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Clinical Oral Investigations

, Volume 18, Issue 8, pp 1963–1968 | Cite as

Effect of nonsurgical periodontal therapy (with or without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes: a short-term longitudinal randomized case–control study

  • Fawad JavedEmail author
  • Hameeda Bashir Ahmed
  • Abid Mehmood
  • Crawford Bain
  • Georgios E. Romanos
Original Article

Abstract

Objective

The aim of the present short-term longitudinal randomized case–control study was to assess the effect of nonsurgical periodontal therapy (NSPT) (with and without oral doxycycline delivery) on glycemic status and clinical periodontal parameters in patients with prediabetes.

Material and methods

Sixty-six patients with prediabetes and periodontal disease were included. Characteristics of the study cohort (age, gender, socioeconomic status [SES] education status, duration of prediabetes, and type of treatment adopted for prediabetes management) were recorded. Patients were randomly divided into two groups (33 patients/group). In group 1, scaling and root planing (SRP) was performed, and in group-2, patients underwent SRP and oral doxycycline (100 mg) administration once daily for 15 days. In each group, the following parameters were investigated at baseline and after 3 months: (a) fasting blood glucose level (FBGL), (b) hemoglobin A1c (HbA1c), and (c) periodontal parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and clinical attachment loss [AL]). Statistical analysis was performed using Student’s t test.

Results

There was no significant difference in age, gender, SES, education status, and duration and treatment of prediabetes among individuals in groups 1 and 2. Three months post-NSPT, FBGL and HbA1c were significantly reduced among patients in group 1 (P < 0.05) and group 2 (P < 0.05) compared to baseline. Three months post-NSPT, PI (P < 0.05), BOP (P < 0.05), and PD (P < 0.05) were significantly reduced among patients in group 1 (P < 0.05) and group 2 (P < 0.05) compared to baseline. There was no difference in clinical AL between the groups after 3 months of NSPT.

Conclusion

NSPT (with and without oral doxycycline delivery) reduces hyperglycemia and periodontal inflammation in patients with prediabetes.

Keywords

Dental scaling Hemoglobin A1c Hyperglycemia Nonsurgical periodontal debridement Prediabetic state Root planing 

Notes

Acknowledgments

The authors would like to thank the College of Dentistry Research Center and Deanship of Scientific Research at King Saud University, Saudi Arabia for funding this research project (project # FR 0071).

Conflict of interest

The authors report no conflict of interest related to the present study.

