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Sun Y, Zhang W, Lu L, Zhao D, Wang S, Pan Y, Li C. Effect of non-surgical periodontal therapy on hemoglobin A1c in periodontitis patients without diabetes mellitus: A systematic review and meta-analysis. J Dent 2024; 145:104974. [PMID: 38642823 DOI: 10.1016/j.jdent.2024.104974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/26/2024] [Accepted: 03/26/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVES This systematic review was aimed to evaluate the effect of non-surgical periodontal therapy (NSPT) on hemoglobin A1c (HbA1c) in periodontitis patients without diabetes mellitus (DM). DATA/SOURCES The present systematic review and meta-analysis were performed through searching the following electronic databases: EMBASE, MEDLINE, Web of Science, Cochrane Library and Open GREY. Interventional studies of periodontitis patients without DM were investigated. HbA1c changes in these patients before and after NSPT were analyzed. Subgroup analysis and sensitivity analysis were employed to identify sources of heterogeneity. STUDY SELECTION Three reviewers independently selected the eligible studies by screening the titles and abstract. Then, a full-text analysis was performed. The reasons for excluding studies were recorded. Any disagreements were settled by discussion with a fourth reviewer. All the four reviewers extracted and crosschecked the data, and disagreements were resolved by discussion. There are 21 case-series studies (self-controlled studies) and 1 non-randomized interventional studies (NRIs) were included. RESULTS For periodontitis patients without DM, a total of 469 individuals from 22 studies were enrolled. The pooled analysis demonstrated that it was significantly changed in HbA1c levels at 3-month follow-up (0.16 with 95 % CI 0.04, 0.27; P = 0.008), and 6-month follow-up (0.17 % with 95 % CI 0.08, 0.27; P < 0.001) compared with baseline. Smoking, gender, experience of periodontal therapy and HbA1c value at baseline could be the sources of heterogeneity. CONCLUSIONS NSPT is potentially beneficial for the management of HbA1c in periodontitis patients with high risks of DM. However, high-quality randomized controlled trials are still necessary to confirm these conclusions. CLINICAL SIGNIFICANCE The systemic review evaluated the effect of NSPT on HbA1c in periodontitis patients without DM. The analysis may be beneficial to the management and control of the high risks of DM in periodontitis patients.
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Affiliation(s)
- Yangyang Sun
- Department of Periodontology, School and Hospital of Stomatology, China Medical University, Shenyang, PR China
| | - Weijia Zhang
- Department of Periodontology, School and Hospital of Stomatology, China Medical University, Shenyang, PR China
| | - Lijie Lu
- Department of Periodontology, School and Hospital of Stomatology, China Medical University, Shenyang, PR China
| | - Dan Zhao
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, PR China; Beijing Laboratory of Oral Health, Capital Medical University, Beijing, PR China
| | - Songlin Wang
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, PR China; Beijing Laboratory of Oral Health, Capital Medical University, Beijing, PR China
| | - Yaping Pan
- Department of Periodontology, School and Hospital of Stomatology, China Medical University, Shenyang, PR China; Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China.
| | - Chen Li
- Department of Periodontology, School and Hospital of Stomatology, China Medical University, Shenyang, PR China; Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China.
