Long-term effect of periodontal surgery on oral health and metabolic control of diabetics
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Abstract
Objective
The objective of
this study was to evaluate impact of periodontal surgery on periodontal
health and on glycaemia control of type 1 and type 2 (T1DM; T2DM)
diabetics with severe periodontitis, during 12 months follow-up, in
comparison with non-diabetic controls.
Materials and methods
A total of 23 T1DM
and 10 T2DM patients with respective number of matched non-diabetics
were examined prior to, and 3, 6 and 12 months after periodontal
surgery. Glycosylated haemoglobin (HbA1c) reflected control of DM.
Periodontal parameters were oral debris (DI-S), probing pocket depth
(PPD), clinical attachment loss (CAL) and bleeding on probing (BOP).
Results
Periodontal status
in all diabetics improved after 3 months and remained so during
follow-up: mean (SD) DI-S > 1 (T1DM 1.1(0.5)/0.9(0.7); T2DM
1.2(0.4)/0.8(0.4)), PPD >5 mm (T1DM 35.1(32.2)/5.1(7.8); T2DM
46.3(24.2)/13.0(10.9)), CAL ≥6 mm (T1DM 44.4(37.0)/24.52(27.2)); mean %
BOP >50 % (T1DM 57.1(25.1)/22.8(20.8)), T2DM 59.4(20.8)/18.9(15.7)), p < 0.05.
Mean HbA1c values decreased in T2DM patients after 3 months and
remained stable during follow-up. No improvement of glycaemia control
was observed in T1DM patients. Positive correlation between mean HbA1c
and CAL changes was observed (r = 0.842, p < 0.05). Mean changes of periodontal parameters did not differ between diabetics and controls.
Conclusion
Periodontal surgery improved significantly periodontal status of all patients and metabolic control of T2DM patients.
Clinical relevance
Research findings
concerning long-term effect of periodontal surgery among patients with
diabetes mellitus are scarce. We found that surgical periodontal
treatment positively affects periodontal health of all diabetics and
improves metabolic control of type 2 DM. There is a positive correlation
between clinical attachment loss and glycosylated haemoglobin levels.
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