Treatment of periodontal disease in diabetics reduces glycated hemoglobin
Treatment of periodontal disease in diabetics reduces glycated hemoglobin
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DOI：
10.1902/jop.1997.68.8.713
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发表时间：
1997-08-01
影响因子：
4.3
通讯作者：
Genco, RJ
中科院分区：
文献类型：
--
作者：
Grossi, SG;Skrepcinksi, FB;Genco, RJ
牙周病是糖尿病患者中一种常见的感染性炎症性疾病。本研究的目的是评估牙周病治疗对糖尿病代谢控制水平的影响。113名患有牙周病和非胰岛素依赖型糖尿病(NIDDM)的美洲原住民(81名女性和32名男性)被随机分为5个治疗组。牙周治疗包括：1)局部用水和全身多西环素100 mg，疗程2周；2)局部用0.12%洗必泰和全身多西环素100 mg，连用2周；3)局部用聚维酮碘和全身多西环素100 mg，连用2周；4)局部用0.12%多西环素和安慰剂；5)局部用水和安慰剂(对照组)。在治疗前、治疗后3个月和6个月进行评估，包括探诊深度(PD)、临床附着水平(GAL)、牙龈下菌斑中牙龈卟啉单胞菌的检测以及血糖和糖化血红蛋白(HbA(1c))的测定。治疗后，所有研究组的临床和微生物均有改善。与对照组相比，多西环素治疗组在探诊深度和牙龈下卟啉单胞菌方面显示出最大的减少。此外，在接受全身多西环素治疗的3个月时，所有3组患者的平均HBA均显著降低(P<0.04)，达到治疗前的近10%。牙周感染的有效治疗和牙周炎症的减少与糖化血红蛋白水平的降低有关。因此，控制牙周感染应成为糖尿病患者整体管理的重要组成部分。
PERIODONTAL DISEASE IS A COMMON infection-induced inflammatory disease among individuals suffering from diabetes mellitus. The purpose of this study was to assess the effects of treatment of periodontal disease on the level of metabolic control of diabetes. A total of 113 Native Americans (81 females and 32 males) suffering from periodontal disease and non-insulin dependent diabetes mellitus (NIDDM) were randomized into 5 treatment groups. Periodontal treatment included ultrasonic scaling and curettage combined with one of the following antimicrobial regimens: 1) topical water and systemic doxycycline, 100 mg for 2 weeks; 2) topical 0.12% chlorhexidine (CHX) and systemic doxycycline, 100 mg for 2 weeks; 3) topical povidone-iodine and systemic doxycycline, 100 mg for 2 weeks; 4) topical 0.12% CHX and placebo; and 5) topical water and placebo (control group). Assessments were performed prior to and at 3 and 6 months after treatment and included probing depth (PD), clinical attachment level (GAL), detection of Porphyromonas gingivalis in subgingival plaque and determination of serum glucose and glycated hemoglobin (HbA(1c)). After treatment all study groups showed clinical and microbial improvement. The doxycycline-treated groups showed the greatest reduction in probing depth and subgingival Porphyromonas gingivalis compared to the control group. In addition, all 3 groups receiving systemic doxycycline showed, at 3 months, significant reductions (P less than or equal to 0.04) in mean HbA,, reaching nearly 10% from the pretreatment value. Effective treatment of periodontal infection and reduction of periodontal inflammation is associated with a reduction in level of glycated hemoglobin. Control of periodontal infections should thus be an important part of the overall management of diabetes mellitus patients.