Effects of Non-Surgical Periodontal Treatment on Clinical Response, Serum Inflammatory Parameters, and Metabolic Control in Patients With Type 2 Diabetes: A Randomized Study

Background: Scientific evidence on the effects of chronic periodontitis on diabetes mellitus remains inadequate and inconclusive. This intervention study is designed to evaluate the effects of periodontal treatment on clinical response, systemic inflammatory parameters, and metabolic control in patients with Type 2 diabetes. Methods: A total of 134 patients were randomly allocated into two treatment groups and one control group. Treatment group 1 underwent non-surgical periodontal treatment at baseline and additional subgingival debridement at the 3-month follow-up. Patients in treatment group 2 received non-surgical periodontal treatment and supragingival prophylaxis at the 3-month follow-up, and those in the control group received no intervention throughout the study. All participants were reexamined at 1.5, 3, and 6 months after initial treatment. At each visit, clinical periodontal examinations were conducted and blood samples were taken to evaluate high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-a (TNF-alpha), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), and lipid profiles. Results: Both treatment groups had a significantly lower hsCRP level after periodontal therapy (P < 0.05). Although HbA1c declined significantly in treatment group 2 (P <0.05), the intergroup difference for HbA1c, FPG, TNF-alpha, and lipid profiles was not statistically significant after therapy (P > 0.05). Conclusions: Non-surgical periodontal treatment can effectively improve periodontal and circulating inflammatory status. Despite a lack of strong evidence, trends in some results support improved glycemic control after periodontal treatment in patients with diabetes. J Periodontol 2012;83:435-443.