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Xu X, Lu H, Huo P, Jin D, Zhu Y, Meng H. Effects of amoxicillin and metronidazole as an adjunct to scaling and root planing on glycemic control in patients with periodontitis and type 2 diabetes: A short-term randomized controlled trial. J Periodontal Res 2024; 59:249-258. [PMID: 38115631 DOI: 10.1111/jre.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To assess the effects of amoxicillin and metronidazole with scaling and root planing (SRP) on periodontal parameters and glycemic control in patients with severe periodontitis and diabetes mellitus. BACKGROUND Adjunctive antibiotics use is advantageous for treating periodontitis in patients with severe periodontitis and diabetes. However, the effects of adjunctive antibiotic use on hemoglobin A1c (HbA1c) levels remain unclear. METHODS This short-term, randomized controlled trial enrolled patients with severe periodontitis and type 2 diabetes. The patients were randomly allocated to SPR only (i.e., control) or SPR + antibiotics (500 mg of amoxicillin and 200 mg of metronidazole, three times daily for 7 days) groups. Periodontal and hematological parameters were assessed at baseline and 3 months after treatment. Inter- and intra-group analyses were performed using Student's t-tests, Mann-Whitney U tests, and the binary logistic regression models. p-values of <.05 were considered statistically significant. RESULTS This study enrolled 49 patients, with 23 and 26 patients in the SRP-only and SRP + antibiotics groups, respectively. The periodontal parameters improved significantly and similarly in both groups after treatment (p < .05). The SRP + antibiotics group had more sites of improvement than the SRP-only group when the initial probing depth was >6 mm. (698 [78.96%] vs. 545 [73.35%], p = .008). The HbA1c levels decreased in the SRP-only and SRP + antibiotics groups after treatment (0.39% and 0.53%, respectively). The multivariable binary logistic regression model demonstrated that antibiotics administration and a high baseline HbA1c level were associated with a greater reduction in the HbA1c level (odds ratio = 4.551, 95% confidence interval: 1.012-20.463; odds ratio = 7.162, 95% confidence interval: 1.359-37.753, respectively). CONCLUSIONS SRP and SRP plus systemic antibiotics were beneficial for glycemic control. Adjunctive antibiotic use slightly improved the outcome for patients with severe periodontitis and poorly controlled diabetes.
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Affiliation(s)
- Xinran Xu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - He Lu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Pengcheng Huo
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Dongsiqi Jin
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunxuan Zhu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Huanxin Meng
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Govindharajulu R, Syed NK, Sukumaran B, Seshadri PR, Mathivanan S, Ramkumar N. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024; 25:114-117. [PMID: 38514407 DOI: 10.5005/jp-journals-10024-3642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIM The study aims is to evaluate the antibacterial effect of vitamin D3 against the red complex bacteria, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia in chronic periodontitis patients. MATERIALS AND METHODS The study comprised 98 participants with chronic periodontitis. All clinical parameters including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and a microbiological assay of P. gingivalis, T. denticola, T. forsythia were assessed at the baseline. All study participants who underwent scaling and root planning were divided into two groups, A and B, each with 49 patients and only group B patients were advised to take vitamin D supplementation of 60,000 IU granules, once daily for 2 months. All the patients of both the groups were recalled at the end of 2nd month and all the clinical and microbiological parameters were reassessed. RESULTS After two months, there was a reduction in all the clinical markers in both groups, but the group B patients showed more improvement following non-surgical treatment vitamin D intake. There was also a statistical reduction in P. gingivalis, T. denticola, and T. forsythia following administration of vitamin D in group B patients compared to group A. CONCLUSION These discoveries proposed that vitamin D has a superb antimicrobial impact against red complex periodontal microbes and might be considered a promising compound in the counteraction of periodontal disease. CLINICAL SIGNIFICANCE Vitamin D is considered to possess anti-inflammatory and antimicrobial activity, which may help to delay the progression of periodontitis. So, vitamin D3 can be used as a potential supplement that could be employed to stop the advancement of periodontal disease. How to cite this article: Govindharajulu R, Syed NK, Sukumaran B, et al. Assessment of the Antibacterial Effect of Vitamin D3 against Red Complex Periodontal Pathogens: A Microbiological Assay. J Contemp Dent Pract 2024;25(2):114-117.
