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Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser

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Abstract

Background

Periodontal treatment in diabetic patients reduces systemic inflammatory burden and hence should be closely coordinated with the patient’s overall clinical diabetic management.

Objective

To evaluate the effectiveness of diode laser (DL) (Biolase EpicTM, 940 nm, Irvine, CA, USA) as an adjunct to scaling root and planing (SRP) on periodontal health and glycated hemoglobin (HbA1c) level of type 2 diabetes mellitus (T2DM) patients suffering from generalized chronic periodontitis (CP), currently, stage II or above/grade B or C periodontitis.

Materials and methodology

After initial screening of 55 T2DM patients, a total of 44 T2DM-CP patients (between the age group of 30 and 65 years) were selected and randomly assigned into two groups. The groups were divided into control group (n=22), treated with scaling and root planing alone (SRP alone), and experimental group (n=22), treated with scaling and root planing along with laser therapy (SRP + DL). Laser irradiation was accomplished at perio pocket setting of 0.8 W (average) in a pulse interval of 1.0 ms and pulse length of 1.0 ms delivering 24 J of energy using a 300-μm fiber optic delivery system.

Results

Thirty-seven out of 44 enrolled T2DM-CP patients completed the study. Both treatment modalities, i.e., SRP alone and SRP+DL resulted in mean significant (p < 0.001) improvement in periodontal health parameters (plaque index (PI), gingival index (GI), probing pocket depth (PPD) and clinical attachment loss (CAL)) and glycemic level (RBS, FBS, and HbA1c) in T2DM-CP patients after 6 months, and was higher in SRP+DL group in comparison to SRP alone. Among the periodontal health parameters, the mean PPD reduction and CAL gain were 51.78% and 48.26% in control as compared to 61.56% and 62.54% in experimental group respectively, whereas the mean significant reduction in HbA1c was 13.8% in SRP alone and 22.52% in SRP+DL group after 6 months (p < 0.05).

Conclusion

Periodontal treatment involving SRP+DL contributes to improved periodontal health parameters and HbA1c level in T2DM-CP patients.

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References

  1. Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodntol 6(1):99–112

    Article  CAS  Google Scholar 

  2. Koçak E, Sağlam M, Kayış SA, Dündar N, Kebapçılar L, Bruno G et al (2016) Nonsurgical periodontal therapy with/without diode laser modulates metabolic control of type 2 diabetics with periodontitis: a randomized clinical trial. Lasers Med Sci 31:343–353

    Article  Google Scholar 

  3. Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Grazziani F et al (2017) Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. J Clin Periodontol 00:1–12

    Google Scholar 

  4. American Diabetes Association (2018) Introduction: standards of medical care in diabetes. Diabetes Care 41(1):S1–S2

    Google Scholar 

  5. Taylor GW, Borgnakke WS (2008) Periodontal disease: associations with diabetes, glycemic control and complications. Oral Dis 14:191–203

    Article  CAS  Google Scholar 

  6. Awartini FA (2009) Evaluation of the relationship between type 2 diabetes and periodontal disease. Saudi Med J 30:902–906

    Google Scholar 

  7. Obradovic R, Kesic L, Mihailovic D, Jovanovic G, Antic S, Brkic Z (2012) Low-level laser therapy as an adjunct in periodontal therapy in patients with diabetes mellitus. Diabetes Technol Ther 14:799–803

    Article  CAS  Google Scholar 

  8. Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z (2017) Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review. Lasers Med Sci 32:449–459

    Article  Google Scholar 

  9. Barbosa FI, Araújo PV, Machado LJC, Magalhães CS, Guimarães MMM, Moreira AN (2018) Effect of photodynamic therapy as an adjuvant to non-surgical periodontal therapy: periodontal and metabolic evaluation in patients with type 2 diabetes mellitus. Photodiagn Photodyn Ther 22:245–250

    Article  Google Scholar 

  10. Castro dos Santos NC, Andere NMRB, Araujo CF, de Marco AC, dos Santos LM, Jardini MAN et al (2016) Local adjunct effect of antimicrobial photodynamic therapy for the treatment of chronic periodontitis in type 2 diabetics: split-mouth double-blind randomized controlled clinical trial. Lasers Med Sci 31:1633–1640

    Article  Google Scholar 

  11. Bunjaku V, Popovska M, Grcev A, Mrasori S, Kameri A, Sllamniku Z et al (2017) Non-surgical periodontal treatment and low level laser therapy (LLLT) outcomes for patients suffering from type 2 diabetes mellitus, obesity and chronic periodontitis. J Int Dent Med Res 10:214–221

    Google Scholar 

  12. Aoki A, Miyuki K, Sasaki, Watanabe H, Ishikawa I (2004) Lasers in nonsurgical periodontal therapy. Periodontol 36:59–97

    Article  Google Scholar 

  13. Sgolastra F, Severino M, Gatto R, Monaco A (2013) Effectiveness of diode laser as adjunctive therapy to scaling root planning in the treatment of chronic periodontitis: a meta-analysis. Lasers Med Sci 28:1393–1402

