Evaluation of Non - Surgical Periodontal Therapy in Diabetic Patients.
Condition: Diabetes Mellitus, Type 2; Periodontal Diseases
MeSH terms: Periodontal Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Unfavorable systemic conditions condition a low resistance of the host to the virulence of
      the aggressive agent, causing in a periodontal disease and may lead to difficulties in the
      therapeutic response. The longer the duration of diabetes, it is suggested that greater
      severity of periodontal disease and loss of insertion. The objective of the present study
      will be to evaluate the clinical, microbial and immunological characteristics in diabetic
      subjects with chronic periodontitis submitted to non-surgical periodontal treatment. Will be
      120 individuals with chronic periodontitis, including 60 type 2 diabetic subjects and 60
      healthy should receive and have access to the informed consent form. Medical and dental
      clinical examination should be performed and evaluation microbial and immunological
      properties of gingival fluid and saliva respectively. Non-surgical periodontal therapy with
      subgingival scaling should be performed in all individuals who will be evaluated at two
      times: at the beginning and after 90 days of the periodontal therapy with new performing
      clinical exams and collecting oral samples, oral hygiene instructions will be addressed in
      two sessions. The data will be subjected to appropriate statistical tests and shall provide a
      comparison between the times. There seems to be a relationship between type 2 diabetes and
      periodontal disease and studies that provide the implementation of therapy are essential for
      clarifying the relationship.
    

Detailed description: 
      There is a need for more intense metabolic control of the diabetic patient with periodontal
      disease, since the destruction of the periodontal tissues may be more aggressive, and a rapid
      control of the oral infection in these patients is essential to avoid the exacerbation of the
      metabolic imbalance. The initiation and progression of diabetes probably involve the
      interaction of a multiplicity of factors, these being hereditary and immunological factors
      that are governed by environmental factors. It can be observed that there is a lack of
      awareness of oral complications between diabetics and health care providers, and it is
      extremely important to understand how diabetes affects oral health and there is a need for
      regular follow-up of patients with diabetes mellitus by dentists and medical professional.
      The objective of the present study was to evaluate diabetic individuals with chronic
      periodontitis submitted to non-surgical periodontal treatment using clinical parameters and
      blood tests of fasting glycemia and glycated hemoglobin. The study was approved by the
      Research Committee of the Metropolitan University of Santos, nº 1.806.841 and all the
      patients involved in the research had access to the informed consent form. The diagnosis of
      diabetes was obtained through blood tests that test blood glucose levels, thus, before
      clinical evaluations, and 90 days after the periodontal treatment were performed fasting
      blood glucose tests. Healthy patients also underwent blood tests. After the anamnesis,
      periodontal clinical examination was performed by a previously trained and calibrated
      periodontist. Periodontal clinical parameters were realized. After periodontal therapy, all
      patients underwent further periodontal and laboratory blood tests. The data obtained were
      tabulated and received statistical treatment through the Anova and Chi square tests. There
      seems to be a relationship between type 2 diabetes and periodontal disease and studies that
      provide the implementation of therapy are essential for clarifying the relationship.
    

Intervention name(s): Non-surgical periodontal treatment
Intervention type(s): Procedure
Intervention description(s): all the individuals included in the study received periodontal treatment with scaling and root planing with the use of local anesthesia and removal of factors that could cause biofilm retention such as fixed prosthesis, restorations, cervical abrasions. Four weekly sessions lasting 30 minutes each.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Diabetes mellitus, periodontal diseases, periodontal index