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Affiliation(s)
- Ramaprabha Govindharajulu
- Department of Periodontology, GRS Dental Clinic, Mayiladuthurai, Tamil Nadu, India, Phone: +91 9245196777, e-mail:
| | - Nubesh K Syed
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Al-Qassim, Kingdom of Saudi Arabia
| | - Binsu Sukumaran
- Department of Prosthetic Dental Sciences, Benser Dental Clinic, Kerala, India
| | - Pavithra R Seshadri
- Department of Periodontics, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India
| | | | - Narayane Ramkumar
- Department of Periodontology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
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Yan S, Man Y, Lu J, Cui L, Niu F, Qin J. The "double-edged" role of progesterone in periodontitis among perimenopausal women undergoing or not undergoing scaling and root planing. Front Endocrinol (Lausanne) 2023; 14:1224763. [PMID: 37645411 PMCID: PMC10461080 DOI: 10.3389/fendo.2023.1224763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/26/2023] [Indexed: 08/31/2023] Open
Abstract
Objective Progesterone (PG) is an important sex steroid hormone commonly administered to protect the endometrium in perimenopausal women. The present study aimed to explore differential responses of periodontitis to PG in perimenopausal women who did or did not undergo scaling and root planing (SRP). Methods A total of 129 perimenopausal women with mild-to-moderate periodontitis were enrolled and underwent treatment as follows: SRP (n = 35); SRP + PG (n = 34); PG (n = 31); and no treatment (s) (n = 29). Pocket probing depth (PPD), clinical attachment level (CAL), sulcus bleeding index (SBI), and bleeding on probing (BOP) were measured using periodontal probes. Three inflammatory markers, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) were measured using ELISA techniques. Results PPD, CAL, SBI, BOP, and levels of inflammatory factors in GCF were all significantly decreased in perimenopausal women with periodontitis after SRP. In patients who did not undergo SRP, 6 months of PG treatment significantly elevated PPD, SBI, BOP, and GCF levels of CRP, IL-6, and TNF-α. In contrast, PG exhibited inhibitory effects on periodontal inflammation in patients who underwent SRP, evidenced by significantly decreased BOP and IL-6, and slightly decreased SBI, CRP, and TNF-α. PG-induced changes dissipated 6 months after withdrawal of PG (at 12 months). Conclusions Among perimenopausal women with periodontitis, PG enhanced periodontal inflammation in the absence of SRP but inhibited periodontal inflammation in those who underwent SRP.
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Affiliation(s)
- Shengjie Yan
- Department of Stomatology, Shengli Oilfield Central Hospital, Dongying, China
| | - Ying Man
- Department of Stomatology, Shengli Oilfield Central Hospital, Dongying, China
| | - Jun Lu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liyun Cui
- Department of Stomatology, Shengli Oilfield Central Hospital, Dongying, China
| | - Feifei Niu
- Department of Gynaecology, Shengli Oilfield Central Hospital, Dongying, China
| | - Jianyong Qin
- Department of Stomatology, Shengli Oilfield Central Hospital, Dongying, China
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Bains VK, Mahendra J, Mahendra L, Mittal M, Gunam V. Quantitative Association of Platelet-Rich Fibrin (PRF) and Hyperacute Serum (HAS) with Glycemic Control (HbA1c) in Chronic Periodontitis Patients: An Ex vivo Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S601-S607. [PMID: 37654372 PMCID: PMC10466603 DOI: 10.4103/jpbs.jpbs_428_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 09/02/2023] Open
Abstract
Aim To evaluate correlation of PRF and HAS with glycemic control (HbA1c) and other systemic parameters amongst the chronic periodontitis patients. Materials and Methods Twenty-seven non-smoker, non-tobacco users, non-alcoholic moderate chronic periodontitis volunteers (Stage II, Grade A or B), aging between 40 and 50 years of both genders with type 2 diabetes mellitus (T2DM, HbA1c >6.5%) or without T2DM (HbA1c <6.5%), were recruited. After recording vitals and demographic parameters, 20 ml of intravenous fasting blood was collected, of which 11 ml blood was used for investigating complete blood count, lipid profile, glycated hemoglobin (HbA1c), C-reactive protein, and fasting insulin level. As per the standard protocol, PRF and HAS was prepared from the 9-ml blood sample of the patients. PRF obtained was quantified using Wensar's analytical balance with a readability of 0.0001 g. Prepared HAS from the fibrin clot was quantified using a micropipette and stored in 2 ml Eppendorf vials. Results Mean values of PRF and HAS obtained in the study were 2.0089 ± 0.844 g (ranged between 0.0 g and 3.968 g) and 1.540 ± 0.552 ml (ranged between 0.00 and 3.500 ml), respectively. The amount of PRF and HAS obtained were significantly higher in non-diabetic patients (mean 2.3093 g and 1.743 ml, respectively) as compared to diabetic patients (mean 1.5762 g and 1.266 ml, respectively). Results suggested a significant correlation between HbA1c level and quantification of PRF (P=0.007) and HAS (P=0.037), whereas no correlation was observed between HbA1c levels and hematologic, lipid, and demographic parameters. Conclusion Within the limitation of the present study, it can be concluded that a significant correlation exists between the HbA1c level and quantification of PRF and HAS.
