected with human immunodeficiency virus (HIV) and chronic periodontitis (CP). Study Design HIV-infected (test group) and non–HIV-infected (control group) adults patients with CP were selected. Gingival index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load, salivary interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-α), and Candida spp count were analyzed at baseline, 30, and 90 days after NSPT. Results Twenty-two patients infected with HIV and 20 patients not infected with HIV were evaluated. Candida spp count and salivary IL-6, IL-8, and TNF-α levels were higher in the test group than in the control group. Both groups presented decrease in Candida spp oral count, GI, PD, IL-6, and IL-8 as well as gain of CAL after NSPT at 30 and 90 days. In addition, patients from test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. Conclusions NSPT had a beneficial effect on the clinical parameters of CP and on the Candida spp oral count and salivary levels of IL-6 and IL-8 in both groups, and also on the HIV-infection status. This study investigated the effect of nonsurgical periodontal therapy (NSPT) on the clinical and immunologic profile and oral colonization of Candida spp in patients infected with human immunodeficiency virus (HIV) and chronic periodontitis (CP). HIV-infected (test group) and non–HIV-infected (control group) adults patients with CP were selected. Gingival index (GI), probing depth (PD), clinical attachment level (CAL), number of teeth, CD4+ T lymphocytes and viral load, salivary interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-α), and Candida spp count were analyzed at baseline, 30, and 90 days after NSPT. Twenty-two patients infected with HIV and 20 patients not infected with HIV were evaluated. Candida spp count and salivary IL-6, IL-8, and TNF-α levels were higher in the test group than in the control group. Both groups presented decrease in Candida spp oral count, GI, PD, IL-6, and IL-8 as well as gain of CAL after NSPT at 30 and 90 days. In addition, patients from test group showed an increase of CD4+ T lymphocytes and a decrease of viral load. NSPT had a beneficial effect on the clinical parameters of CP and on the Candida spp oral count and salivary levels of IL-6 and IL-8 in both groups, and also on the HIV-infection status.

Effects of non-surgical periodontal therapy on inflammatory markers of psoriasis: A randomized controlled trial.

The purpose of this randomized controlled clinical study was to evaluate the effect of non-surgical mechanical periodontal therapy on the inflammatory status and severity of psoriasis in subjects with psoriasis. The study population consisted of 92 periodontitis patients with psoriasis vulgaris suffering from an untreated periodontal disease. Two randomized groups were formed from these patients: immediate periodontal therapy (test group, n=46) and delayed periodontal therapy (control group, n=46). Periodontal clinical measures, on salivary interleukin 2, interleukin 6 and secretory immunoglobulin A levels and the Psoriasis Area and Severity Index (PASI) scores were evaluated at baseline and on the 8th week in control and test groups. Eight weeks after completion of non-surgical periodontal therapy (test group) or initial examination (control group), a significant decrease was observed in interleukin 2, interleukin 6 level and in PASI score, whereas a significant increase was observed in secretory immunoglobulin A levels in the test group (p<.05). Within the limits of this study, the results suggest that effective periodontal therapy improves the psoriasis condition in patients afflicted by both diseases.

EFFECTIVENESS OF NON-SURGICAL PERIODONTAL THERAPY ON AMLODIPINE INDUCED GINGIVAL ENLARGEMENT: A CASE REPORT

Gingival enlargement, [sometimes abbreviated to GO (gingival overgrowth)] is an increase in the size of the gingiva. It is a common feature of gingival disease. Gingival enlargement is a well known side-effect of drugs like anticonvulsants, calcium channel blockers and immunosuppressant. A case of amlodipine induced gingival enlargement was reported and after drug substitution when the patient was treated non-surgically (scaling and root planing), the enlargement subsides to a normal state which suggested the effectiveness of non-surgical periodontal therapy in the treatment of drug induced gingival enlargement.&#x0D; Keywords: Anticonvulsants, Immunosuppressants, Calcium channel blockers, gingival enlargement

Effect of non-surgical periodontal therapy on renal function in chronic kidney disease patients with periodontitis: a systematic review and meta-analysis of interventional studies.

