Effects of periodontal therapy with topical antibiotics in the glycemic control of diabetic patients: systematic review.

2019 ◽  
Vol 27 (1) ◽  
pp. 31-42
Author(s):  
Gloria Cristina Aranzazu-Moya
Keyword(s):  
Periodontal Disease ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Inclusion Criteria ◽  
Topical Antibiotics ◽  
Bias Risk ◽  
Black Scale ◽  
Glycated Hemoglobin A ◽  
Modest Reduction

Background: Periodontal disease is considered as a diabetes complication and has been suggested that periodontal treatment plus antibiotics should reduce glycated hemoglobin A, by reducing local production of pro inflammatory substances. Objective: To evaluate diabetic patients with periodontal disease under periodontal treatment plus topical antibiotics and reduction of  HbA1c, compared to diabetic patients under periodontal treatment without antibiotics. Materials and Methods: Using PUBMED, SCOPUS, WEB OF SCIENCE, EMBASE and Google Scholar data bases, were screened documents from 2008 to 2018. The documents included were the clinical studies, which included non-surgical periodontal treatment plus topical antibiotics, whose outcomes included the HbA1c report. Two independent researchers evaluate title; abstract and bias risk with Downs Black scale and Cochrane tool. Documents with a score higher than 15 on average by the two evaluators were included. Results: Five articles, which find inclusion criteria, were identified. Two documents failed to demonstrate statistically significant effect when compared to non-surgical periodontal therapy alone. Conclusion: In general a modest reduction of HbA1c was identified when using antibiotic therapy.

scholarly journals The role of maintenance in periodontal disease

Dental Update ◽  
2019 ◽  
Vol 46 (10) ◽  
pp. 959-965
Author(s):  
Joanna Batt ◽  
Phil Ower ◽  
Praveen Sharma
Keyword(s):  
Periodontal Disease ◽  
Clinical Relevance ◽  
Tooth Loss ◽  
Initial Therapy ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
New Classification ◽  
Periodontal Health ◽  
Periodontal Breakdown

There is increasing recognition, made explicit in the new classification for periodontitis, that periodontitis is a lifelong disease that is not ‘cured’ but rather ‘managed’. This paper focuses on how the response to periodontal treatment is ideally measured and how decisions are made as to whether the treatment has been ‘successful’ or not. The roles of both the patient and practitioner in the maintenance of periodontal health for those patients who respond to initial therapy are crucial. Patients not responding to initial, non-surgical periodontal therapy also need to be appropriately managed, as outlined in this paper. CPD/Clinical Relevance: This paper highlights the importance of maintenance of periodontal health, as an integral part of the overall management of patients with periodontitis, in order to minimize further periodontal breakdown and eventual tooth loss.

scholarly journals Referral pattern of periodontal disease among general dental practitioners in iraq

2020 ◽  
Vol 23 (4) ◽  
pp. 7p
Author(s):  
Banaz Jabbar Ali ◽  
Alyamama Mahmood Alwan ◽  
Chinar Jabbar Ali
Keyword(s):  
Periodontal Disease ◽  
Phase I ◽  
Maintenance Phase ◽  
Treatment Phase ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Referral Pattern ◽  
Referral Patterns ◽  
Dental Practitioners ◽  
General Dentists

Objectives: To evaluate the type of “periodontal treatment” performed by general dental practitioners and the referral patterns of periodontists in Iraq. Material and methods: A total of 201 general dentists were asked to complete a self-administered questionnaire consisting of nine questions regarding periodontal treatment and the referral patterns of periodontists. Results: The study showed that 91.1% of general dental practitioners (GDPs) performed “phase-I therapy”, and most of them done “scaling”. Regarding surgical periodontal therapy, only 12.9% of them performed surgical periodontal therapy, half of the GDPs did gingivectomy, and less than 30% performed crown lengthening. When evaluating maintenance therapy after periodontal treatment, it was found that 77.9% of the GDPs scheduled appointments for patients in the maintenance phase, 49.4% of them after one month, 24.7% after three months, and 15.6% after six months. Using TRUF analysis, most general dentists believed that the patient and periodontal factors were responsible for the recurrence of periodontal disease. Conclusions: There is still a lack of awareness of periodontal surgical procedures among the “general dental practitioners”. Thus, it is essential to increase the comprehension of periodontal treatment among general dentists.KEYWORDS Periodontal treatment; Phase-I therapy; Surgical periodontal treatment; General dental practitioner; Referral pattern Attitude.

scholarly journals Evaluation of Oxidative Stress before and after Using Laser and Photoactivation Therapy as Adjuvant of Non-Surgical Periodontal Treatment in Patients with Rheumatoid Arthritis

Antioxidants ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 226
Author(s):  
Maria-Alexandra Martu ◽  
Petra Surlin ◽  
Luminita Lazar ◽  
George Alexandru Maftei ◽  
Ionut Luchian ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Oxidative Stress ◽  
Periodontal Disease ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Oxidative Stress Markers ◽  
Treatment Needs ◽  
Disease Treatment ◽  
Stress Markers ◽  
And Oxidative Stress