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Affiliation(s)
- Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Jaideep Mahendra
- Department of Periodontology, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Little Mahendra
- Maktoum Bin Hamdan Dental University College, Dubai, United Arab Emirates
| | - Madhukar Mittal
- Department of Endocrinology and Metabolism, AIIMS, Jodhpur, Rajasthan, India
| | - Valli Gunam
- College of Allied Health Sciences, Sri Venkateswaraa University, Chennai, Tamil Nadu, India
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Ramaprabha G, Khan NS, Kunusoth R, Kakati I, Hussain Qadri SS, Seshadri PR. Assessment of Outcome of Oral Supplementation of Vitamin D3 as an Adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Type II Diabetes Mellitus - A Randomized Controlled Clinical Trial. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S346-S349. [PMID: 37654407 PMCID: PMC10466594 DOI: 10.4103/jpbs.jpbs_543_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/08/2022] [Accepted: 11/19/2022] [Indexed: 09/02/2023] Open
Abstract
Background Both diabetes and periodontitis affect millions of people worldwide and Vitamin D insufficiency may create a conducive environment for the progression of diabetes and periodontal disease. The aim of the study was to assess the outcome of oral supplementation of Vitamin D3 in patients with Type 2Diabetes Mellitus with generalized chronic periodontitis, as an adjuvant toscaling and root planing. Methodology A total of 92 patients, including 46 each in non-diabetic and diabetec group. Clinical parameters including Plaque Index (PI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), Clinical Attachment Level (CAL), levels of Vitamin D in serum, and Fasting Blood sugar were assessed at the baseline. SRP was finished for each participant in the trial. Following SRP, the first 25people in each group got 60,000 IU of oral vitamin D3 granules once a week for eight weeks, while the remaining 21 subjects from each group did not. At the conclusion of the 8th week following interventions, all the indicators were reviewed. Results Following SRP and Vitamin D supplementation there was a measurably critical reduction in every one of the periodontal clinical indicators in both groups. In both groups, there was a statistically significant rise in serum vitamin D levels. Conclusion In addition to SRP, vitamin D supplementation shows promise as a host immunomodulatory drug in the management of periodontitis, particularly in patients with diabetes mellitus.
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Affiliation(s)
- G Ramaprabha
- Department of Periodontics, GRS Dental Clinic, Mayiladuthurai, Tamil Nadu, India
| | - Nubesh S. Khan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Al-Qassim, Kingdom of Saudi Arabia
| | - Ramesh Kunusoth
- Department of Oral and Maxillofacial Surgery, MNR Dental College and Hospital, Sangareddy, Telangana, India
| | - Indrajit Kakati
- Department of Oral and Maxillofacial Surgery, Guwahati, Assam, India
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Effectiveness of periodontal intervention on the levels of N-terminal pro-brain natriuretic peptide in chronic periodontitis patients. J Circ Biomark 2022; 11:48-56. [PMID: 36381349 PMCID: PMC9644434 DOI: 10.33393/jcb.2022.2454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background: N-terminal-pro-brain natriuretic peptide (NT-proBNP) is an inactive hormone that is seen during inflammation and is a known biomarker of cardiovascular disease (CVD). Evidence suggests that periodontitis has a bidirectional relationship with CVD and NT-proBNP has a potential role in periodontal disease. However, there is no evidence on the impact of nonsurgical periodontal therapy (NSPT) on the levels of NT-proBNP in gingival crevicular fluid (GCF) and serum in patients with chronic periodontitis. Hence, the aim of this study was to compare the levels of NT-proBNP in GCF and serum in patients with chronic generalized periodontitis. Materials and methods: GCF and serum samples were collected in 19 patients with chronic periodontitis before and after NSPT after 6 weeks and the cumulative or reduction in values of NT-proBNP in GCF and serum was assessed. NT-proBNP levels in GCF and serum were determined by enzyme-linked immunosorbent assay. Results: The concentrations of NT-proBNP were significantly reduced in GCF and serum after NSPT. Statistically significant difference of NT-proBNP concentration between pre- and postgroups in GCF was apparent (p < 0.0001), whereas statistically nonsignificant results in NT-proBNP serum levels when compared at baseline to postoperative state with mean of 61.77 (22.6 standard deviation [SD]) preoperatively and 72.67 (51.86 SD) postoperatively (p = 0.0007) was observed. Conclusion: Significant reduction of NT-proBNP concentrations in GCF and serum in patients with chronic periodontitis subjected to NSPT was observed. This may account for a significant relation between periodontal disease, bacteremia, and CVD.