This systematic review evaluated the impacts of non-surgical periodontal therapy (NSPT) in patients with chronic kidney disease (CKD) and periodontitis in order to explore causality and assess the potential benefits of co-management. This systematic review and meta-analyses were conducted by searching MEDLINE, EMBASE, PubMed, Cochrane Library, and Open GREY. Interventional studies of adult patients suffering from CKD and periodontitis were investigated. Effect of NSPT on renal function was analyzed. A total of 109 participants from four case-series studies and 97 participants from one randomized controlled trial were included in this review. Sixty percent of the eligible studies (3/5) aimed at the effect of NSPT on nutritional status and systemic inflammation in dialysis patients. The other two studies concluded a beneficial impact of NSPT on estimated glomerular filtration rate (eGFR) in patients with CKD stages 2-4. Moreover, two meta-analyses were accomplished on eGFR and serum creatinine to evaluate the changes between baseline and 3-month follow-up. The pooled mean of eGFR was not significantly different pre- and post-NSPT using random and fixed-effect models. The change for creatinine was not significant using the random effect model but was significant when the fixed effect model was used (p < 0.001). There is insufficient evidence to conclude the potential benefit of NSPT on renal function in CKD patients with periodontitis. Periodontitis contributes to the inflammatory burden and has been associated with impaired kidney function in many observational studies. However, well-designed clinical trials in pre-dialysis patients investigating the impact of NSPT on renal function-related parameters are missing.

Evaluation of nonsurgical management of chronic periodontitis patients with chronic kidney diseases using prohepcidin

ABSTRACTPurpose: This study was aimed to define the effect of nonsurgical periodontal therapy on chronic periodontitis in chronic kidney disease patients and healthy patients by detection of prohepcidin level in the blood. Materials and methods: The study included 20 chronic periodontitis patients that were divided into:-Group I included 10 patients with chronic kidney disease; Group II which involved 10 healthy patients . Chronic periodontitis was defined through probing pocket depth and by clinical attachment level. All clinical and biochemical parameters were evaluated afterward 3 months of non-surgical periodontal cure. Results: The improvement in clinical parameters showed the efficacy of NSPT in both groups. The periodontal therapy was the cause to reduce prohepcidin level in both groups and a higher reduction in CKD group in comparison to control group at baseline and after 3 months. Conclusion: By reduction in serum prohepcidin and systemic inflammatory response, nonsurgical periodontal treatment has proved to be an effective method to control inflammation seen in patients with CKD.

Effect of non-surgical periodontal therapy on concentrations of salivary biomarkers in patients with chronic periodontitis: A clinical trial.

Background Certain salivary biomarkers that are considered unique in relation to the physiological aspects of periodontitis can be helpful in the diagnosis of periodontitis by considering quantitative changes in such biomarkers. This study was undertaken to answer the question to what extent non-surgical periodontal treatment can affect concentrations of salivary biomarkers in patients suffering from chronic periodontitis. Methods Eighteen patients with generalized moderate-to-severe chronic periodontitis were recruited for this study by considering periodontal parameters of gingival index (GI), probing pocket depths (PPD), clinical attachment levels (CAL) and a number of radiographic parameters. Salivary samples were analyzed at baseline and at one-month interval after non-surgical periodontal treatment consisting of scaling and root planing. Concentrations of salivary biomarkers, including cortisol, immunoglobulin A (Ig A), IL-6, interferon-γ, soluble intercellular adhesion molecule-1 (sICAM) and ALP, were determined with the use of an ELISA kit. Data were subjected to statistical analyses using paired t-test, with SPSS 15. Statistical significance was set at P<0.05. Results Mean levels of IgA and interferon-γ decreased significantly after treatment (P<0.05); however, cortisol concentrations increased significantly after treatment. In addition, the decrease in IL-6, sICAM-1 and ALP levels were not significant (P>0.05). Conclusion The results showed that the salivary levels of IgA and interferon-γ decreased and those of cortisol increased significantly subsequent to scaling and root planing.

Effect of nonsurgical periodontal therapy on the level of salivary antioxidants in patients with generalized moderate-to-severe chronic periodontitis.

