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Effect of Scaling and Root Surface Debridement on Lipid Profile in Type-2 Diabetes Patients with Chronic Periodontitis

* Zainab S. Mahmood, **Chenar A. Mohammad

MSc student, Hawler medical university, College of Dentistry, Erbil, Iraq
** Department of Periodontology, Hawler Medical University, College of Dentistry, Erbil, Iraq.

Submitted: 03/06/2018; Accepted: 22/07/2018; Published 31/08/2018



Objective: Periodontitis is the most common inflammatory conditions affecting the periodontal tissues and considered as one of the complications of type 2 diabetes mellitus. The study aimed to evaluate the effects of scaling and root surface debridement on clinical periodontal parameters and serum lipid profile levels in chronic periodontitis and type 2 diabetes patients.

Methods: The study enrolled on 45 patients, 15 systemically healthy patients with chronic periodontitis, 15 well controlled (glycated hemoglobin <8%) and 15 poorly controlled (HbA1c ≥8%) type 2 diabetic patients with chronic periodontitis. Intra-oral clinical parameters (plaque index, gingival index, probing pocket depth, and clinical attachment loss) and blood samples were collected to test high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC) and triglyceride (TG) for all patients at baseline and after 30 days of periodontal therapy. One-way ANOVA used to compare between groups.

Results: The study groups showed significant reduction in clinical periodontal parameters after 30 days of periodontal therapy (P < 0.000), while no significant differences were seen in serum lipid profile (P >0.05). Non-significant differences were also seen between the 3 groups in relation to clinical periodontal parameters and serum lipid profiles after periodontal therapy P > 0.05.

Conclusions: Scaling and root surface debridement reduce clinical parameters of periodontitis in all study groups, however, no significant reduction of lipid profile were exhibited.


Keywords: Periodontitis, Type 2 diabetes, Periodontal treatment, Lipid profile.                           

