Effects of Nonsurgical Periodontal Therapy on Salivary 8-Hydroxy-Deoxyguanosine Levels and Glycemic Control in Diabetes Mellitus Type 2 Patients

Diabetes and periodontitis are complex chronic diseases that are potentially interrelated, as well as associated with oxidative stress. Thus, the aim of the present study was to evaluate the influence of nonsurgical periodontal treatment on salivary 8-hydroxy-deoxyguanosine (8-OHdG) levels and glycemic control in patients suffering from both diabetes mellitus type 2 (DM2) and periodontitis. The study sample included 53 DM2 patients, while 31 systemically healthy patients served as controls. Participants in both groups suffered from periodontitis of comparable severity. Periodontal clinical parameters, namely plaque index (PI), gingival index (GI), papilla bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, along with salivary 8-OHdG levels and glycated hemoglobin (HbA1c). Levels of 8-OHdG were analyzed by ELISA. All aforementioned parameters were evaluated prior to commencing the study and at 90-day follow-up upon nonsurgical periodontal therapy completion. At baseline, salivary levels of 8-OHdG in DM2 patients were significantly higher (1.17 ng/mL) than those measured for the control group (0.75 ng/mL) and showed significant positive correlation with GI and PPD (p < 0.05). Three months after nonsurgical periodontal therapy, the salivary 8-OHdG levels were significantly reduced in DM2 patients (p < 0.05). Analysis results also revealed statistically significant changes in all measured clinical parameters between baseline and three-month follow-up in both groups (p < 0.05). Upon treatment completion, a decline in the HbA1c level was noted in DM group, but it did not reach statistical significance (p > 0.05). It can be concluded that DM2 patients benefit from non-surgical periodontal therapy, as indicated by a marked reduction in their salivary 8-OHdG level and a modest improvement in glycemic control. Short-term clinical benefits noted in the DM group were similar to those observed in the non-diabetic periodontal patients.

[1]  I. Gušić,et al.  CLINICAL AND MICROBIOLOGICAL ASSESSMENT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN CONTROLLED AND UNCONTROLLED TYPE 2 DIABETIC PATIENTS , 2021, Acta clinica Croatica.

[2]  M. Herrmann,et al.  Connection between Periodontitis-Induced Low-Grade Endotoxemia and Systemic Diseases: Neutrophils as Protagonists and Targets , 2021, International journal of molecular sciences.

[3]  Yi Li,et al.  Baseline HbA1c Level Influences the Effect of Periodontal Therapy on Glycemic Control in People with Type 2 Diabetes and Periodontitis: A Systematic Review on Randomized Controlled Trails , 2021, Diabetes Therapy.

[4]  I. Gušić,et al.  THE INFLUENCE OF PERIODONTAL DISEASE TREATMENT ON 8-HYDROXY-DEOXYGUANOSINE CONCENTRATIONS IN SALIVA AND PLASMA OF CHRONIC PERIODONTITIS PATIENTS , 2020, Acta clinica Croatica.

[5]  J. Gamonal,et al.  Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis , 2019, Journal of applied oral science : revista FOB.

[6]  S. Metha,et al.  A study on the change in HbA1c levels before and after non-surgical periodontal therapy in type-2 diabetes mellitus in generalized periodontitis , 2019, Journal of family medicine and primary care.

[7]  M. Muthuraj,et al.  Effect of scaling and root planing on levels of 8-hydroxydeoxyguanosine in gingival crevicular fluid of chronic periodontitis patients with and without Type II diabetes mellitus , 2017, Journal of Indian Society of Periodontology.

[8]  C. Arana,et al.  Increased salivary oxidative stress parameters in patients with type 2 diabetes: Relation with periodontal disease. , 2017, Endocrinologia, diabetes y nutricion.

[9]  S. Gopalakrishnan,et al.  Effects of Non-Surgical Periodontal Therapy on Plasma Level of Reactive oxygen Metabolites and Glycemic Status in type-2 Diabetic Patients With Chronic Periodontitis , 2017 .

[10]  R. Montenegro,et al.  Influence of Periodontal Disease on Changes of Glycated Hemoglobin Levels in Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study , 2017, Journal of periodontology.

[11]  M. Serdar,et al.  Impact of non-surgical periodontal therapy on saliva and serum levels of markers of oxidative stress , 2017, Clinical Oral Investigations.

[12]  S. Virani,et al.  Effect of Long-Term Periodontal Care on Hemoglobin A1c in Type 2 Diabetes , 2016, Journal of dental research.

[13]  C. Faggion,et al.  An overview of systematic reviews on the effectiveness of periodontal treatment to improve glycaemic control. , 2016, Journal of periodontal research.

[14]  B. Avcı,et al.  The effect of initial periodontal treatment on plasma, gingival crevicular fluid and salivary levels of 8-hydroxy-deoxyguanosine in obesity. , 2016, Archives of oral biology.

[15]  M. Serdar,et al.  High sensitivity detection of salivary 8-hydroxy deoxyguanosine levels in patients with chronic periodontitis. , 2015, Journal of periodontal research.

[16]  R. Rajput,et al.  Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA1c. , 2015, Journal of oral science.