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Mahendra J, Bains V, Mahendra L, Mittal M, Valli G. Markers, pathways, and current evidence for periodontitis-associated insulin resistance: A narrative review. J Int Soc Prev Community Dent 2022; 12:475-487. [DOI: 10.4103/jispcd.jispcd_92_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/26/2022] [Accepted: 08/16/2022] [Indexed: 11/07/2022] Open
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Gheorghe DN, Popescu DM, Salan A, Boldeanu MV, Ionele CM, Pitru A, Turcu-Stiolica A, Camen A, Florescu C, Rogoveanu I, Surlin P. Non-Surgical Periodontal Therapy Could Improve the Periodontal Inflammatory Status in Patients with Periodontitis and Chronic Hepatitis C. J Clin Med 2021; 10:jcm10225275. [PMID: 34830557 PMCID: PMC8619210 DOI: 10.3390/jcm10225275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Non-surgical periodontal therapy (NSPT) is the first essential step for the management of any periodontitis patient. This study aims to evaluate the impact of NSPT on pro-inflammatory mediators’ regulation and on clinical parameters in periodontitis patients who suffer from chronic hepatitis C. At baseline, selected patients were clinically evaluated for their periodontal status. A subsequent quantitative assessment of C-reactive protein and pentraxin-3 in samples of gingival fluid was performed by Enzyme-Linked Immunosorbent Assay (ELISA). Afterwards, NSPT was performed. Three months after NSPT, the clinical and ELISA assessments were repeated. The results show an improvement of the clinical parameters in periodontitis patients at the three-month recall. In chronic hepatitis C patients with periodontitis, the gingival fluid levels of pro-inflammatory markers reduced significantly. The targeted markers also expressed significant correlations with the clinical parameters used for the assessment of periodontitis’ severity. The results suggest that, while chronic hepatitis C patients exhibited a more negative periodontal status at baseline as compared to non-hepatitis ones, NSPT is effective in decreasing the local periodontal inflammatory reaction and in proving the periodontal status of this type of patients. Given the limitation of the study, periodontal screening and NSPT should be included in the integrated therapeutical approach of chronic hepatitis C patients, for its impact on the local inflammatory response.
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Affiliation(s)
- Dorin Nicolae Gheorghe
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
| | - Dora Maria Popescu
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
- Correspondence: (D.M.P.); (M.V.B.)
| | - Alex Salan
- Department of Oral Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.); (A.C.)
| | - Mihail Virgil Boldeanu
- Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (D.M.P.); (M.V.B.)
| | - Claudiu Marinel Ionele
- Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.M.I.); (I.R.)
| | - Allma Pitru
- Department of Oral Pathology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adina Turcu-Stiolica
- Department of Pharmacoeconomics and Statistical Analysis, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adrian Camen
- Department of Oral Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.); (A.C.)
| | - Cristina Florescu
- Department of Internal Medicine and Cardiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ion Rogoveanu
- Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.M.I.); (I.R.)
| | - Petra Surlin
- Department of Periodontology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (D.N.G.); (P.S.)
