Diabetes and Periodontitis – can improvement of glycaemia also ameliorate periodontitis?

 

Objective:

To investigate whether an improvement of glycaemia (reduction of HbA1c) in patients with type 1 or 2 diabetes can ameliorate the clinical manifestations of pre-existing periodontitis.

Methods:

This was an observational clinical study enrolling hospitalized patients with type 1 or type 2 diabetes. At baseline the health status of the patients and quality of metabolic control was assessed.

At the end-of-study visit, after an observation period of 6 – 8 months, all parameters determined at baseline were re-assessed in an outpatient setting. During the observation period diabetes therapy was optimized according to national and international guidelines.

• Efficacy endpoints (baseline and endpoint)

• Glycaemia: HbA1c

• State of periodontitis: Probing depth; bleeding on probing; attachment loss; gingival recession; loosening; furcation

• Statistics: comparison baseline vs. endpoint by Excel and R (Version 3.2.5), t-test.

Results:

Enrolled were 141 patients with type 1 or 2 diabetes after giving informed consent (evaluation based on 100 patients).

• HbA1c was reduced from 9.6% to 7.5%; difference 2.1%; CI 2.5% to 97.5% (p < 0.0001)

• Improvement probing depth: 0.57 mm (± 0.35 mm) (p < 0.0001)

• Improvement bleeding on probing: 71% (± 61%) (p < 0.0001)

• Improvement attachment loss: 0.45 mm (± 0.38 mm) (p < 0.0001)

• Rise gingival recession: 0.13 mm (± 0.18 mm) (p < 0.0001)

• No significant improvement for loosening and furcation.

Conclusion:

The intensification of antihyperglycemic therapy resulted in significant reduction of HbA1c and significant improvements of periodontitis-related parameters. The implication of these observations is: Quality of metabolic control in people with diabetes impacts on the health of their periodontal attachment. Therefore, good glycaemic control is important also for conservation of teeth.