Clinical, Microbial, and Immune Responses Observed in Patients With Diabetes After Treatment for Gingivitis: A Three-Month Randomized Clinical Trial

Author(s)

Raslan, Suzane A. ^[1] ; Cortelli, Jose R. ^[2] ; Costa, Fernando O. ^[3] ; Aquino, Davi R. ^[2] ; Franco, Gilson C. N. ^[4] ; Cota, Luis O. M. ^[3] ; Gargioni-Filho, Antonio ^[1] ; Cortelli, Sheila C. ^[2]

Affiliation

^[1] Univ Taubate, Sch Dent, Sao Paulo - Brazil

^[2] Univ Taubate, Ctr Periodontal Res, Taubate, SP - Brazil

^[3] Univ Fed Minas Gerais, Sch Dent, Belo Horizonte, MG - Brazil

^[4] Univ Estadual Ponta Grossa, Sch Dent, Ponta Grossa, Parana - Brazil

• Document type: Journal article
• Source: Journal of Periodontology; v. 86, n. 4, p. 516-526, APR 2015.
• Web of Science Citations: 1

Abstract

Background: Although patients with diabetes are frequently affected by periodontitis, only a few investigations have focused on gingivitis in this at-risk population. This randomized placebo-controlled clinical trial compared the response to a gingivitis treatment protocol that combined mechanical procedures and daily use of an essential oil (EO) mouthrinse between patients with and without diabetes. Methods: The whole-mouth periodontal probing depth (PD), gingival index (GI), and plaque index (PI) were monitored in gingivitis cases among systemically healthy patients (n = 60) or those with diabetes (n = 60) at baseline and 3 months after treatment. Levels of Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, and total bacterial load were determined by a real-time polymerase chain reaction in intrasulci plaque samples. The volume of gingival crevicular fluid (GCF) was quantified, and interleukin-1 beta (IL-1 beta) levels were determined in GCF samples. After a full-mouth ultrasonic debridement, patients were randomly assigned to an EO or a placebo rinse for 90 days (40 mL/day). The data were analyzed through repeated-measures analysis of variance and multiple comparisons Tukey tests (P <0.05). Results: GI was more severe in the diabetes group. Diabetes impaired GI and reduced GCF volume. PD, bacterial levels, and IL-1 beta improved similarly in both systemic conditions. The adjunctive use of EO provided greater reductions of PI, GI, total bacterial load, T. forsythia, A. actinomycetemcomitans, and GCF volume. Conclusions: Response to gingivitis treatment in patients with diabetes can slightly differ from that in patients without diabetes. Daily use of an EO mouthrinse after ultrasonic debridement benefited patients with and without diabetes. (AU)

• FAPESP's process: 10/20424-1 - Evaluation of mechanical-chemical gingival therapy of diabetic, obese or obese diabetic subjects: quantitative and qualitative analysis of local and systemic aspects.
• Grantee: Sheila Cavalca Cortelli
• Support Opportunities: Regular Research Grants
• FAPESP's process: 11/02371-0 - Evaluation of gingival therapy in diabetic, obese or diabetic/obese subjects
• Grantee: Suzane A Raslan
• Support Opportunities: Scholarships in Brazil - Doctorate