(1) Background: The aim of this split-mouth design study was to analyze the clinical periodontal indexes and oxidative stress markers in gingival crevicular fluid modifications after three periodontal disease treatment possibilities (scaling and root planning—SRP; SRP and diode laser—L; SRP and photodynamic therapy—PDT). (2) Methods: The study was conducted on 52 patients: systemically healthy subjects with periodontal disease—non-RA (n = 26); and test group (n = 26) subjects with rheumatoid arthritis and periodontal disease—RA. Clinical periodontal measurements (probing depth—PD; Löe and Silness gingival index—GI; papillary bleeding index—PBI; and periodontal community index of treatment needs—CPITN) and oxidative stress markers (8-hydroxy-2’-deoxyguanosine (8-OHdG) and 4 hydroxynonenal (4-HNE)) were analyzed at baseline (T0), after three sessions of periodontal treatment (T1), and 6 months after treatment (T2). (3) Results: Periodontal therapy improved clinical periodontal measurements and oxidative stress markers in both analyzed groups, with supplementary benefits for laser- and PDT-treated periodontal pockets. (4) Conclusions: The analyzed oxidative stress markers decreased significantly following non-surgical periodontal therapy in both rheumatoid arthritis and systemically healthy patients. All the periodontal disease treatment possibilities analyzed in this study offered clinical and paraclinical improvements; however, the association of laser with SRP and photodisinfection with SRP yielded the best clinical and paraclinical outcomes when compared to SRP alone.

scholarly journals Periodontal Treatment Protocol for Decompensated Diabetes Patients

2021 ◽  
Vol 2 ◽  
Author(s):  
Matías Dallaserra ◽  
Alicia Morales ◽  
Nayib Hussein ◽  
Marcela Rivera ◽  
Franco Cavalla ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Glycated Hemoglobin ◽  
Treatment Guideline ◽  
Infectious Complications ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Expert Committee ◽  
Systemic Complications ◽  
The Impact

Background: Decompensated diabetes is associated with a higher prevalence and severity of periodontitis and poorer response to periodontal therapy. It is conceivable that periodontal therapy may cause systemic and local complications in this type of patients. The aim of the present study was to identify and describe the best available evidence for the treatment of periodontitis in decompensated diabetics.Material and methods: An expert committee including participants from different areas gathered to discuss and develop a treatment guideline under the guidance of the Cochrane Associate Center, Faculty of Dentistry, University of Chile. In total, four research questions were prepared. The questions prepared related to decompensated diabetic patients (glycated hemoglobin >8) were, (1) Does the exposure to periodontal treatment increase the risk of infectious or systemic complications? (2) Does the antibiotic treatment or prophylaxis, compared to not giving it, reduce infectious complications? (3) Does the exposure to periodontal treatment, compared to no treatment, reduce the glycated hemoglobin levels (HbA1c)? Last question was related to diabetic patients, (4) Does the exposure to a higher level of HbA1c, compared to stable levels, increase the risk of infectious complications? Based on these questions, a search strategy was developed using MEDLINE and EPISTEMONIKOS. Only systematic reviews were considered.Results: For question 1, the search yielded 12 records in EPISTEMONIKOS and 23 in MEDLINE. None of these studies addressed the question. For question 2, the search yielded 58 records in EPISTEMONIKOS and 11 in MEDLINE. None of these studies addressed the question. For question 3, the search yielded 16 records in EPISTEMONIKOS and 11 in MEDLINE. Thirteen addressed the question. For question 4, the search yielded 7 records in EPISTEMONIKOS and 9 in MEDLINE. One addressed the question.Conclusions: In decompensated diabetic patients, there is lack of scientific information about risk of infectious or systemic complications as a result of periodontal treatment and about the impact of antibiotic treatment or prophylaxis on reduction if infectious complications. A defined HbA1c threshold for dental and periodontal treatment in diabetic patients has yet to be determined. Finally, periodontal treatment does have an impact on HbA1c levels.

scholarly journals Outcomes of Periodontal Treatment in Diabetes Mellitus Patients at Kiruddu Referral Hospital in Uganda. A Prospective Cohort Study

2021 ◽  
Author(s):  
Haruna Kiryowa ◽  
Erisa Mwaka ◽  
William Buwembo ◽  
Ian Munabi ◽  
Charles Rwenyonyi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Gingival Crevicular Fluid ◽  
Fusobacterium Nucleatum ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Clinical Attachment Loss ◽  
Mean Differences

