| Object: To observe the short and long term changes of periodontal indexes, fasting blood sugar and serum advanced glycation end products in chronic periodontitis patients accompanied with typeⅡdiabetes mellitus after periodontal initial therapy, evaluate the changes of these parameters after different treatment time interval, preliminarily discuss their correlation before and after periodontal initial therapy, and provide theoretical basis for clinical treatment of the periodontitis patients accompanied with diabetes mellitus.Methods: Our study is agreed by Beijing university medical ethics committee, who in charge of national science and technology support projects, focusing on the periodontal disease and systemic disease related research and the corresponding treatments. 40 patients with moderate or severe periodontitis in Xi'an who were diagnosed as typeⅡdiabetes by the endocrine specialist were enrolled in this study as volunteers. All the patients provided informed consent. The 40 patients were equally assigned into two groups. the patients of the first group received complete initial periodontal therapy and further maintenance therapy at each visit (20 patients, DM1 group) and those of the second group had no periodontal treatment (20 patients, DM2 group). There are totally 10 patients lost in the follow-up (5 patients per group, namely a lost to follow-up rate of 25%). Thus there were 15 patients in each group went into final evaluation. The levels of probing depth (PD), attachment level (AL) after periodontal base treatment and the levels of fasting plasma glucose (FPG), advanced glycation end products (AGEs) before periodontal base treatment are defined as baseline. The two groups of patients were required for return visit at the 3rd, 9th and 21st months after the first visit. At each return visit, blood collection was performed from the elbow vein. Part of the blood sample was used to test fasting blood glucose by department of clinical laboratory of oral hospital of The Fourth Military Medical University. The other part of the blood sample was prepared and stored at -70 C°, which was used to test the serum AGEs content using ELISA kit. After blood collection, the patients received the Florida electronic periodontal probe examination to record the periodontal indices of PD and AL. The patients in DM1 group received periodontal initial therapy and those of DM2 group received dental health instruction. SPSS12.0 was used to analyze the data, which was expressed as (x|-)±s. One way ANOVA was used to determine the statistical level between two groups and among the different time intervals of each group. p < 0.05 was considered to be significant.Results:1. Comparisons of the parameters at different time points in DM1 group.(1) Comparisons of the parameters at various time points to baseline.After periodontal initial therapy, the PD and AL at each return visit are significantly lower than the baseline levels (p < 0.05). The levels of AGEs and AL at each return visit are significantly higher than the baseline (p < 0.05).(2) Comparisons of the same parameters at different return visit.There are no significant difference compared each other for the parameters of PD and PEG at the 3rd, 9th and 21st months after initial visit (p > 0.05). The level of AL at the 21st month after initial visit is significantly higher than those at the 3rd and 9th month (p < 0.05). The levels of AGEs increase constantly with time, and they show statistically significant among different time intervals (p < 0.05).2. Comparisons of the parameters at different time points in DM2 group.(1) Comparisons of the parameters at various time points to baseline.The levels of PD, AL and AGEs at each return visit are significantly higher than baseline (p <0.05). The levels of FPG at the 9th and 21st month are significantly higher than the baseline (p <0.05).(2) Comparisons of the same parameters at different return visit.The level of PD at the 21st month is significantly higher than those at the 3rd and 9th month (p <0.05). The levels of AL, FPG and AGEs increase constantly with time, showing statistically difference (p < 0.05).3.Comparisons of the same parameter at different time points between two groups.(1) There is no significant difference for the baseline of each parameter between two groups at each time point (p > 0.05).(2) Comparisons of the same parameter at each return visit between two groups.The levels of PD of DM2 group are significantly higher than those of DM1 group at the 3rd, 9th ,21st month (p < 0.05). There is no significant difference for AL between two groups at each time point. (p > 0.05). The levels of AGEs and FPG of DM2 group at the 21st month are significantly higher than those of DM1 group (p < 0.05).4.Comparison of D-value for the same parameter at different time point in each group.(1) PD:(d|-)0-3 is significantly higher than (d|-)3-9,(d|-)9-21 in DM1 group(p < 0.05) and (d|-)9-21 is significantly higher than (d|-)0-3,(d|-)3-9 in DM2 group (p < 0.05). There are significantly differences in (d|-)0-3 and (d|-)9-21 between two groups(p < 0.05)(2)AL: (d|-)9-21 is significantly higher than (d|-)0-3 and (d|-)3-9 in DM2 group(p < 0.05).There is significantly differences in (d|-)9-21 between two groups(p < 0.05).(3)FPG: (d|-)0-3 is significantly lower than (d|-)3-9 and (d|-)9-21 in DM2 group(p < 0.05).There is significantly differences in (d|-)0-3 between two groups(p < 0.05).(4)AGEs: (d|-)0-3 is significantly lower than (d|-)3-9 and (d|-)9-21 in DM1 group(p < 0.05). There are significantly differences in D-value among those at various time points in DM2 group (p < 0.05).There are significantly differences in (d|-)0-3 and (d|-)9-21 between two groups(p < 0.05).5. Correlation AnalysisEvery parameter at different time points is normally distributed in two groups. There is no significantly correlation among the parameter at different time points in the two groups.Conclusion:1. There are significantly changes in PD, FPG 3 months after periodontal initial therapy of the periodontitis patients accompanied with typeⅡdiabetes mellitus, which maintain stably for long-term thereafter.2. Regular effective periodontal initial therapy has some effect on periodontal condition improvements, but shows no obvious effect on the periodontal attachment level.3. Regular effective periodontal initial therapy has certain effect to restrain the increase of AGEs in serum.4. There are no significantly correlations between the parameters at different time point in two groups. |
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