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Nana Nana AR, Tsobgny Tsague NF, Lontchi-Yimagou E, Bengondo Messanga C, Tankeu A, Katte JC, Balti Vounsia E, Dehayem M, Sobngwi E. Effects of non-surgical treatment of chronic periodontitis on insulin resistance and glucose tolerance in subjects without diabetes (PARODIA 2 study). J Investig Med 2021; 69:1377-1381. [PMID: 34261767 PMCID: PMC8485124 DOI: 10.1136/jim-2021-001831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/03/2022]
Abstract
This study aimed to assess the effects of non-surgical periodontal treatment (NSPT) of chronic periodontitis on insulin sensitivity, glucose tolerance, and serum C reactive protein (CRP) level in individuals without diabetes. Twenty individuals without diabetes with chronic periodontitis underwent NSPT, which consisted of complete scaling, polishing, root planing, and irrigation of the periodontal pockets with a 10% povidone-iodine solution. Periodontal indices (plaque index, gingival bleeding index, pocket depth, and clinical attachment loss), insulin sensitivity using the Short Insulin Tolerance Test index (KITT), glucose tolerance derived from oral glucose tolerance test, and serum CRP level were measured before and 3 months after the intervention. This study was carried out at the National Obesity Center of Yaoundé Central Hospital, Cameroon. After 3 months, we observed significant improvement in periodontal parameters (all p<0.001) and insulin sensitivity (3.72 (2.99-4.17) %/min before treatment vs 4.04 (3.67-4.78) %/min after treatment, p=0.001) and significant decrease in serum CRP level (2.35 (1.46-4.18) mg/L before vs 1.53 (1.03-2.12) mg/L after, p=0.033). There was a trend toward improvement in glucose tolerance, although not statistically significant after the intervention. This study suggests that NSPT of chronic periodontitis in individuals without diabetes is associated with increased insulin sensitivity and decreased serum CRP levels.Trial registration number NCT02830113.
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Affiliation(s)
- Arnel Redon Nana Nana
- Department of Periodontology, Oral and Maxillo-Facial Surgery, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Nadia-Flore Tsobgny Tsague
- Department of Periodontology, Oral and Maxillo-Facial Surgery, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Eric Lontchi-Yimagou
- Diabetes Research Center, Albert Einstein College of Medicine, Bronx, New York, USA.,Laboratory of Molecular Medicine and Metabolism, Biotechnology Center, Université de Yaoundé I, Yaounde, Cameroon
| | - Charles Bengondo Messanga
- Department of Periodontology, Oral and Maxillo-Facial Surgery, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Aurel Tankeu
- Department of Internal Medicine and Specialties, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Jean-Claude Katte
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
| | - Eric Balti Vounsia
- Department of Internal Medicine and Specialties, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Mesmin Dehayem
- Department of Internal Medicine and Specialties, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon
| | - Eugene Sobngwi
- Department of Internal Medicine and Specialties, University of Yaounde I Faculty of Medicine and Biomedical Sciences, Yaounde, Cameroon .,National Obesity Center, Yaoundé Central Hospital, Yaoundé, Cameroon
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Vo TTT, Lee CW, Chiang YC, Chen YW, Yu YH, Tuan VP, Wu CZ, Lee IT. Protective mechanisms of Taiwanese green propolis toward high glucose-induced inflammation via NLRP3 inflammasome signaling pathway in human gingival fibroblasts. J Periodontal Res 2021; 56:804-818. [PMID: 33729569 DOI: 10.1111/jre.12879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/25/2021] [Accepted: 03/03/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate protective effects of Taiwanese green propolis (TGP) against high glucose-induced inflammatory responses in human gingival fibroblasts (HGFs) through NLRP3 inflammasome signaling pathway. BACKGROUND NLRP3 inflammasome has been implicated in the progression of both diabetes mellitus and periodontitis, suggesting a common potential therapeutic target for these diseases. Propolis is renowned for various biological activities, particularly anti-inflammation and antioxidant, representing a promising therapy for many conditions. However, underlying mechanisms remain unclear. METHODS The cytotoxicity of TGP was evaluated by cell viability assay. The mRNA levels and protein expression or secretion of various inflammatory molecules and NLRP3 inflammasome-related molecules in high glucose-exposed HGFs with or without pretreatment of TGP (5 μg/ml) were determined by real-time PCR and western blot or specific kits, respectively. Intracellular and mitochondrial ROS measurements, NADPH oxidase activity determination, and subcellular fractions were performed to assess ROS generation. The transcriptional activity of NF-κB was measured by luciferase reporter kit. The signaling components were further differentiated using pharmacological inhibitors of ROS and small interfering RNAs of TLR2, TLR4, or NF-κB. RESULTS High glucose could induce IL-1β-driven inflammatory responses in HGFs via the activation of NLRP3 inflammasome regulated by TLR2/TLR4 coupled ROS in NF-κB-dependent manner. TGP had no adverse impact on the cell viability of HGFs at concentrations no greater than 10 μg/ml, and could exert inhibitory effects on high glucose-induced inflammatory responses via the interruption of NLRP3 inflammasome signaling pathway. CONCLUSION Taiwanese green propolis could elicit protective effects against IL-1β-driven inflammation in high glucose-exposed HGFs through TLR2/TLR4 combined ROS/NF-κB/NLRP3 inflammasome pathway.