Abstract Introduction: Periodontitis is a common complication of diabetes mellitus associated with poor glycemic control. The relationship between periodontal disease and glycemic control in patients with diabetes mellitus remains unclear. This study set out to determine the outcomes of periodontal treatment in diabetic patients in Uganda. Methods: Using a cohort study design, 41 adult diabetic patients with periodontal disease were enrolled and followed up for 3 months. Fasting blood sugar, glycated hemoglobin levels, pocketprobing depth, bleeding and clinical attachment loss at baseline and 3 months after periodontal treatment were determined. Gingival crevicular fluid was assessed to detect presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Bacteroides forsythus and Fusobacterium nucleatum. Data were analyzed using R version 4.10. Mean differences were calculated to determine effect of treatment and multiple logistic regressions was used to determine association between Hba1c and the different variables.Results: Of the41 participants, 61% were females while 39% were males. The average age was 49.2 years (S.D = 11.2)while the mean BM1 was 27.8 (S.D = 4.8). Overall, there was a reduction in the average number of teeth with bleeding sites, those with pockets and the frequencies of selected bacteria except Fusobacterium nucleatum at 3 months after periodontal treatment. Following periodontal treatment, 39% of the participants had an improvement in their glycemic control (mean HbA1c reduction of 1.86) with age < 47.1 years, diabetic duration less than 1.6 years, BM1< 27.7 and HBA1c >8.9 at baseline being positively associated with this improvement. Conclusion: Treating periodontal disease in diabetic patients especially those with HBA1c <9.0 can improve glycemic control. However, larger studies need to be conducted to ascertain why some patients fail to attain an improved metabolic control following this intervention.

scholarly journals Significant of Antibiotic prophylaxis for diabetic patients with periodontal disease, 1 hour before phase 1 periodontal therapy

2020 ◽  
Vol 10 (1) ◽  
pp. 28-30
Author(s):  
Puja Shrestha ◽  
Md Ashif Iqbal ◽  
Orin Chowdhury Bristy ◽  
Nimesh Sherestha
Keyword(s):  
Periodontal Disease ◽  
Antibiotic Prophylaxis ◽  
Periodontal Diseases ◽  
Phase 1 ◽  
Periodontal Therapy ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Management Protocol ◽  
Patients With Diabetes ◽  
Systemic Antibiotics

People with diabetes are more likely to have periodontal diseases than people without diabetes. Periodontal disease is often considered a complication of diabetes. On the other hand, severe periodontal disease can increase blood glucose levels. Special care and management protocol need to be addressed to patients with diabetes during periodontal therapy. Systemic antibiotics in conjunction with scaling and root planning can offer an additional benefit over SRP alone in the treatment of periodontitis. This review aims to evaluate the significance of antibiotic prophylaxis for diabetic patients with the periodontal disease before 1 hour/ 1-2 days of phase 1 periodontal therapy. The goal of antibiotic prophylaxis is to prevent the onset of injections through the entranceway provided by the therapeutic action. But currently, no established guidelines are in place for antibiotic prophylaxis before periodontal therapy. Update Dent. Coll. j: 2020; 10 (1): 28-30

The Biochemical Effects of Non-surgical Periodontal Therapy in Patients with and without Chronic Renal Disease

2017 ◽  
Vol 68 (3) ◽  
pp. 605-607
Author(s):  
Cerasela Dorina Sincar ◽  
Nicoleta Ioanid ◽  
Ioana Rudnic ◽  
Ioana Martu ◽  
Sorina Mihaela Solomon ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Periodontal Disease ◽  
Renal Disease ◽  
Chronic Periodontitis ◽  
Chronic Renal Disease ◽  
Systemic Disease ◽  
Systemic Inflammatory Response ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Control Group

Recent studies have shown an association between high levels of biomarkers and periodontitis, association which decreases after the periodontal treatment. Because of this association with systemic inflammatory response, chronic periodontitis was recently included as a risk factor for chronic renale disease. Specifically, in this study we hypothesized that a part of chronic inflammatory response observed in patients with chronic renale disease is due to physiopathological reactions caused by the presence of chronic periodontitis, which, during the course of its evolution, induces an increase in the expression of inflammatory markers. Patients were divided into two groups: the first group consisted of patients with chronic renale disease and periodontal disease who were undergoing periodontal treatment (test group) and the second group, control group, composed of patients without any systemic disease, but who experienced moderate to severe chronic periodontitis, also periodontal treated. Blood samples were taken for biochemical analysis at baseline and at 3 months after periodontal therapy. Venous blood was collected in vacuum tubes between 7:00 am and 9:00 am after 12 hours after the last meal. A tube containing EDTA was analyzed for blood following parameters: albumin, uric acid, creatinin, urea. An association between periodontal disease and renale disease is often found in studies using a population where the renale disease is already diagnosed. In these cases, duration of renal end stage and type of topical and systemic treatment administered to patients significantly affect the association. Therefore, we have shown that periodontitis may promote any detectable changes in renal function. Thus, by analogy, in this study the test groups and control groups were compared not only with each other but also comparative analyzes were performed based on the reference values of markers of renal dysfunction. We think it could be plausible existence of a causal link between periodontal disease and chronic renal disease both by glomerular invasion by periodontal pathogens, directly and indirectly through systemic inflammatory effect caused by chronic periodontitis. Success of periodontal therapy reduce systemic inflammatory response and decreases levels of biochemicals markers indicating that this may be an important intervention therapy in patients with chronic renale disease.

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