References

  1. 1.
    Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol 6:99–112PubMedCrossRefGoogle Scholar
  2. 2.
    Javed F, Sundin U, Altamash M, Klinge B, Engstrom PE (2009) Self-perceived oral health and salivary proteins in children with type 1 diabetes. J Oral Rehabil 36:39–44PubMedCrossRefGoogle Scholar
  3. 3.
    Javed F, Nasstrom K, Benchimol D, Altamash M, Klinge B et al (2007) Comparison of periodontal and socioeconomic status between subjects with type 2 diabetes mellitus and non-diabetic controls. J Periodontol 78:2112–2119PubMedCrossRefGoogle Scholar
  4. 4.
    Javed F, Tenenbaum HC, Nogueira-Filho G, Nooh N, O’Bello Correa F, et al (2013) Periodontal inflammatory conditions among gutka-chewers and non-chewers with and without prediabetes. J Periodontol 84:1158–1164Google Scholar
  5. 5.
    Javed F, Al-Askar M, Al-Rasheed A, Babay N, Galindo-Moreno P et al (2012) Comparison of self-perceived oral health, periodontal inflammatory conditions and socioeconomic status in individuals with and without prediabetes. Am J Med Sci 344:100–104PubMedCrossRefGoogle Scholar
  6. 6.
    Javed F, Klingspor L, Sundin U, Altamash M, Klinge B et al (2009) Periodontal conditions, oral Candida albicans and salivary proteins in type 2 diabetic subjects with emphasis on gender. BMC Oral Health 9:12PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Javed F, Al-Askar M, Samaranayake LP, Al-Hezaimi K (2013) Periodontal disease in habitual cigarette smokers and nonsmokers with and without prediabetes. Am J Med Sci 345:94–98PubMedCrossRefGoogle Scholar
  8. 8.
    Javed F, Thafeed Alghamdi AS, Mikami T, Mehmood A, Ahmed HB et al (2013) Effect of glycemic control on self-perceived oral health, periodontal parameters and alveolar bone loss among patients with prediabetes. J Periodontol. doi: 10.1902/jop.2013.130008 Google Scholar
  9. 9.
    Javed F, Ahmed HB, Saeed A, Mehmood A, Bain C (2013) Whole salivary interleukin-6 and matrix metalloproteinase-8 levels in chronic periodontitis patients with and without prediabetes. J Periodontol. doi: 10.1902/jop.2013.130514 Google Scholar
  10. 10.
    Nishimura F, Iwamoto Y, Mineshiba J, Shimizu A, Soga Y et al (2003) Periodontal disease and diabetes mellitus: the role of tumor necrosis factor-alpha in a 2-way relationship. J Periodontol 74:97–102PubMedCrossRefGoogle Scholar
  11. 11.
    Javed F, Al-Askar M, Al-Hezaimi K (2012) Cytokine profile in the gingival crevicular fluid of periodontitis patients with and without type 2 diabetes: a literature review. J Periodontol 83:156–161PubMedCrossRefGoogle Scholar
  12. 12.
    Takeda M, Ojima M, Yoshioka H, Inaba H, Kogo M et al (2006) Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. J Periodontol 77:15–20PubMedCrossRefGoogle Scholar
  13. 13.
    Koromantzos PA, Makrilakis K, Dereka X, Offenbacher S, Katsilambros N et al (2012) Effect of non-surgical periodontal therapy on C-reactive protein, oxidative stress, and matrix metalloproteinase (MMP)-9 and MMP-2 levels in patients with type 2 diabetes: a randomized controlled study. J Periodontol 83:3–10PubMedCrossRefGoogle Scholar
  14. 14.
    Ohnishi T, Bandow K, Kakimoto K, Machigashira M, Matsuyama T et al (2009) Oxidative stress causes alveolar bone loss in metabolic syndrome model mice with type 2 diabetes. J Periodontal Res 44:43–51PubMedCrossRefGoogle Scholar
  15. 15.
    Costa PP, Trevisan GL, Macedo GO, Palioto DB, Souza SL et al (2010) Salivary interleukin-6, matrix metalloproteinase-8, and osteoprotegerin in patients with periodontitis and diabetes. J Periodontol 81:384–391PubMedCrossRefGoogle Scholar
  16. 16.
    Gaikwad SP, Gurav AN, Shete AR, Desarda HM (2013) Effect of scaling and root planing combined with systemic doxycycline therapy on glycemic control in diabetes mellitus subjects with chronic generalized periodontitis: a clinical study. J Periodontal Implant Sci 43:79–86PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Chen L, Luo G, Xuan D, Wei B, Liu F et al (2012) Effects of non-surgical periodontal treatment on clinical response, serum inflammatory parameters, and metabolic control in patients with type 2 diabetes: a randomized study. J Periodontol 83:435–443PubMedCrossRefGoogle Scholar
  18. 18.
    Auyeung L, Wang PW, Lin RT, Hsieh CJ, Lee PY et al (2012) Evaluation of periodontal status and effectiveness of non-surgical treatment in patients with type 2 diabetes mellitus in Taiwan for a 1-year period. J Periodontol 83:621–628PubMedCrossRefGoogle Scholar
  19. 19.
    Al-Zahrani MS, Bamshmous SO, Alhassani AA, Al-Sherbini MM (2009) Short-term effects of photodynamic therapy on periodontal status and glycemic control of patients with diabetes. J Periodontol 80:1568–1573PubMedCrossRefGoogle Scholar
  20. 20.
    Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF (2003) Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol 74:1361–1367PubMedCrossRefGoogle Scholar