Background In the course of periodontal diseases, polymorphonuclear leukocytes (PMNs) produce oxidative agents and free radicals, thus triggering oxidant-antioxidant disequilibrium in the saliva. Due to the reduction of antioxidant protective effect, oxidative stress is induced, destroying periodontal tissues. This study aimed to investigate the consequences of the non-surgical phase of periodontal therapy on the level ofsalivary antioxidantsin patients with generalized moderate-to-severe chronic periodontitis. Methods Un-stimulated salivary samples were collected from 43 patients with generalized moderate-to-severe chronic periodontitis for 5 minutes. Clinical parameters, including clinical attachment loss (CAL), bleeding on probing (BoP) and pocket depth (PD), were recorded in each tooth and subsequently, scaling and root planing (SRP) was carried out. After four weeks, salivary samples were collected once again, and the above-mentioned clinical parameters were recorded. Following centrifugation and freezing at a temperature of -80°C, salivary samples were examined simultaneously in a single day, and the level of their antioxidants was measured with ferric reducing ability of plasma (FRAP) method using a spectrophotometer. Results The concentration of salivary antioxidants significantly increased four weeks following the non-surgical periodontal therapy (P<0.0001). Moreover, the clinical parameters of CAL, BoP and PD showed a significant decrease in 4 weeks as well (P<0.0001). Conclusion The level of salivary antioxidants in patients with generalized moderate to severe chronic periodontitis significantly increased after etiotropic periodontal therapy, indicating the possible beneficial influence of periodontal therapy on the level of salivary antioxidants in patients suffering from periodontitis.

Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis

BackgroundGlycemic control is vital in the care of type 2 diabetes mellitus (T2DM) and is significantly associated with the incidence of clinical complications. This Bayesian network analysis was conducted with an aim of evaluating the efficacy of scaling and root planning (SRP) and SRP + adjuvant treatments in improving glycemic control in chronic periodontitis (CP) and T2DM patients, and to guide clinical practice.MethodsWe searched the Pubmed, Embase, Cochrane Library and Web of Science databases up to 4 May 2018 for randomized controlled trials (RCTs). This was at least three months of the duration of study that involved patients with periodontitis and T2DM without other systemic diseases given SRP. Patients in the control group did not receive treatment or SRP combination with adjuvant therapy. Outcomes were given as HbA1c% and levels fasting plasma glucose (FPG). Random-effects meta-analysis and Bayesian network meta-analysis were conducted to pool RCT data. Cochrane’s risk of bias tool was used to assess the risk of bias.ResultsFourteen RCTs were included. Most were unclear or with high risk of bias. Compared to patients who did not receive treatment, patients who received periodontal treatments showed improved HbA1c% level, including SRP (the mean difference (MD) -0.399 95% CrI 0.088 to 0.79), SRP + antibiotic (MD 0.62, 95% CrI 0.18 to 1.11), SRP + photodynamic therapy (aPDT) + doxycycline (Doxy) (MD 1.082 95% CrI 0.13 to 2.077) and SRP + laser (MD 0.66 95% CrI 0.1037, 1.33). Among the different treatments, SRP + aPDT + Doxy ranked best. Regarding fasting plasma glucose (FPG), SRP did not show advantage over no treatment (MD 4.91 95% CI − 1.95 to 11.78) and SRP with adjuvant treatments were not better than SRP alone (MD -0.28 95% CI -8.66, 8.11).ConclusionThe results of this meta-analysis seem to support that periodontal treatment with aPDT + Doxy possesses the best efficacy in lowering HbA1c% of non-smoking CP without severe T2DM complications. However, longer-term well-executed, multi-center trails are required to corroborate the results.

The effect of non-surgical periodontal therapy on serum anticardiolipin antibodies in chronic periodontitis patients associated with cardiovascular disease

The effect of non-surgical periodontal therapy on serum anticardiolipin antibodies in chronic periodontitis patients associated with cardiovascular disease

The effect of non-surgical periodontal therapy on the level of CCL25 in GCF of chronic periodontitis patients

The effect of non-surgical periodontal therapy on the level of CCL25 in GCF of chronic periodontitis patients

Effect of non-surgical periodontal therapy on serum and crevicular level of advanced glyacation end product in chronic periodontitis among a sample of the Egyptian population