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Affiliation(s)
- Thi Thuy Tien Vo
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiang-Wen Lee
- Department of Nursing, Division of Basic Medical Sciences, Chronic Diseases and Health Promotion Research Center and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Taiwan.,Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Taiwan.,Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan.,College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Yao-Chang Chiang
- Department of Nursing, Division of Basic Medical Sciences, Chronic Diseases and Health Promotion Research Center and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Taiwan.,Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Taiwan
| | - Yue-Wen Chen
- Department of Biotechnology and Animal Science, National Ilan University, Yilan, Taiwan
| | - Yu-Hsiang Yu
- Department of Biotechnology and Animal Science, National Ilan University, Yilan, Taiwan
| | - Vo Phuoc Tuan
- Endoscopy Department, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Ching-Zong Wu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Dentistry, Lotung Poh-Ai Hospital, Yilan, Taiwan
| | - I-Ta Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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12
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Soi S, Bains VK, Srivastava R, Madan R. Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser. Lasers Med Sci 2021; 36:1307-1315. [PMID: 33521870 DOI: 10.1007/s10103-021-03261-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 01/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient's overall clinical diabetic management. OBJECTIVE To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis. MATERIALS AND METHODOLOGY After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-μm fiber optic delivery system. RESULTS Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05). CONCLUSION Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.
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Affiliation(s)
- Sunakshi Soi
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India.
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
| | - Rohit Madan
- Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India
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13
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Dengizek Eltas S, Gursel M, Eltas A, Alptekin NO, Ataoglu T. Evaluation of long‐term effects of diode laser application in periodontal treatment of poorly controlled type 2 diabetic patients with chronic periodontitis. Int J Dent Hyg 2019; 17:292-299. [DOI: 10.1111/idh.12384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 01/22/2023]
Affiliation(s)
| | - Mihtikar Gursel
- Department of Periodontology, Faculty of Dentistry Selcuk University Konya Turkey
| | - Abubekir Eltas
- Department of Periodontology, Faculty of Dentistry University of Health Science Istanbul Turkey
| | | | - Tamer Ataoglu
- Department of Periodontology, Faculty of Dentistry Selcuk University Konya Turkey
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14
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Khanuja PK, Narula SC, Rajput R, Sharma RK, Tewari S. Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population. Front Med 2017; 11:110-119. [DOI: 10.1007/s11684-016-0484-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 08/17/2016] [Indexed: 12/17/2022]
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15
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Pitchika V, Thiering E, Metz I, Rothmaier K, Willenberg A, Hickel R, Standl M, Kocher T, Heinrich J, Kühnisch J. Gingivitis and lifestyle influences on high-sensitivity C-reactive protein and interleukin 6 in adolescents. J Clin Periodontol 2017; 44:372-381. [DOI: 10.1111/jcpe.12690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2016] [Indexed: 01/12/2023]
Affiliation(s)
- Vinay Pitchika
- Department of Operative Dentistry and Periodontology; University Hospital; Ludwig-Maximilians-Universität München; Munich Germany
- Institute of Epidemiology I; Helmholtz Zentrum Munich; German Research Centre for Environmental Health, Neuherberg; Munich Germany
| | - Elisabeth Thiering
- Institute of Epidemiology I; Helmholtz Zentrum Munich; German Research Centre for Environmental Health, Neuherberg; Munich Germany
- Dr. von Hauner Children's Hospital; Division of Metabolic Diseases and Nutritional Medicine; Ludwig-Maximilians-Universität München; Munich Germany
| | - Isabel Metz
- Department of Operative Dentistry and Periodontology; University Hospital; Ludwig-Maximilians-Universität München; Munich Germany
| | - Katrin Rothmaier
