Evaluation of Periodontal Status and Effectiveness of Non-Surgical Treatment in Patients With Type 2 Diabetes Mellitus in Taiwan for a 1-Year Period

Background: The periodontal status and effects of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and periodontal disease are assessed. Methods: One-hundred patients with type 2 diabetes (mean +/- SD hemoglobin (Hb)A1c level: 7.3% +/- 0.94%) and periodontal disease were recruited for this study. The group with moderate-to-severe periodontal disease included patients with >1 tooth with a probing depth (PD) >= 5 mm and >2 teeth with a clinical attachment loss (AL) >= 6mm, and the group with mild periodontal disease included patients with <1 affected tooth, and >2 affected with a clinical AL >= 6mm. Patients (28 patients in the mild group and 72 patients in the moderate-to-severe group) underwent non-surgical periodontal treatments. We analyzed differences in serum concentrations of metabolic parameters (glycated hemoglobin and low-density lipoprotein), inflammatory parameters (interleukin [IL]-1 beta and C-reactive protein [CRP]), and periodontal parameters between the two groups before treatment and at 3, 6, 9, and 12 months post-therapy. Results: Seventy-five patients with diabetes (21 patients in the mild group and 54 patients in the moderate-to-severe group) completed the study. Significant differences in the plaque index (PI), gingival index (GI), PD, and clinical AL at examination times were observed in the whole cohort (P<0.05). We observed significant differences in the PI, GI, and PD in the moderate-to-severe group (P<0.05), whereas there was only a significant difference in PD in the mild group (P<0.05) between baseline and 12 months post-treatment. Both groups experienced improved glycemic control, but the difference was insignificant. CRP and IL-1 beta levels were significantly different at examination times for the whole cohort (P<0.05). No significant positive association among metabolic and inflammatory parameters at 12 months post-therapy were found. Conclusion: Non-surgical periodontal treatment improved and maintained the periodontal health of patients with well-controlled diabetes, but no significant reduction of metabolic parameters was observed over a 1-year period. J Periodontol 2012;83:621-628.