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1. Milasin J, Jakoba NN, Stefanovic D, Sopta J, Pucar A, Lekovic V, et al. Periodontal Inflammation as Risk Factor for Pancreatic Diseases. In: Nagal A, editor. Inflammatory Diseases-A Modern Perspective. China: In Tech; 2011. P 131-56.
2. Taniguchi CM, Kondo T, Sajan M. Divergent regulation of hepatic glucose and lipid metabolism by phosphoinositide 3-kinase via Akt and PKClambda/zeta. Cell Metab. 2006;3(5):343-53. 
3. Saeed KMI, Asghar RJ, Sahak MN. Prevalence and risk factors associated with diabetes mellitus among Kabul citizens—Afghanistan, 2012. Int J Diabetes Dev Ctries. 2015;35(3):297–03.   
4. Chapple IL, Genco R. Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodotol. 2013;84(4 Suppl):S106-12.
5. Winning L, Patterson CC, Neville CE, Kee F, Linden GJ. Periodontitis and incident type 2 diabetes: a prospective cohort study. J Clin Periodontol. 2017;44(3):266-74.
6. Jaramillo A, Lafaurie GI, Millán LV, Ardila CM, Duque A, Novoa C, et al. Association between periodontal disease and plasma levels of cholesterol and triglycerides. Colombia Médica. 2013;44(2):80-86.
7. Machado AC, Quirino MR, Nascimento LF. Relation between chronic periodontal disease and plasmatic levels of triglycerides, total cholesterol and fractions. Braz Oral Res. 2005;19(4):284–89. 
8. Khoshkhounejad AA, Shayesteh Y, Khoshkhounejad G. The Relationship Between Periodontal Disease and Blood Lipid Levels in Cardiovascular Patients. A Thesis for Doctoral Degree in Dentistry No. 4229. Teheran University of Medical Sciences; 2003
9. Almeida Abdo J, Cirano FR, Casati MZ, Ribeiro FV, Giampaoli V, Viana Casarin RC, et al. Influence of dyslipidemia and diabetes mellitus on chronic periodontal disease. J Periodontol. 2013;84(10):1401–08.
10. Penumarthy S, Penmetsa GS, Mannem S. Assessment of serum levels of triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol in periodontitis patients. J Indian Soc Periodontol. 2013;17(1):30–35. 
11. Taleghani F, Shamaei M, Shamaei M. Association between chronic periodontitis and serum lipid levels. Acta Med Iran. 2010;48(1):47–50.
12. Santos VR, Lima JA, De Mendonça AC, Braz Maximo MB, Faveri M, Duarte PM. Effectiveness of full-mouth and partial-mouth scaling and root planing in treating chronic periodontitis in subjects with type 2 diabetes. J Periodontol. 2009;80(8):1237-45.
13. Fu YW, Li XX, Xu HZ, Gong YQ, Yang Y. Effects of periodontal therapy on serum lipid profile and proinflammatory cytokines in patients with hyperlipidemia: a randomized controlled trial. Clin Oral Investig. 2016;20(6):1263-69.
14. Santos VR, Ribeiro FV, Lima JA, Napimoga MH, Bastos MF, Duarte PM. Cytokine levels in sites of chronic periodontitis of poorly controlled and well-controlled type 2 diabetic subjects. J Clin Periodontol. 2010;37(12):1049-58.
15. Xiong X, Elkind-Hirsch KE, Vastardis S, Delarosa RL, Pridjian G, Buekens P. Periodontal Disease Is Associated With Gestational Diabetes Mellitus: A Case-Control Study. J Periodontol. 2009;80(11):1742-9.
16. Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22(1):121-35.
17. Löe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontol Scand. 1963;21(6):533-51.
18. Lindhe J, Niklaus PL, Karring T. Clinical periodontology and implant dentistry. 5th ed. Blackwell Munksgard: Blackwell publishing company; 2008.
19. Newman MG, Taki HH, Klokkevold PR. Caranza FA. Caranza´s clinical periodotology. 10th ed. Missouri: Saunders Elsevier, Philadelphia, USA; 2007.
20. Allen EM, Matthews JB, O'Halloran DJ, Griffiths HR, Chapple IL. Oxidative and inflammatory status in Type 2 diabetes patients with periodontitis. J Clin Periodontol. 2011;38(10):894-901.
21. Arigbede AO, Babatope BO, Bamidele MK. Periodontitis and systemic diseases: A literature review. J Indian Soc Periodontol. 2012;16(4):487-91
22. Iacopino AM. Periodontitis and diabetes interrelationships: role of inflammation. Ann Periodontol. 2001;6(1):125-37.
23. Kudva P, Tabasum ST, Garg N. Evaluation of clinical and metabolic changes after non-surgical periodontal treatment of type 2 diabetes mellitus patients: A clinico biochemical study. J Indian Soc Periodontol. 2010;14(4):257-262.
24. Kardeşler L, Buduneli N, Çetinkalp Ş, Kinane DF. Adipokines and inflammatory mediators after initial periodontal treatment in patients with type 2 diabetes and chronic periodontitis. J Periodontol. 2010;81(1):24-33.
25. Mohan M, Jhingran R, Bains VK, Gupta V, Madan R, Rizvi I, et al. Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus. J Periodontal Implant Sci. 2014;44(4):158-68.
26.Kıran M, Arpak N, Ünsal E, Erdoğan MF. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol. 2005;32(3):266-72. 
27. Goncalves D, Correa FOB, Khalil NM, De Faria Oliveira OMM, Orrico SRP. The effect of non-surgical periodontal therapy on peroxidase activity in diabetic patients: a case–control pilot study. J Clin Periodontol. 2008;35(9):799-806.
28. George AK, Janam P. The short-term effects of non-surgical periodontal therapy on the circulating levels of interleukin-6 and C-reactive protein in patients with chronic periodontitis. J Indian Soc Periodontol. 2013;17(1):36-41.
29. D’aiuto F, Nibali L, Parkar M, Suvan J, Tonetti M. Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. J Dent Res. 2005;84(3):269-73.
30. Oz SG, Fentoglu O, Kilicarslan A, Guven GS, Tanrtover MD, Aykac Y, et al. Beneficial effects of periodontal treatment on metabolic control of hypercholesterolemia. South Med J. 2007;100(7):686-91.
31. Duan J, Ou-Yang X, Zhou Y. Effect of periodontal initial therapy on the serum level of lipid in the patients with both periodontitis and hyperlipidemia. Beijing Da Xue Xue Bao Yi Xue Ban. 2009;41(1):36-39.
32. Mantzoros CHS, Li T, Manson JE, Meigs JB, Hu FB. Circulating adiponectin levels are associated with better glycemic control, more favorable lipid profile, and reduced inflammation in women with type 2 diabetes. J Clin Endocrinol Metab. 2005; 90(8):4542–48.

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