HEALING RESPONSE TO NONSURGICAL PERIODONTAL THERAPY IN PATIENTS WITH DIABETES-MELLITUS - CLINICAL, MICROBIOLOGICAL, AND IMMUNOLOGICAL RESULTS

The aim of the present study was to monitor clinical, microbiological, medical, and immunological effects of non-surgical periodontal therap y in diabetics and healthy controls. 20 IDDM (insulin dependent, n=7) or NIDDM (non-insulin dependent, n=13) diabetic patients (median durat ion 11.5 years, range of HbA(1C): 4.4-10.6%) with moderate to advanced periodontal disease and 20 matched healthy control patients, were sub jected to supragingival pretreatment and subsequent subgingival therap y. Periodontal examinations (API, PBI, BOP, PPD, PAL), microbiological examinations (culture), medical routine examinations, and immunologic al examinations (oxidative burst response of PMNs to TNF-cs and FMLP) were performed at baseline, 2 weeks after supragingival, and 4 months after subgingival therapy. 4 months after completion of non-surgical t herapy, the following compared to baseline significant (p less than or equal to 0.05) changes (Delta) of clinical parameters (median) were f ound in diabetic patients versus control patients: Delta API (30.4% ve rsus 36.3%), Delta PBI (22.9% versus 24.2%), Delta BOP (39.5% versus 4 6.9%). The median % per patient of pockets with PPD greater than or eq ual to 4 mm decreased from 41.9% to 28.3% in diabetics, and from 41.6% to 31.8% in controls. Microbiologically, similar reductions of periop athogenic bacteria were found in diabetics and controls. Neither perio dontal data nor the oxidative burst response of PMNs showed any signif icant difference (p>0.05) between diabetics and control patients. In t his study, periodontal therapy had no significant influence on medical data of diabetics. In conclusion, this study indicates that metabolic ally well-controlled diabetics might respond to non-surgical periodont al therapy as well as healthy control patients.