ITALY: Study on Periodontal Treatment in T2D Patients

One-stage full-mouth scaling (FM-SRP) triggers a robust acute-phase response at 24 hours following treatment compared to conventional quadrant-wise (Q-SRP) scaling in patients with type 2 diabetes (T2D), a recent study published in the Journal of Clinical Periodontology has shown.

"Such acute systemic acute perturbations may counteract the benefit systemic effects of periodontal treatment with regards to HbA1c reduction and improvement in endothelial function in patients with type 2 diabetes," Filippo Graziani from the University of Pisa in Pisa, Italy, and colleagues wrote in their study.

Dr. Graziani and colleagues conducted the study to compare the endothelial function and level of inflammatory markers at 24 hours (Day 1) and 90 days (Day 90) following conventional quadrant-wise compared to one-stage full-mouth scaling in patients with T2D.

The study included patients affected by type 2 diabetes and periodontitis. They were randomly allocated to receive FM-SRP or Q-SRP and followed up on Day 1 and Day 90. The following parameters were collected at baseline, Day 1, and Day 90:

• Vital signs
• Serum samples
• Flow-mediated dilation (FMD)

The collection of periodontal variables was done at baseline and Day 90. The concentration of C-reactive Protein (CRP) was determined on Day 1 after periodontal treatment (primary outcome). Between-group comparisons and intragroup comparisons were made. A total of 40 subjects were included.

Findings

• FM-SRP produced a remarkable increase in CRP and a significant reduction in FMD on Day 1 compared to Q-SRP.
• The absolute HbA1c (mmol/mol) change from baseline to Day 90 was significantly improved in the Q-SRP (ΔHbA1c=-1.59) compared to the FM-SRP group (ΔHbA1c=-0.8).

"FM-SRP sets off a robust acute-phase response at 24 hours after treatment compared to Q-SRP," the researchers wrote in their study. "Such systemic acute perturbations may offset the benefit systemic effects of periodontal treatment with regards to HbA1c reduction and improvement in endothelial function in subjects with type 2 diabetes."

Reference

Graziani F, Gennai S, Marruganti C, Peric M, Ghiadoni L, Marhl U, Petrini M. Acute-phase response following one-stage full-mouth versus quadrant non-surgical periodontal treatment in subjects with comorbid type 2 diabetes: A randomized clinical trial. J Clin Periodontol. 2022 Dec 14. doi: 10.1111/jcpe.13760. Epub ahead of print. PMID: 36517997.