AIMS: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. METHODS: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500 ng/ml and <500 ng/ml. The group with hsCRP over 500 ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500 ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N=118) who did not visit dentists (E: initial hsCRP>500 ng/ml; F: hsCRP<500 ng/ml). RESULTS: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P<0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P<0.01 and P<0.001, respectively). CONCLUSIONS: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP>500 ng/ml), treatment to reduce hsCRP using antibiotics is recommended.
AIMS: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. METHODS: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500 ng/ml and <500 ng/ml. The group with hsCRP over 500 ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500 ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N=118) who did not visit dentists (E: initial hsCRP>500 ng/ml; F: hsCRP<500 ng/ml). RESULTS: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P<0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P<0.01 and P<0.001, respectively). CONCLUSIONS: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP>500 ng/ml), treatment to reduce hsCRP using antibiotics is recommended.
Authors: Wenche S Borgnakke; Iain L C Chapple; Robert J Genco; Gary Armitage; P Mark Bartold; Francesco D'Aiuto; Paul I Eke; William V Giannobile; Thomas Kocher; Kenneth S Kornman; Niklaus P Lang; Phoebus N Madianos; Shinya Murakami; Fusanori Nishimura; Steven Offenbacher; Philip M Preshaw; Amin Ur Rahman; Mariano Sanz; Jørgen Slots; Maurizio S Tonetti; Thomas E Van Dyke Journal: J Evid Based Dent Pract Date: 2014-05-21 Impact factor: 5.267
Authors: Terry C Simpson; Jo C Weldon; Helen V Worthington; Ian Needleman; Sarah H Wild; David R Moles; Brian Stevenson; Susan Furness; Zipporah Iheozor-Ejiofor Journal: Cochrane Database Syst Rev Date: 2015-11-06
Authors: Nadia-Flore Tsobgny-Tsague; Eric Lontchi-Yimagou; Arnel Redon Nana Nana; Aurel T Tankeu; Jean Claude Katte; Mesmin Y Dehayem; Charles Messanga Bengondo; Eugene Sobngwi Journal: BMC Oral Health Date: 2018-02-26 Impact factor: 2.757