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Clinical and inflammatory changes following routine scaling and root planing in periodontitis patients with and
Li Li1, Xue Yang1, Xuguang Yang1
1Department of Endocrinology and Metabolism, the Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, China.
Objective:
To prospectively observe changes in periodontal clinical outcomes and local and blood-derived inflammatory markers among patients with periodontitis with and without type 2 diabetes following routine scaling and root planing (SRP).
Methods:
This prospective observational cohort study consecutively enrolled patients with periodontitis and classified them according to pre-existing diabetes status. SRP was provided as part of routine clinical care and was not assigned or modified by the investigators; no untreated concurrent comparison group was included. Periodontal clinical parameters, gingival crevicular fluid levels of TNF-α, IL-1β, and IL-10, and peripheral blood-derived NLR and SII were assessed at baseline and approximately 3 months. HbA1c was additionally evaluated as an exploratory outcome in participants with diabetes.
Results:
At 3 months, PD, BI, and PLI were significantly lower than baseline in both groups (P < 0.05), whereas CAL did not change significantly. BI remained higher in the diabetes-associated periodontitis group than in the non-diabetic periodontitis group (P = 0.039). Gingival crevicular fluid TNF-α decreased significantly in both groups (P < 0.001) but remained higher in the diabetes-associated periodontitis group at 3 months (P < 0.001). IL-1β did not change significantly in either group. IL-10 increased significantly in the non-diabetic periodontitis group (P < 0.05), whereas the increase in the diabetes-associated periodontitis group was not significant. NLR and SII decreased significantly in both groups, with no significant between-group differences at baseline, 3 months, or in the magnitude of change. In participants with diabetes, HbA1c showed a non-significant numerical decrease from 8.37 ± 1.03% to 8.07 ± 1.06% (P = 0.081).
Conclusion:
Among patients receiving routine SRP, periodontal clinical parameters and selected inflammatory markers improved over the 3-month follow-up in both groups. Participants with diabetes had higher residual local inflammation at 3 months, reflected by higher BI and gingival crevicular fluid TNF-α levels, whereas no significant between-group differences in changes in blood-derived inflammatory indices were detected. HbA1c decreased numerically but not significantly; therefore, no conclusion regarding improved glycemic control can be drawn.