- Department of Operative Dentistry and Periodontology; University Hospital; Ludwig-Maximilians-Universität München; Munich Germany
| | - Anja Willenberg
- Institute for Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics; University Hospital of Leipzig; Leipzig Germany
| | - Reinhard Hickel
- Department of Operative Dentistry and Periodontology; University Hospital; Ludwig-Maximilians-Universität München; Munich Germany
| | - Marie Standl
- Institute of Epidemiology I; Helmholtz Zentrum Munich; German Research Centre for Environmental Health, Neuherberg; Munich Germany
| | - Thomas Kocher
- Unit of Periodontology; School of Dentistry; University Medicine Greifswald; Greifswald Germany
| | - Joachim Heinrich
- Institute of Epidemiology I; Helmholtz Zentrum Munich; German Research Centre for Environmental Health, Neuherberg; Munich Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine; University Hospital of Munich; Ludwig-Maximilians-Universität München; Munich Germany
| | - Jan Kühnisch
- Department of Operative Dentistry and Periodontology; University Hospital; Ludwig-Maximilians-Universität München; Munich Germany
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16
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Torumtay G, Kırzıoğlu FY, Öztürk Tonguç M, Kale B, Calapoğlu M, Orhan H. Effects of periodontal treatment on inflammation and oxidative stress markers in patients with metabolic syndrome. J Periodontal Res 2015; 51:489-98. [DOI: 10.1111/jre.12328] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2015] [Indexed: 12/20/2022]
Affiliation(s)
- G. Torumtay
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - F. Y. Kırzıoğlu
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - M. Öztürk Tonguç
- Department of Periodontology; Faculty of Dentistry; Süleyman Demirel University; Isparta Turkey
| | - B. Kale
- Department of Internal Medicine; Faculty of Medicine; Süleyman Demirel University; Isparta Turkey
| | - M. Calapoğlu
- Department of Biochemistry; Faculty of Arts and Sciences; Süleyman Demirel University; Isparta Turkey
| | - H. Orhan
- Department of Biostatistics and Medical Informatics; Faculty of Medicine; Süleyman Demirel University; Isparta Turkey
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17
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Tawfig A. Effects of non-surgical periodontal therapy on serum lipids and C-reactive protein among hyperlipidemic patients with chronic periodontitis. J Int Soc Prev Community Dent 2015; 5:S49-56. [PMID: 25984468 PMCID: PMC4428020 DOI: 10.4103/2231-0762.156524] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: To evaluate the effect of non-surgical periodontal therapy on plasma lipid levels in hyperlipidemic patients with chronic periodontitis. Materials and Methods: After considering the inclusion and exclusion criteria, 30 hyperlipidemic patients with chronic periodontitis in the age group of 30–70 years, undergoing treatment in Ahmed Gasim Cardiac and Renal transplant Centre in north Sudan were recruited for the study. Patients were randomly assigned to the study and control groups. The study group received non-surgical periodontal therapy – oral hygiene instructions, scaling and root planing. The control group participants received only oral hygiene instructions. Lipid profile [total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG)], C-reactive protein (CRP), and periodontal parameters [Plaque index (PI), Gingival index (GI), probing pocket depth (PD), and attachment loss (ATL)] were measured and compared at baseline and after 3 months of the respective intervention. Between-groups analysis was done using independent “t” test and within-group analysis was done using dependent “t” test. Results: At baseline, groups were comparable based on lipid profile and periodontal parameters. After 3 months, the control group showed significant decrease in the PI and GI scores while there was no significant change in the other parameters. However, the study group showed significant decrease in the LDL and CRP levels along with a significant decrease in PD, ATL, PI, and GI scores, compared to the baseline values. Conclusion: Local non-surgical periodontal therapy resulted in improved periodontal health, with significant decrease in the LDL and CRP levels in hyperlipidemic patients with chronic periodontitis. Hence, local non-surgical periodontal therapy may be considered as an adjunct in the control of hyperlipidemia, along with standard care.
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Affiliation(s)
- Ahmed Tawfig
- Department of Preventive Dentistry, Division of Periodontics, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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