  21. 21.
    Sgolastra F, Severino M, Pietropaoli D, Gatto R, Monaco A (2012) Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials. J Periodontol 84:958–973PubMedCrossRefGoogle Scholar
  22. 22.
    Koromantzos PA, Makrilakis K, Dereka X, Katsilambros N, Vrotsos IA et al (2011) A randomized, controlled trial on the effect of non-surgical periodontal therapy in patients with type 2 diabetes. Part I: effect on periodontal status and glycaemic control. J Clin Periodontol 38:142–147PubMedCrossRefGoogle Scholar
  23. 23.
    Akalin FA, Baltacioglu E, Sengun D, Hekimoglu S, Taskin M et al (2004) A comparative evaluation of the clinical effects of systemic and local doxycycline in the treatment of chronic periodontitis. J Oral Sci 46:25–35PubMedCrossRefGoogle Scholar
  24. 24.
    Smith GT, Greenbaum CJ, Johnson BD, Persson GR (1996) Short-term responses to periodontal therapy in insulin-dependent diabetic patients. J Periodontol 67:794–802PubMedCrossRefGoogle Scholar
  25. 25.
    Association AD (2011) Standards of medical care in diabetes—2011. Diabetes Care 34(Suppl 1):S11–S61CrossRefGoogle Scholar
  26. 26.
    Ozcelik F, Yiginer O, Arslan E, Serdar MA, Uz O et al (2010) Association between glycemic control and the level of knowledge and disease awareness in type 2 diabetic patients. Pol Arch Med Wewn 120:399–406PubMedGoogle Scholar
  27. 27.
    Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235PubMedGoogle Scholar
  28. 28.
    Muhlemann HR, Son S (1971) Gingival sulcus bleeding—a leading symptom in initial gingivitis. Helv Odontol Acta 15:107–113PubMedGoogle Scholar
  29. 29.
    Armitage GC, Svanberg GK, Loe H (1977) Microscopic evaluation of clinical measurements of connective tissue attachment levels. J Clin Periodontol 4:173–190PubMedCrossRefGoogle Scholar
  30. 30.
    Genco RJ, Grossi SG, Ho A, Nishimura F, Murayama Y (2005) A proposed model linking inflammation to obesity, diabetes, and periodontal infections. J Periodontol 76:2075–2084PubMedCrossRefGoogle Scholar
  31. 31.
    Armitage GC (1996) Periodontal diseases: diagnosis. Ann Periodontol 1:37–215PubMedCrossRefGoogle Scholar
  32. 32.
    Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6PubMedCrossRefGoogle Scholar
  33. 33.
    Pontes Andersen CC, Buschard K, Flyvbjerg A, Stoltze K, Holmstrup P (2006) Periodontitis deteriorates metabolic control in type 2 diabetic Goto-Kakizaki rats. J Periodontol 77:350–356PubMedCrossRefGoogle Scholar
  34. 34.
    Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S (1996) Periodontal disease and cardiovascular disease. J Periodontol 67:1123–1137PubMedCrossRefGoogle Scholar
  35. 35.
    Grossi SG (2001) Treatment of periodontal disease and control of diabetes: an assessment of the evidence and need for future research. Ann Periodontol 6:138–145PubMedCrossRefGoogle Scholar
  36. 36.
    Page RC (1998) The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Ann Periodontol 3:108–120PubMedCrossRefGoogle Scholar
  37. 37.
    Loos BG, Craandijk J, Hoek FJ, Wertheim-van Dillen PM, van der Velden U (2000) Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol 71:1528–1534PubMedCrossRefGoogle Scholar
  38. 38.
    Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW et al (1997) Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol 68:713–719PubMedCrossRefGoogle Scholar
  39. 39.
    Ryan ME, Ramamurthy NS, Golub LM (1998) Tetracyclines inhibit protein glycation in experimental diabetes. Adv Dent Res 12:152–158PubMedCrossRefGoogle Scholar
  40. 40.
    Li C, Ford ES, Zhao G, Mokdad AH (2009) Prevalence of pre-diabetes and its association with clustering of cardiometabolic risk factors and hyperinsulinemia among U.S. adolescents: National Health and Nutrition Examination Survey 2005–2006. Diabetes Care 32:342–347PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Viswanathan V, Kumpatla S, Aravindalochanan V, Rajan R, Chinnasamy C et al (2012) Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One 7:e41367PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Fawad Javed
    • 1
    Email author
  • Hameeda Bashir Ahmed
    • 2
  • Abid Mehmood
    • 3
  • Crawford Bain
    • 4
  • Georgios E. Romanos
    • 5
  1. 1.Engineer Abdullah Bugshan Research Chair for Growth Factors and Bone Regeneration, 3D Imaging and Biomechanical Lab., College of Applied Medical SciencesKing Saud UniversityRiyadhSaudi Arabia
  2. 2.Department of DentistryAl-Farabi Dental CollegeRiyadhSaudi Arabia
  3. 3.Department of DentistryJinnah HospitalKarachiPakistan
  4. 4.Department of PeriodontologyDubai School of Dental MedicineDubaiUnited Arab Emirates
  5. 5.Department of Clinical Affairs, School of Dental MedicineStony Brook UniversityStony BrookUSA

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