[17]  L. Hyman,et al.  Factors associated with the clinical response to nonsurgical periodontal therapy in people with type 2 diabetes mellitus. , 2014, Journal of the American Dental Association.

[18]  E. Schoenfeld,et al.  The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. , 2013, JAMA.

[19]  A. Andjelković,et al.  [Impact of the level of metabolic control on the non-surgical periodontal therapy outcomes in diabetes mellitus type 2 patients--clinical effects]. , 2013, Srpski Arhiv za Celokupno Lekarstvo.

[20]  B. Avcı,et al.  8-hydroxy-deoxyguanosine levels in gingival crevicular fluid and saliva in patients with chronic periodontitis after initial periodontal treatment. , 2013, Journal of periodontology.

[21]  R. Genco,et al.  Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. , 2013, Journal of periodontology.

[22]  P. Preshaw,et al.  A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. , 2013, Journal of clinical periodontology.

[23]  G. Pendyala,et al.  Evaluation of Total Antioxidant Capacity of Saliva in Type 2 Diabetic Patients with and without Periodontal Disease: A Case-Control Study , 2013, North American journal of medical sciences.

[24]  J. Sardi Oxidative Stress in Diabetes and Periodontitis , 2013, North American journal of medical sciences.

[25]  P. Eke,et al.  Update of the case definitions for population-based surveillance of periodontitis. , 2012, Journal of periodontology.

[26]  Hsueh-Wen Chang,et al.  Evaluation of periodontal status and effectiveness of non-surgical treatment in patients with type 2 diabetes mellitus in Taiwan for a 1-year period. , 2012, Journal of periodontology.

[27]  M. Benarroch,et al.  Altered redox homeostasis in human diabetes saliva. , 2012, Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology.

[28]  Carlos Serrano,et al.  Periodontal conditions in a group of Colombian type 2 diabetic patients with different degrees of metabolic control. , 2012, Acta odontologica latinoamericana : AOL.

[29]  H. Griffiths,et al.  Oxidative and inflammatory status in Type 2 diabetes patients with periodontitis. , 2011, Journal of clinical periodontology.

[30]  L. Bucur,et al.  SALIVARY 8-HIDROXY-2-DEOXY GUANOSINE AS OXIDATIVE STRESS BIOMARKER FOR THE DIAGNOSIS OF PERIODONTAL DISEASE , 2010 .

[31]  R. Amid,et al.  Comparison of the effect of non-surgical periodontal therapy with and without systemic doxycycline on the health of periodontium and hba1c in type 2 diabetic patients without good glycemic control , 2009 .

[32]  T. Maruyama,et al.  Periodontitis-induced lipid peroxidation in rat descending aorta is involved in the initiation of atherosclerosis. , 2009, Journal of periodontal research.

[33]  T. Tomofuji,et al.  Periodontitis and increase in circulating oxidative stress , 2009 .

[34]  N. Khalil,et al.  The effect of non-surgical periodontal therapy on peroxidase activity in diabetic patients: a case-control pilot study. , 2008, Journal of clinical periodontology.

[35]  T. Tomofuji,et al.  Mechanical stimulation of gingiva reduces plasma 8-OHdG level in rat periodontitis. , 2008, Archives of oral biology.

[36]  K. Król,et al.  Total antioxidant status and 8-hydroxy-2′-deoxyguanosine levels in gingival and peripheral blood of periodontitis patients , 2007, Archivum Immunologiae et Therapiae Experimentalis.

[37]  T. Takata,et al.  Chronic administration of lipopolysaccharide and proteases induces periodontal inflammation and hepatic steatosis in rats. , 2007, Journal of periodontology.

[38]  A. Thai,et al.  Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus. , 2007, Journal of clinical periodontology.

[39]  Koichi Ito,et al.  A marker of oxidative stress in saliva: association with periodontally-involved teeth of a hopeless prognosis. , 2005, Journal of oral science.

[40]  A. Kashiwagi,et al.  Abnormal glutathione metabolism and increased cytotoxicity caused by H2O2 in human umbilical vein endothelial cells cultured in high glucose medium , 1994, Diabetologia.

[41]  S. Taysı,et al.  Antioxidant status and lipid peroxidation in type II diabetes mellitus , 2003, Cell biochemistry and function.

[42]  M. Kesavulu,et al.  Lipid peroxidation and antioxidant enzyme status in Type 2 diabetics with coronary heart disease. , 2001, Diabetes research and clinical practice.

[43]  K. Wager,et al.  The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. , 2001, Journal of clinical periodontology.

[44]  L Tronstad,et al.  Systemic diseases caused by oral infection. , 2000, Clinical microbiology reviews.

[45]  R. Holman,et al.  Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study , 2000, BMJ : British Medical Journal.

[46]  U. Saxer,et al.  Patient motivation with the papillary bleeding index. , 1977, The Journal of preventive dentistry.

[47]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. , 1964, Acta odontologica Scandinavica.

[48]  H. Löe,et al.  PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. , 1963, Acta odontologica Scandinavica.

[49]  J. Silness,et al.  11. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDITION , 1963 .