RESUMO
BACKGROUND: Type 2 diabetes mellitus (DM) and periodontitis have a bidirectional relationship that is well documented in many reviews and epidemiological studies. Periodontitis has been referred to as the sixth complication of diabetes mellitus. Various studies showed improvement in Interleukin-6 levels as well as metabolic parameters after non-surgical periodontal therapy in chronic periodontitis patients with type 2 DM. Objective: To evaluate the effect of scaling and root planing (SRP) on salivary levels of IL-6 and assessment of clinical parameters in CP patients with and without T2DM. METHODS: We included 50 CP patients with well-controlled T2DM (Group I), and 50 CP patients without T2DM as controls (Group II) with evident clinical inflammation, ≥ 5mm probing depth (PD) and a relative attachment level (RAL) of ≥ 5mm. Following a brief medical and dental history plaque index (PI), gingival index (GI), gingival bleeding index (BI), PD, and RAL were recorded, and an unstimulated saliva was collected. Following SRP therapy, the clinical parameters and IL-6 levels were measured after seven days, 14 days, and 30 days. Intragroup and intergroup comparisons were carried out using a paired t-test and an independent t-test. The statistical significance was set at P < 0.05. Data were analyzed using computer software, Statistical Package for Social Sciences (SPSS) v. 22.0 (IBM Corp., Armonk, NY). RESULTS: Intergroup comparisons of IL-6 levels at different intervals showed a significantly higher reduction in Group II than in Group I (p=0.000). While the mean difference in the GI scores from baseline to 30 days was significantly higher in Group I patients (p=0.000), the difference in the mean PI (p=0.004), mean BI (p=0.000), mean PD (p=0.000) and mean RAL scores (p=0.000) were significantly higher in Group II patients. CONCLUSION: This study indicates that scaling and root planing is effective in glycemic control and also has a role to play in the level of salivary IL-6 in periodontal health and T2DM with chronic periodontitis. Elevated salivary IL-6 levels indicate periodontal inflammation which is further increased in T2DM patients. Hence, elevated IL-6 can be considered a marker of periodontal destruction.
RESUMO
AIM: The study's aim was to assess and compare the clinical parameters, plasma reactive oxygen metabolites (ROM) levels, gingival crevicular fluid (GCF) resistin, serum resistin values, and red complex bacteria in obese or overweight subjects with and without periodontitis and also to determine the effect of non-surgical periodontal therapy (NSPT) on plasma ROM, serum, and GCF resistin values in obese or overweight subjects with chronic periodontitis. MATERIAL AND METHODS: A total of 160 subjects were recruited and designated into four groups with 40 subjects each as group I - obese with chronic periodontitis; group II - normal weight subjects with chronic periodontitis; group III - obese subjects with healthy periodontium; and group IV - normal weight subjects with healthy periodontium. The periodontal parameters, plasma ROM, GCF resistin and serum resistin, and red complex bacteria levels were estimated at baseline. After baseline assessment, scaling and root planing (SRP) were done in the patients of groups I and II. Two months after the completion of SRP, clinical parameters such as plaque index (PI), probing pocket depth (PPD), gingival index (GI), and clinical attachment loss (CAL), plasma ROM levels, serum resistin, and GCF resistin levels were analyzed. RESULTS: An increase in plasma ROM, GCF resistin, and red complex bacteria levels was observed in obese subjects with periodontal disease and the increase was noted in obese subjects with healthy periodontium. Comparing plasma ROM, GCF resistin values between groups I and II, 2 months after SRP, a decrease in these levels were observed in group II. CONCLUSION: Our study results depict that obesity can be considered as a risk indicator for periodontal disease. CLINICAL SIGNIFICANCE: Obesity has a negative impact on both general health and oral health. Promoting appropriate physical activity, healthy eating behavior, and oral hygiene practice are fundamental elements of the prevention of both obesity and periodontal disease.
