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Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes

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Abstract

Objectives

This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and non-diabetic subjects for up to 1 year. Secondary aim was to evaluate the effects of this therapy on the salivary levels of periodontal pathogens between diabetics and non-diabetics.

Material and methods

Twenty-six type 2 diabetic subjects and 28 non-diabetic subjects with mild-to-moderate periodontitis received full-mouth scaling and root planing within 24 h, application of chlorhexidine digluconate (CHX) gel in pockets and tongue plus CHX rinses for 14 days. Clinical monitoring was performed at baseline, 3, 6, and 12 months post-therapy. Salivary levels of red complex bacterial species were evaluated at baseline, 6, and 12 months post-therapy by qPCR.

Results

Intention-to-treat analyses were performed for seven diabetics and three non-diabetics that did not return for the 12-month evaluation. Most clinical parameters improved significantly at 3, 6, and 12 months post-therapies for both groups (p < 0.05). Overall, there were no significant differences in clinical parameters between groups after therapy (p > 0.05). At 1 year, 39.3% and 50.0% of the non-diabetic and diabetic subjects, respectively, achieved the desired clinical endpoint for treatment (≤ 4 sites with probing depth ≥ 5 mm) (primary outcome variable) (p > 0.05). FMD did not promote changes in the salivary levels of pathogens in either of the groups (p > 0.05). Levels of T. forsythia were lower in diabetic than in non-diabetic subjects at 6 months post-therapy (p < 0.05).

Conclusions

Type 2 diabetic subjects and systemically healthy subjects with mild-to-moderate periodontitis responded similarly to the proposed FMD protocol for up to 1 year.

Clinical relevance

There is a general thought that diabetics do not answer as well as non-diabetics to periodontal treatments. However, this study showed that diabetics and non-diabetics respond equally to the FMD protocol.

Trial registration

ClinicalTrials.gov Identifier: NCT02643771.

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Notes

  1. Colgate Total® 12, Colgate Palmolive Co., São Paulo, SP, Brazil

  2. North Carolina, Hu-Friedy, Chicago, IL, USA

  3. LightCycler 2.0, Roche Diagnostics GmbH, Mannheim, Germany

  4. MasterPure™, Epicenter, Madison, WI, USA

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Funding

This study was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)- Finance Code 2305/2011.

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Rio Grande do Norte, Av. Sen. Salgado Filho, 1787 Lagoa Nova, Natal, Rio Grade do Norte, 59056-000, Brazil

    Mariana Linhares Almeida, Eduardo Aleixo Figueira, Janaína Cavalcante Lemos, Cintia Mirela Guimarães Nobre & Bruno César de Vasconcelos Gurgel

  2. Department of Periodontology, Dental Research Division, Guarulhos University, São Paulo, Brazil

    Mariana Linhares Almeida, Poliana Mendes Duarte & Tamires Szeremeske Miranda

Authors
  1. Mariana Linhares Almeida
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  2. Poliana Mendes Duarte
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  7. Bruno César de Vasconcelos Gurgel
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Correspondence to Bruno César de Vasconcelos Gurgel.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee in Clinical Research of the Federal University of Rio Grande do Norte (CAAE: 0151.0.051.000-11) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study, informed consent was obtained from all individual participants included in the study.

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Almeida, M.L., Duarte, P.M., Figueira, E.A. et al. Effects of a full-mouth disinfection protocol on the treatment of type-2 diabetic and non-diabetic subjects with mild-to-moderate periodontitis: one-year clinical outcomes. Clin Oral Invest 24, 333–341 (2020). https://doi.org/10.1007/s00784-019-02927-8

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