    Article  Google Scholar 

  14. Chandra S, Shashikumar P (2019) Diode laser - a novel therapeutic approach in the treatment of chronic periodontitis in type 2 diabetes mellitus patients: a prospective randomized controlled clinical trial. J Lasers Med Sci 10:56–63

    Article  Google Scholar 

  15. Saglam M, Kantarci A, Dundar N, Hakki SS (2014) Clinical and biochemical effects of diode laser as an adjunct to nonsurgical treatment of chronic periodontitis: a randomized, controlled clinical trial. Lasers Med Sci 29:37–46

    Article  Google Scholar 

  16. Crispino A, Figliuzzi MM, Iovane C, Giudice TD, Lomanno S, Pacifico D et al (2015) Effectiveness of a diode laser in addition to non-surgical periodontal therapy: study of intervention. Ann Stomatol VI:15–20

    Google Scholar 

  17. Paul P, Bilichodmath S, Sameera U (2018) Clinical and glycemic level evaluation of the efficacy of diode laser and antibiotics with scaling and root planing in treating chronic periodontitis patients with diabetes. J Dent Lasers 12:24–30

    Article  Google Scholar 

  18. Cao R, Li Q, Wu Q, Yao M, Chen Y, Zhou H (2019) Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis. BMC Oral Health 19:176

    Article  Google Scholar 

  19. Löe H, Silness J (1963) Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 21:533–551

    Article  Google Scholar 

  20. Silness J, Löe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135

    Article  CAS  Google Scholar 

  21. Mohan M, Jhingran R, Bains VK, Gupta V, Madan R, Rizvi I et al (2014) 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 44:158–168

    Article  Google Scholar 

  22. Qadri T, Javed F, Johannsen G, Gustaffson A (2015) Role of diode lasers (800–980Nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: a systematic review. Photomed Laser Surg 33:568–575

    Article  Google Scholar 

  23. Convissar RA (2016) Principles and practice of laser dentistry, 2nd edn. Elsevier, New York

    Google Scholar 

  24. Kocak E, Sağlam M, Arslan U et al (2020) Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci 35:1403–1410

    Article  Google Scholar 

  25. Le R, Zhe Z, Daxu L, Chunni D, Hong T (2018) Clinical efficacy of semiconductor laser-assisted minocycline in moderate-to-severe chronic periodontitis patients with type 2 diabetes mellitus. Trop J Pharm Res 17:1165–1170

    Article  CAS  Google Scholar 

  26. Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA (2005) Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 84:1154–1159

    Article  Google Scholar 

  27. Takeda M, Ojima M, Yoshioka H, Inaba H, Kogo M, Shizukuishi S et al (2006) Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. J Periodontol 77:15–20

    Article  CAS  Google Scholar 

  28. Lalla E, Lamster IB, Stern DM, Schmidt AM (2001) Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetics: mechanisms and insights into therapeutic modalities. Ann Periodontol 6:113–118

    Article  CAS  Google Scholar 

  29. Kolbe MF, Ribeiro FV, Luchesi VH, Casarin RC, Sallum EA, Nociti FH Jr et al (2014) Photodynamic therapy during supportive periodontal care: clinical, microbiologic, immune inflammatory, and patient centered performance in a split-mouth randomized clinical trial. J Periodontol 85:e277–e286

    Article  CAS  Google Scholar 

  30. Singh M, Bains VK, Jhingran R, Srivastava R, Madan R, Maurya SC et al (2019) Prevalence of periodontal disease in type 2 diabetes mellitus patients: a cross-sectional study. Contemp Clin Dent 10:349–357

    PubMed  PubMed Central  Google Scholar 

  31. ICMR Guidelines for management of type 2 diabetes 2018. https://medulletin.com. Accessed 28 Jan 2021

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Authors and Affiliations

  1. Department of Periodontology, Saraswati Dental College, 233, Tiwari Ganj, Faizabad Road, Chinhat, Lucknow, UP, 226028, India

    Sunakshi Soi, Vivek Kumar Bains, Ruchi Srivastava & Rohit Madan

Authors
  1. Sunakshi Soi
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  2. Vivek Kumar Bains
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  3. Ruchi Srivastava
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  4. Rohit Madan
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Corresponding author

Correspondence to Vivek Kumar Bains.

Ethics declarations

Study is financed by the authors themselves. Infrastructural support provided by the Institute.

Ethics approval

Research protocol and study design approved by Institutional Human Ethics Committee and Institutional Research & Development Committee. Written informed consent obtained from human participants.

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The authors declare no competing interests.

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Key messages

Diode laser as adjunct to SRP showed additional benefits in T2DM-CP patients in terms of their periodontal and systemic health parameters.

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Soi, S., Bains, V.K., Srivastava, R. et al. Comparative evaluation of improvement in periodontal and glycemic health status of type 2 diabetes mellitus patients after scaling and root planing with or without adjunctive use of diode laser. Lasers Med Sci 36, 1307–1315 (2021). https://doi.org/10.1007/s10103-021-03261-w

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  • DOI: https://doi.org/10.1007/s10103-021-03261-w

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