Background: AGEs are formed under oxidative conditions and are called advanced glyco-xidation end products. Periodontitis is a multifactorial inflammatory condition. The periodontal tissue damage is caused directly by bacteria and indirectly by inflammation and immunologic response against the bacteria. This inflammatory response is characterized by generation of prolonged release of neutrophil proteolytic enzymes, pro-inflammatory mediators and reactive oxygen species (ROS). Therefore, periodontitis is strictly linked to numerous pathologies which are related to production of oxidative stress and AGEs. Methods: The study was conducted on thirty participants, they were divided into two groups; group (A) which included fifteen medically free subjects, and group (B) which included fifteen patients suffering from periodontitis. Serum and GCF samples were collected for assessment of AGEs before and after non -surgical periodontal therapy. Data were analysed by SPSS. Results: Periodontitis group showed statistically significant higher mean AGE levels than control group in both serum and GCF samples. Moreover, there was a statistically significant decrease in AGE levels in both serum and GCF after treatment.Conclusion: Crevicular level of AGEs can be used as a non-invasive diagnostic and prognostic biomarker for periodontitis.

Effect of non-surgical periodontal treatment on gingival crevicular fluid and serum leptin levels in periodontally healthy chronic periodontitis and chronic periodontitis patients with type 2 diabetes mellitus.

The aim of the present study was to evaluate the effect of non-surgical periodontal therapy (NSPT) on gingival crevicular fluid (GCF) and serum leptin levels and glycemic status in periodontally healthy patients with chronic periodontitis (CP) with and without type 2 diabetes mellitus (T2DM). Ninety patients were divided into three groups: periodontally healthy (group 1), CP (group 2) and CP with T2DM (group 3). The groups were evaluated for clinical parameters of probing pocket depth (PPD), clinical attachment level (CAL), plaque index, gingival index, biochemical parameters of GCF, serum leptin levels, and glycemic status pre- and post-NSPT. The baseline PPD and CAL for group 2 was 4.98±0.49mm and 5.35±0.55mm, respectively; for group 3 it was 5.60±0.38mm and 6.01±0.38mm, respectively. There was a considerable reduction in these parameters post-NSPT, with group 2 showing better resolution. Pretreatment serum leptin levels revealed increasing values from group 1 to group 3 and decreasing GCF values from group 3 to group 1, exhibiting an inverse relationship. Group 3 also showed an improvement in glycemic status post-NSPT. NSPT was effective in improving clinical parameters, increasing GCF, reducing serum leptin levels, and also improving glycemic status in patients with CP and CP with T2DM.

Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes: A randomized controlled trial

ObjectiveTo investigate the effect of non-surgical periodontal therapy on insulin resistance and sensitivity among individuals with borderline diabetes not receiving medications. MethodsA crossover, randomized controlled trial was conducted among participants with borderline diabetes diagnosed by a 75-g oral glucose tolerance test. Participants were randomly assigned to either an early or later intervention group. The early intervention group underwent non-surgical periodontal therapy of scaling and root planing during the first 6 months, followed by a 6-month non-intervention period. The order was reversed in the later intervention group. Primary outcomes included: fasting or post-load serum glucose and insulin, body mass index (BMI), HOMA-IR, HOMA-β, and Matsuda Index. ResultsSeventy-four participants were randomized, and 71 participants completed the trial. There were no significant differences between groups in glucose and insulin concentrations during the intervention and non-intervention periods. When analyzed within groups by median-split of bleeding on probing (BOP) levels before intervention, the lower BOP group showed improved changes in BMI, HOMA-IR, HOMA-β, and Matsuda Index (P < 0.05). Further, we observed a positive correlation between baseline BOP and change in BMI (P = 0.06). Change in BMI was positively correlated with changes in HbA1c, HOMA-IR, and HOMA-β (P < 0.05), and inversely correlated with change in Matsuda Index (P = 0.001). ConclusionsPeriodontal therapy had no significant effect on markers related to insulin and glucose metabolism among individuals with borderline diabetes. However, participants with a lower BOP (%) showed significant improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index. Clinical significanceAmong individuals diagnosed with borderline diabetes, those who had <37% of a lower BOP (%) showed potential improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index following non-surgical periodontal therapy.